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Optimist Prime

» WaPo: In health-care reform, no deficit cure (Lori Montgomery)
» WaPo: Even if health bill passes soon, wait for reforms could be long (David Hilzenrath)

I guess the Washington Post has graduated from the "Some say/Others say" school of journalism (via Montgomery's story) ...

Optimists say the $848 billion package drafted by Senate Majority Leader Harry M. Reid (D-Nev.) contains all the most promising ideas for transforming the health-care system and encouraging doctors and hospitals to work more efficiently. They say it would eventually reduce both private premiums and the swelling cost of government health care for the elderly and poor.

Even pessimists don't necessarily disagree. But they see scant evidence that those ideas would quickly bear fruit, and in the short term they fear that the initiative would leave Washington struggling to pay for a new $200 billion-a-year health program even as existing programs require vast infusions of cash to care for the aging baby-boom generation.

Those concerns were magnified by the release of Reid's bill, which the Senate will begin debating on Monday. Democrats were thrilled when the nonpartisan Congressional Budget Office reported that the package was fully "paid for" -- meaning lawmakers had identified spending cuts and tax increases sufficient to cover the cost of expanding coverage to 30 million additional people.

But the measure would not deliver on Democrats' most ambitious claims, the CBO found. While the package would not worsen the nation's record deficits, it would not significantly improve them, either now or in the future. Reid's bill would shave less than 2 percent from deficits projected to top $9 trillion over the next decade. And it would make only "small reductions" after that, the CBO said -- about 0.25 percent of GDP -- to deficits projected to balloon to roughly 14 percent of the economy by 2035.

"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.

But seriously, there's a reason some of us who don't quarrel with comprehensive solutions to improve health care availability aren't seeing eye to eye with this bill. Sure, most of the arguments from the elected class are beyond farcical. But the reality is that the current versions of the bills are asking us to trust the federal government to do something it hasn't ever been known to do well in the past: stick to a commitment to cut health care costs.

If the entirety of HarryCare were offered at a much reduced tab, minus the individual mandate, I'd probably have little concern for it and be cheering it on. It's one thing to renew hope that pilot projects for cost savings can be scaled up in the future when the promise exceeds the cost. But the latest offering seem upside down, and that's a shame for much of the good that the bills have to offer beyond my objections.

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