Health-care reform will not be remembered for its price tag
Ezra Klein
WashPost
The numbers came first. The Senate bill, we now know, costs a smidge under $850 billion during its first 10 years, cuts the deficit by $127 billion, and covers 31 million people. In the second decade, it cuts the deficit by an improbably large $650 billion. But we don't know anything else. We haven't seen the CBO's full score yet, nor do we know any of the specifics in the bill. Reid's office released the numbers before it let anyone see the language. It wants the numbers burned into the media's mind. They're the message, at least for now.
In a way, it's fitting. Health-care reform is increasingly hostage to numbers that are disconnected from the reality of the bill and its purpose. It's a real victory to push your bill below $850 billion if the point is to get it below $900 billion. But what if that's not the point? Most experts think the bill needs about $1.2 trillion to be truly affordable. Compromising beneath $900 billion might be necessary, but it's nothing to celebrate. It's a concession, not an accomplishment.
It is, in fact, quite far from the questions that will determine the bill's success. In 10 years, no one will remember whether the bill cost more or less than $850 billion, and I doubt that the public option, if it remains in the legislation, will be particularly relevant either. They'll remember whether the bill worked -- whether it covered people at a price they could afford, and began the overdue and urgent work of cost control. And we pretty much know the policies that will figure into the analysis.
First and foremost are the subsidies. And not just the premium subsidies. Keep an eye on the limits placed on out-of-pocket costs and the generosity of the basic benefit package. Helping people pay the premiums on a plan they can't afford if they get sick, or that doesn't really help them, isn't much of a victory.
(Continued here.)
WashPost
The numbers came first. The Senate bill, we now know, costs a smidge under $850 billion during its first 10 years, cuts the deficit by $127 billion, and covers 31 million people. In the second decade, it cuts the deficit by an improbably large $650 billion. But we don't know anything else. We haven't seen the CBO's full score yet, nor do we know any of the specifics in the bill. Reid's office released the numbers before it let anyone see the language. It wants the numbers burned into the media's mind. They're the message, at least for now.
In a way, it's fitting. Health-care reform is increasingly hostage to numbers that are disconnected from the reality of the bill and its purpose. It's a real victory to push your bill below $850 billion if the point is to get it below $900 billion. But what if that's not the point? Most experts think the bill needs about $1.2 trillion to be truly affordable. Compromising beneath $900 billion might be necessary, but it's nothing to celebrate. It's a concession, not an accomplishment.
It is, in fact, quite far from the questions that will determine the bill's success. In 10 years, no one will remember whether the bill cost more or less than $850 billion, and I doubt that the public option, if it remains in the legislation, will be particularly relevant either. They'll remember whether the bill worked -- whether it covered people at a price they could afford, and began the overdue and urgent work of cost control. And we pretty much know the policies that will figure into the analysis.
First and foremost are the subsidies. And not just the premium subsidies. Keep an eye on the limits placed on out-of-pocket costs and the generosity of the basic benefit package. Helping people pay the premiums on a plan they can't afford if they get sick, or that doesn't really help them, isn't much of a victory.
(Continued here.)
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