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Ezra Klein’s Take on the Republican Health Care Bill

John on November 5, 2009 at 12:19 pm

Typical is probably the best way to say it:

CBO begins with the baseline estimate that 17 percent of legal, non-elderly residents won’t have health-care insurance in 2010. In 2019, after 10 years of the Republican plan, CBO estimates that …17 percent of legal, non-elderly residents won’t have health-care insurance. The Republican alternative will have helped 3 million people secure coverage, which is barely keeping up with population growth. Compare that to the Democratic bill, which covers 36 million more people and cuts the uninsured population to 4 percent.

According to CBO, the GOP’s alternative will shave $68 billion off the deficit in the next 10 years. The Democrats, CBO says, will slice $104 billion off the deficit.

Of course he leaves out all the really important data. For starters, there are not 50 million uninsured now and won’t be in 2010. Of those who are uninsured (the President said 30 million in his address to Congress) a significant percentage (amounting to 10 million or more people) are uninsured by choice, i.e. they can afford insurance but are young and healthy and don’t care to buy it. The actual number of uninsured who need help and aren’t eligible for any other program is probably under 5%.

In any case, it’s true the Democratic bill covers all of these people. How? By creating a mandate that says they either buy insurance or pay a fine for not buying it. The point is, Republicans don’t support mandating insurance. Some even wonder if it’s constitutional. What other service or commodity are Americans required by law to purchase. Car insurance? Only if you want to drive a car on public roads. If you walk or ride a bike, it’s not required.

The other thing Ezra never mentions is the cost. The Democratic bill costs about $1.3 trillion if you account for the doc fix. And that’s still assuming Congress is actually going to make the medicare cuts no one believes they’ll actually make in the coming years. The Democratic bill cheats further by taking in 10 years of taxes but only offering 6-7 years of services within the budget window.

Without all the gimmicks the real cost is probably a lot closer to 2 trillion over ten years. And that’s a best estimate. If past is prologue (social security, medicare, Mass Care) the real cost will likely be 50% higher out of the gate. By contrast, the CBO scored the Republican plan as costing around $60 billion over ten years. $60 billion vs. $2 trillion. Funny he didn’t mention that at all.

Finally, Ezra also fails to point out that the Democratic plan more or less guarantees doctor rationing and increased premiums across the board. The Republican plan, by contrast, would cut premiums across the board according to the CBO, by as much as 7%.

So if you want the government, already $1.4 trillion in the red, to spend a few trillion more on a program that will raise costs, increase rationing and lead to a government takeover, there’s only one game in town. If however, you want a fix that will reduce costs without adding to the deficit or forcing people to buy insurance, one exists. Not that you’d know that reading Klein. But as is common with Ezra’s blog, what he leaves out is more important that what he actually says.

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Category: Health & Education |

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