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Posts Tagged ‘costs’

Reactions To Hectic Senate Weekend

The Senate voted early this morning to file cloture, or move forward, in the final steps toward passing its health overhaul bill. The vote was not certain when the weekend began, and only after Sen. Ben Nelson, D-Neb., announced his support did the action proceed. Reid is now saying a final vote will take place by Christmas.

Bloggers were recovering from a busy weekend, trying to make sense of the big picture as the legislation moves forward.

Wonk Room’s Igor Volsky notes, “The Senators voted from their desks — a customary practice reserved for the most significant votes. Once the presiding president read the final tally, Democrats rushed over to congratulate Majority Leader Harry Reid (D-NV).” He posts video of the vote, below:

The Washington Post’s Ezra Klein compares the Senate’s version with President Obama’s campaign health plan. Klein notes that the public plan was dropped and Obama didn’t initially include an individual mandate,

But whether you love the Senate bill or loathe it, whether you’re impressed by Obama’s effort or disappointed, it is very hard to argue that the bill Congress looks likely to pass is fundamentally different from the approach Obama initially advocated. “The Obama-Biden plan both builds on and improves our current insurance system,” the campaign promised, and on that, for better or for worse, they’ve delivered.

Despite Klein’s conclusion that the plan isn’t very different from Obama’s campaign promise, Heritage’s Conn Carroll says the Senate bill’s passage “is only the beginning of a much larger health care fight.” He continues, “This bill will only make every single problem with out health care system worse: higher spending, higher deficits, and worse care. Former-Democratic National Committee Chair Howard Dean said on Meet the Press yesterday, ‘[This bill] simply sets us on a track in this country which is expensive and where we’re going to have lots more political fights.’ Dean is dead on. President Barack Obama’s signature on this health care bill settles nothing.”

Jacob Goldstein of the Wall Street Journal’s Health Blog looks at Congressional Budget Office estimates released this weekend that found certain provisions are estimated to make little difference: “During all the last-minute action this weekend, CBO put out its estimates on the latest version of the Senate bill. As it turns out, replacing the public option with private plans overseen by a government agency — a sort of “public option lite” that was a key part of the compromise — makes almost no difference to how the bill would work in the real world, according to CBO.”

Grace-Marie Turner lists 12 “constituencies that will be gored, to which senators will have to answer next time they go before the voters.” She includes “everyone.”

Huffington Post’s Drew Westen is disappointed with Obama’s leadership, saying his actions “soured” young people to politics:

Somehow the president has managed to turn a base of new and progressive voters he himself energized like no one else could in 2008 into the likely stay-at-home voters of 2010, souring an entire generation of young people to the political process. It isn’t hard for them to see that the winners seem to be the same no matter who the voters select (Wall Street, big oil, big Pharma, the insurance industry). In fact, the president’s leadership style, combined with the Democratic Congress’s penchant for making its sausage in public and producing new and usually more tasteless recipes every day, has had a very high toll far from the left: smack in the center of the political spectrum.

The American Spectator’s Philip Klein notes that some health insurance stocks are rising this morning.

James Capretta takes a closer look at the final version and says it’s “still a budget buster.”

And from the other perspective, Health Beat Blog’s Maggie Mahar has a series of posts looking at the details, including potential affordability challenges for older Americans, Ben Nelson’s abortion compromise and the “glass half empty/glass half full” viewpoints.

Mark Trahant reports that the Indian Health Care Improvement Act is in both the Senate and House versions.

And in the wake of the coming vote, Bob Laszewski wonders, “Is there anyone left, on either side of the political spectrum, who wants the Senate health care bill to pass?”

Monday, December 21st, 2009

Tags: abortion, costs, howard dean, nelson, reid, senate
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Foggy Future for Senate Bill

The Senate voted Saturday night to begin debate on its health overhaul bill, leaving liberal bloggers jittery about the bill’s future while conservatives enumerate the many challenges to come.

But first — Politifact deconstructs an email by Sen. Orrin Hatch, R-Utah, where he says the Senate health bill is longer than War and Peace. Politifact’s take? “So while Hatch is right if you simply count pages, when you use a more accurate comparison — the number of words — War and Peace is actually longer. In other words, he is right by one measurement, but not by the best measurement. So it turns out that Democrats aren’t as wordy as a Russian novelist. Who knew? We find his claim Barely True.”

