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December 28, 2009 at 07:00 PM
To make health reform fiscally sound, Congress should give Medicare cost-cutters sharp scissors and raise a proposed tax on high-cost health benefits packages.
The Concord Coalition, Arlington, Va., a group of Democrats and Republicans who want to reduce the size of the U.S. budget deficit, has published those recommendations in a commentary on the major House health bill, H.R. 3962, and the major Senate health bill, H.R. 3590.
In 2019, when the programs proposed by each bill would be up and running, the House bill would spend $207 billion per year on coverage expansion, and the Senate bill would spend $199 billion, the coalition says.
Bringing uninsured people into an unreformed, unsustainable health finance system could make the situation worse, and there is no guarantee that Congress could offset the proposed spending increases by making proposed cuts in Medicare and Medicare Advantage funding stick, the coalition says.
But doing nothing would be irresponsible, because “virtually all analysts and policymakers, regardless of ideology or partisan affiliation, agree that national health care costs are on an unsustainable track,” the coalition says.
The coalition says the best solution would be to let the cost controls in the health bills take effect, then see if the cost controls worked before expanding coverage.
“Expanding coverage first means adding more than 30 million people to a system that is not assured of improving value or outcomes and is fiscally unsustainable already,” the coalition says.
