It is frustrating for many people to watch health reform debate sidestep address cost containment in a meaningful way, but big changes are often best accomplished in incremental steps.

In a post on Commonhealth, Richard Lord, president and CEO of Associated Industries of Massachusetts, laments that Congress has not learned an obvious lesson from his state’s 2006 health reform: If coverage expands without cost containment, the result is unsustainable.

He points to the importance of scrapping fee-for-service medicine:

Maybe Massachusetts will have to lead the way on the cost issue after all, just as we did with access. I am heartened by the near total consensus here that we need to move away from our current “fee for service” payment system, which rewards providers for volume, toward global payments that would providing greater incentives for efficiency and quality care. Obviously there would be significant advantages to a national approach to reshaping our health care payment system: apart from competitiveness and consistency issues, federal action would avoid Medicaid and ERISA constraints. But if Washington lacks the political determination to confront this issue head on, I am hopeful that Massachusetts will once again lead the way on cost containment – without which all of our great accomplishments will not be sustainable.