Bending the cost curve in health care: innovation or incrementalism

Let's Get Fundamental is a thoughtful op-ed piece by David Brooks in the New York Times today discussing the state of the health care reform. He argues that this is not the time to go incremental, but go transformational by getting at the fundamental problem of dysfunctional incentives that drive up costs. "Instead of true reform we got a series of bills that essentially cement the present system in place. The proposals do not fundamentally challenge the fee-for-service system. They don't make Americans more accountable for their own health care spending. They don't reduce costs. They just add more people into the mess we've got." He bolsters his argument with new report published by the Brookings Institution Bending the Curve: Effective Steps to Reduce Long-Term Health Care Spending Growth. The report merits a look as the President prepares his speech before a joint session of Congress next week. Briefly, the report starts with the premise that standard short-term measures to address rising costs, like reducing prices will not succeed. Instead, legislation should reform payment systems, regulations, and institutions that currently prevent patients from quality care at the lowest cost. This is a grand innovation challenge. I am interested in what you think.