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Thread: CBO deals new blow to health plan

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    Elite Member witchcurlgirl's Avatar
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    Default CBO deals new blow to health plan

    CBO deals new blow to health plan

    For the second time this month, congressional budget analysts have dealt a blow to the Democrat's health reform efforts, this time by saying a plan touted by the White House as crucial to paying for the bill would actually save almost no money over 10 years.


    A key House chairman and moderate House Democrats on Tuesday agreed to a White House-backed proposal that would give an outside panel the power to make cuts to government-financed health care programs. White House budget director Peter Orszag declared the plan "probably the most important piece that can be added" to the House's health care reform legislation.


    But on Saturday, the Congressional Budget Office said the proposal to give an independent panel the power to keep Medicare spending in check would only save about $2 billion over 10 years- a drop in the bucket compared to the bill's $1 trillion price tag.


    "In CBO's judgment, the probability is high that no savings would be realized ... but there is also a chance that substantial savings might be realized. Looking beyond the 10-year budget window, CBO expects that this proposal would generate larger but still modest savings on the same probabilistic basis," CBO Director Douglas Elmendorf wrote in a letter to House Majority Leader Steny Hoyer on Saturday.


    On his White House blog, Orszag who served as CBO director in 2007 and 2008 downplayed the office's small probable savings number in favor of the proposal's more speculative long-term benefits.


    "The point of the proposal, however, was never to generate savings over the next decade. ... Instead, the goal is to provide a mechanism for improving quality of care for beneficiaries and reducing costs over the long term," Orszag wrote. "In other words, in the terminology of our belt-and-suspenders approach to a fiscally responsible health reform, the IMAC is a game changer not a scoreable offset."

    But scoreable offsets are the immediate savings that fiscally conservative Blue Dogs and other Democratic moderates have been pushing for precisely because they will help offset the bill's cost.


    The proposal's meager savings are a blow to Democrats working furiously to bring down costs in order to win support from Blue Dogs, who have threatened to vote against the bill without significant changes. The proposal was heralded as a breakthrough on Tuesday after Blue Dogs and House Energy and Commerce Chairman Henry Waxman emerged from the White House with agreement on giving the independent panel, rather than Congress, the ability to rein in Medicare spending.

    Republicans pounced on CBO's analysis as another demonstration that Democratic proposals don't control costs.


    "The President said that rising health care costs are an imminent threat to our economy and that any reform must reduce these long-term costs. But CBO has made clear once again that the Democrats' bills in Congress aren't reducing costs and in fact could just make the problem worse," said Senate Republican Leader Mitch McConnell.
    Saturday's CBO analysis caps a tough week of blown deadlines, partisan bickering and fierce intra-party fighting among Democrats.

    On Friday, the tension between the Blue Dogs and Waxman exploded when Waxman threatened to bypass his committee and bring the reform bill straight to the House floor without a vote. The move infuriated Blue Dogs who have used their crucial committee votes to leverage changes to the bill.


    But by late Friday, Waxman said their colleagues had pulled the two groups "back from the brink" and back to the negotiating table.

    Still, Hoyer said there was little chance that that the House would pass a health reform legislation before Friday when lawmakers are expected to leave Washington for summer recess.

    House Republican Leader John Boehner's office said that it's time to hit the legislation's reset button.


    "This letter underscores the enormous challenges that Democrats face trying to pay for their massive and costly government takeover of health care. In their rush to pass a bill, Democrats continue to ignore the stark economic reality facing our nation," said Boehner spokeswoman Antonia Ferrier. "Let's scrap the current proposal and come together in a meaningful way to reform health care in America by reducing cost, expanding access and at a price tag we can afford."




    CBO deals new blow to health plan - Chris Frates - POLITICO.com
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    Elite Member Fluffy's Avatar
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    Sunday, July 26, 2009

    Don't think it doesn't matter:
    In their health care reform coverage, media have repeatedly given considerably more attention to perceived setbacks to progressive reform efforts than to events that signal progress for those efforts. A Media Matters for America analysis of transcripts available in the Nexis database has found that broadcast and cable news featured almost twice as many segments mentioning the American Medical Association's (AMA's) reported opposition to a public insurance plan as segments mentioning the AMA's recent announcement that it supported the House Democrats' health care reform bill, which includes a public plan.

    That finding is consistent with an earlier Media Matters study showing that the number of cable news segments in Nexis mentioning an initial Congressional Budget Office (CBO) analysis of an incomplete version of a Senate health committee draft bill was far greater than the number of segments mentioning a later CBO analysis. That later analysis showed that an updated version of the bill would cover more people for less than the earlier scoring had suggested. Media Matters has also documented a pattern in which media suggest that President Obama's reform effort is in serious jeopardy, despite events -- including the AMA endorsement and revised CBO score -- that indicate reform efforts have made substantial progress.

