T-Word Looms Large In Health Care Cost Debate The preliminary price tag of $1 trillion for a health care overhaul bill has Republicans up in arms and one Senate committee back to the drawing board. But one expert says the figure is a drop in the bucket compared to how much the nation currently spends on health care.
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T-Word Looms Large In Health Care Cost Debate

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T-Word Looms Large In Health Care Cost Debate

T-Word Looms Large In Health Care Cost Debate

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It's MORNING EDITION from NPR News. I'm Steve Inskeep.

This just in: health care reform is going to cost money. President Obama in a speech to the American Medical Association this week said he expected making health care affordable for all Americans to cost, quote, on the order of a trillion dollars over the next ten years.

President BARACK OBAMA: That's real money, even in Washington.

(Soundbite of laughter)

INSKEEP: Although lawmakers on Capitol Hill are not laughing over the price tag. NPR's Julie Rovner reports.

JULIE ROVNER: Earlier this week, the Congressional Budget Office said a bill now being debated at the Senate Health, Education, Labor and Pensions Committee might cost $1 trillion over the next decade.

There wasn't too much concern about that number. That bill wasn't finished and the estimate was for only part of it. But when the CBO said a more complete draft being worked on by the Senate Finance Committee might cost $1.6 trillion over that same period senators hit the panic button.

Finance Committee Chairman Max Baucus immediately said he'd go back to the drawing board to rework the measure.

Senator MAX BAUCUS (Democrat, Montana): I think it'll be under a trillion -probably just under a trillion - and it'll be fully paid for.

ROVNER: Baucus, who's been working hardest of the five committee chairman in charge of the health care effort to find bipartisan consensus said his decision to scale things back was based on conversations he's been having with his Senate colleagues.

Senator BAUCUS: I just think it's what the country wants, really, and what Congress wants. I think that if you go over $1 trillion it starts to run into some natural resistance, which causes problems we don't need to have.

ROVNER: One of those problems is the way Republicans jumped all over that trillion dollar word. Here's how Georgia Senator Johnny Isakson put it at the Senate Health Committee on Wednesday.

Senator JOHNNY ISAKSON (Republican, Georgia): If you converted dollars to seconds, and you said how many years will it take for a trillion seconds to pass, it's 317,097 years, 11 months and two days.

ROVNER: But while Baucus may be correctly reading the mood of his colleagues they may not be correctly reading the mood of the public. At least that's the conclusion of Andrew Kohut of the Pew Research Center for People and the Press. Kohut says that the public is generally averse to massive new spending programs…

Mr. ANDREW KOHUT (Pew Research Center for People and the Press): It's still very pro free enterprise and has reservations about big government and big budget deficits.

ROVNER: But the public is even more eager to see something done about health care. And when he and his colleagues asked specifically which is more important, fixing health care or controlling the deficit…

Mr. KOHUT: A pretty wide majority say fixing health care. So with respect to priorities, the priority is with health care reform not the budget deficit.

ROVNER: In fact, say some budget analysts, Congress could be shooting itself in the foot if it spends too little on health care. Jacob Hacker is a political scientist at the University of California, Berkeley and the author of the health care plan on with most of the current congressional plans are based. He says it is possible to do a plan for under $1 trillion over 10 years, but the only way is likely by doing less for those in the middle class.

Mr. JACOB HACKER (Political science, University of California Berkeley): And that's a huge mistake, because we learned from the failure of the Clinton health plan that you really have to address the concerns of middle class Americans about the affordability and security of their coverage. You have to answer the question what's in it for me.

ROVNER: Hacker also says that senators shouldn't be rattled by the size of the numbers, because in comparison to what the U.S. spends now on health care, more than $2.2 trillion a year, another $1 trillion over the next 10 really isn't all that much.

Mr. HACKER: It's a drop in the bucket in many ways. If you think about it, the difference between $1 trillion and $1.5 trillion over 10 years is probably about a half of a percent of difference in growth in health spending over those years.

ROVNER: Or you could look at the number the way children's math and science author David Schwartz did last year on SCIENCE FRIDAY.

Mr. DAVID SCHWARTZ (Author): A trillion dollars would be enough to buy a thousand boxes of Girl Scout cookies for every person in the United States, if that's how you wanted to use the money.

ROVNER: Now, that would likely set off a debate in Congress.

Julie Rovner, NPR News, Washington.

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