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Devastating news.  Douglas Elmendorf, director at CBO, told congress yesterday that the health care legislation would significantly increase deficit rather than save money.  

This is getting reported on MSNBC now, but I see nothing here discussing this.  

CBO Report

WASHINGTON (Reuters) - Congressional Budget Office director Douglas Elmendorf told lawmakers on Thursday legislation to expand health care coverage would increase federal healthcare costs "to a significant degree" and revenue will need to be found to keep from increasing the deficit.

There are savings that are very hard to articulate, but rethugs are using this report to pummel the healthcare bill.  

Elmendorf told the panel, "The coverage proposals in this legislation would expand federal spending on health care to a significant degree and in our analysis so far we don't see other provisions in this legislation reducing federal health spending by a corresponding degree."

mcjoan has a diary on the front page with more details

Originally posted to dangoch on Fri Jul 17, 2009 at 10:16 AM PDT.

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Comment Preferences

  •  Tip Jar (3+ / 0-)

    "War is Peace, Freedom is Slavery, Ignorance is Strength", George Orwell, "1984" -7.63 -5.95

    by dangoch on Fri Jul 17, 2009 at 10:16:42 AM PDT

  •  okay, one question: (5+ / 0-)

    WHICH healthcare bill is he referring to? The house bill or the senate bill?  There are at least two floating out there.

    You are entitled to express your opinion. But you are NOT entitled to agreement.

    by DawnG on Fri Jul 17, 2009 at 10:18:47 AM PDT

  •  Tax the rich / eom (6+ / 0-)

    Today's dessert special is Plain Baked Alaska

    by shpilk on Fri Jul 17, 2009 at 10:19:06 AM PDT

  •  This could kill healthcare (2+ / 0-)
    Recommended by:
    rock the ground, John Minehan

    If it does not reduce costs, then maybe dems should halt the bills moving through committee and find a way to cost cuts

    •  I suspect that will be the issue (0+ / 0-)

      wih any compromise.

      •  You can't give rethugs anywhere to push (0+ / 0-)

        they will push anything that is negative.  Their leach holders will pay anything to get this legislation killed.

        "War is Peace, Freedom is Slavery, Ignorance is Strength", George Orwell, "1984" -7.63 -5.95

        by dangoch on Fri Jul 17, 2009 at 10:41:24 AM PDT

        [ Parent ]

        •  I think we need to get this into the (1+ / 0-)
          Recommended by:

          private sector to the degree possible.  Costs only get contained by markets.

          •  Are you fucking serious? (0+ / 0-)

            No.  That's gotta be snark.

            Universally despised by all the right people.

            by The Creator on Fri Jul 17, 2009 at 11:09:04 AM PDT

            [ Parent ]

          •  Bull shit. Look at the cost to us. Because (0+ / 0-)

            of the private sector.  Contained Markets, it is to laugh.

          •  they do, eh? (0+ / 0-)

            then how did we get into this mess to begin with?

            It's almost ALL private sector markets ... that are rigged by the insurance companies to maximize profit.  How the hell can we contain costs when it's clear that this particular market benefits from us being sick, and they're beholden to their shareholders?

            When will we ever learn that PROFIT cannot be a part of the equation when endangering people's lives adds to a company's bottom line?--Earicicle

            by billlaurelMD on Fri Jul 17, 2009 at 11:10:51 AM PDT

            [ Parent ]

            •  The best way to control costs (2+ / 0-)
              Recommended by:
              IndianaDemocrat, Mother Shipper

              would be to have people pay their medical bills themselves and shop around for good deals.  

              The problem is that the costs are too high now to do that w/o an insurance model and, despite Web-MD, it is hard to shop around if you are not a doctor or a nurse.

              What you need is a co-op structure built around not-for-profits to negotiate insurance rates down.  USAA in car insurance is one model; another would be the health Plans of the Screen Writers' Guild and the Screen Actors' Guild.

              PPOs got doctors and institutional providers eat big discounts over the last 10-15 years.  Now the PPOs need to fork over.  

