They've built a bill that Washington's toughest scorekeeper says will cut the deficit by more than a trillion dollars over 20 years. They're getting attacked for the taxes and Medicare reforms that save all that money. But the country doesn't believe the savings are real.
Sam, here's couple of things that I think are important to keep in mind. The 'Washington scorekeeper' in this article is the CBO. But the CBO is just a number crunching mechanism based on assumptions of economic growth rates, revenue streams, future health costs, etc.....a big mixture of assumed numbers. It doesn't have the mandate or the capacity to pass judgment on whether or not the numbers it is handed are fallacious in any way. As a former CBO director said to the NY Times, it's a process of 'fantasy in, fantasy out'.
The other thing is that something important is being overlooked. The administration claims that there are mechanisms in the plan that will serve to slow the rate of increase in national healthcare spending. The country now spends approx. $2.5 trillion a year on healthcare and this amount is projected to keep growing at a certain percent, and the administration is arguing that this plan will slow the amount of the increase, i.e. reduce the percentage. If it was going to grow at 8%, maybe it will now grow at 7% (just made-up numbers).
Let's say this is true. The rate of increase will be reduced. This is good but also kind of meaningless at the same time. Why? Because the problem with the plan isn't the overall amount of cost itself, it's the share of the cost that the government will now pay, once the plan is fully in place. This is why "the country doesn't believe the savings are real".
The government will be taking a lot of already existing costs onto itself. It will assume payment for a bigger percentage of a cost pie that is growing in size, although growing less rapidly. The plan is full of lots of goodies. There's pretty much some kind of financial benefit in it for everyone. To call it a plan to take care of the uninsured is disingenuous, imo. First is the fact that it will only help 70% of the currently uninsured by its own admission. 30% are left out. What happens to them? What the plan really is is a plan by the govt. to make things easier for lots of people.... many more than the currently uninsured will spend less on their health needs than they would have spent. Not necessarily because costs will go down overall, but because the government will pick up a bigger share of their tab.
The plan has been sold on the basis of the country having an obligation to help out the uninsured. The selling of the plan rests on the premise that the uninsured are the poorest segment of society. But the plan itself doesn't meet those criteria. It doesn't take care of 30% of the uninsured and it has goodies in it even for the wealthy, unless some kinds of means testing mechanisms are put in place. For example, it will eliminate the prescription drug donut hole for seniors and it will install CLASS, a benefit by which anyone can buy cheap nursing home insurance directly from the government.
There are plenty of outright gifts in the plan. The government will be giving plenty money to people who don't need it. Designing a plan that deliberately does this at a time when federal budget risks keep growing worse is really strange, I think. Some of the ways the administration has proposed paying for it are really strange, too. If a public company had such a business model for its own expansion, nobody would invest in it.
The bill's basic theory is to try pretty much everything in the hopes that some of it works out
This doesn't cut it with a lot of people.....shades of that old 'leap of faith' thingie :) |
