Archive | 9:22 AM

CBO cost estimates for health care – read the fine print

20 Nov

You are probably reading about the CBO estimates for the Senate health care bill including a net positive effect on the deficit. What you don’t here are things like the increased cost being imposed on the private sector, the costs for the IRS and HHS to run the new bureaucracy that are not part of these calculations, the fact that only 4-5 million Americans will join the public option and that the option’s premiums may be higher than the private sector in part because the government plan will not manage claims (just like Medicare). You probably won’t hear that the new Long Term Care insurance that is added to this bill will generate over $72 billion of the assumed revenue because claims cannot be paid for five years after premiums begin to be paid by Americans.

And you probably won’t here much about what the CBO blog says in the last sentence in this paragraph (I added emphasis):

“Based on the extrapolation described above, CBO expects that Medicare spending under the bill would increase at an average annual rate of roughly 6 percent during the next two decades—well below the roughly 8 percent annual growth rate of the past two decades (excluding the effect of establishing the Medicare prescription drug benefit). Adjusting for inflation, Medicare spending per beneficiary under the bill would increase at an average annual rate of roughly 2 percent during the next two decades—much less than the roughly 4 percent annual growth rate of the past two decades. Whether such a reduction in the growth rate could be achieved through greater efficiencies in the delivery of health care or would reduce access to care or diminish the quality of care is unclear.”

And what about costs imposed on the private sector, here is what the CBO says:  

 

I'm glad the federal deficit is in good shape

“The total cost of mandates imposed on the private sector, as estimated by CBO and JCT, would greatly exceed the threshold established in UMRA for private entities ($139 million in 2009, adjusted annually for inflation). The most costly mandates would be the new requirements regarding health insurance coverage that apply to the private sector. The legislation would require individuals to obtain acceptable health insurance coverage, as defined in the legislation. The legislation also would penalize medium-sized and large employers that did not offer health insurance to their employees if any of their workers obtained subsidized coverage through the insurance exchanges. The legislation would impose a number of mandates, including requirements on issuers of health insurance, new standards governing health information, and nutrition labeling requirements. CBO estimates that the total cost of intergovernmental mandates would greatly exceed the annual threshold established in UMRA for state, local, and tribal entities ($69 million in 2009, adjusted annually for inflation). The provisions of the legislation that would penalize those entities—if they did not offer health insurance to their employees and any of their workers obtained subsidized coverage through the insurance exchanges—account for most of the mandate costs.” 

 
 
 
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“Only positive outcome is short-term improved access”

20 Nov

If we stop and take a look at the logic used by Congress in shaping health care, we frequently find there isn’t any.

Consider this, they place a tax on high cost health plans, they then require that there be 100% coverage for many services and no limits on benefits plus want to use co-pays in lieu of coinsurance all of which add to the cost of coverage and push more health plans over the allowed maximum cost before taxation.

They subsidize coverage for people up to 400% of the poverty level, but the difference between the subsidy and the total cost is raised because of all the mandated benefits.

Could I have a little less help from Congress please

We want to control health care cost so we remove more and more of the reason why Americans should be aware of and concerned about health care costs and we further limit personal responsibility…hey, if somebody else is paying the electric bill why turn off the lights when you leave the room?

As one commenter noted, “only positive outcome is short-term improved access. Quality and Cost efficiencies are toast because the system and the process are not the focus.”

So perhaps Congress does have some logic, keep the masses happy by expanding coverage and then take credit for solving the health care problem and the consequences be damned, they are for another Congress to worry about.

 

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