BEFORE THE GOP REDISCOVERS ITS LOVE OF THE CBO…. Douglas Elmendorf, director of the Congressional Budget Office, told lawmakers this morning that the health care reform measures under consideration would likely increase government spending over the next decade, rather than save the government money.
Ezra Klein responds to this by recommending some ground rules for reform critics, who want to use the CBO findings to undermine reform. Ezra says opponents must do some combination of the following:
a) Support, as the CBO says you should, the eradication of the tax exclusion that protects employer-based health-care insurance;
b) Support, as Lewin and Commonwealth says you should, a public insurance option that can bargain at Medicare’s rates;
c) Support, as the Office of Management and Budget and every health-care wonk in town says you should, one of the various policies floating around to give MedPAC authority to continually reform and modernize Medicare;
d) Support some form of aggressive cost-sharing that would make people extremely angry because it will save money by reducing their access to health-care services;
e) Support comparative effectiveness review that can judge not only the effectiveness but also the cost-effectiveness of various treatments, and give the federal government authority to use that data when deciding reimbursement rates.
It’s unlikely, of course, that conservatives will honor these rules, because to do so would be to be intellectually honest about the exercise. As Ezra explained in June: “In most cases, individuals arguing that health reform is too expensive are dead-set against policies that would make it cheaper. It’s a neat trick: Their opposition to real cost controls makes health-care reform pricey, and then they attack it on grounds of cost.”