Fiscal Pressures Start Mounting Ahead of Health Care Debate
One of the biggest flashpoints in the coming congressional health care debate will be how much money can be saved by reforming the nation's presently broken system. The White House budget included $634 billion over 10 years for health reform, paid for by in part by trimming the system's existing payments to insurance companies, doctors, and drug-makers.
Not surprisingly, the same industries in line for a fiscal whacking to help fund the health care bill are hoping that Congress gets a little more creative with its attempts to pay for the measure.
Thanks to Ezra Klein, we see insurers (Aetna, Blue Cross Blue Shield), the pharmaceutical industry's trade group, and the American Medical Association signing on to a letter that urges congressional budget chairmen "develop a more flexible approach to pay-as-you-go for health care reform."
Pay-as-you-go is the congressional budget principle that calls for offsetting all new spending with an equal amount of cuts -- keeping the national ledger balanced, in essense. The ideal "flexible approach," to paying for health care, the letter-writers continue, would be one that "reaffirms the importance of offsets but accommodates the need for significant short-term expenditures that will help set the health system on a path toward significant long-term savings and improvement in the long-run fiscal future of our country."
One of the budget chairmen who received that letter is Sen. Kent Conrad (ND), who sounded a big note of alarm just yesterday on the general price tag of health care, without even beginning to touch the method of paying for it.
"When I hear, 'we're not going to see any savings [from health care] for 10 years,' I become skeptical ... [and ask] 'is this really a move to save money?'," Conrad told reporters yesterday after his committee heard testimony on the health care budget.
So you have powerful interest groups urging the Hill's budget-writers to accept hefty early spending that would pay off further down the line, while one of those same budget-writers wonders why more savings can't be had earlier. Sounds like a push-pull dynamic may be developing ...
Josh
Matt
Eric
We need complete and honest side-by-side comparison by ALL the proposals out there by the Congressional Budget Office, including single payer (Conyers HR-676) and strong public option (e.g. HCAN, Rep. Pet Starks AmeriCare), along with whatever mediocre compromise Baucus is negotiating away with Grassley, Enzi and Bennett.
The side-by-side comparison should include projected costs to state governments, employers and to households of different income levels. For 2010 and beyond.
Then we can see how much the costs are, who pays, how, etc.
It was fascinating how the best recent national proposals analysis we have, the one done by Lewin for Commonwealth that showed that the only proposal that actually controlled total costs, Starks AmeriCare (which really strong public option and not all single payer), continues to be ignored; see:
http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=777197
Meanwhile the main argument is over which "mainstream" plan explodes whose budget. For exampe, Wyden-Bennett does not control total costs, but does "score" well with CBO insofar as it saves the federal government budget, but dumps the extra onto the states, localities, employers and individuals. Same for Baucus' latest financing scheme. No wonder he was pressuring the CBO to "fix the results" last week.
March 13, 2009 5:03 PM | Reply | Permalink
"reaffirms the importance of offsets but accommodates the need for significant short-term expenditures that will help set the health system on a path toward significant long-term savings and improvement in the long-run fiscal future of our
country."
People who write this kind of gobbledygook should be sent to work in coal mines.
March 13, 2009 5:03 PM | Reply | Permalink
Well, I will wager a bet that the obama administration figures that the 634 billion allocated will pretty much cover the expense of medicare for all with cost saving and cutting measures and getting everyone in the system. We only pay like 2 times as much if not more per person than other countries. Get the system under control and the costs and the savings will be substantial. Get the pharma industry regulated and honest. Stop the stupid money wasted on stupid adds promoting drugs that people don't need. Get the insurance industry out of the mix and look out how cheap, efficient and excellent the care will be.
Any takers? I bet a lunch.
March 13, 2009 6:09 PM | Reply | Permalink
Well, this is making me sick.
Cost is a secondary issue. The primary issue is care. This is so typical of today's Democratic Party. The party fears that the touchy feely care thing is just too leftie so it tries to sell the idea on cost. Republicans and Blue Dogs will clean our clocks on the cost issue, gut the bill and leave all but the wealthy worse off.
As to Dorgan, every time I hear about the latest ND kid or mom or dad heliported into Minneapolis for trauma care I think how we liberal taxpayers of Hennepin County are footing the infrastructure for those Blue Dog turkeys like Dorgan. Ever notice where the health care is best? It's sure not in states where cost replaces care as the primary value.
March 13, 2009 6:23 PM | Reply | Permalink