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Those were some scary numbers on the cost of health-care reform the Congressional Budget Office released last week. As they should have, the figures sent the Senate committees scurrying back to try to rework their bills to get the 10-year cost under $1 trillion.
That was the price tag President Obama put on reform and the figure he was "almost all the way to covering" with his proposed $950 billion in tax increases and budget cuts.
And then the CBO weighed in. The CBO said the Senate health committee’s bill would cost $1 trillion, but cover only 16 million of the 46 million uninsured Americans. The Senate finance committee’s proposal would cover twice as many of the uninsured, but at a cost of $1.6 trillion.
These are daunting but not insurmountable costs. As some have pointed out, President George W. Bush’s tax cuts cost $1.8 billion, and we were able to handle those, although at some cost to the deficit.
Assuming these cost estimates are accurate — and forecasting the cost of federal spending programs is more art than science — the initial cost of health-care reform is not the problem; the continuing rise in costs is.
And, except for some nibbling at the margins, there do not appear to be any broad-based cost-control measures in the offing. For example, the country faces a growing shortage of primary-care doctors, who would be the front line in any broad-based health system and the best check on unneeded procedures.
The Democrats’ most serious cost-control measure is the so-called public option, a government-sponsored health insurance program offered along with private insurance plans to provide competition and a brake on costs.
This has become the principal point of Republican attack. The GOP’s shrill cries that this is some kind of European-style "socialism" actually make you begin to wonder if the Europeans aren’t onto something.
More calmly, the Republicans argue that the government plan will be able to offer expensive choices that private plans won’t be able to match, eventually driving private insurers out of the market.
Maybe that unhappy outcome is not outside the realm of possibility, but surely with all the brainpower now focused on health care it is possible to design a public option to serve those who, in any reform plan, will remain beyond the reach of private insurance.