              •  It's Called CATSTROPHIC HEALTHCARE (2+ / 0-)
                Recommended by:
                John Minehan, Mother Shipper

                That, and percentage reimbursement, is what i've offered my employees for 7 years now. With higher lifetimes than I could ever afford under a standard, low-deductible program.

                You'd be AMAZED at how healthcare costs get cut when the employees learn what prescription drug prices ACTUALLY are.

                The stop going to Walgreen's and CVS, and start going online or to Walmart for drugs.

                One employee, last year, found a $1,200 price difference in CT Scans from one side of town to the other!

              •  The term "insurance" has evolved a meaning (1+ / 0-)
                Recommended by:
                John Minehan

                in the health care context that it doesn't have anywhere else.  The term "prepaid health care" is more apt to how many understand "health insurance".

                Comparing car insurance (which is also distorted by mandates, laws and regulations) to health insurance begs the fact that we don't expect our car insurance company to pay for our gas, oil, tires and maintenance.

  •  Revenue will be found through (3+ / 0-)
    Recommended by:
    Cedwyn, HeyMikey, The Creator

    a healthier, more productive citizenry that is working and able to pay taxes rather than ailing and infirmed unable to work.

    I don't think that the models that these guys are taking in the big picture, but that doesn't surprise me at all.  A zillion economists couldn't see a recession coming that anyone paying attention could have - and some did - predicted.

    •  It is very hard to score the intangibles (2+ / 0-)
      Recommended by:
      madmsf, HeyMikey

      you can bet the rethugs will not give a shadow of a doubt no matter what.  Anything that can be negative will be used by them

      "War is Peace, Freedom is Slavery, Ignorance is Strength", George Orwell, "1984" -7.63 -5.95

      by dangoch on Fri Jul 17, 2009 at 10:24:53 AM PDT

      [ Parent ]

      •  No it isn't actually. (3+ / 0-)
        Recommended by:
        Cedwyn, Cory Bantic, coffeetalk

        We can score the costs to our economy including loss of productivity from illnesses that could be prevented or controlled through decent basic healthcare access; we can score the cost to businesses in not only training costs for employess who have to be replaced; we can score the cost to our economy in lost business to other nations with national healthcare AND cite specific examples like Toyota going t Canada over the US because of the healthcare issue; we can score the cost to society of people needing emergency room care as opposed to catching illness at a more manageable stage; and we can score a whole lot more.  

        If any of these things were indeed "intagibles", we would not even have been able to make the case for change in the system in the first place.  We now have about two decades worth of data showing the situation reeling out of control.  Any honest survey of "cost" of a program should include reasonable measures of what other costs will be alleviated as a result - and they aren't doing that at the CBO.

        •  It sure isn't my expertize, but I'm just ringing (0+ / 0-)

          the bell to bring it to DKos attention.  CBO needs to work on scoring intangibles

          "War is Peace, Freedom is Slavery, Ignorance is Strength", George Orwell, "1984" -7.63 -5.95

          by dangoch on Fri Jul 17, 2009 at 10:39:42 AM PDT

          [ Parent ]

          •  And you have to figure in private health spending (3+ / 0-)
            Recommended by:
            inclusiveheart, RantNRaven, Vexed

            If my taxes go up $100/month, but my premiums-deductibles-copays go down $110/month, I come out ahead.

            It drives me nuts that nobody in the media looks at this.

            "The true strength of our nation comes not from the might of our arms or the scale of our wealth, but from the enduring power of our ideals." - Barack Obama

            by HeyMikey on Fri Jul 17, 2009 at 10:43:29 AM PDT

            [ Parent ]

            •  Since when does MSM do any thinking (1+ / 0-)
              Recommended by:

              They just "report".  Noe Andrea is saying bunch of congressional members want "more time".  Slow down.

              "War is Peace, Freedom is Slavery, Ignorance is Strength", George Orwell, "1984" -7.63 -5.95

              by dangoch on Fri Jul 17, 2009 at 10:46:08 AM PDT

              [ Parent ]

            •  But the CBO point is that (1+ / 0-)
              Recommended by:

              there is not indication that your premiums will go down.  