The New Republic’s Jonthan Cohn surveys the health reform landscape and asks, “Should We Laugh? Cry? Or Both?” He portrays the upcoming weeks as sure to be painful for progressives:

Victories are more likely to come in the form of ground not conceded than ground gained. Every day that legislation doesn’t get worse is a day to cherish.

That may not sound like much to celebrate. But to get a bit of perspective, glance over to the other ideological corner–where the right, and many of its kindred special interests, are going absolutely crazy.

Hot Air’s Ed Morrissey looks at a new Rasmussen poll that finds the lowest level of public support thus far: “The more people see of ObamaCare and the way Nancy Pelosi and Harry Reid have to force it through Congress, the less they like it. Rasmussen’s latest survey on the legislation shows support for the bill reaching its nadir, 38%, with an 18-point deficit from public opposition, which is 56%. It’s the first time in Rasmussen’s surveys of likely voters that support for Barack Obama’s signature agenda item has dropped below 40%.” Rasmussen consistently found lower levels of public support throughout the debate.

Grace-Marie Turner: “The cost of health care is indeed the top issue, and the American people understand that new taxes never will be enough to pay for Reid’s or Pelosi’s reform plans.” She offers a list of signs that there is “turbulence ahead” including a new public opinion poll and Senators’ statements before the vote.

The Washington Post’s Ezra Klein explains why the vote doesn’t make things eaiser: “During that debate, they will need to call cloture votes in order to amend the bill. After that process is finished, there will be another cloture vote to begin voting on the bill. At this point in the history of the United States Senate, Harry Reid pretty much needs to call a cloture vote before he can sneeze. It’s all cloture votes, all the time. And the fact that Reid won today’s vote doesn’t mean he’ll win tomorrow’s.”

Heritage’s Brian Darling gives an example of how the Senate process could be injected with even more hot political issues: “This process may go in one of two directions. It is possible that Reid uses the amendment process to buy just enough votes to pass the bill through targeted special interest amendments. … Scenario two kicks in if opponents of the bill play hardball. If opposing Senators offer non-germane amendments like the legislation to restore the 2nd Amendment in the District of Columbia or a resolution of disapproval for Attorney General Eric Holder’s decision to try Kahlid Sheik Mohammed in federal courts.”

And Wonk Room’s Igor Volsky made an interesting catch — he finds Sen. Blanche Lincoln, who has pledged to oppose a bill with a public option — in a bit of a bind. Her website says she supports it.

Monday, November 23rd, 2009

Tags: costs, length, public opinion, senate
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Another Wrench In Health Overhaul Debate, This Time From CMS

A new Centers for Medicare and Medicaid Services report has sparked a renewed wave of attacks and defenses of Democrats’ plans to overhaul the health care system. The report found the House-passed health bill would increase health costs by $289 billion over 10 years and could cause reduced access to services for Medicare beneficiaries. As the Washington Post’s Ezra Klein says, like much in politics, “What they found depends on who you ask,” though he acknowledges “the report may prove very important in the coming negotiations between the House and the Senate.”

Heritage’s Conn Carroll says the report “blows the lid off of every one of Obama’s claims” about the health bill, and calls it a “deathblow for Obamacare.”

Hot Air’s Ed Morrissey writes, “In other words, the warnings about the Canadianization of the American health-care system have proven correct, especially as far as Medicare enrollees are concerned. We already have a crisis in providers for the government-run network. Thanks to unrealistic compensation schedules, many providers have stopped taking new Medicare patients, forcing them to fewer providers and into longer waits for care. The CMMS [sic] study shows that the massive cuts proposed by the Pelosi plan in the House and the Reid plan coming to the Senate floor would — not surprisingly — make a bad situation worse.”

Michelle Malkin reacts, “Ho-hum. Nothing to see here except another massive act of generational theft.”

Reason’s Peter Suderman on CMS’s estimate of the Medicare cuts: “Now, I think we ought to resist the idea that Medicare should be untouchable, and I think Republicans (who ordered the report, presumably expecting to find this outcome) have done themselves a disservice by pushing that notion. But I also think it’s pretty disingenuous to sell a plan based on the idea that you can make massive cuts to the program without substantially altering or reducing benefits in ways that beneficiaries won’t like.”

