Thursday, October 8, 2009

CBO should score systemwide savings from health reform

Supporters of comprehensive, single payer health reform are looking forward to a report from the Congressional Budget Office on how much ths kind of system would cost. But in 1993, when I worked with Senator Wellstone on his S.491, the original national single payer bill, CBO's "score" was dramatic and groundbreaking for showing how much the system would save:

By definition any single payer system contributes to federal spending: the feds pick up the tab for all health care expenses. The important part is the escalating savings from single payer - more and more, the longer the system is in place. In its 1993 report, the CBO illustrated that the single payer system not only slows the rate of growth in health spending - what the President calls "bending the cost curve" - it saved more every year from total national health expenditures: a reduction of $67 billion in 2002, $110 billion in 2003.

Look at this:
(By calendar year, in billions of dollars)

1997 1998 1999 2000 2001 2002 2003
Total 1,163 1,263 1,372 1,488 1,613 1,748 1,894 2,052

Changes from Baseline (effects of the single payer bill)
Total a 60 59 35 4 (minus 29) (minus 67) -110

SOURCE: Congressional Budget Office,
a. Less than $500 million.

Now the CBO seems to be saying it will calculate only the cost to the federal government, sending the bill sponsors on the House side into exercises to cut promised benefits and alter other provisions to reduce the impact on the federal deficit. CBO should go back to answering the full range of critical questions for the American public, most notably: How much is this going to cost me? The answer is that single payer would save a ton.

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