To: Alighieri who wrote (598947 ) 1/26/2011 5:04:46 PM From: TimF 2 Recommendations Respond to of 1574205 ...while providing health care for 30M additional people? False. Everyone has access to emergency health care now, and some degree of non-emergency health care. The bill won't even provide health care insurance to 30 million more people. It will provide for subsidies and mandates, but that isn't the same as providing insurance. And the extra regulation will increase the cost of insurance so it might wind up with a situation of having less people insured. We might instead increase insurance coverage, the actual consequences are not clear, so all sorts of claims can be made, but its very unlikely to increase by 30 million. And to the extent that it does it won't be the federal government providing health care for 30 million, or even providing health insurance for 30 million, instead it will just be the federal government psuhing millions to buy insurance under threat of a penalty. And as i-node points out the number of involuntarily uninsured because they can't afford it is far below 30 million in the first place. Even if it did actually provide for care or for insurance for tens of millions of people, it would still be reasonable, even important, to evaluate its impact on spending and deficits, and to evaluate the accuracy of claims about those things. The fact is that it will clearly increase federal spending on health care, that's pretty much beyond dispute, its also a problem. It will also (to the extent it actually does increase coverage) increase total health care and health insurance spending (a claim for more people covered with more access to health care, if true that will raise costs, also the mandates for coverage for more things, or more generous coverage in general increase costs). It also likely will increase the deficit, and even if it does not it will use up potential tax revenue that could have been used to increase the deficit. So even in the unlikely event that it does slightly decrease the deficit, its still fiscally unsound. Even if it does decrease the deficit its like this - --- Give me $1 billion to cut the budget deficit I have a plan to reduce the budget deficit. The essence of the plan is the federal government writing me a check for $1 billion. The plan will be financed by $3 billion of tax increases. According to my back-of-the envelope calculations, giving me that $1 billion will reduce the budget deficit by $2 billion. Now, you may be tempted to say that giving me that $1 billion will not really reduce the budget deficit. Rather, you might say, it is the tax increases, which have nothing to do with my handout, that are reducing the budget deficit. But if you are tempted by that kind of sloppy thinking, you have not been following the debate over healthcare reform. Healthcare reform, its advocates tell us, is fiscal reform. The healthcare reform bill passed last year increased government spending to cover the uninsured, but it also reduced the budget deficit by increasing various taxes as well. Because of this bill, the advocates say, the federal government is on a sounder fiscal footing. Repealing it, they say, would make the budget deficit worse. So, by that logic, giving me $1 billion is fiscal reform as well. To be honest, I don't really need the money. But if I can help promote long-term fiscal sustainability, I am ready to do my part.gregmankiw.blogspot.com