Meanwhile, over on the left…

Mother Jones’ Kevin Drum argues that the report itself is pessimistic:

What CMS is saying is that the healthcare sector tends to be labor intensive, and thus won’t be able to improve its efficiency as rapidly as the broader economy. Which might be true. Still, it’s worth noting that this is basically a counsel of despair. It suggests that controlling the growth of healthcare spending is hopeless, and any attempt to try it won’t work. We’re just going to have to pay doctors and hospitals as much as they want. I don’t buy that. It’s plain that eventually we’re going to have to control healthcare spending one way or another, and the sooner we give it a serious try the better.

Wonk Room’s Igor Volksy thinks the report is a “wake-up call to for reformers as much as it is a full and complete rejection of critics who argue that the House bill will undermine the existing health care system.” He writes, “The report is not without its positives, and lawmakers must accept the bad with the good. If the CMS analysis suggests that reform legislation should adopt robust cost-containment provisions, it also applauds the bill for expanding coverage by building and strengthening the current public/private system.”

Lastly, more from Ezra Klein, who recommends next steps for Democrats:

It seems like the smart path forward is to give these cuts a credible shot, and if they don’t work, either ease the cuts or reform Medicare to save money in other ways, perhaps by going after fee-for-service more aggressively.

But Medicare cuts are a crude tool. The more damning conclusion from the CMS report is that the House bill has little else to control costs, and that’s largely accurate. This report shouldn’t lead reformers to abandon efforts to trim Medicare, but it should convince them that the bill can do more on the cost control front.

The Senate now has the advantage of reading this report, questioning CMS about its methodologies and tweaking its bill to ensure a better verdict. But it’s already part of the way there. The Senate Finance Committee’s bill has two cost-control measures the House … doesn’t: Super MedPac and the excise tax. Alongside that, it has a much more aggressive package of delivery-system reforms.

Monday, November 16th, 2009

Tags: benefits, cms, costs, entitlements, house bill, medicare, reform
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Taxing and Saving?

Yesterday we looked at Ezra Klein’s list of ways Democrats could avoid a filibuster, and today abortion rights supporters might see a benefit to using a different way of bypassing the Senate tradition: Politico’s Jonathan Allen reports that “Democrats will almost certainly kill the anti-abortion Stupak amendment in the process if they go to Plan B on passing health care — using a filibuster-proof reconciliation bill — budget experts say.”

There’s been another theme emerging during this recess week besides more back-and-forth over the Stupak amendment: controlling costs and raising taxes.

Hot Air’s Ed Morrissey is unhappy with a proposal to increase the capital gains tax, saying, “The Pelosi Plan would strangle the economy.”

Wonk Room’s Igor Volsky makes a table that compares increasing the Medicare payroll tax (currently being floated in the Senate) versus the House’s surtax on high income earners.

Robert Laszewski expands on his nod toward an independent commission to look at health care costs. He thinks the fate of a bill “might just hinge more not on how ‘robust’ the public option would be but on how ‘robust’ an entitlement commission would be.”

Perhaps there’s another reason for a commission: Heritage’s Ed Haislmaier is unconvinced that Congress will make the future cuts to Medicare that it is proposing: “Enacting H.R. 3961 would mean that Congress has thrown in the towel on its previous attempt to control Medicare spending. It will also mean that no rational person can believe that Congress will actually enforce any new Medicare spending cuts included in pending health care legislation. That, in turn, would mean that new health care legislation would actually result in further, massive increases in either Federal borrowing or taxes.”

Lastly, a key architect of Massachusetts’ reform plan and an economic adviser to many Dems, MIT’s Jonathan Gruber, offers his thoughts on the amount of cost control in the bills. It’s not necessarily a ringing endorsement (via an interview with Ezra Klein):

Here’s how I think about this: Do you know Pascal’s wager? Why not believe in God? I think of health-care reform similarly. We don’t know if we’ll really bend the cost curve. But if we do this and we don’t do anything, we still go bankrupt in 100 years. We don’t lose much. But if we do it and it works, then it’s a savior.

It also moves the conversation on cost control in a way that’s impossible without this bill. It does real things on cost control, and then it does real things to make cost control more politically viable. It lays the groundwork for doing more. To kill this bill for not doing enough on cost control would be like criticizing the Yankees for not winning the Super Bowl. They won the World Series! They did what they could do!

