Health Care: Trends, Challenges and Changes

Special Guests: Robert L. Bixby, Josh Gordon

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On the latest Facing the Future, Concord Coalition Executive Director Robert L. Bixby and Senior Policy Advisor Josh Gordon joined me to discuss health care, from challenges and changes to the Affordable Care Act to trends driving up federal spending in key programs.


“There are a few challenges, other than the immediate viral challenge, that the health care system is facing,” Gordon said. “We always have the challenge of healthcare costs, which tend to grow faster than the economy; that is the challenge both for individual budgets and the federal budget.”

“When The Concord Coalition looks at this problem, we really look at the long-term trajectory of federal spending and how federal spending on our major health care programs from a federal budget perspective will grow faster than the economy in the future,” he said. “Both because of health care inflation and also because we have more people becoming eligible for our public programs.”

Gordon also spoke on the implications of the latest legal challenge to the Affordable Care Act, which is about to be heard by the U.S. Supreme Court.

If the Court determines that the ACA is no longer valid law, he said some of the major pieces of the law, such as Medicaid expansion and marketplace subsidies would likely be eliminated. And the future of protections for preexisting conditions and young adults under the age of 26 are very much in doubt.

My guests discussed the President’s budget proposal and its health care implications too. Bixby highlighted a health reform “vision” listed in the President’s proposal that lacks detail but still purports to save $800 billion.

“Other than the ‘vision’ line item, there were about $400-500 billion in proposed savings in Medicare … they’ve been in presidential budgets going back to the Obama administration, different ways that health care economists and experts have promoted reducing spending in Medicare without cutting individual benefits.”

Gordon said, although he thought that was a good section in the budget, it likely is not going anywhere right now because “it’s hard to take one part of the health care budget seriously while another part overshadows that with its really unusual lack of specificity.”

I asked how we get to a position where bipartisan reform in health care is possible. Gordon said, “The key, I think, will be for whoever tries to deal with healthcare reform next, to think about what can provide the greatest benefit, to the most amount of people, in the shortest amount of time, and I think there are ways to build on the current health care system that would do that.”

“If we spend less of our money on an inefficient healthcare system, that gives us more money for investments in economic growth in more efficient higher growth sectors of the economy, and if we can be more fiscally responsible with our health care programs, the reduction in future debt will help grow the economy of the future.”

Hear more on Facing the Future. I host the program each week on WKXL, (N.H.), and it is also available via podcast. Join me and my guests as we discuss issues relating to national fiscal policy with budget experts, industry leaders and elected officials. Past broadcasts are available here. You can subscribe to the podcast on Spotify, iTunes, Google Play Music or with an RSS feed. And follow Facing the Future on Facebook.


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