Budget and Health Care - Joined at the Hip

And sooner or later, the grind may force us to consider hip replacement surgery, which may or not be covered, depending on our age, health status, or choice of a public option plan.

As the Senate takes up Harry Reid's health care legislation, the old nagging questions persist. Without apparent irony, the Washington Post carries this headline: In health care reform, no deficit cure. Not exactly, in vino, veritas, besides, I expect there's more vino than veritas in Senate chambers. Really, no deficit cure? From the WaPo:

"The hope that health-care reform would take care of our budget problem has evaporated," said Isabel Sawhill, a fiscal expert at the Brookings Institution.

Many budget experts also worry that lawmakers may not have the stomach to keep the new taxes and spending cuts intended to pay for the package. Republicans are already planning to offer an amendment to strike more than $400 billion in proposed Medicare cuts from the package, a move that would blow a huge hole in financing for the bill.

In merging bills drafted in committee, meanwhile, Reid significantly watered down two of the most important cost-containment provisions: a tax on high-cost health insurance policies that was opposed by labor unions and an independent commission that had been designed to automatically and methodically restrain Medicare spending. Senior White House officials have called those provisions critical, but House leaders are adamantly opposed to both.

Did anyone really believe that this thing would not only pay for itself but also cut the deficit? I doubt it.

While the Senate fusses with the bill, state governments are reckoning the costs and effects on their unbalanced budgets. Here's Tennessee Gov. Phil Bredeson, saying what most governors must be thinking.

A couple of polls show most of the public would prefer lawmakers move on to economic recovery and jettison the health care debate. Gallup reports 49 percent want their member of Congress to oppose the legislation, while 44 percent lean toward it. 

That's closer than I would have thought. Still, it's hard to see the numbers improving for the reformers.

Former and would-be Oregon Gov. John Kitzhaber thinks Congress has made a mistake by emphasizing access over costs. Here's the NPR coverage. 

"I don't believe that what's going to come out of Congress is going to have any impact on the medical cost inflation, which is what's really crushing individuals and businesses, and really putting the country at economic risk," he says.

There's much to dislike in Kitzhaber's plan - rationing, for example - but he's right to focus on costs.

The Massachusetts model, still touted in policy circles, tends not to be so highly regarded in the Bay State, where Rasmussen Reports that more voters consider it a failure than a success

In 2006, Massachusetts implemented its own statewide version of health care reform and 32% of the state’s voters consider that reform a success. The latest Rasmussen Reports telephone survey of the Bay State finds that 36% consider the plan a failure and another 32% are not sure. 

Smart, incremental reforms still make a great deal more sense than big government takeovers.