Friday, November 13th, 2009

Tags: abortion, costs, house bill, medicare, reid, senate bill, spending, taxes
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Veteran’s Day Roundup

It’s a bit slow in the blogosphere on this Veteran’s Day – maybe not just because of the holiday, but also as a reaction to the past week’s overwhelming pace of activity. But never fear, it’s never entirely quiet out there.

Two bloggers are taking critical inventory of new state laws governing health insurance and the uninsured. Insure Blog’s Henry Stern is looking at “state experiments” in health reform. He focuses on a program in Ohio that is supposed to insurane an additional 52,000 residents by capping rates. After the program started, one Anthem Blue Cross Blue Shield carrier announced it was no longer selling a particular plan in the state. Stern concludes, “So what’s the lesson here? When you restrict carriers’ ability to compete in the market, consumers end up with fewer choices. Maybe that was the point of this exercise (wonders the cynic), but it certainly does not bode well for similar efforts on a national scale.”

Louise Norris ponders another state law, this time in Colorado, that prohibits underwriting small group premiums. Norris thinks there’s some flaws in the law’s design that could raise prices: “But while HB1355 was beneficial to groups with unhealthy members, the majority of small groups in Colorado had a discount before HB1355 took effect. And if those groups are unable to afford their new, higher rates, they can opt to cancel their coverage – which leads to higher prices for groups that remain covered. On a national level, as far as individual health insurance is concerned, HB1355 should be considered a warning sign. Getting rid of medical underwriting is the right, and fair, thing to do. But not if people can come and go as they please in the insurance system.”

Elsewhere, The New Republic’s Jonathan Cohn reports that a drug industry deal with the administration on health reform could actually lead to an increase in pharmaceutical prices. Cohn looks at a new report from the consulting group IMS Health, which found “that the drug industry will see average annual growth of 3.5 percent between 2008 and 2013.”

Hot Air’s Allah Pundit ruminates about former President Clinton’s talk with Senate Democrats: “I think he’s right that they’re winning, actually, if ‘winning’ is defined in terms of whether a bill passes or not. The abortion death struggle will give Reid a headache and they’ll probably have to end up dropping the public option, but Clinton’s strategy is a sound one: Pass anything you can pass now, then spend next year doing whatever it takes to woo voters and minimize the inevitable GOP gains in the midterms.”

James Capretta on Critical Condition examines the health overhaul bills’ efforts to contain costs and concludes, “The federal government, subject as it is to the constraints of politics, can’t do it. The only way to slow the pace of rising costs without sacrificing quality is by building a functioning marketplace, with cost-conscious consumers driving the allocation of resources. The government must play an important oversight role in such a marketplace. But if we rely on politicians, or even commissions that answer to them, for cost control, what we will get is lower quality, not more efficiency.”

Former Speaker of the House Newt Gingrich, R-Ga., is guest posting on Marilyn Werber-Serafini’s blog about health care fraud and abuse. He asks, “Are the anti-fraud efforts contained in the leading Senate and House bills likely to produce significant savings? What sort of provisions should be contained in order to maximize savings?” Responders include Henry Aaron, John Goodman, Uwe Reinhardt and Marilyn Werber Serafini.

And Don McCanne of Physicians for a National Health Program, a veteran, reflects and points to a new Harvard study estimating 2,266 veterans died in part because they lacked health insurance and access to care. McCanne, a single-payer supporter, writes, “How can we continue to support a fragmented, dysfunctional financing system that allows some of our veterans (not to mention tens of thousands of others of us) to die merely because we have placed a higher priority on nurturing the private insurance industry than we have on improving access for everyone through a more effective health care financing system? Our veterans. How can we let them down like this?”

Wednesday, November 11th, 2009

Tags: clinton, costs, gingrich, pharma, reform, rx, state, veterans
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Anticipating The Finance Vote

The New York Times is inviting readers to start a conversation as the Senate Finance Commitee finally ends its own — members are scheduled to vote shortly on the committee’s health overhaul bill, the product of months-long negotiations and the last major congressional panel to take up reform.

The only committee member tweeting today is Orrin Hatch, R-Utah, who announces (unsurprisingly) “I will be voting against the Finance Committee health care bill today.”

