The shouting war over health reform’s effect on the budget got a little louder today when the director of the Office of Management and Budget, Peter Orszag, pushed back at conservative bloggers who are saying federal officials were disingenuous about the real costs of the law.
First, let’s go back in time….just a little:
Last week, Congressional Budget Office Director Doug Elmendorf posted on part of a presentation he gave to the Institute of Medicine on health care and the deficit. Elmendorf wrote, “In considering the opportunities for achieving that reduction in spending growth, there are grounds for both optimism and pessimism. On the upside, there is considerable agreement that a substantial share of current spending on health care contributes little if anything to people’s health, and providers and health analysts are making significant efforts to make the health system more efficient. On the downside, it is not clear what specific policies the federal government can adopt to generate fundamental changes in the health system.”
Conservative commentators quickly focused on the downbeat assessment. Heritage’s Conn Carroll, who initially blogged about Elmendorf’s report last week, returned to the subject today, saying: “now that Obamacare has become (hopefully only temporarily) the law of the land, the CBO is singing a slightly different tune.”
Orszag posted a defense on his blog today: “CBO Director Doug Elmendorf recently gave a presentation on health costs and the fiscal outlook. Doug concludes that the federal budget remains on an unsustainable course even after enactment of the Affordable Care Act, and I wholly agree with him.” But he goes on to add “The new law incorporates the most promising ideas from economists and leaders from across the political spectrum to control health care costs. As I have written before, this includes the vast majority of the options CBO itself suggested for reducing long-term health care cost growth. And we now have a variety of new institutions that will be devoted to guiding policy toward higher-quality and lower-cost outcomes”
Elsewhere in the blogosphere, Health Beat Blog’s Maggie Mahar reviews an update of Philip Longman’s book on the Veteran’s Affairs health care system. Mahar writes: “In other words, reformers don’t have to start from scratch. The VA already has laid out a roadmap and it would be happy to share the comparative effectiveness research that it has gathered with the rest of the nation. We don’t have to look to Europe to find examples of systems that work. I believe that studying care in Europe can be extraordinarily useful, but on the phone, Longman confided that, as a young journalist, he was told, “Never start a sentence, ‘In Sweden, they . . .’” Americans are more likely to be persuaded by home-grown solutions.”
Cato’s Michael Cannon has a different take on the VA — pointing to reports of problems with the system. Cannon says, “ObamaCare will produce similar horrors, and for the same reason: all economic systems serve the people who control the money. Under ObamaCare and the VA, patients don’t control the money. The government does.”
Talking Points Memo created an interactive map of what they’re calling the “Shadow Congress,” or former members of Congress now working as lobbyists in Washington, D.C. TPM counted 172 “shadow members.”
Hot Air’s Ed Morrissey responds to reports that parts of Canada may privatize some health care services, saying, “That does prompt a question, though, on whether a little privatization is possible — a question that the US is considering in the opposite direction. If Canada will no longer cover some of these necessary procedures, it will have to allow for insurers to sell policies to cover the costs … If Canada allows that, why wouldn’t Canadians want to get insured for other issues as well? And if the electorate gets health-care coverage in a more rational and accessible manner than they do now, why would they tolerate government control in the future?”
On the Health Affairs Blog, legal expert Timothy Jost writes about new requirements for nonprofit hospitals under the health overhaul law. Jost says the requirement “crowns a long-standing campaign by Senator Charles Grassley to increase the accountability and ‘charitability’ of tax exempt hospitals.”
David Catron on the American Spectator calls Donald Berwick, President Barack Obama’s nominee to lead the Centers for Medicare and Medicaid Services, “a blinkered ideologue with an abiding admiration for Britain’s National Health Service (NHS), and the significance of this for the future of U.S. health care can hardly be overstated.”
Wonk Room’s Igor Volsky writes that the National Federation of Independent Business is having trouble getting other business groups to join in a lawsuit seeking repeal of the new health overhaul law, saying: “Small businesses may not be overly enthusiastic about the new law — given the misinformation about the law and the complexity of the measure, that’s not surprising — but they would be foolish to join a frivolous lawsuit that cuts them out of negotiations with HHS about any new regulations.”
Dylan Matthews, guest-posting on Ezra Klein’s blog, notes that abortion rights groups are lobbying in support of other reproductive health issues, like mandatory coverage of birth control pills. Matthews says: “Abortion rights groups seemed to be caught unaware when the Stupak amendment initially passed the House, and while some organizing occurred afterward, the damage was done. It should have served as a warning against future complacency, one Planned Parenthood at least seems to be heeding.”
The New Health Dialogue’s Meredith Hughes looks at a Commonwealth Fund report on community health centers. Hughes says the report recommends these centers “need referral partnerships with hospitals, increased health IT capacity, and to adopt the qualities of patient centered homes. As we move forward in building and improving our community health center infrastructure, it’s important to keep these qualities in mind.”