              In order for that to happen, the growth in overall health care costs -- what it costs to treat this medical condition -- has to go down.  And, while the bills out there do increase access to care, the CBO is saying that the overall cost of health care will not only NOT go down, but the curve will go "the wrong way" -- increasing more than it is now.  

              •  I ain't no expert (0+ / 0-)

                but I have tried to work my way through most of what is out there, and I also keep coming up short on what, if anything, is in any of these plans to reduce costs. The only thing I see is a $5,000 max outlay. That's good, I guess, but I'm not sure it's good enough. What is in any of the bills to reduce the costs of PREMIUMS? I don't deny I may be missing it. Can someone point it out?

                They don't win until we give up.

                by irmaly on Fri Jul 17, 2009 at 11:18:47 AM PDT

                [ Parent ]

                •  Yes. Look at this diary . . . (0+ / 0-)


                  The gist: There is now a Medicare board that recommends what treatments Medicare should and shouldn't pay for. They currently have no power to enforce their recommendations. Obama has just proposed to make their recommendations law unless Congress overrides them -- kinda like the military base closing commission.

                  I don't think this is in either bill, currently. But the diary I linked says Obama has just put it on the table.

                  "The true strength of our nation comes not from the might of our arms or the scale of our wealth, but from the enduring power of our ideals." - Barack Obama

                  by HeyMikey on Fri Jul 17, 2009 at 11:46:06 AM PDT

                  [ Parent ]

              •  See new front page diary on CBO report. NT (0+ / 0-)

                "The true strength of our nation comes not from the might of our arms or the scale of our wealth, but from the enduring power of our ideals." - Barack Obama

                by HeyMikey on Fri Jul 17, 2009 at 11:46:37 AM PDT

                [ Parent ]

    •  Fairy dust. (1+ / 0-)
      Recommended by:
      Jay Elias

      We'd better be able to do better than that.

    •  This is not only about finding revenue (0+ / 0-)

      it's about slowing the growth in health care costs and spending.  

      Obama has promised that any successful bill must do that.  The CBO report is saying that, as far as it can tell, what is on the table now does not slow that growth -- it does not, in the expression Obama has repeatedly used, "bend the curve."    

  •  Basic structure looks good. (0+ / 0-)

    There are some cheaper ways to do this and I suspect we will see these changes in practice.

  •  The problem is that DEMS are using the CBO... (9+ / 0-) to hammer real healthcare reform. Elemendorf's statement was elicited by Kent Conrad, and was immediately used by Max Baucus to attack the House healthcare reform plan.

    The Blue Dogs are still playing offense, while we - the proponents of a robust public option that will actually restrain cost increases - are still playing defense. This is the fault of Democratic leadership in Congress.

      •  Obama should let Reid know that his job... (2+ / 0-)
        Recommended by:
        LordMike, The Creator on the line. Ask Trent Lott how much the majority leader's position is worth once a White House held by your own party let's it be known that it would prefer to change leaders. YOU'RE TOAST.

        Obama has Reid by the balls. He should start squeezing. If Reid can't deliver the Senate for a reform plan with a robust public option, then Reid must go.

    •  Exactly. We can be our own worst enemy (1+ / 0-)
      Recommended by:

      "War is Peace, Freedom is Slavery, Ignorance is Strength", George Orwell, "1984" -7.63 -5.95

      by dangoch on Fri Jul 17, 2009 at 10:29:01 AM PDT

      [ Parent ]

    •  The probelm is that this will be (1+ / 0-)
      Recommended by:

      the next MSM/GOP talking point, sigh.It might affect healthcare poll number if Dems don't counter it.
      I don't think we should just blow the CBO report off, Dems can use this opportunity to make sure we get a strong public option reduces healthcare cost overtime.

      •  The exact reason for calling this out (1+ / 0-)
        Recommended by:

        We need to react to this news because the rethugs sure are.  We need to counter this.  Slinkerwink, nyceve, we need to make this top priority so the rethugs don't get any foothold

        "War is Peace, Freedom is Slavery, Ignorance is Strength", George Orwell, "1984" -7.63 -5.95

        by dangoch on Fri Jul 17, 2009 at 10:38:12 AM PDT

        [ Parent ]

        •  This CBO report is getting a lot of play (1+ / 0-)
          Recommended by:
          in the MSM, its on every major News site even MSNBC. So far i have not seen any Dem countering or pushing back on this report.

