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Friday, June 19, 2009

Knowing the Score: Doing Our Part to Keep Hope Alive

Okay, everyone in Washington was a bit taken aback by the first official "score" of a health care reform proposal. Keeping score, of course, is at the very essence of everything in our nation's capital, but in this case "score" refers to the budgetary impact of a piece of legislation, as analyzed by the Congressional Budget Office.


Since (for the time being at least) everyone agrees health care reform has to be budget neutral, the score is a very big deal indeed. Every dime of added cost has to be offset by some kind of payment cut or (gasp) new tax.

No one thinks it will be cheap to expand coverage to the 46 million (and growing) uninsured population in the US, but neither does anyone know for sure exactly how much it will cost. (Or, what is more important, how much CBO thinks it will cost, which is what matters when it comes to how much you have to budget to pay for it.)

So, when CBO reported back that the first bill--admittedly little more than a rough draft from the senate Health Committee--would cost $1 trillion dollars over 10 years while reducing the population of the uninsured by just 16 million, it caused a fair bit of consternation.

With all due respect to folks like Utah Republican Senator Bob Bennett--who is fond of saying that high quality health coverage is cheaper than the mismash of inadequate coverage we have today, so that there really is a "free lunch" on health care reform--well, there is in fact no free lunch. At least not in CBO's eyes. You can't just provide subsidized insurance for the masses, wave your arms and get to universal coverage. It costs money. Lots of money.

And with that, the health care reform push stalled--at least for a week--while everyone reconsiders how best to proceed.

Never fear: The IN VIVO Blog is here. Time for some outside the box thinking on alternatives that can reduce the population of the uninsured without breaking the bank. Here are our modest proposals:
  1. Bus the uninsured to Canada. Figure 1 million buses of 46 people each, plus a driver and gas money. Got to be less than $1 trillion.

  2. Start another war. Commit ground forces. End the war. Spend the savings on health care.

  3. Harvest the organs of the uninsured. Sell them to the wealthy.

  4. Relocate the 46 million uninsured to McAllen, Texas. Give Texas back to Mexico. (Or just let it secede).

  5. Have President Obama go on Oprah to promote downloadable internet coupons for free health care. Blame unexpectedly high demand for program failure.

  6. Steal John McCain's insurance card. Make 46 million copies. That way everyone can have coverage just like a member of Congress.

  7. Replace glue on postage stamps with a cocktail of Lipitor, Prozac and Provigil. Sit back and wait for heart attacks to go down, productivity to go up.

  8. Take Obama's $900 billion set aside for health care to the roulette table at the Mandalay Bay. Put it all on black.(Ed. Note: Wesley Snipes approves!) If red comes up, nationalize the casino. Repeat at other Vegas hotels until you have $3 trillion in winnings.

  9. Maybe the swine flu can take case of the problem?

  10. Tax snarky bloggers until you have enough money or they stop.

1 comment:

상율 said...

I suppose some common sense and cool head can solve this cost problem.
As we know, the public option currently being discussed is modeled after Massachusetts Plan, under which about 97% of all Massachusetts residents are now covered.
According to the approach of CBO, its rate of the uninsured in Massachusetts should be far greater than the present one at the moment.
Moreover, in case the strong public option, medical IT, increased efforts in prevention, and a broader array of cost-saving plans and beyond add to the Massachusetts Plan, the cost containment does not matter at all. And most importantly, the promising stem cell research is making its way.
To date, private insurers have coexisted profitably with Medicare and Medicaid for many years.
Basically, healthy society leads to better productivity and better performance.