Reaching Across the Aisle to Lower Health Care Costs

In March 2026, LDI Senior Fellow Ezekiel J. Emanuel and Brian Blase spoke together on a panel at an event on health care affordability, organized by Penn LDI and Penn Washington. They reached consensus on numerous drivers of health care costs and potential reforms. Now they have jointly authored an op-ed in the Washington Post about these ideas, which published on October 26, 2026.

Review the Washington event recap and read key insights from all the panelists. An excerpt from the op-ed is below.

The two of us stand on opposite sides of the political divide — one a liberal, the other a conservative. We served in senior White House health policy roles for separate administrations. We disagree about the Affordable Care Act and other issues. But we agree on many of the biggest problems facing U.S. health care — and on many solutions, too.

The challenges in the health care industry are myriad. Americans now spend over $1.6 trillion annually on hospital costs — nearly a third of total health care spending. Since 2000, hospital prices have more than tripled, rising nearly twice as fast as general health care prices and three times as fast as inflation. Hospital consolidation has reduced competition.

Navigating care and coverage can be extraordinarily complex, and the employers covering roughly 160 million Americans often do a poor job getting good deals. Without fixed budgets, Medicare and Medicaid encourage states, insurers and providers to maximize federal payments regardless of service quality and health outcomes. Annual insurance churn gives insurers less reason to invest in the long-term health of their customers when the savings may not materialize for years.

But there are several opportunities for lawmakers on both sides to address these issues and provide Americans with better health care at lower costs:

Reforming payment policy and encouraging competition would help bring down high hospital prices. Medicare and private insurers pay much more for services performed in a hospital outpatient department than in a doctor’s office, ambulatory surgery center or imaging center. These payment differences incentivize hospitals to acquire physician practices and bill insurers and patients at the higher rate, which raises costs without improving care.

Medicare should pay the same amount for the same service, regardless of where it is delivered. This could save taxpayers and beneficiaries nearly $200 billion over a decade and reduce hospital consolidation, which would lower private insurance premiums.

Read the full op-ed.