          Dems need to take to the airwaves and push back. Sunday talk shows would be parrating this report Ad nauseam.

          •  Shrum is on now. With help like that, who needs (1+ / 0-)
            Recommended by:


            "War is Peace, Freedom is Slavery, Ignorance is Strength", George Orwell, "1984" -7.63 -5.95

            by dangoch on Fri Jul 17, 2009 at 10:51:29 AM PDT

            [ Parent ]

          •  You can't "push" (0+ / 0-)

            a noodle.  It's time to wake up and realize they don't have this thing well structured yet, not by miles, and they're not gonna have it well structured in the next three weeks.

            •  The problem is (0+ / 0-)

              they aren't ever going to have it structured because they are not willing to take on the insurance companies. They have to implement something in the plans that actually reduces (or stalls out) premium and copay costs. Until that happens, we will keep running up against the same brick wall. You can't have it both ways: lightly regulated private, for profit insurance companies--totally focused on bottom line profits OR lower premiums and co-pays and better access.

              You simply can't have both!

              They don't win until we give up.

              by irmaly on Fri Jul 17, 2009 at 11:25:10 AM PDT

              [ Parent ]

      •  It is NOT a "talking point" (0+ / 0-)

        it's a real and true fact, and we had better deal with it.

        •  It is a completely irrelevant fact (2+ / 0-)
          Recommended by:
          Cedwyn, The Creator

          And it would only be relevant if ANY of the alternative programs - Baucus's, Conrad's, etc.) promised to be more effective in constraining federal healthcare expenditures, and it's a fact that they'll be WORSE.

          •  Obama has repeatedly promised (1+ / 0-)
            Recommended by:

            that health care reform would dramatically slow economy-wide health care cost growth AND not add a dime to the deficit.

            He has said those things many times.  I have always taken him at his word.

            •  It will dramatically slow economy-wide... (0+ / 0-)

              ...cost growth, and the CBO doesn't contradict that. The CBO scored only federal government costs, and federal government costs will grow, but be more than offset by economy wide savings.

          •  It is NOT irrelevant -- Obama has repeatedly (0+ / 0-)

            said that any legislation must "bend the curve" -- i.e., cut the growth of health care costs and overall spending in this country.  (We already spend far more per capita than other countries.)  

            The CBO is saying that, not only does this NOT "bend the curve," but it actually makes the curve worse.  

            There's no way that it can be ignored.  It's one of Obama's main criteria for a successful bill.  

            •  It does bend the curve... (1+ / 0-)
              Recommended by:

              ...but CBO admits it didn't score that bend. The only aspect of any proposed healthcare reform plan that promises to bend the cost curve in the long-term is the public option, because it will permit a large public program to exploit the same administrative efficiencies and non-profit advantages that give Medicare such a huge advantage over private insurers.

              But the CBO is only scoring the direct effects on federal govt. expenditures, and is not considering the secondary benefits of cost advantages that will permit the public option to provide competitive pressure on the private insurers. It's this competitive pressure on the private insurers that will "bend the curve" on aggregate healthcare costs.

              •  Where is the CBO conclusion (0+ / 0-)

                that it "bends the curve"?  The express quote from the CBO is that it does NOT bend the curve.

                You are assuming it does, and that's fine.  But Congress does not take assumptions of people who are advocating for a position.  They need the CBO to say it will bend the curve, and the CBO has expressly said that it will not.  The CBO is perfectly capable of scoring the kinds of things you mention, so if that will make the difference, Democrats should request that it will be scored.

                And besides, it's not about just health insurance premiums.  "Bending the curve" is about health care costs -- what it costs for a routine delivery of a baby, what it costs to treat an elderly person for pneumonia, that kind of thing.  There seems to be nothing I've seen that would slow the growth of health care costs in this country.  

