Friday, March 19, 2010

Healthcare Costs, Government Accounting and Accountability

The Congressional Budget Office has just released an estimate that the Health Care bill before the House of Representatives will actually reduce the deficit over the next 10 years. In fact, the numbers they give are:

a) The bill will cost $940 Billion over the next ten years
b) The bill will reduce the deficit – by raising more money – by $138 billion during that ten-year period.
c) The bill will reduce the budget deficit another $1.2 Trillion over the following ten years.

To which I have one question: Does anyone believe this?

First, take a close look at the numbers above. The first issue is that this bill will mean that the new healthcare plan will distribute $940 billion over ten years, while increasing tax revenue $1,078 billion. Then, according to the CBO the plan, which will ostensibly cost roughly $1 trillion over the following ten years, will result in $2.2 trillion in additional revenue.

Maybe I’m confused, but it seems to me that Americans are being told to spend an additional $3.3 trillion dollars over the next 20 years. As individuals, whether the money goes out as tax or a healthcare bill, it still goes out the front door. That works out to $165 billion more per year going out the front door. Or $550 per person per year more out the front door. Not per household, per person. For the average household of 4, that’s $2200. Per year.

Didn’t they say the point of this was to reduce costs to Americans?

But the point will be made that this will be paid by the wealthiest Americans. The ones who already pay the bulk of the taxes. And it will be paid by taxing their savings and investments, which provide the money for economic growth.

But, even more to the point, ask yourself some simple questions: when was the last time a government program stayed on budget. Medicare, started in 1967, has grown at a 13% compounded rate (on average) every year since then. That was in no one’s forecast.

Medicare was supposed to address a host of issues in the healthcare field, yet it seems that the situation ahs not only gotten worse since 1967, it has done so at an accelerated pace.

Healthcare is not alone in this regard. The Department of Energy, founded some 32 years ago – To Reduce US Dependence on Imported Oil – has done no such thing, has not been able to produce a viable national energy policy, our dependence on foreign oil grows and so does the DOE budget.

The Department of Education was founded in 1980. The Department states that its mission is ‘excellence and access.’ The Department of Education’s budget has grown from $14 billion in 1980 to $64 billion last year (it actually spiked in 2006 to $100 billion). Yet the problems of poor standardized test performances and high dropout rates among the poor continues; the problems the Department of Education was supposed to address. (For those who are curious, the US spends roughly $1.1 trillion per year on education, mostly at state and local levels, considerably more than is spent on national security.

We as a nation have spent a great deal of money on the Department of Education, on the Department of Energy, on Medicare and Medicaid. More to the point, we have spent a great deal more on these departments and programs then anyone ever suggested we ever would. The budgets have grown at truly prodigious rates over the years. But two things are also true: in no case have they successfully addressed the problem for which they were created, and two, having failed in their mission, no one has ever stopped (or even slowed) the funding of these programs.

Now we have the CBO telling us that the healthcare bill will reduce our deficits. I suppose one could argue that one of these days they are going to get it right. But I for one am not willing to bet on it.

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