Commentators are still buzzing about the insurance industry’s unexpected Sunday night report (pdf) saying the committee’s bill would significantly raise premiums.

The Atlantic’s Marc Ambinder reports on the reaction: “Hoping to pop this trial balloon before it expands, the White House and allies have counterpunched with an alacrity unfamiliar to Democrats. They’re first attacking the industry’s motives, which isn’t surprising. The Senate Finance Committee’s health staff, on the White House’s urging, held an unprecedented background call with more than 50 reporters this afternoon to rebut the report’s substance.”

Politico’s Chris Frates has his own summary of remarks from report author PriceWaterhouseCoopers: “Hey, we weren’t paid to evaluate the effects of the entire bill, but rather a small slice of it.”

The Washington Post’s Ezra Klein looks at numbers being floated by the White House compiled by MIT economist Jon Gruber, and says, “Gruber certainly has a lot less incentive to twist the facts than the insurance industry does, and his numbers, at least, are free from any glaring deficiencies.”

And National Journal’s Marilyn Werber-Serafini queries her experts, “How much merit is there [to the report]?” Thoughtful but predictable responses follow from Michael Cannon, John Goodman, Len Nichols and Ron Pollack.

Many reports are focused on how Republican Olympia Snowe, Maine, will vote, but The New Republic’s Jonathan Cohn reports that “one Democrat also remains a question mark: Ron Wyden.” An interview follows.

Cato’s Michael Cannon looks beyond today’s vote and predicts trouble: “The problem that Democrats have faced from Day One is finally coming to a head. The Left and the health care industry both want universal health insurance coverage. The industry, because universal coverage means massive new government subsidies. The Left, because that’s their religion. But universal coverage is so expensive that Congress can’t get there without taxing Democrats.”

Elsewhere, the Galen Institute has launched a new health reform site, healthreformhub.org that rounds up conservative analyses and opinion.

Tuesday, October 13th, 2009

Tags: ahip, baucus, costs, finance committee, insurance, reform, snowe
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AHIP’S Awakening

On the eve of the Senate Finance Committee vote, America’s Health Insurance Plans, the key insurer lobby, has emerged from the sidelines with a critical new study (pdf) by PriceWaterhouseCoopers that finds the bill will increase the average cost of a family plan.

The insurance lobby was a key opponent of President Clinton’s reform plan in 1994, most famously producing the “Harry and Louise” ads, supported the broad principles of the Democratic health overhaul intiatives. Bloggers are wondering if this apparent change in course could be a game-changer in the larger debate.

Politico’s Chris Frates headlines his post “And The Knives Come Out” and writes, “This could be a turning point that the White House and Baucus worked hard to avoid – when industry begins to publicly oppose Democratic reforms.”

Tevi Troy of the National Review’s Critical Condition says “Losing the insurers at this late hour is a blow to the White House’s hopes of keeping key industries aboard as the Baucus bill approaches a Finance Committee vote tomorrow. In addition, the study is giving Republicans ammunition against the Baucus bill.” He goes on to note: “trying to prevent people from feeling actual health-cost increases is one of the reasons that American health-care costs so much in the first place.”

The Washington Post’s Ezra Klein jokes, “In the hallowed tradition of the tobacco and energy industries, the health insurance industry has commissioned a report projecting doom and despair for those who seek to reform its business practices.”

The New Republic’s Jonathan Cohn says though PriceWaterhouseCoopers is probably “right about a few things,” the report makes several assumptions: “Plenty of experts, including the CBO, don’t think health care providers will simply charge private insurers more to make up for declining revenue from Medicare. The experts could all be wrong, but PriceWaterhouseCoopers doesn’t even acknowledge this belief let alone explain why it might be wrong. Indeed, nowhere in the document does the firm reveal its methods, which is interesting since–unlike CBO or even, say, a private outfit like Lewin–PriceWaterhouseCoopers is not particularly known for this sort of modeling.”

Heritage’s Ernest Istook defends the report: “The PWC projections track what The Heritage Foundation and many others have said about the legislation: It does not save money. It simply taxes those who have health coverage and uses the money to give care to others.”

