MEGAN MCARDLE: Health-Care Costs Are Driven By Technology, Not Presidents. Well, presidents can drive them up. But read on:

Those of you who do not spend many happy waking hours parsing health statistics may be unaware that the rate of increase in health-care spending has slowed in recent years. The administration and not a few people in the press are fond of claiming this as a victory for President Barack Obama’s Patient Protection and Affordable Care Act, aka Obamacare. The program is so fantastic on cost control, the argument goes, that providers have naturally started to control costs in preparation for the actual implementation. Authors Amitabh Chandra, Jonathan Holmes and Jonathan Skinner dismiss this explanation. Most of the cost controls haven’t kicked in yet, while one cost-increasing factor (the expansion of private insurance coverage to children under 26) has already taken effect. More importantly, as they note, “the downturn in health-care cost growth began in 2006, back when Barack Obama was still a relatively unknown senator from Illinois.” . . .

Which leaves us with technological change, and that’s what much of the discussion centered on. Cost growth, the argument goes, is largely driven by innovation. Not necessarily good innovation — quite a bit of time was spent denigrating Proton Beam facilities (used for cancer treatment) that cost in the tens of millions of dollars and don’t seem to do patients much good, yet whose total number is set to double between 2010 and 2014. And this is where I started to get nervous. Most participants agreed that if you want to control costs, you need to stop third-party payers from paying for new technologies — particularly Medicare, which is not very discriminating, and which makes it hard for private insurers to deny a treatment that the U.S. government has thereby endorsed. Several people argued rather hopefully that the government could do this — and maybe even would do this, with moves, in Medicare and Obamacare, toward bundled payments and “Accountable Care Organizations.” But no one offered any reason to believe that the government, or the ACOs, would only shut down bad innovation.

Five years ago, when the national health-care debate began in earnest, I worried that national health care would slow innovation. The U.S. is not an efficient user of health care, I argued, but our lavish reimbursements fund innovation. Much of that innovation is bad, which is true of basically any technological frontier; it takes a lot of users, and a lot of iterations, to figure out what works and what doesn’t. But some of it is good — life enhancing, or even extending. If the U.S. shut down that engine, some people might be helped now, but a lot of people in the future might suffer or die from things we could have cured, if we hadn’t shut down the innovation machine.

I still worry about that, personally. While I think we’re on the cusp of the technological cost-lowering revolution that Andy Kessler has been projecting for a while, I still worry that ObamaCare will kill innovation at precisely the time when it was ready to take off.