Nearly all these projected savings would come from cuts in federal reimbursements, which critics fear could prompt hospitals to simply charge private insurers more.
"We need to make it increasingly uncomfortable to deliver care that is inefficient," said McClellan, who is helping to lead a bipartisan effort including former Senate majority leaders to push for reform.
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Political pressure
Part of the reason such measures are not being proposed is political. Pressing doctors to accept guidelines on the most beneficial and cost-effective way to treat patients, for instance, instead of leaving such decisions to individual doctors, could alienate the American Medical Assn.
And the president and his congressional allies are trying to maintain the support of a broad array of groups. But unless Democrats can show more commitment to reducing costs, the consensus that has sustained the Obama administration's effort may begin to crack.
"Cost is where the middle ground is," said Mark Blum, who helped lead liberal healthcare campaigns in Vermont and West Virginia and now directs America's Agenda, a partnership between labor unions and businesses.
"There is a sense that we need to refocus," Blum said.
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noam.levey@latimes.com
