Thread by @zackcooperYale

🚨How do you reduce health spending?🚨
We are launching a new project - ‘1% Steps for Health Care Reform’. We're working with leading health policy scholars and the goal is harness research to illustrate tangible steps to reduce health care spending.

The core idea-if the US health system was a country, it’d be the 4th largest country in the world. There’s not 1 thing wrong in a system so big. There are lots of little problems that add up. We asked experts to identify discrete problems & propose reforms healthaffairs.org/do/10.1377/hbl…

The project (onepercentsteps.com) brings together an amazing group of scholars who are making concrete policy recommendations on steps to reduce health spending.

(all the authors even got an avatar...I think Jon Gruber's is most realistic).
onepercentsteps.com/authors/

We have proposals from @Michael_Chernew @LeemoreDafny @nealemahoney @MartinSGaynor @JonSkinner17 @ProfFionasm @amitabhchandra2 @AmandaStarc1 @ashleyterese @Mario_Macis @Jabaluck @porszag @rahulrekhi @jwswallace and co. onepercentsteps.com/authors/

All the briefs are aimed at policy makers and are accessible at: onepercentsteps.com/policy-briefs/

We wrote up a summary of the core idea underlying the 1% Steps for Health Care Reform project in a piece @Health_Affairs.
healthaffairs.org/do/10.1377/hbl…

We understand the allure of hoping for silver-bullet solutions to reform the US health system. There aren’t many country music songs written about incrementalism. Nevertheless, health economists owe it to the public to come up with tangible steps to reduce health care costs now.

The paper has 16 briefs written by an awesome collection of folks. They span a range of topics – antitrust, drug pricing, Medicare policy, Medicaid policy. Collectively the savings on offer would save hundreds of billions (9% health spending).

onepercentsteps.com/policy-briefs/

One percent of US health spending is about $30-40bn per year. We can get there with small changes I the health system. What could we get for a 1% savings? How about universal pre-k! newamerica.org/education-poli…

There’s awesome work by @JonSkinner17 on reducing health care fraud in home health. (When he was on home hospice, my father received 8 commodes so I can attest this is a real thing!).
onepercentsteps.com/policy-briefs/…

.@amitabhchandra2 discusses ways to reform the orphan drug act. onepercentsteps.com/policy-briefs/…

.@porszag and @rahulrekhi offer some wiring changes to claims adjudication that would save billions. onepercentsteps.com/policy-briefs/…

I was blown away by the savings from increasing kidney donations. Small that ramped up kidney donations would reduce Medicare spending by nearly a percent.
onepercentsteps.com/policy-briefs/…

onepercentsteps.com/policy-briefs/…

Historically, it's been easy for folks to dunk on what doesn't work. The challenge we posed to the authors was to describe what would reduce health spending and to write it down. We got discrete recommendations that add up to big savings.

Over the next few days, I'll try and tweet out all the amazing briefs. Hugely grateful to @Arnold_Ventures who made this work possible. The project isn't what academics usually do but we hope it makes a difference.

Perhaps most importantly, we want to hear your ideas and to keep posting discrete policies based on evidence. Send on your ideas for evidence based interventions to reduce health spending