All snark aside, I hope you get my point. And, as an individual who (unfortunately) worked in a claims processing environment for two years, even the government imposed fee schedules in the US for an MRI pay far more than $260 for an MRI. The price goes even higher for an open MRI. Is it too logical to assume that government imposed price controls, a la Japan, may have led to the MRI machine never having been invented in the first place?

A clinic that could never justify an MRI machine, can now hire several more doctors and buy the needed equipment to meet the demand of the many newly insured. Having that MRI in house cuts a lot of waste compared to scheduling and billing a 3rd provider.

In Japan, where the gov. sets price ceilings on every medical treatment, the top price a clinic can charge for a night in the hospital is about $75 and the top price for an MRI is about $260. The actual price you will pay for each is about $25 and about $160 respectively.

If you click on the link you’ll see what plan the CBO has analyzed.
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“neither the original post nor any of the comments has anything to do with some “Republican plan.”

My point is that among the three options in the real world (current law, the GOP plan and the Obama plan), the Obama plan is the best in terms of cutting the deficit, not to mention in expanding access to hc insurance. I apologize if pointing this out has caused you distress.
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“In any event, your comment says nothing about whether the health-reform plans now before Congress will reduce or increase deficits.”

You must have missed this in my post:

“* CBO says the GOP plan will cut $68 billion off the deficit over the next 10 years.

“* CBO says the Obama plan will cut $104 billion off the deficit between now and 2019.”
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“The issues are whether the CBO scoring, which says these plans will reduce the deficit, is accurate (it’s not) and, if it’s not, whether this is the CBO’s fault or Congress’s (Congress’s).”

Do you have a better, non-partisan source for scoring legislation?Maybe you haven’t examined one of these scores, but it’s not as easy as you seem to think. CBO has a good reputation on both sides of the aisle and off Capital Hill.
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“it just means both parties lie to us on a regular basis.”

Welcome to politics, corporate accounting, credit ratings and statistics.

“The Obama plan, in other words, covers 12 times as many people and saves $36 billion more than the Republican plan.”

I don’t know what “Republican plan” you are talking about; neither the original post nor any of the comments has anything to do with some “Republican plan.” In any event, your comment says nothing about whether the health-reform plans now before Congress will reduce or increase deficits. The issues are whether the CBO scoring, which says these plans will reduce the deficit, is accurate (it’s not) and, if it’s not, whether this is the CBO’s fault or Congress’s (Congress’s). It is true that this game of “let’s write a bill that the CBO will score as deficit-reducing and later take away the cost-cutting part” is regularly played by both parties. That doesn’t make it any less dishonest; it just means both parties lie to us on a regular basis. “I am shocked, shocked ….”

I believe your description applies to the 8 years of the Bush admin. when the GOP let Gramm-Rudman expire and took the lid off all budgetary contraints. Of course, during this period budget deficits skyrocketed.

During the Clinton years the Dem Congress accepted the budget constraints of Gramm-Rudman which is part of the reason we went from big deficits to surpluses in those years. (Of course, strong economic growth helped.)

Congress has now reinstituted those restraints which, in most but not all cases, require Congress to offset spending increases and tax cuts with matching spending cuts or tax increases. As a result, the game-playing you decry will be tougher than it was during the Bush admin and more like it was during the Clinton years.

Furthermore, it’s not enough to criticize the Obama plan in a vacumn. We need to take a look at how the Obama reforms would affect deficits compared to current law and the GOP plan.

While Steve did not provide a link to the CBO report he characterizes (and like jambarama, I can’t find it, and I’m pretty good at digging CBO reports up), I will:

http://cbo.gov/ftpdocs/107xx/doc10705/hr3962amendmentBoehner.pdf

This report provides the comparisons we need. Here’s a brief summary:

* Today, 17% of legal, non-elderly residents don’t have health care insurance.

* Under the GOP plan, in 2019, 17% of legal, non-elderly residents won’t have health care insurance. So, no change.

* Under the Obama plan, in 2019, 4% of legal, non-elderly residents won’t have health care insurance. This means an additional 36 million people will be covered.

But surely the GOP plan does a better job of reducing the deficit. Not so.

* CBO says the GOP plan will cut $68 billion off the deficit over the next 10 years.

* CBO says the Obama plan will cut $104 billion off the deficit between now and 2019.

The Obama plan, in other words, covers 12 times as many people and saves $36 billion more than the Republican plan.

So, since the healthcare exchanges are going to involve government subsidized plans being offered by traditional insurance companies, this overlap you claim cannot materialize. In fact, just the opposite would be true. New accounts payable, payroll, etc. would need to be established to process the subsidies from the government to the insurance companies. This is an additional cost, not an overlapping one.

Cheers!

Developing a Universal Healthcare system will necessarily involve creating institutional systems that overlap with those used by Medicare.

For instance medical billing and collections, hospital privileges administration, accounts payable, payroll are all things needed by the new system that will be put to use serving medicare as well.

Why is it hard to believe that creating a second healthcare system will allow for cuts in services to one of them in areas of overlap?

This is a good analogy for the “starve the beast” GOP ideology – offered as a weak defense for not living up to conservative spending promises. It is also a good analogy for the many fold “spend to save” arguments from the democrats – especially on health care. And it may be a good analogy for the CBO’s take on Obama’s proposal, but there is no way I can tell that from this article.

The bills now in Congress don’t contain “open-ended promises of this sort,” they actually require reducing Medicare expenses. Nobody, including the people at the CBO, believes that these reductions will go into effect, because it is all but certain that Congress will pass new laws to prevent this, even if the health care bill passes. Congress has done this be3fore; the new laws restoring earlier Medicare “cuts” are called the “doctor fix.” But the CBO cannot ignore the budgetary effect of a provision in the bill it is scoring on the ground that Congress will later undo what it proposes to enact. So Ryan Yin is right: the blame here attaches not to the CBO, which has no choice, but to those pushing the health-care bill, who have included in that bill a cost-reduction provision that they know will later be repealed. This enables our President to claim that the bill won’t increase the deficit. He’s lying.