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EDITORIAL: Cost? Who knows?

The "fate of White House and congressional efforts to overhaul the nation's health care system is likely to depend on the price tag, but there's no precise, reliable way to estimate the cost," McClatchy Newspapers reported this week.

"This is very difficult to quantify," Amitabh Chandra, a professor of public policy at Harvard University and a health care expert, told the McClatchy Washington Bureau, speaking about the proposed health care takeover.


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  • Such "structural shifts are incredibly hard to predict," agreed Gus Faucher, the director of macroeconomics at Moody's Economy.com.

    Really?

    Take the nation's largest existing government medicine scheme, Medicare -- please. "The two primary lessons of Medicare," wrote Steven Hayward and Erik Peterson in "The Medicare Monster, A Cautionary Tale" (Reason magazine, January 1993 -- www.reason.com/news/show/29339.html) "are the chronic problem of woefully underestimating program costs and the impossibility of genuine cost control. ...

    "At its start, in 1966, Medicare cost $3 billion. The House Ways and Means Committee estimated that Medicare would cost only about $12 billion by 1990 (a figure that included an allowance for inflation). This was a supposedly 'conservative' estimate. But in 1990 Medicare actually cost $107 billion."

    That means Medicare managed to cost nine times the original projection, only 27 years after it started. Benefit outlays as of 2007? Thirty-two times initial estimates.

    As for the new Democratic health care proposals, the Congressional Budget Office put the 10-year price at between $1 trillion and $1.6 trillion, depending on the plan.

    The Obama administration and lawmakers further promise that any health plan would be "paid for," meaning that it wouldn't increase the federal deficit. Obama and top Democrats say they can fund their plans with a combination of health care cost savings and as-yet-unspecified higher taxes.

    How much in new taxes?

    Taking those figures of $1 trillion and $1.6 trillion, and multiplying by either nine (if we want a realistic estimate of costs, 27 years out) or by 32 (if we want some sense of what Obama-KennedyCare might cost by 2054) um ... would that start to add up to what Sen. Everett Dirksen used to call "real money"?

    And that's assuming everyone is being "straight." The Bush administration was widely criticized after revelations it deliberately underestimated the cost of its new Medicare prescription-drug initiative as Congress considered the plan in 2003. Some Republicans had vowed not to back any bill with a price tag of more than $400 billion over 10 years, so the administration said publicly it would cost less than that. Later, Medicare officials conceded that they hid their internal estimate of $551 billion.

    The only thing we know for sure is that when competitors have an incentive to lower costs while adding features in order to gain more market share, costs on all kinds of things tend to drop. Compare prices -- in inflation-adjusted dollars -- for home computers and color televisions to what such things cost when first introduced.

    On the other hand, when a product or service is delivered by a government monopoly, the opposite happens. Job security comes first, and quality tends to drop, even as prices go through the roof.

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    Report abuse

    Nuke A. Whale wrote on July 06, 2009 09:14 AM: Where is the compassion for all the people who will suffer when the government takes over our health care? You know, the Canadians who must come here to get care they can't in Canada!

    They sure aren't going to go to Cuba.


    Report abuse

    Judy wrote on July 06, 2009 07:44 AM: Idiots. Medicare should be expanded, not abolished.


    Report abuse

    Unbalanced Fred wrote on July 06, 2009 07:02 AM: Fred:

    If you got your news somewhere other than the Huffington Post or the MSM (same thing), you would know the Republicans have offered alternative plans, including reforms during the Bush administration.

    But you're either too ignorant or too partisan to care.


    Report abuse

    Rasputin wrote on July 05, 2009 09:34 PM: Saw a superb bumper sticker today:

    "If you think healthcare is expensive now, just wait till it's free."

    Couldn't have put it better myself.

    FABFred, please, PLEASE shut up.


    Report abuse

    Fairly Unbalanced Fred wrote on July 05, 2009 09:30 PM: Great response Fred! Kinda tough to answer when you have to wait to see what the talking points are. Hurry off to Huffington now to see what you think.


    Report abuse

    Fairly Unbalanced Fred wrote on July 05, 2009 09:28 PM: Reading must not come easy to you.


    Report abuse

    Fair and Balanced Fred wrote on July 05, 2009 07:42 PM: What is the Republicon Health Care Plan?

    Smile. You are just one diagnosis away from financial ruin.

    Smile.

    The drug companies, the insurance companies, and the Las Vegas Republicon-Journal would have it no other way.


    Report abuse

    Fair and Balanced Fred wrote on July 05, 2009 07:40 PM: In terms of cost in the industrialized world, we are at the top.

    In terms of outcomes, we are near the bottom.

    What's your solution?

    All the Republicons do is kvetch.

    Ask them for their plan, and they act like the idiots posting just above my most recent post.


    Report abuse

    Fairly unbalanced Fred wrote on July 05, 2009 07:28 PM: Straw dog Fred. We don't advocate doing nothing. How about control our borders and drop illegals from our system? Tort reform? Insurance portability? Tax credits for premiums paid? More emphasis on Medical Savings Accounts? Realistic caps on malpractice suits?Standardized national policy so Insurance Companies don't have to write 50 policies to cover 50 states? Put the consumer back in charge to introduce competition? Nice try Fred.I know you just parrot what Barry and Huffington say. Not your fault.


    Report abuse

    Fair and Balanced Fred wrote on July 05, 2009 07:14 PM: Everyone reading this is just one, just one diagnosis away from financial ruin.

    What is the cost of doing nothing?

    What is the cost of doing nothing?

    What plan does the Las Vegas Republicon-Journal advocate and what will it cost?

    How much coverage will the Republicon-Journal street vendors, who walked up and down the traffic medians last year, in 100+ heat with little shade, qualify for?

    What kind of coverage do Republicon-Journal Sherman Frederick and Thomas (COPD) Mitchell carry?

    How does their coverage compare to your's and mine.

    Smile.

    You're just one diagnosis away from financial ruin.

    The Las Vegas Republicon-Journal wants to keep it that way.


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