Lanhee Chen and Topher Spiro: Health Care Everyone Can Agree On

BloombergView, November 3, 2014

Republicans and Democrats have little occasion to agree on anything in these toxic times. Nowhere are their differences more acute than on health-care policy.

The two of us disagree on whether the Affordable Care Act is improving the U.S. health system, whether it is good policy, and whether it should continue to exist. It’s such a lightning rod that broad consensus on alterations to the law may never be reached.

Yet it is still possible to make progress on changes that will improve the health-care system. Disagreements about the future of Obamacare need not stop us from agreement in other areas. And it starts with emphasizing the role that states can and should play in slowing the increase in health-care costs.

Conservatives and progressives agree that cost growth will continue to be a problem in the coming years. We agree that this makes it harder for American families to make ends meet. Conservatives worrythat such increases worsen yearly deficits and the national debt. Progressives believe that increasing costs contribute to rising inequality by consuming larger shares of workers’ incomes, while crowding out public investment in education, infrastructure and research.

We propose a model in which states could opt to be responsible for health-care costs and quality, earning financial rewards for success. They would become the driving force for action to constrain costs.

States are well-suited to take the lead here for several reasons.

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