Alas, lost in all the sound and fury about AIG and executive bonuses is the news that many stakeholders in the health care reform debate have lost their collective minds.
Bob Laszewski posted last week about the document signed by many of the more active health care reform groups/advocates suspending the ‘pay as you go’ requirements that require Congress to find sources of funding for new spending initiatives.
Instead, the signatories (including Phrma, the US Chamber, AFL-CIO, Families USA, and various physician and provider organizations) have called on Congress to ignore the final cost of health care reform.
It will come as no surprise that this is happening now, as health care reform is starting to move from the discussion stage to front-and-center. And the broad themes and feel-good goal setting is now being replaced by the much tougher discussion about who gets to pay for reform. As CQ Today reported on 3/9 suspending the PAYGO rules will allow Congress to “avoid tough choices that could splinter” the coalition of health care reform advocates that so far has been fairly unified in its support of reform.
It’s crunch time. Several House and Senate committees will be taking up health care reform legislation this week. We’re now going to get into the nitty-gritty of who wins and who loses – because there simply cannot be health care reform without cost containment.
We cannot afford the ongoing costs of Medicare and Medicaid, much less expand coverage, until and unless Congress and the President make some very hard decisions. Suspending PAYGO is nothing less than an effort to avoid making those choices – to saddle future taxpayers with yet another unaffordable obligation.
To date, the Administration and Congress have gone after health care costs by hitting the insurers and other peripheral players. Now it’s going to get interesting. The device manufacturers, drug companies, physicians and hospitals are all going to have to take a hit – a big one. There is just far too much care, too many medications and procedures, too many services and treatments that are unproven or downright useless. But these treatments all provide big bucks to device manufacturers, drug companies, and the providers who prescribe, dispense, and install them.
Health care reform will not happen until we attack costs.
Unless spineless Senators and Representatives give in to these stakeholders and abandon all fiscal responsibility.
Unfortunately there’s precedence for avoiding fiscal responsibility – Medicare’s Part D program, which now has an $8 trillion unfunded ultimate liability.
Mar
23
Joe– all of the debates before Congress now, but especially the healthcare debate, have to be cognizant of this salient fact– there is a limit to how much debt we can float. There is a point at which the world will quit buying our IOUs. What makes this especially dangerous is that no one will know where that point us until we have crossed it and no one comes to next T-bill auction. (Premier Wen did give us a hint, however, and we should take that very seriously.) Once that happens, our entire economy will be in a real free fall that will make this look like the good old days. Suspending PAYGO– for any purpose– is idiocy. Every $100BB borrowed takes us closer to that unseen cliff in the fog. Once we go over the edge, nothing can rescue us.
Joe,
Direct hit!
No one has truly looked at cost. I watched the same groups that created the problem tell the President that they were all behind him. He can’t be that naive. And, I truly don’t believe (hope?) he is. Virtually no one in the health care industry has been hurt by the present economic situation. Health care costs can be reduced but the pundits either “ain’t” got a clue or are so incestuously involved in the system that they don’t care. Keep up the good work.
..ken