The Affordable Care Act Does Control Health Care Costs

Editor’s Note: In this letter to the editor of the New York Times, Henry Aaron responds to Steven Rattner’s September 16, 2012 op-ed on the Affordable Care Act, writing that the Act does an effective job in controlling health care costs.

To the Editor:

I disagree with Steven Rattner that President Obama’s health reform was inattentive to cost control and that rationing care to the elderly is needed to slow the growth of health care spending.

The Affordable Care Act deserves a solid “A” for including virtually every cost control idea anyone has come up with — limits on tax breaks for employer-sponsored health insurance, accountable care organizations, bundled payments, comparative effectiveness analysis, a commission to regulate payments, reforms in insurance design and much more.

Transforming the current chaotic mélange of health care payment and delivery arrangements into a genuine system will take many years, because current arrangements are entrenched and structured to resist effective cost control.

The task for this generation should be to implement the many promising cost-control measures in the health reform legislation. There are better ways to respond to today’s budget challenges than to renege on the commitment made nearly half a century ago to assure the elderly, people with disabilities and the poor health care comparable to that enjoyed by the rest of us.

HENRY J. AARON
Washington, September 18, 2012