Kennedy plan estimated to cost $4 trillion, four times CBO estimate; legislation pushed at frantic pace

The Congressional Budget Office (CBO) released a cost estimate of $1 trillion over 10 years for the Democrats’ Senate bill, scheduled to be marked up in the Health, Education, Labor and Pensions (HELP) Committee on July 18. This draft did not include provisions to increase Medicaid eligibility to 150% of poverty, or subsidies to persons earning up to 500% of poverty. It would leave 30 million uninsured (American Spectator, AmSpecBlog 6/16/09).

Adding in these provisions, which would lower the uninsured to less than 1% of the population, would raise costs to $4 trillion, according to calculations by Health Systems Innovations Network (HSI). About 79 million Americans would shift from private to government insurance. There is no mention of removing the tax exclusion for health insurance (worth some $300 billion per year) or of changes to Medicare or Medicaid, except for the need to reduce fraud.

The CBO’s estimate of crowd-out (loss of private coverage) was 23 million. The CBO noted that if enacted the bill would break a key Obama promise that those with private insurance would not be harmed.

Leading Democrats such as Christopher Dodd (D-CT) complained that CBO did not take into account receipts or savings from increased tax revenues as people moved from employment-based to other coverage, payments of penalties by uninsured persons, and reductions in outlays for Medicaid and SCHIP—including reduced payments to physicians. Also the CBO refused to take Congress at its word on savings assumptions, as from prevention.

Dodd told reporters that “reform” would affect 100% of the population. He could not, however, answer questions about the cost. “Contentious issues like a public plan” had been intentionally omitted from the draft submitted to CBO (CNS News 6/17/09).

The New England Journal of Medicine continues to weigh in with frequent articles.

“Some of the most prominent shortcomings of the U.S. health insurance market are rooted in the fact that the system is a voluntary one,” write Linda J. Blumberg and John Holohan in the issue slated for publication on July 2. They favor an individual mandate as the most politically feasible route to universal coverage.

In an update on congressional action dated June 18, John Iglehart notes the accelerated timetable for passing a bill through the House of Representatives by July 31. Neither Republicans nor the 50 Democrats in the House Blue Dog Coalition have participated in the secretive process.

A major issue is whether to eliminate the tax exclusion for employer-sponsored insurance—“the government’s third-largest health insurance expenditure (after Medicare and Medicaid).”

Iglehart also writes that the committees have yet to grapple seriously with the issue of what to do about the 21% reduction in physician Medicare fees scheduled for next January.

After the table-setting, the congressional posturing, and the Long Tease (the current stage) comes the scrum, writes New York Times columnist David Brooks. “You want the scrum to be quick before some of the interest groups realize they’ve been decapitated.”

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8 thoughts on “Kennedy plan estimated to cost $4 trillion, four times CBO estimate; legislation pushed at frantic pace

  1. 1.) Nothing formulated in secret is ever good
    2.)Maybe after we doctors have lost our jobs, then we will have time to get involved in politics, and go after these socialists politically and remove them from office. We are reaping the fruits of inattention.

  2. America is the land of the proud, the free, the independent, the self suficient, or at least it was at the founding. America is rapidly becoming the land of tyrannical government. Is it to be stand on your own two feet or be dependent ciphers? Do we want to be brothers keepers and be kept as members of the tribe, subjects of the ruler or do we want to be free men responsible for ourselves? It is either or, A or non A.

  3. Paul Begola, assistant under then-President Bill Clinton, was quoted as once saying, “stroke of the pen, law of the land, kind of cool!”. This is all which might be required of Mr. Obama if a Democratic Congress votes to exclude the tax benefits for private healthcare policies after passage of a ‘public option’…sure to cure most ‘shortcomings’ brought about by non-mandatory participation, as voiced by The New England Journal and Hillary Clinton.
    The accessibility and quality of our nation’s healthcare, along with the future of our profession, are on the line in this, thus far, non-debate.

  4. Just as a word of encouragement, I am a third year med student and am not in favor of the liberal plan. Sometimes I think I’m alone in this, but there are still conservatives! It is inattention that has allowed other less productive members of society to take over the policymaking. Pray for our country and our healthcare! God, the true healer on which this nation was founded, can heal our country IF we will turn from our wickedness and stand up for moral principles. THANKS to those who stand. God bless!

  5. The liberals in the Congress would love nothing more than to have the health care debate degenerate into matters of minutiae over dollars the government spends on programs it will “provide” through alterations of the Social Security Act and the tax code.

    Don’t be fooled by this. Health care is not fundamentally about which government programs should provide health care and “fund” it; rather, health care is about whether government should be involved at all, other than to protect the individual rights of the patients and physicians involved in those relationships. I advocate the latter position. Medical care is a private matter, and only the patient and physician are the proper focus of that relationship.

    It is an insidious evil in America today that the so-called humanitarian politicians are laying the seeds of America’s destruction; and it is a sad irony they are doing it in the name of “caring” for those who need medical care most, medical care that those same politicians will make impossible if they succeed with their altruistic goal of need over greed.

    It’s time to let the politicians know that they will have the blood of patients on their hands if they succeed in destroying the last remaining remnant of private medical care in America. If you care about your life, the lives of your family, and the future of America, it’s time to speak now, or there will be no America. It will have been destroyed from within by cutting it’s own throat.

  6. We have to do more than speak as no one but us is listening. Similar to what must happen with new Oman taxes, we must be willing to act in a unified and demonstrable way to show all Americans, political and patient, how necessary it is to have physician services as available as they are today. Time to organize and take a “time out” except for emergency care until the balance of power changes.

  7. Physicians and Specialist need to speak out and get connected with the grassroots organizations. If they don’t, they will lose what they have anyway. I find it ironic that most American citizens/patients are crying out against this “presrciption for disaster”, yet the medical community is basically silent. America does not want Universal Health Care.

    We need each other and you have our support. I never thought I would see the day where I am sitting in the exam room waiting for my doc to make a call to the government, to get approval for a procedure that would save my life. This is the HMO on steroids. Talk to your patients and get their feedback. They need you to stand up for them and stand with them.

    The Obama administration in essence will be playing God by determining who gets what, when and for how long. Suffering is a part of life, but not when it is forced upon someone who could otherwise make choices for themselves.

    The clock is ticking …

  8. Pingback: Kennedy bill breaks Obama’s promises « AAPS News of the Day

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