Austin gets to the office earlier than I do, so he beat me to this post. He also did a great job, so I won’t take my toys and go home.
I’ll add one small point. If we accept Miller’s critique that both (1) and (2) are true, then we accept that we spend way too much on (a) care that doesn’t work. Mixed in with that is (b) care that does work. How do we reduce (a) without reducing – or maybe increasing – (b)?
Some people say that consumers are the best vehicles for doing that. Give them the money and purchasing power and let them decide for themselves. Others say that we should use experts and work in the system to identify (a) versus (b) and then work to decrease (a).
I favor the latter, and I think the former may result in harm. Miller is forgetting there are other ways to cut Medicare spending than cost-shifting.
If you think Austin already made this point, I apologize for the duplication. But it’s critical, and so often missed.