    Following the June 10 publication of a New York Times article reporting that the AMA "will oppose creation of a government-sponsored insurance plan," broadcast and cable news networks ran a total of 23 segments from June 11 through June 14 that mentioned or discussed the AMA's reported stance, according to a search of transcripts available in the Nexis database. By contrast, following the July 16 announcement by the AMA that it supported passage of the House Democrats' health care reform bill, the networks ran a total of 12 segments from July 16 through July 20 mentioning or discussing the AMA's endorsement
    Americans always get nervous when their leaders are perceived to be losers. In fact, they hate it. And when the media skews toward failure unfairly, it has an effect on public opinion.

    It's been clear to me for some time that much of the media (with some notable exceptions) was looking for failure on this one. They like conflict and
    they don't actually care about whether or not health care gets done. Mark Halperin said right out that we should bet against health reform because:
    "Most journalists still have health insurance."
    Now one can make the argument that this bias exists against whoever is in charge of the agenda. But you wouldn't have much evidence to support it:
    Network newscasts, dominated by current and former U.S. officials, largely exclude Americans who are skeptical of or opposed to an invasion of Iraq, a new study by FAIR has found. of all

    Among the major findings in a two-week study (1/30/032/12/03) of on-camera network news sources quoted on Iraq:


    * Seventy-six percent of all sources were current or former officials, leaving little room for independent and grassroots views. Similarly, 75 percent of U.S. sources (199/267) were current or former officials.

    * At a time when 61 percent of U.S. respondents were telling pollsters that more time was needed for diplomacy and inspections (2/6/03), only 6 percent of U.S. sources on the four networks were skeptics regarding the need for war.

    * Sources affiliated with anti-war activism were nearly non-existent. On the four networks combined, just three of 393 sources were identified as being affiliated with anti-war activism--less than 1 percent. Just one of 267 U.S. sources was affiliated with anti-war activism--less than half a percent.
    I suspect that there is a bit of mass psychology at work here, in which the media collectively understands that it's blamed for failing its responsibility under Bush and so feels that it needs to demonstrate its independence this time out. (It also knows that it was pretty gushy toward Obama during the campaign and now that he has come down to earth as a politician, they feel embarrassed.)

    This happened with Clinton and Carter too. For a variety of reasons, the press holds Democrats to tougher standards, mostly because of their own failures during Republican presidencies. And because they overreact in Democratic administrations, they inevitably go easier on Republicans. How much of this is political bias is unknown, but it doesn't matter. The effect is the same.

    The media remain a huge part of the problem and it's important that we not forget that in all of our holding of Democratic feet to the fire. Chuck Todd and the rest of the kewl kidz see it all as a big political game and they are both the umpires and the color men. And that actually makes them very powerful players.

    Reforming government will never be enough.

    digby 7/26/2009 06:30:00 PM
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    Elite Member witchcurlgirl's Avatar
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    ^ Very interesting, especially when read as a companion piece to the NYTimes story last week about the White House's media manipulation.
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    Elite Member kingcap72's Avatar
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    Media manipulation is going on with all sides. The insurance companies/corporate media are trying to scare people into not wanting healthcare reform by demonizing it. And the White House is trying to scare people into supporting reform by demonizing the people who are against it. And both sides are using the costs angle.

    But, the fact remains, we need reform. It's more important that the Dems get their shit together. The only role the media should be playing is providing the public with a progress report and the details of reform, whenever we get those details.

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    Elite Member Grimmlok's Avatar
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    LOL like that will ever happen!
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    Elite Member Cali's Avatar
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    Quote Originally Posted by witchcurlgirl View Post
    ^ Very interesting, especially when read as a companion piece to the NYTimes story last week about the White House's media manipulation.
    I missed that article. Can you link to it?

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    Elite Member Fluffy's Avatar
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    Battle Of The Math Nerds: Two Number Crunchers Square Off Over Health Care

    By Brian Beutler - July 27, 2009, 3:28PM

    On Saturday, for about the third time since the health care debate really picked up steam on Capitol Hill, the Congressional Budget Office released an analysis that triggered bad headlines for health care reformers and big head aches for the White House.

    According to CBO Director Doug Elmendorf, a proposal widely touted by the White House to give an external panel the authority to reform Medicare and Medicaid would save a mere $2 billion over a 10 year time horizon--less than one percent of the overall cost of the legislation.

    "CBO deals new blow to health plan" blared a headline at Politico--conventional wisdom that threatened to provide new momentum to reform opponents on the Hill and within the greater Republican machine.

