The four of us came together to change the conversation around how to improve health care and constrain cost growth.
What we learned is that, until better care is prioritized over more care, our nation will continue to face a problem with health-care costs. The good news is that, through thoughtful policy, practitioners can be encouraged through rewards to focus more on what is best for their patients and less on the number of tests and procedures they can order.
The even better news is that it can cost less.
With the Bipartisan Policy Center, we will release a report Thursday with more than 50 recommendations to achieve the critical goal of improving the quality and affordability of care for all Americans while containing high and rising health-care spending. This report is the culmination of nearly a year of work, including stakeholder outreach, thorough research and substantive analytics to quantify the impact of our proposed policies.
Health-care cost drivers are complex and interwoven, but the most problematic ones we identified are the inefficiencies, misaligned incentives and fragmented care delivery in the current fee-for-service system.
To address these, we seek to promote coordinated and accountable systems of delivery and payment, building on what has proved successful in the private and public sectors. Organized systems of care emphasize the value of care delivered over the volume of care. These systems are often better able to meet patients' needs and desires and are able to effectively reimburse providers and practitioners for delivering high-quality care.
In all our proposals, we sought to avoid simple cost-shifting as a means to generate federal budgetary savings, instead promoting transparency and protecting patient choice. We also focused on reforms that will incite transformation across the health-care system, not limited to Medicare.
In brief, our recommendations:
• Preserve the promise of traditional Medicare while adding more choices and protections for beneficiaries, including accountable systems of care and a stronger, more competitive Medicare Advantage program.
• Strengthen and modernize the traditional Medicare benefit, including adding a catastrophic cap, rationalizing cost-sharing and premiums and expanding access to assistance programs for those with low incomes.
• Limit the tax-favored treatment of overly expensive insurance products.
• Empower patients by promoting transparency and streamline quality reporting.
• Advance the nation's understanding of potential cost savings from prevention programs, through support for research and innovation on effective strategies to address costly chronic conditions.
• Offer incentives to states to promote policies that will support a more organized, value-driven health-care delivery and payment system, such as supporting medical liability reform and strengthening their primary-care workforce.
All these policies are designed to improve the quality and value of our nation's health care. That is where every health-reform effort should start. The savings that we achieved - $560 billion over 10 years in debt and deficit reduction - is the outgrowth of our work, not the goal.
No single set of recommendations can fix the health-care system or the nation's debt and deficit crisis overnight, but we hope this report can start a constructive, pragmatic dialogue among policymakers and political leaders. By presenting this report to federal, state and private-sector leaders, we hope to promote a dialogue and a shared understanding of strategies to put our nation's health system, as well as its economic outlook, on a sounder and more sustainable path.
Tom Daschle, a Democrat, is a former senator from South Dakota. Bill Frist, a Republican, is a former senator from Tennessee. Pete Domenici, a Republican, is a former senator from New Mexico. Alice Rivlin is a former director of the Congressional Budget Office. The four co-chair the Bipartisan Policy Center's Health Care Cost Containment Initiative.