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Thursday, July 30, 2009 - 11:18 AM

The Congressional Budget Office once again validates some intuition many of us had about health care reform: when you have health costs rising much faster than the economy is growing, a package that expands coverage but is unwilling to tax health benefits to pay for it is not likely to add up to a deficit-neutral plan over the longer term. The basic problem is that the cost of coverage expansion will continue to increase at the same rate as health care costs, but the tax increase offsets will only grow (at best) at the rate of economic growth. Then you have an additional problem that many of the offsets might be one-time cuts or cuts whose value does not even keep up with economic growth or inflation. 

Quoting from pages 12-13 of the report (a letter to Congressman Dave Camp (R-MI) on the House tri-committee proposal), emphasis added:

Looking ahead to the decade beyond 2019, CBO tries to evaluate the rate at which the budgetary impact of...

Tuesday, July 28, 2009 - 5:13 PM

Yesterday, experts from the Iowa Committee for Value in Healthcare -- a diverse group of Iowa health care providers, purchasers, payers, patient advocates, and policy analysts -- sent a letter to President Obama and Congressional leaders indicating the principles for value-based health care reform that should be considered in any health care legislation. 

This committee was established as part of The Concord Coalition's Fiscal Stewardship Project to suggest ways that health reform could be enhanced to create a more value-based system. As Congressional efforts toward health reform continue through the summer, value, cost and long-term savings have become more prominent aspects of the debate. Achieving value in the health care system is essential for the ...

Thursday, July 23, 2009 - 9:19 PM

While the President's press conference Wednesday night got a lot of attention and focused substantially on health care, he also did an interview with Washington Post editorial page editor Fred Hiatt earlier in the day. The wide-ranging interview touched on health care reform, but also on a lot of the other subjects Concord Coalition members are interested in -- like deficits, debt, Social Security reform and a BRAC-like fiscal commission. It is worth a read.

Wednesday, July 22, 2009 - 5:59 PM

In today’s Washington Post, Harold Meyerson complains that the centrist “Blue Dog” Democrats have a “can’t do” attitude when it comes to health care reform:

[O]ur government used to actually pave roads, build bridges and allow for secure retirements by levying taxes on those who could afford to pay them. To today’s centrist Democrats, this has become a distant memory, a history lesson they cannot grasp. The notion that actual individuals might have to pay to secure the national interest appalls them. In the House, the Blue Dogs doggedly oppose proposals to fund universal coverage by taxing the wealthiest 1 percent of the nation’s households…

Centrist Democrats’ opposition to health reform verges on the incoherent. A caucus (the Blue Dogs) formed ostensibly to promote balanced budgets now disapproves of the proposed taxes that would cover the expenses of the new programs. The congressional centrists say, commendably, that they want to squeeze more economies out of the system, but they oppose giving more power to an agency that would set the payment...

Friday, July 17, 2009 - 3:39 PM

From my previous post, it might be clear that there's finally some serious discussion on the Hill about cost control within the health care reform debate. 

Today, the Administration weighed in with an important proposal that might provide the best shot at making sure health care reform legislation has a lasting legacy of reducing costs. (See a summary of the proposal here).

As CBO director Orszag explains, they are looking to create an independent council which will be able to set payment rates and alter payment systems in Medicare, and these recommendations will be done regularly and will take effect unless the President and then Congress explicitly decide to ignore them.  

In this proposal, the body of experts would be called the Independent Medicare Advisory Council or IMAC. The idea for such...

Thursday, July 16, 2009 - 2:25 PM

Health Care reform is moving quite quickly on the Hill and it is almost impossible to keep up with all of the developments in Congress and all of the great reporting in the media on what is needed for fiscally responsible health care reform. So, over the next 90 days as health care dominates the political agenda, we are going to try to briefly highlight developments as they occur by linking to other sources and throwing in Concord material as it is published.

The links brought to you today cover the fundamental cost control issues being discussed (or unfortunately not discussed) as legislation makes its way through the House and Senate Committees.

  • The big news today, as reported in The Washington Post, CNN and elsewhere, is that CBO director Elmendorf testified in front of the Senate Budget Committee and proclaimed that the legislative developments he has seen (the House bill and the Senate's HELP committee bill) seem to "significantly expand the...
Thursday, July 16, 2009 - 10:20 AM

The Tabulation and The Concord Coalition would like to congratulate our own Diane Lim Rogers for her blog EconomistMom.com being named as one of the Wall Street Journal's “Top 25" economics blogs.

In addition to being Concord's Chief Economist and the mother of four, Diane finds spare time to do her own blogging about sometimes complicated fiscal issues in an easily digestable, accesible and fun way -- and that skill is one of the many things that the Wall Street Journal recognized today.

Well done Diane!

Tuesday, June 30, 2009 - 12:15 PM

It has almost become axiomatic that growing health care costs, rather than population aging, is the overwhelming cause of a projected spike in federal spending. That notion was dispelled in CBO’s Long-Term Budget Outlook published last week. As explained in the report:

“Federal spending on Medicare, Medicaid, and Social Security will grow relative to the economy both because health care spending per beneficiary is projected to increase and because the population is aging. Spending on Medicare and Medicaid will be driven by both factors, while Social Security spending will rise because of the population’s aging. Between now and 2035, aging is projected to make the larger contribution to the growth of spending for those three programs as a share of GDP. After 2035, continued increases in health care spending per beneficiary are projected to dominate the growth in spending for the three programs.”

 

Later in the report, CBO quantifies the relative effects of aging and health care growth on projected...

Thursday, June 25, 2009 - 9:30 AM

After reading this post, hopefully all of our loyal readers will finally understand the simplicity and beauty of the Pay-As-You-Go (PAYGO) concept. 

First, I should mention that today we published an issue brief on the new statutory PAYGO law proposed by President Obama and introduced in the House of Representatives to coincide with today's PAYGO hearing in the House Budget Committee, featuring OMB Director Orszag. This proposal puts in place a law that requires any new spending or tax cut legislation to be offset so that it does not increase the deficit. If it did, the law forces automatic spending cuts designed to balance out the difference.

The Concord Coalition supports enactment of statutory PAYGO. The basic message in our brief is that PAYGO can be, and has been in the past, an important budget enforcement tool that helps promote fiscal responsibility. However, PAYGO shouldn't be thought of as more than that, and certainly not as a silver bullet that can somehow solve the nation's long-term fiscal...

Monday, June 22, 2009 - 10:05 AM

On June 15 and June 16, leaders from various youth organizations traveled to Washington, D.C. for a youth conference hosted by The Concord Coalition and the Youth Entitlements Summit (YES), and underwritten by The Peter G. Peterson Foundation. The event aimed to encourage public discourse among the "Millennial generation" about the nation's fiscal challenges and to generate a collective plan of action for grassroots efforts to do the same. 

Last month, at an event for young activists, I found myself on the spot once I mentioned The Concord Coalition’s work on fiscal awareness. A fellow attendant replied, “Look, I’m not trying to be rude, but I just don’t think the debt matters.” Such indifference concerned me until I watched America’s future leaders passionately discussing the need to fix this imbalance to save our economic futures.

On the first day of the conference, we heard from politicians and scholars who are heavily involved in the fiscal policy arena, including the...