In general, Americans dislike their government. Washington is an epithet. A foreign land where people who are out of touch do silly things.
Get specific and Americans admire and respect their government. We honor the courage of our soldiers. We watch movies and TV shows about the exploits of our FBI agents.
Less glamorous, but still worthy of respect is the Congressional Budget Office. These are the wonks and numbers nerds who try to keep lawmakers honest by costing out proposals and asking the tough question: "How much will this cost?"
CBO will be answering those very questions soon on health care reform. CBO's answers will help determine whether the public option lives or dies. Even whether we get reform or not.
Whatever CBO does, we already know there will be a large margin for error. Former CBO Director Doug Holtz-Eakin tells me CBO faces a number of daunting challenges.
Many of the health care reforms Congress is considering make large changes. There is a lot that is new here -- interstate health insurance markets, health exchanges, new insurance rules. Whenever you have new stuff, Holtz-Eakin says you have more room for error.
CBO is also constrained to score what Congress tells it to score. Score is budget-speak for cost out. So, if the Senate Finance Committee says Congress will cut doctor pay by 20% in a couple years, CBO has to believe Congress. It can't label that unlikely and send out a cost-estimate based on a more likely reality.
And that's probably a good thing. CBO is known for trying hard to be non-partisan. It's a "just the facts" kind of place. They take the rules seriously. It's boring, but important. And courageous in a way. By resisting political pressure to tell lawmakers what they want to hear, CBO improves the health care debate.
That doesn't mean that CBO will get it right. In fact, they are probably likely to be wrong. But that is the nature of budget forecasts. It's hard to tell the future. But, Americans might be surprised to know just how earnestly some people in Washington are trying to get it right.
Comments
Hehe, "wonk" is an interesting job title.
Someone mentioned Tuesday that making (non-ER) healthcare available to many people for the first time would increase costs dramatically because they would choose to use it. I guess the alternative would be to deny them care completely and hope to benefit from their demise? Will the CBO tell us which method is more cost effective?