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Health Care Summit: Health Care Reform and Deficit Reduction

If the Congressional Budget Office is the referee for lawmakers, then health care reform and deficit reduction is a sport in which everything is a close call at the plate. The CBO admits that its estimates are far from perfect and depend on a number of uncertain variables. Yet, lawmakers frequently commend the CBO as a respected, well-run, independent governmental agency.

That said, here’s what you need to know about the CBO, health care reform and deficit reduction, specifically as it relates to the Health Care Summit. The CBO says Democrats’ version of health care reform will reduce the deficit by more than $100 billion in the first decade and possibly more than $1 trillion in the second decade. Republicans’ version of health care reform will reduce the deficit by $61 billion in the first decade. Thus, the Democrats’ version is seemingly better, but it might also be riskier. With greater upfront expenditures and enacting a more comprehensive version of reform, there is less certainty. Maybe the Democrats’ version won’t substantially change the deficit; maybe it could save $3Trillion….

Health Care Summit Blog: Health Care Reform and Deficit Reduction

2:40PM. Vice Pres. Joe Biden. Introduces health care reform and deficit reduction. Says health care costs have doubled over the last decade, wrecking individual, state, and federal budgets. Both parties are facing rising Medicare costs that could double again in the next decade to $1.7T in 2019. Claims that health care reform (the Senate plan) will save $1T over the next two decades. Admits numbers are estimates, but the bills will save money. Says the goal has to be to provide reasonable care to seniors without bankrupting the country.

2:50PM. Rep. Paul Ryan. Agrees health cost inflation is driving us off a cliff. Says that entitlements have become an empty promise to Americans. Claims CBO score is misleading because bill takes 10 years of taxes to generate six years of health care and that the real cost of the bill would be over $2T without this discrepancy. Reiterates philosophical difference about the role of government in health care system.

2:55PM. Pres. Obama. Indicates strong disagreement on the numbers. Questions whether Republicans think Medicare Advantage is working. Claims the private insurance industry that runs the Advantage Program is wasteful, could be used to close the donut hole. Says nobody can claim that seniors, as a group, are better off without Advantage Program.

3:00PM. Rep. Xavier Becerra. Claims there’s no point in continuing discussion unless there’s an agreement to trust CBO. There is a back and forth between Reps. Ryan and Becerra about whether both sides are accurately representing CBO scores. Becerra claims that the CBO says that the Senate bill reduces the deficit, bends the cost-curve, and generates savings to close the donut hole for seniors.

3:10PM. Sen. Chuck Grassley. Says CBO recognizes double accounting that distorts numbers. Says Democrats are trying to count dollars twice. Claims that people aren’t cognizant of the consequences of their actions. Says House bill hits small businesses too hard. Senate bill hits middle-class too hard. Says this is the first time federal government has ever said that “you have to buy something,” referring to the individual mandate. Claims reform puts health care institutions and deliver in jeopardy, that rural and downtown urban America won’t tolerate hospitals closing down.

(Fact-Check: In this NY Times article, the CBO tries to explain why it’s okay to count dollars twice.)

(Pres. Obama says without the courage to cut Medicare Advantage, state and federal budgets will get swallowed up, and people aren’t any better off and hospitals will be unaffected.)

3:20PM. Sen. Kent Conrad. Calls entitlements 800-pound gorilla in the room. Argues Medicare will go broke in 8 years without reform and that denying the need for Medicare cuts is admitting that the country will drive over the cliff. Says Sen. Coburn’s remark about 5% of chronically ill Medicare patients using 50% of budget is the most important comment of the day. Says the average senior is taking 16 pills a day, but medically only needs 8 of the pills. Some pills work against each other.

3:25PM. Rep. John Boehner. Claims that the thing he’s heard more from Americans than anything else in the last 6 months is to scrap the current bill. Claims health care reform amounts to a new entitlement program that will bankrupt the country. Calls reform dangerous experiment. Says despite problems, the country has best health care system in the world. Calls mandates unconstitutional. Claims in five years everybody will have to get health insurance through exchange. Says Senate bill allows for taxpayer-funded abortion. (More shifting, tension in the room.)

(Pres. Obama implies that Boehner is taking a good discussion and inserting partisan talking points. Says he’ll get back to Boehner about his issues after the Summit.)

3:30PM. Rep. Jim Cooper. Welcomes bipartisan competition on deficit reduction, hopes it’s supported by votes. Claims people talk tough, but don’t vote tough. Claims Congress has habit of leaving tough issues to successors. Says that too many members of Congress are unwilling to even accurately measure the deficit problem and that both parties are to blame.

3:35PM. Sen. John McCain. Argues that California and Texas have implemented effective medical malpractice reform. Lawsuit filings are down. Doctor recruitment is up. Claims all the federal government has to do is enact this reform to see similar benefits. Says he understands majority’s frustration over not getting their agenda through, but reconciliation is inappropriate for 1/6 of federal budget.

(Pres. Obama says Americans don’t care about Congressional procedures, but that they believe a single majority vote is legitimate. Denies that medical malpractice reform will save a substantial amount of money, $5B a year at most. Wants to pursue some version of medical malpractice reform, nonetheless.)

3:45PM. Sen. Dick Durbin. Says that as a lawyer he argued for both sides concerning medical malpractice reform. Reiterates $5B a year is not significant savings but more will die if medical malpractice is enacted. Argues that it’s an important issue but not as important as it’s made out to be. Claims federal employees with government-administered health insurance have the best health care in the world.