Jeff Goldsmith is not only one of the most thoughtful observer’s of U.S. health care, he is one of the few policy wonks who eschews crisis mongering. That all-too-rare reluctance to contrive a black cloud for every silver lining informs his latest post at the Health Affairs blog. Countering the general pessimism that greeted the recent CMS report on health spending, Goldsmith predicts “a more durable downtrend in spending growth”:
How long it will last is anyone’s guess, but another year or two of moderate health spending growth is entirely possible, as well as the prospect of at least a fourth year of flat gross domestic product (GDP) percentage (at 16 percent).
How does he come to that conclusion? By looking at the main drivers of health care spending:
The late 1990s upsurge in health costs was driven by three factors: rising hospital admissions, rising prescription drug sales, and rising diagnostic procedure volume. For different reasons, all three of these growth factors are in remission today.
The only potential fly in the ointment is the recession that so many in the “news” media (speaking of crisis mongers) have been gleefully predicting:
If health costs as a percentage of U.S. GDP breaks out in 2008 from its four-year plateau at 16 percent, it will be because of the denominator (e.g. a recession), not a resurgence of health spending.
And Goldsmith doesn’t think health care reform, assuming it actually materializes, will have much effect one way or the other:
Whatever the fate of health reform, providers and suppliers to the health care industry are facing a very tough environment as this decade draws to an end … a return to double-digit health cost growth appears to be a long way off.
In today’s climate of health care apocalypticism, it’s refreshing to read a commentator who objectively examines the data and isn’t afraid to find good news.
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