Virginia Postrel did a post which asked what I think is a very reasonable question: If the Obama Administration is so sure that we can eliminate lots of medical costs without a reduction in health outcomes, why doesn’t it actually do this for Medicare first and prove it, before restructuring the U.S. healthcare sector around its theories?
Peter Orszag at OMB responded. As far as I can see from his
email as reproduced phone conversation as summarized at Ms. Postrel’s blog, his response to this specific point boils down to this:
Medicare First—changing Medicare and waiting to see how it works before messing around with the rest of the health care system—won’t work politically.
UPDATE: As per Ms. Postrel’s comment here, and her original post, she quoted Peter Orszag from a phone conversation, rather than recieving an email from him.