Last week, the Senate Finance Committee voted 12–11 not to wait for the Congressional Budget Office to “score” its health-care bill before the committee votes on it. Imagine that: Some senators actually wanted to know how much the bill costs before voting on it.
Let them get away with something like that, and before you know it they’ll be demanding honest accounting practices — sending the whole legislative process to hell in a hand basket.
When it comes to the health-care-reform debate, you see, honest budgeting is nowhere to be seen.
Start with the simple matter of how much health-care reform will cost. The House bill, HR 3200, will cost roughly $1.3 trillion over 10 years — or so we’re told. By the same token, the Senate Finance Committee bill is supposed to cost just under $900 billion. Sure, that’s a lot of money — but it still badly understates the true cost.
The CBO provides 10- year projections of a bill’s cost. But most provisions of the health bill don’t take effect until 2014. So the “10-year” cost projection only includes six years of the bill.
Plus, the costs ramp up slowly. In its first year, the House bill would only cost about $6 billion; in its first three, less than $100 billion. The big costs are in the final years of the 10-year budget window — and beyond. In fact, over the first 10 years that the House bill would be in existence (2014 to 2024), its costs would be closer to $2.4 trillion. Similarly, the real cost of the Senate bill over 10 years of operation is estimated at $1.5 trillion.
Worse, the trajectory of the costs after 10 years rises dramatically — meaning “reform” would cost even more in its second 10 years and beyond.
Such gimmicks also infest the projections of how much reform will add to the deficit. CBO says the House bill adds $235 billion to the deficit. But that, again, cuts off arbitrarily in 2019. Beyond that date, the bill adds enormously to the deficit, about $1.5 trillion in the second 10 years. In fact, if the health-reform bill were treated like other entitlements, such as Social Security and Medicare, which are required to have a 75-year actuarial forecast, its unfunded liabilities would exceed $9.2 trillion.
Of course, the Senate Finance Bill is supposed to be deficit-neutral. But that claim relies on other forms of budgetary flimflam.
For example, the Senate bill relies on Medicare “savings” that Congress keeps refusing to make. Specifically, Medicare has long been ordered to cut 21 percent from what it pays health-care providers — yet, each year since 2003, for reasons both good and bad, Congress has voted to defer the cuts.
Does anyone else really think that Congress is simply going to slash payments to doctors and hospitals by 21 percent across the board?
Of course, President Obama has long said we can cut Medicare by $500 billion simply by eliminating fraud, waste and abuse. That would be the same “fraud, waste and abuse” that the government has been cutting since Ronald Reagan first used the term.
The truth is that health-care reform is going to cost us a lot. And we’re going to pay for it in higher taxes and more debt.
No wonder they don’t want us to know.
