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Read Ron Brownstein

Ron Brownstein's latest column is probably the best thing written on both the delivery-system reforms and the cost controls built into the Senate bill. Read it.

By Ezra Klein  |  November 21, 2009; 1:27 PM ET
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A little help here, Ezra? With the outcome today it looks like the first time through the Senate bill will have triggers. So the endgame either has triggers or will go through reconciliation in two bills. Am I correct?

Posted by: cmpnwtr | November 21, 2009 2:55 PM | Report abuse

THAT's the best thing you've read on delivery reforms? A propaganda puff piece? What about wisewon's last post?

The bill spends billions studying what we already know. Meanwhile it studiously avoids things that will absolutely bring down costs, like ending direct marketing to consumers, whenever they rankle stakeholders.

I can tell you right now that Cantwell's basic health plan is going to outperform all delivery system pilot projects in the bill. It has a global budget, capitation, strong IT, a formulary and economies of scale. That's where we should be directing more resources.

Instead we're doing exactly what Brownstein mistakenly claims we're not: We're forcing people into 60%AV high-deductible plans. This will undermine integrated care and cost more in the long run.

Posted by: bmull | November 21, 2009 3:41 PM | Report abuse

I can't think of anything I'd do that they are not doing in the bill. You couldn't have done better than they are doing."

Is Gruber serious? How about what his home state of MA is already trying with BCBS. CAPITATION.

That's what they should have done. Its what worked in the 90's ezra and you've admitted as much before.

Posted by: visionbrkr | November 21, 2009 6:07 PM | Report abuse

I think Brownstein's argument is essentially that the Reid bill is probably the best combination of politics and policy that could possibly be expected. Is it the best possible policy? Almost assuredly the answer is no. However, if you ask a slightly different question that is more to the point---Is it the best possible policy that is achievable in the current political environment, the answer may well be yes.

I have tremendous respect for Brownstein as a political analyst, and for a guy whose chops are primarily as a political reporter and analyst and not a policy wonk, he is more knowledgeable about policy than almost any other straight political reporter or columnist on the national scene. Compare his column to David Broder's and it is clear that Brownstein is far more steeped in the policy considerations here than is Broder, who has become in recent years much too enamored with deficit hawkishness, often at the expense of good policy-making and problem-solving.

I view Brownstein as basically combining the political instincts of legendary elections analyst Charlie Cook with the policy knowledge of E.J. Dionne. In short, he knows his stuff.

Posted by: OHIOCITIZEN | November 22, 2009 4:38 AM | Report abuse

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