For me, one of the more amazing things about this healthcare debate is the way the press and many advocates of healthcare reform have accepted the notion that the fiscal objective should be to pass a healthcare bill that is "deficit neutral."
With healthcare costs unsustainable, why is that an appropriate goal?
Deficit neutral means that any impact of a healthcare bill on the federal budget would neither increase costs, nor would a bill decrease costs, from what they would have been without reform. So, if federal healthcare costs remain the same post-reform, why would we expect the outcome to be any different for the rest of the system? Why shouldn't we believe that post-reform healthcare would cost the same $4.5 trillion and 22 percent of GDP we expect it would cost in 2018 anyway?
Now, the Democratic bills would bring in many millions of people who are uninsured today and that is a real benefit. But we would bring them into that same unsustainable system.
I was struck by a recent exchange between Senator Evan Bayh (D-Ind.) and Fed Chairman Ben Bernanke earlier this summer. In the second minute of this video, Bayh and Bernanke point out that any "deficit neutral" healthcare bill does not get at the "heart of the problem" and agreed we need to do more--we need "systemic reform."
Why then is "deficit neutral" the stated fiscal objective for the President and the Democratic leadership in their healthcare bills?
Robert Laszewski blogs regularly at Health Care Policy and Marketplace Review.