Two of the leading left-leaning health politics experts, Jonathan Cohn and Ezra Klein, post detailed frets about the state of health care reform. Klein calls the project "in danger." Cohn's post is illustrated with a picture of a panic sign. Their thesis: the CBO score of the Senate Finance Committee's initial proposals produce such a wave of unease among Democrats that the back-to-the-drawing board options to save $600 billion are bound to significantly weaken the bill. Both Klein and Cohn -- along with many health economists -- don't necessarily oppose the more expensive versions. Will the system crumble because Max Baucus, the chairman of the finance committee, is wedded to an older model of politics?
How did we get here? Ask Peter Orszag.
The CBO's scores, as have been noted by everyone in the debate, are really only meaningful baselines. Even though they were preliminary for the two Senate plans that were submitted, they matter an awful lot. The rapidity and technical complexity and serious that CBO takes its health scoring can be attributed to.... Oooooooorssszzaaaaag! He's the President's budget director now; he is the immediate past director of the CBO
Before departing, Orszag, anticipating the big push by the new president for health care legislation, beefed up the agency's staff with health care economists and ordered a new, high-speed computer to run a complex health insurance microsimulation model that analyzes health care proposals and their budget impact.
That model, which was revamped this year, analyzes a huge array of demographic data in order to predict how people are likely to respond to changes in the insurance market, including the availability of insurance, changes in premiums and government subsidies. The core data is taken from the Census Bureau's Survey of Income and Program Participation, a survey of roughly 70,000 individuals interviewed at four-month intervals over a 40-month period.
The honest numbers -- and maybe the tougher-than-expected numbers -- are the result of Orszag's determination to get health care financing right -- from the POV of the legislative branch.
Meanwhile, sensing an opportunity, a group of centrist House Democrats and Republicans will hold a joint press conference today to formally oppose using budget reconciliation rules to pass the financing portion of reform. Suffice it to say, this is a debate that the White House doesn't relish.