President-elect Joe Biden rightly says fighting the pandemic and shoring up insurance coverage will dominate the first six months of his term. But what’s the plan for lowering the cost of care—Americans’ No. 1 pre-pandemic concern?
The incoming administration faces a stark choice. Either it can dramatically expand antitrust enforcement and rely on competition to drive down the exorbitant price Americans pay for care. Or it can vigorously pursue payment reform and aggressively push providers into risk-based payment arrangements where profits depend on delivering better outcomes at lower cost.
To do a little of each guarantees the new administration will fail at both.
A careful reading of the Biden campaign website suggests he leans toward the competition model. On the insurance side, his plan for achieving universal coverage begins with repairing the damage done to the Obamacare exchanges and convincing the last dozen holdout states to expand Medicaid. But he