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Congressional Budget Office Presentation to the National Congress on Health Reform The Long-Term Fiscal Context for Health Care Reform Peter Orszag Director.

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Presentation on theme: "Congressional Budget Office Presentation to the National Congress on Health Reform The Long-Term Fiscal Context for Health Care Reform Peter Orszag Director."— Presentation transcript:

1 Congressional Budget Office Presentation to the National Congress on Health Reform The Long-Term Fiscal Context for Health Care Reform Peter Orszag Director September 22, 2008

2 Federal Spending Under CBOs Alternative Fiscal Scenario Percentage of Gross Domestic Product

3 Sources of Growth in Projected Federal Spending on Medicare and Medicaid Percentage of GDP

4 Before we all get too depressed… Embedded in the nations central long-term fiscal challenge appears to be a substantial opportunity: Can we reduce health care costs without impairing health outcomes?

5 Medicare Spending per Beneficiary in the United States, by Hospital Referral Region, 2005

6 The Relationship Between Quality and Medicare Spending, by State, 2004 Composite Measure of Quality of Care Source: Data from AHRQ and CMS.

7 Behavioral Pathways to Increasing Efficiency in Health Care Boost demand for efficiency by increasing the salience of health care costs (for example, making the full cost of insurance more evident to enrollees) Improve information about cost-effectiveness (necessary but not sufficient) and align incentives Shift behavioral norms among health care providers toward more effective, lower-cost, evidence-based care Set cost-effective defaults for both enrollees and health care providers

8 Consumption of Fresh vs. Stale Popcorn from a Medium-Sized (120 g) Container Source: Wansink and Kim (2005).

9 Influence of Container Size on the Consumption of Fresh Popcorn Source: Wansink and Kim (2005).

10 Influence of Container Size on the Consumption of Stale Popcorn Source: Wansink and Kim (2005).

11 Behavioral Avenues for Reform in Federal Nutrition Programs 20 percent of Americans participate in a federal nutrition program Supplemental Nutrition Assistance Program: –Disbursing benefits more frequently could reduce stockpiling and bingeing School Lunch Program: –Placing healthier foods at the front of cafeteria lines could increase their prominence and consumption –Decreasing the size of tables could reduce distraction-driven overeating

12 Increase in Life Expectancy, and Increase in Difference in Life Expectancy by Economic Status Source: Data from Singh and Siahpush (2006) and CDC. Years

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