By Philip Klein on 7.16.09 @ 6:15PM
The Vice President doesn't let facts get in the way of a bad
analogy.
"What I want to do today is speak English with y’all,” Vice
President Joe Biden told an audience of mostly older Americans at
an event in Alexandria on Thursday afternoon's meeting of his
Middle Class Task Force.
Flanked by Health and Human Services Secretary Kathleen Sebelius,
White House Health czar Nancy-Ann DeParle and Barry Rand, CEO of
AARP, Biden said he wanted to make sure people understood the
health care debate in plain language, without the kind of wonky
jargon that dominates discussions of such subjects.
In the course of doing so, he made some bizarre analogies and
never allowed the facts to get in the way.
"Can we possibly afford to do nothing when health care costs have
gone up 57 -- if I'm not mistaken -- percent just since 2002?"
Biden asked rhetorically. "Now folks, if your milk went up 57
percent and no end in sight, guess what? There would be a lot of
dead cows. No one buying milk. You can't afford it."
Beyond the fact that it's hard to understand why the price of
milk or the mortality rate of livestock would have anything to do
with health care reform, Biden's example makes no sense from an
economic standpoint. Basic economic theory would hold that, if
anything, cattle ranchers would respond to rising milk prices by
breeding more cattle.
In his opening remarks and throughout the question and answer
period, Biden kept pounding on the administration's theme that
the only way to control costs is to overhaul the health care
system the way Democrats want to. That in fact, having the
government provide free or heavily subsidized insurance to tens
of millions of more people was actually the fiscally responsible
thing to do.
"The status quo is simply not acceptable -- it's totally
unacceptable," Biden said. "And it's completely unsustainable.
Even if you wanted to keep it the way you have it now, we can't
do it financially. We're going to go bankrupt as a nation."
He said he understood that it may seem counterintuitive to some
people.
"When I say that, people look at me and they say, 'You're telling
me we have to spend money when we're going bankrupt?'" Biden
exclaimed. "The answer is yeah, that's what I'm telling you."
Biden noted that Medicare and Medicaid, unless changes are made,
"will eventually grow larger than what our government spends on
everything else in the world combined."
"Not only is it immoral not to provide everybody with decent
health care, which is my view, the president's view, and the
administration's view," he said. "It is also fiscally
irresponsible."
His comments had an added irony coming on Thursday, because
earlier in the day, the director of the Congressional Budget
Office
testified that the Democratic health care proposals only make
the health care cost issue much worse.
Democrat Kent Conrad, chairman of the Budget Committee, asked CBO
director Doug Elmendorf: "From what you have seen from the
products of the committees that have reported, do you see a
successful effort being mounted to bend the long-term cost
curve?"
Elmendorf responded, "No, Mr. Chairman." He explained, "In the
legislation that has been reported we do not see the sort of
fundamental changes that would be necessary to reduce the
trajectory of federal health spending by a significant amount.
And on the contrary, the legislation significantly expands the
federal responsibility for health care costs."
But in his remarks, Biden pushed back against the way the CBO
assesses the cost of legislation, arguing that it failed to take
into account savings from preventive care.
"We can show these studies done by really first rate think tanks
like the Rand Corporation and these studies funded by medical
schools and hospitals and universities that say hey, look, if we
can prevent people from becoming obese, what would happen is we
would save the health care system billions of dollars," Biden
said. "So we go, and we say to the people who are oppose us,
look, we're not wasting money, we're going to save money, and
they say, 'Show it to me, prove it to me.'"
Then, in a clear reference to the CBO, Biden explained in
layperson's terms, "Then you have these good guys, these
accountants kind of, the green eye shade guys, they sit there and
say, 'well how do we score this? How can we prove like we can
prove in other savings we're talking about where we can add up
all the nickels and dimes and millions and billions and say we
saved that much money?'"
He continued, "So even though we know we're going to save a lot
more money than we're given credit for that we're going to save
with this health care plan, it isn't susceptible to being able to
prove with a sharp pencil, or now, with a mouse on a computer,
exactly how much is going to be saved. So that's what we mean
when we say we're doing things that we know are going to save
you, your grandchildren, billions of dollars over the years and
make you healthier. But, we're not able to prove it yet, because
there's all those studies showing it, it's not scorable."
In reality, there's far from a consensus on whether preventive
care can save money. A New England Journal of Medicine
article published last year warned
against "sweeping statements about the cost-saving potential of
prevention," emphasizing that, "Studies have concluded that
preventing illness can in some cases save money but in other
cases can add to health care costs."
Increasing screening tests among a broader and mostly healthy
population, for instance, can cost more than would be saved
treating a smaller population of people who are actually sick.
As he was wrapping up his remarks, Biden claimed, "We're not
passing anything that isn't paid for, it ain't going to the
deficit." It's rather odd, of course, because normally when you
save money, it means you don't have to pay for it.
In any event, Biden explained that the Democrats would use $600
billion in Medicare savings to pay for most the health care
legislation, but the rest would either be made up of the tax
"surcharge" proposed by House Democrats (which would drive the
top rate above 50 percent) or through capping the charitable tax
deduction on wealthier Americans. In reality, Democratic bills
would also raise taxes on businesses that did not provide health
insurance to their employees and on individuals who do not
purchase insurance on their own -- a direct violation of Obama's
campaign pledge not to raise taxes on those earning less than
$250,000 a year.
Biden offered the crowd another whopper for the road: "If we did
nothing, and did what the HELP committee just passed, we wouldn't
have to do a thing, just the Medicare savings alone would cover
everything."
To translate that into English, as Biden might say, what he is
arguing is that the full cost of the Senate Health, Education,
Labor and Pensions committee bill could be covered by the $600
billion in Medicare "savings" alone -- without the need for any
tax increases. It's true that the CBO did put out an estimate
assessing the cost of the legislation at $597 billion over ten years
-- but that estimate was only measuring a portion of the bill.
Missing from the projection was the cost of expanding Medicaid to
as many as 20 million additional beneficiaries, which the bill
also calls for. And the CBO estimates that the Medicaid provision
alone would cost $500
billion.
So it turns out Biden isn't too good at speaking English. Maybe
he should try Greek next time?