Big news today out of the CBO, where a revamped HELP Committee draft (which now officially includes a public option) was scored at a cost of $600 billion over ten years. The original scoring several weeks back came in at over a trillion without a public plan, which may make Mr. Lieberman’s “too costly public plan” argument
irrelevant worth another look. The draft also includes a new $750/employee fee on employers who don’t offer their employees health insurance. This clause is intended to curb the significant reduction in employment-based coverage toward a public plan that Lewin prophesized.
Financing is surely one of the biggest concerns, though allow me to add some perspective. I attended a seminar last week on payment reform, where Uwe Reinhardt, Professor of Economics at Princeton University, elaborated on the trillion dollar price tag. Unlike a TARP or a stimulus package, the CBO figure spreads over 10 years. Over the same time period, this number represents 3% of national health spending and 0.5% of projected GDP. Not to say $1 trillion isn’t a large amount of money, but when we are looking at fundamentally reforming one sixth of our economy and finally covering the nearly 60 million uninsured Americans it seems like a smart investment.