Max's Adventures in Wonderland

Why health care "reform" won't pay for itself


For Philistines like me, the mysteries of Washington can be both perplexing and wondrous. If you watched noted alchemist Sen. Max Baucus (D-Mont.), conjure up health care gold last week, you probably know what I mean.

Mercifully, House and Senate Democrats recently blocked amendments that would have required health care bills to be posted online for 72 hours before a committee vote, sparing us the needless irritation of grappling with fancy facts about the most consequential piece of legislation in recent memory.

No need to get into the weeds for you and me. No way. Just think of legislation as abstract art. The Congressional Budget Office does.

The CBO's new estimate, which magically meets every one of President Barack Obama's preconditions, is based on "conceptual" language provided by Baucus rather than on any of those maddeningly specific Arabic numerals.

That's because the estimate isn't rooted in an actual bill per se, nor does it incorporate hundreds of amendments that will be part of any final product—well, not exactly … What we do have is a CBO that has been browbeaten long enough by the White House to finally summon the conviction to get a figure that so many wanted to hear.

It's also, believe it or not, free.

According to the CBO, the Senate plan—which actually would cost more than earlier estimates, rising from nearly $800 billion to $829 billion (or $904 billion, according to a number of economists)—has triggered many excited journalists and politicians to claim that the bill miraculously would "pay for itself."

The CBO says that not only would it pay for itself—and this part is really wonderful—but also the government's spending an additional $829 billion over the next 10 years would reduce the federal deficit by $81 billion.

How exactly does health care "reform" pay for itself in Wonderland? In this case, it pays for itself by charging taxpayers new "fees," delivering new mandates and penalties, adding pass-through costs, and cutting hundreds of billions of dollars from Medicare.

As you know, if there's anything old folks—already prone to irascibility from time to time—absolutely adore it's the prospect of cutting their Medicare benefits. Yet even those savings seem to defy reality.

One of the many assumptions in the Baucus plan is that there would be continual cuts in physician reimbursements, cuts that Congress never has allowed and precious few onlookers believe would be politically palatable. So without a major attitude adjustment in Washington, this savings is just fantasy, as well.

Not to worry, though, there are sure things. One of the most popular and cost-effective programs, Medicare Advantage, would take a hit of $117 billion through 2019.

That might seem somewhat mysterious to you. Then again, Medicare Advantage involves private insurance firms (a curse on their house!), which should be squashed like a cockroach.

CBO Director Douglas Elmendorf previously warned that Medicare Advantage payment cuts would have the potential to hurt seniors' private health plans, which, of course, is the point of "reform."

The most exhilarating aspect of this plan, however, isn't that it would do nothing to contain costs for average consumers; it's that average consumers would help pay for it long before they failed to receive any tangible benefits.

According to Democrats, health care reform must be passed this very moment even though it wouldn't kick in until 2013. Don't worry; it would start taxing Americans in 2010, three years before you got nothing.

All of this probably adds up to the most expensive dependency program yet devised.

Coming at a time when the nation has hit 9.8 percent unemployment, with no help from Washington in sight, the latest Pew Research Center survey on the health care issue claims that "more people now generally oppose the health care reform proposals in Congress (47 percent) than favor them (34 percent)."

That 47 percent just doesn't believe. They don't believe higher taxes would bring down costs. They don't believe that more spending could shrink the deficit. They can't believe that fees wouldn't be taxes. Or that an entitlement program, for the first time in history, would pay for itself.

What they do believe in is reality.

David Harsanyi is a columnist at The Denver Post and the author of Nanny State. Visit his Web site at www.DavidHarsanyi.com.


NEXT: Tucked

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  1. Charlie: Since when do you pay to stay in a hospital?

    Doctor: Since always.

    Charlie: Uh, no, I believe that is what taxes are for.

    Mac: Yeah, you don’t pay a fireman to put out a fire.

    Charlie: Or a cop to shoot a guy.

    Dennis: How do you not know how this works? You’ve been in a hospital before.

    Charlie: I?I guess I must have slipped through the cracks. I do always give a fake name ’cause I like to stay off the grid. You know what I mean?