But the American Prospect’s Adam Serwer thinks lawmakers could address AHIP’s concerns: “Despite the hype this seems far from a knockout punch, since there’s still time to fix things in conference if the bill passes the finance committee, and some of the things that AHIP wants changed health-care reform advocates probably want, too. It’s mostly politically frustrating for the White House, who seem to have assumed that all the ‘relevant stakeholders’ had been placated. By ‘relevant’ of course, I mean moneyed interests, not, you know, the American people.”

Monday, October 12th, 2009

Tags: ahip, costs, finance committee, insurance, reform
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Still Chewing Over the Baucus Bill

Bloggers just can’t get enough of the Senate Finance Committee health bill…

Bob Laszewski says that “we could be on our way to devastating the health insurance risk pool” with the Baucus bill “all but gutting” fines for not buying insurance, which may result in not enough healthy or young people buying policies to help stabilize the risk.

Cato’s Michael Cannon says a “fail-safe” inserted into the Finance bill that would automatically cut the cost of the bill should it increase the deficit would be ineffective since “automatic spending cuts never work because today’s Congress cannot bind future Congresses.”

Keith Hennessey writes, “numbers matter,” and spotlights “important numbers and economic forces in these bills that are receiving insufficient attention.”

The Washington Post’s Ezra Klein points out a key difference between reform in 1994 and 2009: “Health-care reform never came to a vote. No one ever had to vote for it or against it. Nor did it ever face down a filibuster. It collapsed long before any procedural impediments were put in its way. This year, something would have to change very drastically for health-care reform to collapse before a vote. That means the few swing votes are going to have to face the pressure of standing in the way of the Democratic Party’s top priority since the days of Harry Truman.”

The Huffington Post broke a story Thursday afternoon that’s been getting a lot of attention — according to Sam Stein, “Senate Democrats have begun discussions on a compromise approach to health care reform that would establish a robust, national public option for insurance coverage but give individual states the right to opt out of the program.” The New Republic’s Suzy Khimm responds, “the fact that we’ve moved from discussing the viability of having a bill at all to trying to hammer out the details is a promising sign overall.”

On AEI’s Enterprise Blog, Former House Speaker Newt Gingrich, R-Ga., says “President Obama has contradicted a number of assurances he gave to the American people,” listing six in particular.

Mother Jones’ Kevin Drum looks at why the U.S. health care system costs so much more than other countries:

We can jabber all we want about incentives and greed and systemic waste, but the bottom line is that if we want to do anything more than nip around the edges, we’d have to pay doctors and nurses less, pay pharmaceutical companies less, pay insurance companies less (or get rid of them entirely), pay hospitals less, and pay device makers less. That’s a lot of very rich and powerful interests who will fight to the death to prevent any serious cost cutting, and it’s why Obama and the Democrats in Congress have largely chosen to buy them off instead.

Friday, October 9th, 2009

Tags: baucus, costs, finance committee, obama
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CBO Strikes Again

The Congressional Budget Office released its updated cost estimate of the Senate Finance Committee bill Wednesday afternoon following hours of Twitter speculation among health policy journalists and wonks. The mood was aptly captured by Politico’s Mike Allen, who declared “CBO OMG” in his daily agenda spotlight, Politico Playbook.

CBO Director Douglas Elmendorf was even more serious than usual, and just gave a run down of the estimate that’s shorter than the official report delivered to Finance Chairman Baucus.

Heritage’s Conn Carroll: “The New York Times awarded Baucus with the headline that the White House has been searching for since the debate first began: “Health Care Bill Gets Green Light in Cost Analysis.’” Carroll says, “But this headline and the accompanying article are fundamentally dishonest,” because it’s not an official CBO score (it was a called “an analysis”), but rather the ‘Chairman’s Mark’, which is written in laymen’s terms. Carroll continues, “Not only does the Baucus bill not even really exist, just a Vapor Bill filled with conceptual language, it is about to be completely thrown out the window when Senate Majority Leader Harry Reid (D-NV) merges it with the deficit busting HELP bill to move it to the Senate floor.”

The Washington Post’s Ezra Klein: “Meet the New Health-Care System, Not That Different From the Old Health-Care System.” He goes on. “This bill will change the insurance situation for 37 million legal residents, 29 million of whom would otherwise be uninsured. That’s a big step in the right direction. But most people will never notice it. When I got an early glimpse of the Senate Finance Committee’s bill back in June, I called it “comprehensive incrementalism,” and I stick by that label. It makes a lot of things a bit better, but it’s not root-and-branch reform.”

