Today’s Senate Finance Committee hearing underlined one of the more important lessons from President Clinton’s failed effort to reform the health care system: when pushing through your plan, don’t let economists be the messengers for reform.
A high Congressional Budget Office score sunk Clinton’s reform plan, and today’s Democrats are trying to challenge the importance of “the number.”
Henry Aaron, a senior economics fellow at the Brookings Institution, has noted that “it’s not infrequent to hear people say it doesn’t make any difference what it really costs. It only matters what CBO says it costs.” But health care, of course, is about more than just numbers. It’s about securing the health of the nation, and real reform will require an upfront investment that doesn’t make for a balanced budget sheet in the short term.
The Congressional Budget Office has admitted as much. It uses a limited amount of evidence to score changes, without really examining the interactions of separate policies (for which there is little evidence) and as Sen. Pat Roberts (R-KS) suggested, insofar as the CBO “tries to predict people’s reactions to our policy changes, it’s almost impossible.”
Consider this interesting exchange between Sen. Max Baucus (D-MT) and Congressional Budget Office director Douglas Elmendorf:
BAUCUS: We’re not in the old situation where whatever CBO says is God. In my judgment you’re not God. My judgment is that the press — there’s a whole new era and, um, you might be Moses, but not God. But I do believe that there are several different intellectually honest pathways to get from here to there. It’s not just one automatic. And so it mean we gotta be ever more creative to find intellectually honest pathways to get the savings we’re going to have to have [inaudible] politically to get health care reform.
Listen to the exchange:
Paul Begala made a very similar argument during the Families USA health care conference, urging Obama to ignore traditional economic caution. In fact, reforming health care on an economic tight rope, is like deciding to respond to a terror attack by first determining if you can fund it. In both cases, there are other factors one must consider.