If the stewards of the ACA-mandated state insurance exchanges are diligent, they may be able to avoid problems such as the death spiral of adverse selection. With careful design, they should be able to establish a functioning market of private health plans. What can we expect of this market?

It is somewhat refreshing to hear such a frank discussion of rationing by House Majority Leader Eric Cantor. He does not pretend that only government programs might lead to rationing, but concedes that the private sector already makes rationing decisions.

This update of health care spending in the United States, as compared with other nations, provides useful graphs that define the magnitude of the problem which is only growing worse. Since the cost containment measures of the Patient Protection and Affordable Care Act will have very little impact on slowing the cost growth, we should consider the advice offered in this report: American policy makers should “examine the tools employed by other countries to rein in costs.” We need to bring single payer to the table – now!

The last Quote of the Day discussed Princeton Economics Professor Uwe Reinhardt’s New York Times blog entry on rationing in Canada and the United States. I (Don McCanne) wrote a response to his article, and he responded to my comments. That response follows.

Professor Reinhardt’s discussion of rationing in the United States and Canada, available at the “an analysis” link in his article above, is an absolute must read for those who really care about how we finance health care.

News reports on this new Commonwealth Fund study have cheery titles such as, “Health Reform Will Make Insurance Affordable for Nearly All Families.” These titles should be extended to include, “… But Not Health Care.”

Having been a general practitioner (as family physicians were called in those days) even before Marcus Welby ventured onto our television screens, I identify closely with the model of the traditional, altruistic physician as exemplified by the fictional Marcus Welby and the real-life Ronald Sroka. In this day of a push toward integrated health care systems, as exemplified by accountable care organizations (ACOs), what role would us relics of Hippocratic medicine rightfully assume?

Today’s quotes provide tastes of the broad spectrum of political flavors inspired by the establishment of the Independent Payment Advisory Board (IPAB). The fervor of the debate risks obscuring an important point that we have made before and must make again: Applying a cap on Medicare payments alone at GDP plus one-half or one percent, without placing the same caps on the rest of health care spending, risks devolving Medicare into an underfunded, lower tier welfare program, with impaired access for Medicare beneficiaries because of a lack of willing providers.

Facts are not partisan. Standard and Poor’s David Blitzer reports only the facts on single payer – and Wall Street needs to hear them.

House Budget Chair Paul Ryan’s proposal for Medicare has two primary goals. It would end Medicare as a government program and shift it to private insurers, and it would reduce the government’s payments to the program, shifting more of the costs to the Medicare beneficiaries.