Looking Ahead

Looking ahead, there are additional steps policymakers couldconsider as they seek to reduce the rate of growth of healthcare spending. Some involve drilling down into particular areasof high cost growth. Others might require major changes in lawthat would create winners and losers and greatly alter the healthcare economy.

John Holahan and Alshadye Yemane examine Medicaid and concludethat the program’s spending growth has largely been drivenby rising enrollment. That could increase even more as the U.S.recession pushes more people into the ranks of the unemployedand uninsured, or as Congress acts to expand Medicaid eligibility.

The authors cite evidence that managed care plans have savedmoney in Medicaid, but they argue that there is plenty of opportunityto save even more. At the top of the list: doing an even betterjob of managing the care costs for the sickest or most disabledenrollees, and of cracking down on aggressive state effortsto draw as heavily as possible on federal matching funds.

Given the contributions of new technologies to growth in healthspending, Mark Pauly suggests that policymakers take a closerlook at the U.S. patent system. Patents protect up-front investmentsin research and development by giving drug and device makersa monopoly for a set period of time.

Pauly acknowledges that it’s not clear whether the currentpatent system could be changed without jeopardizing medicalinnovation. But without directly addressing the costs of advancingtechnology, he contends, no other set of measures will be sufficientto put a lasting brake on health care spending. He suggestsa number of alternative approaches that warrant investigation,including shortening the twenty-year patent term in currentlaw.

What's this?

Home

Current Issue

Looking Ahead

PROLOGUE

Looking Ahead