                •  The public option will restrain healthcare costs (0+ / 0-)

                  Doesn't Medicare currently provide huge savings over the private insurance industry? Of course it does, as evidenced by the fact that Medicare Advantage is subsidized 12% to 13% by taxpayers and still only achieves a 20% market share against traditional, government Medicare.

                  The public option bends the curve on aggregate healthcare costs, but CBO isn't scoring that. It's only scoring federal govt. expenditures, which will go up in the near-term as a result of the public option.

                  Again, the CBO is only scoring federal expenditures, which will go up in the early years even if the curve is bent on aggregate expenditures. The CBO does not score beyond the ten years, and does not consider the beneficial secondary impact of lower health care costs on the federal budget.

  •  I'm hating Ron Wyden right about now (4+ / 0-)
    Recommended by:
    askew, LordMike, Cory Bantic, The Creator

    When you see a letter written be Dinocrat Ben Nelson and signed by Lieberman, Collins, Snowe (in the category of "with friends like these who needs ..." ) and Landrieu, you don't expect to find Ron Wyden's signature as well.  So much for being a progressive.

    I've written an e-mail to Wyden and tried to make it as polite as possible (very difficult to do).

    The letter cites the CBO director's testimony as a reason for the delay.

    We've run up the deficit to 1) "free" the Iraqis, and to 2) make the banks happy, yet the health of Americans, who cares about that?

    It's why I can't get too worked up about health-care reform.  It won't happen.  This is not our country.  

    Why make my blood pressure rise?

    Then I might need to see a doctor, heaven forbid.

  •  Read about this a couple of days ago. (2+ / 0-)
    Recommended by:
    Jay Elias, RantNRaven

    And now the so-called centrists are urging everyone to "slow down" on the bill (iow, let their insurance company overlords have even more a chance to lobby and kill any meaningful reform).

    Regardless of how many folks think the CBO report is important, the deficit should be the priority, that is not the reason why these politicians are urging a slow-down, imo.  For me, I'd rather pay more in taxes or even have my benefits taxed so that everyone can have decent health care coverage.

    The changes, the "slow-down" these "centrists" -- Lieberman, Snowe, Nelson, Collins, Landrieu and Wyden  -- want are not about benefiting the American people.

    •  Doesn't matter. (1+ / 0-)
      Recommended by:
      Jay Elias

      Their motivation is completely irrelevant.  This project is NOT in good shape yet, and it boggles my mind that we can believe it will come magically into focus in the next three weeks.


      •  three weeks? (0+ / 0-)

        it better come together faster than that.  senate is still sitting on its hands without finance

        "War is Peace, Freedom is Slavery, Ignorance is Strength", George Orwell, "1984" -7.63 -5.95

        by dangoch on Fri Jul 17, 2009 at 11:02:30 AM PDT

        [ Parent ]

      •  Eh. (2+ / 0-)
        Recommended by:
        billlaurelMD, The Creator

        mcjoan has a post up right now refuting the media coverage on the CBO report, especially as Elmendorf walked back some of his findings before the Ways and Means Committee:

        But the budget outline that passed the Senate Budget Committee requires a fully funded health reform bill, and both the Senate Finance Committee and the House Ways and Means Committee are proposing different options to pay for reform and ensure that the bill does not add to the deficit. For his part, Elmendorf, is isolating the ledger of the federal government from the context of the entire system. In other words, since many of the savings from reform won’t be reflected in the federal budget, Elmendorf does not consider them. But modernizing the health care system (implementing electronic medical records, health information technology) and reforming the way Medicare and Medicaid reimburse providers will save money for the system as a whole. As Melinda Beeuwkes Buntin and David Cutler pointed out in a recent analysis, these savings can total to some $2 trillion. In fact, even the industry is on record as saying we can reduce the growth rate in annual health spending by 1.5 percentage points a year over the next 10 years, lowering spending overall health care spending by $2 trillion (this represents a 20 percent reduction in projected growth.) Elmendorf is looking at the trunk of the elephant and not the whole....

        In testimony before the House Ways and Means Committee, Elmendorf walked back his comments, saying that in some ways federal spending will increase and in some ways it will decrease.