    There are a number of analytical problems with this framing--sort of what you'd expect when cool kids (like, ahem, the Politico team) stop tormenting their favorite dweebs and start trying to understand their science projects. But as if to underscore just how seriously the administration took the political threat, the White House quickly blasted out a response from Peter Orszag, director of the Office of Management and Budget, which called the CBO's work--and by proxy its director--into question.
    As a former CBO director, I can attest that CBO is sometimes accused of a bias toward exaggerating costs and underestimating savings. Unfortunately, parts of today's analysis from CBO could feed that perception. For example, and without specifying precisely how the various modifications would work, CBO somehow concluded that the council could "eventually achieve annual savings equal to several percent of Medicare spending...[which] would amount to tens of billions of dollars per year after 2019." Such savings are welcome (and rare!), but it is also the case that (for good reason) CBO has restricted itself to qualitative, not quantitative, analyses of long-term effects from legislative proposals. In providing a quantitative estimate of long-term effects without any analytical basis for doing so, CBO seems to have overstepped.
    A predictably nerdy response to a particularly nerdy insult. But that's also polite Washington-ese for, "Step off!"

    And it's easy to see why Orszag, 40, might be frustrated. As you might expect from somebody who makes a career out of churning budget numbers and hoping everything adds up to zero, Orszag, like Elmendorf, 47, places a premium on minimizing the federal deficit. You can imagine the two men joining the same chess club, or castigating a posse of tie dyed progressives for not appreciating the elegance and importance of a balanced federal budget. Though Orszag was mentored by liberal luminary Joseph Stiglitz and Elmendorf studied under conservative Martin Feldstein, Orszag eventually found himself under the spell of progressive bete noir Robert Rubin, many of whose views he appears to share. During the Bush era, he directed the Brookings Institution's decidedly middle of the road Hamilton Project--a Rubin initiative, which Elmendorf himself briefly ran in 2008.

    But over the last several weeks, at the requests of members of Congress, Elmendorf has crossed his natural ally, repeatedly zinging the budget king, and fueling the efforts of health care reform's most entrenched opponents.
    Herewith, a rundown of the perceived slights:

    Analyzing an incomplete version of Senate HELP Committee legislation, CBO found last month that the panel--the more liberal of the two Senate panels with jurisdiction over the issue--would cost a trillion dollars while leaving more than half of the uninsured without insurance.

    That was the first blow--and though the analysis was soon superseded by a more thorough and promising one, it nonetheless became the source of GOP talking points repeated to this day.

    Then, two weeks ago, after the House unveiled its own draft bill, Elmendorf told the Senate Budget Committee that none of the legislation he'd seen would do anything to address the inflation of health care costs over time.

    Now the CBO's at it again, and Orszag's seemingly had enough. Unfortunately for him, though, there's little else he can do aside from writing testy blog posts. The CBO is a congressional agency, hailed by pols and observers alike for its cautiousness, and ability to eschew partisanship whether Republicans or Democrats are running the show. And if Orszag did more than simply register disappointment, he would likely invite yet another political headache for the White House--the charge that the President is trying to influence what should ultimately be an unbiased and statistical, rather than political, project.

    But with so much on the line, it's easy to see why the administration is losing its patience. This is ultimately a familiar story. During the budget wars of the early 1990s, it was a CBO report that many Democrats claim dealt Clinton Care its fatal blow. Like Orszag now, Clinton's then OMB-chief, Alice Rivlin (a one-time CBO director herself) was furious with her successor, Robert D. Reischauer, for running the numbers the way he did.

    What she couldn't have known at the time, though, is that one of the analysts who contributed to that report would later bedevil health care reform efforts in a more public role. His name: Doug Elmendorf.
    Battle Of The Math Nerds: Two Number Crunchers Square Off Over Health Care | TPMDC

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    A Media Matters for America analysis of transcripts available in the Nexis database has found that broadcast and cable news featured almost twice as many segments mentioning the American Medical Association's (AMA's) reported opposition to a public insurance plan as segments mentioning the AMA's recent announcement that it supported the House Democrats' health care reform bill, which includes a public plan.
    The media, especially the cable "news", likes conflict and drama. The AMA endorsing Obama's plan doesn't provide the conflict.

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    Elite Member Cali's Avatar
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    Quote Originally Posted by visitor42 View Post
    The media, especially the cable "news", likes conflict and drama. The AMA endorsing Obama's plan doesn't provide the conflict.
    The ironic thing is that it SHOULD provide conflict. The AMA has pretty much turned into a lobby for health insurance companies and managed care.

    85% of doctors practicing today AREN'T members of the AMA, and for good reason. The AMA often doesn't advance or support the things doctors need, and members keep resigning their membership. Really, the AMA only represent about 15-19% of practicing doctors. So their endorsement, or lack thereof often doesn't reflect the majority opinion of American doctors.

    The professional organizations that are really important, and do represent the bulk of doctors, are the ones that represent the sub-specialties, such as Family Practice, Dermatology, OBGYN, etc.

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