Kent Conrad and the 'Annie Hall' Theory of Health-Care Reform
Kent Conrad is chairman of the Senate Budget Committee and one of the chamber's loudest, and most powerful, deficit hawks. On Tuesday, for instance, he directed the Congressional Budget Office to score the impact of health-care reform over a 20-year time frame, rather than the traditional 10 years. This is a tougher fiscal test than any bill has had to pass in memory.
You could see this as a good thing. Reformers sometimes argue that health-care reform's true impact on the cost curve will be seen over the long term. If CBO's scores reflected that, Conrad's demand could be a boon to reform. But Conrad doesn't appear to believe the scores will reflect that. He called the CBO's scoring of the bill's cost controls "stingy," and predicted that "the savings will be greater than CBO is showing."
In other words, he thinks the CBO is underestimating the savings that reform will deliver, but he wants to see those savings underestimated over a longer period of time, which will make the total gap between the revenues the CBO predicts and the savings it misses appear larger. It's a bit like the restaurant review from "Annie Hall": The food was terrible, and such small portions!
The end result is likely to be a new hurdle for health-care reform: a CBO report that makes the bill's total cost sound higher, as it's measured over 20 years, and its savings seem smaller, as they're underestimated over 20 years. The Huffington Post caught up with Conrad and asked him whether this would kill the reform effort. "No," he replied, "but it makes it more challenging." The question is why Conrad wants to make health-care reform more challenging.
One explanation is that Conrad is a stickler for deficit reduction, even at the cost of health-care reform. After all, the CBO's acid test might be overly difficult, but perhaps a high bar is warranted for a reform of this magnitude. "We've got to have somebody that we give this responsibility to and that we follow," Conrad explained. That would be more credible if not for two data points.
The first came earlier this year when Conrad modified Obama's first budget. Obama had eliminated a couple of Bush-era gimmicks that made the deficit appear smaller than it really was. Bush, for instance, shortened the budget window from 10 years to five, so the total deficit sounded smaller. Obama's budget returned it to the traditional 10. And then Conrad changed it back. The Politico reported that Conrad made this decision "because of the uncertainty of long-range forecasts." Others thought he did it to hide the size of the deficit. In any case, 10 years, as the alert reader will notice, is less than 20 years. If 10 years was too long a time period for certainty, then it is difficult to see how 20 years could possibly be acceptable.
The second came in 2003, when Conrad voted for the Medicare Modernization Act, better known as Medicare Part D. The Congressional Budget Office estimated that the bill would increase the federal deficit by $421 billion and reduce federal revenue by another $174 billion. The total cost to the deficit, then, neared $600 billion. Conrad not only accepted the CBO's 10-year time frame, but he voted for the bill. His press release enthusiastically touted the fact that the bill would "bring more than $70 million to North Dakota hospitals over the next ten years."
Conrad's record in the Senate, then, would lead you to believe a couple of things. For one, he distrusts long-range projections. Even 10 years is too uncertain. He also believes some priorities overwhelm deficit concerns, health-care coverage being one of them. But when faced with a health-care reform that will be deficit neutral within the 10-year time frame, he is demanding that it instead be measured against an even more uncertain 20-year time frame, and by an agency that he claims underestimates savings. The CBO's scores are terrible, in other words, and come in such small portions!
Photo credit: AP Photo/Alex Brandon.
Posted by: katiebird36 | September 16, 2009 9:10 AM | Report abuse
Posted by: spotatl | September 16, 2009 9:25 AM | Report abuse
Posted by: lancediverson | September 16, 2009 9:29 AM | Report abuse
Posted by: rt42 | September 16, 2009 9:32 AM | Report abuse
Posted by: rt42 | September 16, 2009 9:33 AM | Report abuse
Posted by: bmull | September 16, 2009 9:46 AM | Report abuse
Posted by: NicholasBeaudrot | September 16, 2009 10:27 AM | Report abuse
Posted by: jamesoneill | September 16, 2009 10:29 AM | Report abuse
Posted by: ThomasEN | September 16, 2009 10:32 AM | Report abuse
Posted by: markg8 | September 16, 2009 1:49 PM | Report abuse
Posted by: sideshow1979 | September 16, 2009 5:13 PM | Report abuse
Posted by: cautious | September 16, 2009 6:20 PM | Report abuse
Posted by: lensch | September 16, 2009 6:48 PM | Report abuse
Posted by: howard16 | September 16, 2009 7:25 PM | Report abuse
Posted by: lensch | September 16, 2009 8:12 PM | Report abuse
Posted by: howard16 | September 17, 2009 10:51 AM | Report abuse
The comments to this entry are closed.