        You seem awfully willing to believe the implications of a poorly reported story.

    •  It is extemely hard for me... (4+ / 0-) see how any of the current plans qualify as "meaningful reform" in the first place.

      Any plan that is endorsed by the AMA and Wal-Mart is essentially assured to be a bad plan and a disaster for the American people.  If we're on the side of industry cartels and big business, we're on the wrong side.

      The urge to save humanity is almost always a false face for the urge to rule it. ~ H.L. Mencken

      by Jay Elias on Fri Jul 17, 2009 at 11:06:14 AM PDT

      [ Parent ]

      •  I don't disagree ... (1+ / 0-)
        Recommended by:
        Jay Elias

        ... and the double negative is illustrative of my frustration on this issue.

        I want more people covered for medical care.  I am not enamoured of this plan but if it is a step forward to getting more people covered, then I'll support it.

        What I do oppose is politicians who are overtly pandering to the insurance companies in an effort to block the bill entirely and rip out any benefit at all.

        •  I think we all want more people... (1+ / 0-)
          Recommended by:

          ...with more access to health care.

          What I fear, very much, is health care reform which resembles the TARP; in the pursuit of a laudable goal, a massive payout to the least deserving which transfers wealth away from ordinary citizens and to the most politically connected rent seekers.  At some point, if $0.25 cents of every health care dollar spent goes to helping people and $0.75 goes to industry, for example, we're getting almost no return on our investment.

          The urge to save humanity is almost always a false face for the urge to rule it. ~ H.L. Mencken

          by Jay Elias on Fri Jul 17, 2009 at 11:12:00 AM PDT

          [ Parent ]

      •  The proposed public option is meaningful reform.. (0+ / 0-)

        ...although not as good as single-payer. The public option will fairly quickly achieve 80% market share in the insurance market, from which we can more easily push for single-payer and completely wipe out the private heatlh insurance industry.

        •  I'm very unconvinced of this... (1+ / 0-)
          Recommended by:
          Mother Shipper

          ...not just the likely effects of a public option, but I'm also deeply skeptical that eliminating private health insurance companies will do much, if anything, to fix the structural problems in our health care industry.

          I'm not asking you to try to persuade me.  But eliminating the health insurers doesn't eliminate most of the problems.

          The urge to save humanity is almost always a false face for the urge to rule it. ~ H.L. Mencken

          by Jay Elias on Fri Jul 17, 2009 at 11:15:28 AM PDT

          [ Parent ]

        •  How do you figure this? (0+ / 0-)

          The public option will fairly quickly achieve 80% market share

          I want to believe, but I don't see how that can possibly happen if the public option isn't available to everyone.

          I am struggling with all this fast-moving health care activity, but I honestly do believe, until someone can convince me otherwise, that unless we have a public option open to everyone, we do not have any meaningful reform. If it is open to everyone, we can build on that. If it isn't open to everyone, it becomes nothing but a dumping ground.

          In fact, I thought most of us were going to hang with this as our line in the sand.

          They don't win until we give up.

          by irmaly on Fri Jul 17, 2009 at 11:31:01 AM PDT

          [ Parent ]

          •  It is available to everyone... (0+ / 0-)

   the long-term. For instance, although those covered by qualifying employer-provided plans are not eligible for the public option, those employers either are or will be.

            •  Huh? (0+ / 0-)

              those employers either are or will be

              How do you figure? I don't see in any of the bills where employers are eligible to take their employees to the public plan. I may be missing something, granted.

              They don't win until we give up.

              by irmaly on Fri Jul 17, 2009 at 12:05:16 PM PDT

              [ Parent ]

  •  Yeah, that is because the CBO does not factor (1+ / 0-)
    Recommended by:

    in the savings. Only spending.  Just the COST.  So, what ever projected money is saved say by streamlining medical records or more efficient care (read; less emergency room care); preventative medicine effects etc. is not in the CBO number.  You see how it is not an actual accounting of what the REAL cost/gain is?  Just the spending/cost.

    I think you need a better understanding of the issue prior to writing a diary.

    It is not so devastating if you understand what the CBO number actually is.

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