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When a guy like Robert Reich says the health-care legislation lacks adequate cost controls, that's a pretty good sign it lacks adequate cost controls. This isn't Mitch McConnell talking. Reich, labor secretary under Clinton, mainly wants a robust, government-run health insurance option to give private insurers a run for their money. His list of cost-savers:

A public option available to everyone -- not just people who lack insurance -- really would stop costs from rising so quickly. Letting Medicare negotiate lower drug prices would also save money, but probably not as much as Reich thinks. "A major squeeze on Medicare reimbursements for doctors" could have terrible consequences if the targets were primarily general practitioners, who are already getting hammered. The target needs to be specialists -- surgeons, neurologists etc. -- and not just on their fees per procedure (see below).

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Reducing patent protections for new drugs is a terrible, terrible idea. Dollar, for dollar, pharmaceuticals are among the best medical investments going. Telling the biotech companies they'll

get competition from generics the minute their pills hit the market is a perfect way to get them to stop trying -- hurting patients and a key U.S. industry in one stroke.

Reich fails to mention two other cost-control measures missing from the legislation. 1) Malpractice lawsuit reform. This isn't a silver bullet, but it's real money and ought to be thrown in not just as good policy but as a tactical plea for possible Republican support. 2) Much more emphasis on "evidence-based" medicine and reimbursement. The BIG reason for out-of-control medical costs isn't that we're paying surgeons too much. It's that they're doing too many unnecessary surgeries. Have the Congressional Budget Office score those provisions and you'll see even bigger savings.

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