    Mac: Yeah, they usually just give me a bunch of antibiotics, the sores go away, and I walk out.

  2. Not believing in fairy tales is racist.

  3. Gotta love the insurance industry. Their report yesterday basically boiled down to:

    1: We will have to charge more because we will actually have to cover SICK PEOPLE. (Heaven forbid!)

    2: Even under the status quo, we are still gonna jack rates 79% in the next ten years.

    They make a great case for completely scrapping any system involving them.

    1. Yeah, heaven forbid anyone should have to pay for what they get instead of someone else paying for it.

  4. It should be illegal for commoners to read and comment on pending legislation.

    1. It should be illegal for commoners to be able to read.

      1. Which explains the politicians support for the public school system

        1. Oh score!

  5. Yea, Chad, if people can wait until they’re sick to buy insurance, that will jack up the rates. Yea, I know, reality is racist.

  6. The CBO says the plan will be deficit neutral when it scores ten years of taxes for seven years of services. What fool believes it will be deficit neutral the next ten years?

    1. When you realize your Progressive Moral and Intellectual Superiors lied to you about that to get their way, you will get on your knees and thank whatever vile god you worship that they didn’t leave the decision in your hands, because, someday, you will have Progressed enough to know they were right and you needed them to protect you from your own stupidity.

      Not believing that is racist.

  7. NPR (Morning Edition) has had a series so far this week on how patients have contributed to the rise in healthcare spending. The culprit? Direct-to-patient advertising by drug companies.

    Absolutely no mention has been made of the idea that maybe people consume more care because they pay for hardly any of it out of pocket. What, people consume more when something’s “free”? No, that can’t be right. It must be those evil drug companies.

  8. It’s also, believe it or not, free.

    Believe it. The plan covers mental illness.

  9. One of the points that I don’t think that gets made enough is that one of the reasons health care spending keeps rising is because there are always new and improved techniques to keep you healthy and alive.

    Think of how much better treatments are now than before. Knee surgeries are way less invasive than they used to be. Pills are able to keep high blood pressure from croaking you early.

    People love those fancy new treatments. They just don’t think they should have to pay for it. Everyone thinks that his or her neighbors should be happy to kick in for their treatment because they are so wonderful.

    I think the public plan should contain costs by limiting treatments to only those that were available in 1970 or so. People thought health care costs were reasonable back then, so pegging cures to that time period should keep costs down to that level.

    If you are on the public plan no fancy MRI for you! If a doc wants to see something they are just going to have to slice a view port in you. Hip replacement? Call the carpenter for a peg leg dude.

    However if you want the new miracle drugs and procedures you will just have to pony up your money and buy what you want.

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  11. I think the public plan should contain costs by limiting treatments to only those that were available in 1970 or so. People thought health care costs were reasonable back then, so pegging cures to that time period should keep costs down to that level.

    But you don’t understand! The Constitution guarantees my right to have other people pay for me to receive the best possible care!

  12. But I don’t understand. Isn’t the federal government a huge frictionless machine that perfectly allocates resources in the most efficient way possible?

    1. Dah Comrade! I can see you have a bright future in the party!

  13. Dear reason:

    Splitting a short article into two parts just to get an extra “click” is intensely annoying, and kind of makes you look like assholes.

    In case you’re interested.


    ps- Harsanyi, unlike a couple of other “contributors” I could name, does good work.

  14. People love those fancy new treatments. They just don’t think they should have to pay for it.

    You don’t pay for human rights, do you? Of course not!

  15. Guys, it’s all good, because the bill for healthcare reform? $0.00, hell yeah.

  16. Why health care “reform” won’t pay for itself (short form)

    It involves government.

  17. Conservatives apparently support free choice when they control finance and leave their failures to the taxpayer. They scream about loss of freedom if competition is open to all.
    The First Amendment is all about freedom of choice, something conservatives believe is un-American.

    1. What part of, “government is a monopoly” do you not understand? Start using your head. Not some silly idealistic moral compass with no comprehensive guidence system.

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