The Biggest Entitlement Spending Cut in History--and "Deficit Hawks" Are Running Away from It - Health-care reform's grand bargain
It's buried in the health care bill. We think it has teeth--and the Congressional Budget Office agrees:
Ezra Klein - Health-care reform's grand bargain: This is how health-care reform controls costs. It is, at its base, a grand bargain: The coverage expansion gets liberals to agree to, and even advocate for, cost controls they would never otherwise consider. A 6 percent growth target? A super-MedPAC -- now called the Independent Medicare Advisory Board -- that reforms Medicare to save money and whose recommendations are fast-tracked and protected from the filibuster? Hundreds of pages of changes to payment rates and experiments in value-based purchasing and coordinated care efforts? This stuff is very, very real, and it goes into effect very quickly. You may think it's impossible for Congress to cut costs in Medicare and the government will just go bankrupt, but even you'd have to admit that this is what it would look like if the government was cutting costs in Medicare.
If this piece of the bill was passed on its own, it would be the most important cost control bill ever considered by the United States Congress. But you could never have passed it on its own. You needed the coverage to make the grand bargain work. Republicans like to call this bill a trillion-dollar experiment to expand the health-care system, and in some ways, it is. But it's also a multitrillion-dollar experiment to cut costs in the health-care system, and it deserves credit for that, and support from fiscal conservatives. It's easy to talk about cutting costs, but this is the chance for people to actually do it.
So why aren't the world's deficit hawks--the Blue Dogs, the (honest) Republican legislators who care about the country, the Concord Coalition, et cetera, et cetera--all out there hosanna-ing about the health care reform bill?
In the case of the (honest) Republican legislators who care about the country, they probably are--but it is hard to observe an empty set. But the rest? Where are they
