"Democrats in Congress are embracing the spirit of President Obama's call to slow the runaway rise of health-care costs but are shying away from some of the most aggressive techniques for achieving that," The Washington Post reports. "Instead of revolutionizing how care is delivered and paid for, experts say, the legislation being shaped takes a cautious approach to reining in costs."
"The Obama administration has advocated ... moving away from fee-for-service payments, which reward providers for doing more procedures, to a coordinated system that pays doctors and hospitals for doing better." But many are concerned "that the president's ambitious hopes to constrain costs could result in tepid half-measures on Capitol Hill."
For example, taxing high-priced insurance plans would save less money "and is less likely to change medical consumption" than "eliminating the tax exemption for employer-sponsored coverage" altogether. ... Proposals on comparative-effectiveness research and a new Medicare cost-cutting commission have been watered down," and "an array of Medicare pilot projects aimed at paying doctors and hospitals for quality rather than quantity would take years to be implemented nationally -- if they ever were" (Connolly, 11/4).
Related KHN story: Medicare Experiments To Curb Costs Seldom Implemented (Weaver and Steadman, 11/3).