Senate Finance Committee Chairman Max Baucus (D-MT), who ruled single payer off the table before he even started considering healthcare reform, is now trying to pressure the Congressional Budget Office (CBO) to judge the Baucus health plan financially sound.
- Their problem is in reality the Obama/Baucus Building Blocks plan does not control costs, and every independent analysis shows this.
- The House propoals for "Expanded and Improved Medicare for All" that the White House and Senate have pre-empted off the table do control costs.
Total Change in National Health Expenditures, in 2010 (in Billions) Under Different Health Reform Proposals:
Meanwhile, Baucus held a Finance Committee hearing last Wednesday (2/25/09) at which the sole witness was CBO Director Douglas Elmendorf.
According to CongressDaily (2/25), Baucus, other lawmakers, and "some special interest groups have not been particularly pleased with what they view as CBO's conservative scoring of some supposed cost-cutting efforts that are needed to help offset the enormous price tag" of overhauling the health care system under the Baucus plan.
Baucus said if healthcare reform is to pass, the CBO needs to "get ever more creative to find
pathways to get the savings that we have to have." (Edney, CongressDaily, 2/25)
Baucus told the head of CBO at last Wednesdays hearing that the Congressional Budget Office will play a significant role in efforts to overhaul the U.S. health care system because the agency's cost assessments will "make or break this enterprise," CQ HealthBeat. Experienced observers assert that this is Baucus way of pressuring the agency to come up with figures to justify the kind of healthcare reform Baucus wants. Similar pressure in the extreme was placed upon the CBO in the early 1990s when the Clinton health plan was being debated.
The CBO is responsible for scoring any legislative proposal for its true costs and savings. CBO has been recognized for the accuracy of its findings and projections and for its non-partisanship. In fact, a 1991 CBO study found that a single payer system in the US could cover all the uninsured at the (then) current level of spending or less because of reduction in administrative costs.
Many recently proposed healthcare plans, similar to the one Baucus says he is drafting, keep private-for-profit health insurance companies in the mix and are based on claiming hugh savings from such things as the introduction of computerized record keeping. These so called savings are then touted as the way the proposed plan can be paid for.
The CBO has issued a series of recent studies which have found that most savings claimed, in the effort to keep private-for-profit insurance companies in the mix, do not exist. Recent CBO studies of disease management, "medical homes," electronic medical records, comparative effectiveness research, a public plan that competes with the private insurers and others, do not save money as claimed. That is also what numerous peer-review academic research paper have found: Prentice care, Chronic disease management, health IT,,, they are all good things (and done better under the less fragmented more planned single payer plan), but they do not save money in the short or medium term.
Representatative Peter Stark's proposal is being used here to represent all "Medicare for All" like plans.
Building Blocks (i.e. build on what we have now) is the generic version of "keep the private insurance plans in place and increase coverage with mandates" per what President Obama and Senator Baucus are proposing.
Yup: Medicare for All is the economically conservative fiscally responsible plan!
But please don't take my word for it, or the old studies from CBO & GAO.
These charts and analysis are from the independent analysis by Commonwealth Fund which does NOT support single (they support the Building Blocks plan), like Clinton proposed during the campaign and Baucus and Obama are pushing now), and their partner in analysis is the corporate mainstream industry gold-standard Lewin Group (which is actually owned by United Health and so if biased, certainly is biased against single payer).
Here is what is really going on.
Change in Health Spending by Stakeholder Group, Billions of Dollars, 2010
What that table is showing is that all those other proposals -- not only those of Republicans Enzi, Baldwin and Burr, but alas even Building Blocks (aka: Obama and Baucus) and Wyden's -- amount to huge giveaways and bailouts for the private insurance companies. The mainstream Democrat "Building Blocks" plan increases costs overall, and to the federal government and for employers. So when they talk about cost control they know they are lying. Indeed, while the bipartisan Wyden plan saves the Federal Government money, it actually increases total costs even more and dumps those cost onto everybody else: states, employers, families and individuals. So when somebody talks about the CBO analysis showing Wyden's plan is somehow good (revenue neutral or saving the Federal government money), ask them if they know how it effects total costs and who pays more instead. They are all being at best completely disingenuous. Or just lying.
Among the plans that Commonwealth/Lewin looked at, only the Stark Plan (standing in, according to Commonwealth, for all versions of Medicare for All-like proposals, including Conyers HR-676) actually saves money for the overall system, the country as a whole. More on the differences between Stark and Conyers and why Commonwealth did not analyze Conyers is here.
This is no surprise really. GAO and CBO found the same thing in the 1990s when they analyzed single payer and found it really controlled costs and saved money. More recently, The Lewin Group has found the same thing repeatedly in analyses of state-ledvel single payer proposals.
Again, even opponents agree: only Single-Payer like plans can actually control overall total costs.
Oh, yeah it also is the only one that:
- is Universal, covers everybody, 100%
- is Comprehensive covers all health care
- Has no endless co-pays, deductibles, out of coverage, no medical bankruptcies
- Is supported by supported by 60% of the American people (outside of the beltway).
But inside the beltway they keep saying it is "off the table."
Why?
What are you going to do about it?
Call, write or fax Senator Baucus and tell him we need accurate complete numbers not creative figuring.
Single payer should be on the table and should be given a full and fair hearing by the Senate Finance Committee.
Senator Max Baucus
511 Hart Senate Office Bldg.
Washington, D.C. 20510
(202) 224-2651(Office)
(202) 224-9412 (Fax)