Friday, September 18, 2009


On page A10 of its paper Thursday, the Wash Post has a table entitled "The Bills Compared". I was unable to find the same table on-line, so it may only be available in hard copy. But the table's notes say its information was compiled by its staff and taken from information provided by the CBO, the Senate Finance Committee, the Senate HELP Committee and the House Energy and Commerce Committee, the latter three Committees having produced legislation.

Anyway, one feature of the table was to show how many persons are projected to still be uninsured in 2019. The House bill, with a price-tag of $1.3 trillion over ten years would reduce the number of projected insured from 54 million in 2019 to 17 million. And the House bill includes a public option. The Baucus bill, which costs almost half that of the House bill ($774 bill), and notably does not include a public option, would leave 25 million uninsured in 2019, eight million more than the House bill. The Senate HELP Committee's bill, which also includes a public option, would leave the most uninsured, 36 million, in 2019, although its costs over ten years would be only $645 bill, almost $100 bill less than the Baucus bill.

So, each of these bills would improve the number of insured persons, which is expected to increase from the 44 or 45 million or so persons uninsured today. But these bills would cost quite a bit and still leave millions uninsured. More specifically, compared to the House bill, these figures indicate it would require legislation nearly twice as expensive as the Baucus bill to get 8 million more persons insured in 2019. Granted, eight million people is still a lot, but it doesn't seem to me that another $600+ billion provides much bang for the buck.

It's possible I'm missing something here; that the long term effects of these proposals compared to doing nothing would continually decrease the numbers of uninsured, and that this longer term effect isn't reflected in these tables. But that would suggest that the substantive impact of these bills in improving access would be much delayed. If so, that point hasn't been made abundantly clear.

But for all the political flack health reform has stirred up, none of these bills really "wow" me. And I'm still waiting for the opponents of Reform to get really pissed off at the idea of individual mandates. But that would of course imply that opponents are interested in substantive issues.