If there was any lingering doubt that Barack Obama has a knack for public speaking (and there wasn’t), Wednesday’s address to Congress and the nation on health care should have dispelled it. But despite the fine words eloquently delivered, Obama’s promises on cost containment rang false.
“First, I will not sign a plan that will add one dime to our deficits — either now or in the future,” Obama said.
Yet we know that the Congressional Budget Office has estimated that one of the leading health care reform bills, with provisions similar to Obama’s ideas, would add $1 trillion to the budget deficit over the next 10 years.
The president said he would wring hundreds of billions out of Medicare by targeting waste and fraud. A big chunk of that, he said, would come from Medicare subsidies “that go to insurance companies — subsidies that do everything to pad their profits but don’t improve the care of seniors.”
Obama means the Medicare Advantage program, in place since 1997, that allows recipients of Medicare to access their health care benefits through private insurance plans.
It’s been a popular program, as has Medicare in general. But not only is it unfair to describe it as largely waste or fraud, getting rid of it won’t yield nearly the necessary savings.
Going forward, Obama and lawmakers are going to need to offer better details about additional cuts.
The president also said savings in Medicare would come through the creation of a panel of physicians and medical experts on the lookout for fraud and waste. Yet at the same time, he argues that anyone who wants a preventive test for a possible condition or disease will be covered “with no extra charge.” That’s a mandate that one might consider the right thing to do. But it will hardly save the system money.
Meanwhile, Obama paid lip service to the idea of tort reform, arguing correctly that doctors waste money on unnecessary tests and procedures in an attempt to avoid medical malpractice suits.
But presented as a separate pilot program and not as part of the overall health care bill, it’s difficult to see how this initiative will restrain costs to any significant degree for many years.
Most Democratic lawmakers say they won’t vote for a bill that isn’t at least cost-neutral.
Colorado Sens. Mark Udall and Michael Bennet, both Democrats, have said they won’t vote for a plan unless it pays for itself. But given the details offered so far, how can they — or the public — be confident that the plan will achieve that fiscal goal?
We long for health care reform, in part because we’re convinced that rapidly rising costs in our medical system aren’t sustainable. And we’ve supported most of the principles and goals the president outlined this week.
But we still maintain that any health care reform plan — at the very least — must pay for itself.