Hot Air’s Allah Pundit on the line in the analysis “Those estimates are all subject to substantial uncertainty:” “Expect that to be a key GOP talking point given that (a) amendments to Baucus’s bill will wreak havoc with this analysis and (b) Medicare’s initial projection of $12 billion in expenditures for the year 1990 turned out to be “uncertain” too. How uncertain? Actual 1990 expenditures ended up at $107 billion, a cool 800 percent higher than Congress thought they’d be. Woe unto him who relies on any conservative estimate of how much a giant social program will cost.”

The New Republic’s Jonathan Cohn: “This is something we’ve known for a while: The Senate Finance bill isn’t as generous or as protective as it ought to be. But the fact that the measure would actually save money means, or should mean, there’s a bit more room (financially and politically) to throw additional funds at expanding/improving insurance coverage–ideally, by raising a little more money in taxes and/or offsetting savings.”

Donald Marron says the cost estimates released don’t represent the whole picture: “There is a difference between the cost of the Baucus bill ($904 billion) and the cost of its provisions to expand coverage ($829 billion). It is understandable that most commentary focuses on the health insurance provisions. But we should not forget the other $75 billion in spending on other initiatives. Dollar-for-dollar they deserve as much scrutiny as the coverage expansions.”

Wonk Room’s Igor Volksy prepared a table that compares the first Finance bill draft with the final bill.

The Atlantic’s Megan McArdle: “So most of the major components of the program are scheduled to either cost more, or raise less revenue . . . but overall, it’s generating a bigger surplus. It’s the healthcare economist’s version of “We’re losing money on every unit, but we’ll make it up in volume!”

And in a more neutral take, Jacob Goldstein of The Wall Street Journal’s Health Blog identifies “Five Key Numbers,” plus a special “bonus” number, on insurance co-ops.

Thursday, October 8th, 2009

Tags: cbo, costs, finance committee, reform
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Retail Politics

Right-leaning bloggers are going to their ideological roots today to express their views on health policy and Democratic health overhaul proposals.

Heritage’s Conn Carroll says the best policy approach to address problems in the health care system is consumer driven health care, and lists “six key principles of reform that will bring sanity to our nation’s health care system,” which include individuals buying their own health insurance and “transparent” pricing.

Ed Morrissey looks at a new study on retail clinics in Minnesota and says private sector health services work. He concludes, “If we want to reform care, bend the cost curve downward, and promote supply in the health-care industry, we need to learn the lesson from retail health clinics. The top-down reform proposed by Congress threatens to stop real reform and amplify everything that’s currently wrong with the system.”

A long interview in The National Review with Cato’s Michael Cannon brings out the libertarian perspective on policy. A key statment: “Again, when government compels people to purchase health insurance and dictates what they purchase, costs will climb and quality will stagnate. Free markets will not provide universal health-insurance coverage. And that’s okay, because free markets will reduce unmet need by making medical care more affordable — which also makes it easier to meet what need remains.”

Meanwhile, liberal bloggers are focused what President Obama might say in his “major” address to Congress next week.

The Washington Post’s Ezra Klein did some digging and reports that there are two groups vying for the upperhand: “The administration is going to put a plan down on paper. The question is what it will say. Conversations with a number of White House officials make it clear that, at this point, even they don’t know. The argument was raging as recently as last night, and appears to have hardened into two main camps. Both camps agree that the cost of the bill has to come down. The question is how much, and what can be sacrificed.”

The buzz is that the cost will come down to $700 billion over 10 years, instead of $1 trillion. The New Republic’s Jonathan Cohn mulls over the implications of lowering a bill. He writes, “Predictably, the compromises a $700 billion bill require are a lot more severe than the compromises in a $1 trillion bill.”

Lastly, the newest edition of Health Wonk Review is up at the Ludicus Project.

It’s chock full of links to articles and reports and ends with a referral to Mad Kane’s limerick:

Dear Obama, the GOP’s clear:
Won’t support any health reform. Hear?
You can whittle the bill
Down to bupkis — you still
Won’t get votes. Yes they’ve duped you, I fear.

Your naivety’s hurting our cause.
And so how about taking a pause?
Work with Dems on the Hill
To create a fresh bill
That has nary a GOP clause.

KHN: Kaiser Health News

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