Monday, July 20, 2009

"Health Care Reform Costs Too Much" - Compared to What?

As even strong proponents of real health care reform - public option, single-payer - are panicking over the Congressional Budget Office calling reform too expensive, here's how to respond:

"Compared to what?"

Because even if reform costs more than $100 billion a year, more than $200 billion a year, it's still less than doing nothing. It's still less than a bill with no public option, which would be just a giant handout to the health insurance industry dwarfing the Wall Street bailout, which would be worse than nothing.

Besides which, CBO director Elmendorf is full of it because the real cost-cutting measures have yet to be added to the bills.

Jonathan Cohn at TNR explains:

The key thing to remember about Elmendorf's remarks is that CBO has, so far, seen just two pieces of legislation. One is the bill that the Senate Health, Education, Labor, and Pensions (HELP) Committee passed earlier this week. That bill doesn't include the types of reforms that would make a big difference in long-term spending trends, but that's mostly a function of jurisdiction. HELP can't touch Medicare or Medicaid, nor can it fiddle with the tax code. Yet it's through those two levers Congress would most likely influence the growth in health care costs. (It remains to be seen what the Senate Finance Committee, which has that jurisdiction, will do.)

The other piece of legislation CBO has seen--the bill produced by three House committees working together--is another story. That's a complete bill, including Medicare, Medicaid, and the tax system. And the experts who have studied the language closely--or, at least, those I've contacted in the last few days--seem to agree with Elmendorf: The bill, they say, doesn't include the sorts of big reforms that would reduce costs significantly.

But that bill is still very much a work in progress, as House leaders themselves acknowledge. And the White House, among others, has some ideas about how to shape it.

Despite a vow not to draw lines in the sand about reform legislation, President Obama has been adamant that any bill make substantial progress on cost reduction--a pledge his Budget Director, Peter Orszag, reiterated in the course of a brief (and previously scheduled) interview he gave TNR Thursday afternoon. "The legislation that emerges from this process has to contain key provisions that will bend the curve over the long term," Orszag said. "The president has said that and we're in the middle of a legislative process, so it's not surprising that, as you go through that process, there are modifications that are necessary."

Read the whole thing.

Cross-posted at They Gave Us A Republic ....

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