Robert J. Samuelson
When
the lobby from the health-insurance industry—America's Health Insurance Plans
(AHIP)—released a study early this week contending that the Senate Finance
Committee's health-care legislation would increase private insurance premiums
beyond current law, supporters of health-care "reform" were quick to denounce
the report as biased. Among the instant critics were nine prominent health-care
experts, including Henry Aaron of the Brookings Institution and David Cutler of
Harvard, who called the report "flawed" and "not credible." It then scolded the
insurers: "Important issues are at stake in health reform ... But responsible
participants in [the] debate should avoid selective use of evidence and try to
preserve analytic balance."
But
were the "experts" guilty of the same sin? Well, yes.
One
of the advertised virtues of the Baucus plan—named after Senate Finance
chairman Max Baucus—is that it pays for itself and wouldn't increase the
federal budget deficit. But that claim is suspect because it depends on huge
Medicare savings from fee cuts to doctors, hospitals, and other medical
providers. In the past, Congress has prevented such cuts from going into
effect. Counting those savings, the Congressional Budget Office figures the
bill would reduce the deficit $81 billion over the first 10 years. "But
Congress is sure to override the cuts in later years," argues health expert
Joseph Antos of the American Enterprise Institute. If it does, the Baucus bill
could add $376 billion to the deficit in the first decade and "as much as $2
trillion" in the second, Antos says. Before joining AEI, Antos was CBO's assistant director for health and human resources.
In their statement, the health-care experts
critical of the insurance industry don't even mention the possibility that the
Baucus bill might increase the deficit. That's not exactly "analytic balance"; it is a "selective use of
evidence." The statement was released by the Center for American Progress, a
liberal think tank. It asserts that the insurance-industry report, which was
done by the consulting firm PricewaterhouseCoopers, ignores provisions in the
bill that might control health costs and could protect against premium
increases. The report argues that if insurers are required to provide coverage
for all comers regardless of "preexisting conditions," then costs and premiums
will go up unless there's a strong mandate for healthy people to buy insurance
and absorb the higher costs. That point seems incontestable, even if the
report's precise estimates of premium increases are debatable.