ACO Debacle Exposes Obamacare’s Fatal Conceit

That’s the title of my latest Kaiser Health News column. Excerpts:

Obamacare’s number-one idea for improving health care quality and reducing costs is to promote something called “accountable care organizations” in Medicare. That effort is sinking like a stone, because it – like the rest of this sweeping law – is premised on the fatal conceit that government experts can direct the market better than millions of consumers making their own decisions…

The only way to improve quality while reducing costs is to give patients the incentive and the power to say “no” to inefficient providers. The Medicare reforms that passed the House don’t go as far as they should, but they are a good start.

For one thing, they would do a better job of promoting [accountable care organizations]. The House reforms build on Medicare Advantage, which already gives one fifth of Medicare enrollees the freedom to choose their own health plan.  Kaiser Permanente CEO George Halvorson says the new law’s ACO program “is not as good as” Medicare Advantage when it comes to promoting accountable care.

And he should know something about that.