Reform debate circles back to costs, and how to pay for them

In the White House's pitches for health care reform, controlling costs has replaced universal coverage as the leading imperative to overhaul the system. A top White House economist, Christina Romer, said in a public appearance Monday, "Good health care reform is good economic policy," the San Francisco Chronicle reports. "Fixing what's wrong with our health care system is no longer a luxury we hope to achieve – it's a necessity we cannot postpone any longer" (Abate, 6/9).

In one sign of the dire budgetary situation and urgency of cost controls, President Obama is expected to propose  "tough new rules that would require lawmakers to pay for new initiatives – including an overhaul of the health system," the Washington Post reports. "The rules would forbid lawmakers from expanding entitlement programs such as Medicare… unless it is covered by spending cuts or tax increases" (Montgomery, 6/9).

Tax increases are also among the plans for financing the overhaul. "House Democrats are considering a new tax on employer-provided health benefits to help pay for expanding coverage to the uninsured," the Associated Press reports. The Obama administration's receptiveness to that plan is "less-than-rousing," but it has been "gaining currency in recent weeks as Congress intensifies its search for more than $1 trillion to help pay for a health care overhaul" (Espo, 6/9).

Even if Congress does add that tax, it would only "generate $418.5 billion over the next 10 years," CQ Politics reports. "That's not enough to pay the full cost of expanding health insurance to all Americans, but it would make a significant dent in the estimated… price" (Rubin, 6/8).

Wide geographic disparities, another component of cost, also have the attention of lawmakers and the administration, the New York Times reports. "Members of Congress are seriously considering proposals to rein in the growth of health spending by taking tens of billions of dollars of Medicare money away from doctors and hospitals in high-cost areas and using it to help cover the uninsured or treat patients in lower-cost regions," the Times reports" (Pear, 6/8).