01 August 2007

Brookings sets up new healthcare thinktank

Former Bush Medicare director and commissioner of the FDA Mark McClellan will head Brookings' new Engelberg Center for Health Care Reform.


McClellan is just the guy "to provide practical solutions for high-quality, innovative, and affordable health care."

You betcha. He's the guy, after all, who came up with Medicare Plan D, right? Otherwise known as "the doughnut hole"?

The Industry Veteran, a contributor to The Health Care Blog looked at a 2006 debate between McClellan and Uwe Reinhart:
I offer the following as a useful rule of thumb for THCB readers: whenever someone says more IT represents a principal solution to a better health care system, the red light should flash on one’s shit detector.

As uncle Marcus Aurelius advised, let’s return to first principles. Assuming THCB wishes to address the big issues and not turn into a blog for techie nerds, the problems of health care cost, quality and access in the U.S. result from some basic factors. The first of these is that there are too many middle men extracting too much profit (or, in Marshallian terms, too much economic rent) from the system. Among these, third-party payers are both pernicious and dispensable. Most analysts euphemistically classify payers and the efforts of other sectors to deal with them as “administrative costs.” It seems I’ve been seeing these administrative costs pegged at 25-30% of the health care bill for the past twenty years. Since Bush’s millenarian-oil junta has been running the country, I would guess that figure to be substantially higher because payments to providers have been tapering while premiums keep escalating. Given that the administrative costs for Medicare are approximately 2%, it appears self-evident that the current system, based on employers and insurance companies, should appeal only to Reagan-Bush types who consider the proper role of government to be one of handmaiden to business.

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