Health Affairs, 27, no. 3 (2008): 633-644 doi: 10.1377/hlthaff.27.3.633 © 2008 by Project HOPE	New Online   New Issue: China & India   Obesity In China   Pay Cuts For Medicare Docs   Access To Care Woes

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Taxes & Budgets

Health And Budget Reform As Handmaidens

Meeting almost any new major federal budget priority—for children, the elderly, energy independence, budget balance, or even the uninsured—soon will be nearly impossible if health costs grow as projected. Budget-driven reforms in health policy, therefore, are almost inevitable for any president seeking to set new national priorities. Those health reforms must confront the fundamental budgetary flaw of health policy: creation of decision-making structures and incentives that look mainly to benefits while shifting costs freely to others. All players need more reliable mechanisms for making choices reasonably, albeit no longer for open-ended consumption of care or payment to providers.

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