Orszag ’91 speaks on health care law

The new law, which passed in March, begins to address some of the major shortfalls of the current health care system while lowering the projected growth in health spending, Orszag said. But implementation of more cost-cutting measures will be needed to further rein in costs.

“The bottom line is ... that more will be necessary, but that there are building blocks in the bill that are as promising as any alternative,” Orszag said.

Further health care reform is needed not just to improve health care, but also to strengthen the country’s financial state, he said.

“Our long-term fiscal future in the United States is disproportionately driven by health care costs,” Orszag said. “It is the single most important determinant of our long-term fiscal outcome.”

Orszag said the only substantial component missing from the final legislation was strong tort reform, suggesting that further reform is needed to address the current culture of malpractice lawsuits.

On that front, Orszag suggested that health information technology could allow researchers to both improve treatment guidelines and make them more readily accessible. Doctors following clinical guidelines should in turn be offered “safe harbor” from patient lawsuits, he said.

But Orszag emphasized that there are no silver bullets for health care.

“Excess costs are spread throughout the health care system, and there’s not one individual area that is going to be the solution to either the level or the rate of increase in health care cost,” Orszag said.

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While Orszag recognized that the public may be skeptical of health care law, he said that such views were based on outdated first impressions of earlier versions of the legislation.

In August 2009, when people across the country rallied against health care reform, the only legislation that had been released was the initial House of Representatives bill.

This version “leaned way toward coverage” and was seen as an insufficient attempt to reduce costs, Orszag said.

Unfortunately, Orszag added, this bill “became the prism through which health care reform was viewed, even though the final bill does a lot more.”

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In response to opposition to the bill from some members of Congress, Orszag said, “the irony I would find is that most of the people who are complaining about the lack of cost containment in the health bill are those eager to then reverse the cost measures.”

Orszag became director of the Congressional Budget Office in 2007, and was named head of the Office of Management and Budget in 2008. He resigned from his post this July and has since become a contributing columnist for the New York Times and a distinguished visiting fellow at the Council on Foreign Relations.