Especially about the future. That may be the message of Jon Gabel of the National Opinion Research Center’s op-ed in the Washington Post, handicapping the CBO’s record on predicting savings that result from healthcare reform:
The budget office’s cautious methods may have unintended consequences in the current health care reform effort. By underestimating the savings that can come from improved Medicare payment procedures and other cost-control initiatives, the budget office leads Congress to think that politically unpopular cost-cutting initiatives will have, at best, only modest effects. This, in turn, forces Congress to believe it can pay for reform only by raising taxes, which then makes reform legislation more difficult to pass.
The Congressional Budget Office’s integrity is beyond questioning. But the record shows that it has substantially overestimated the cost of health care reform three times out of three. As Congress now works on its greatest push for reform in generations, the budget office needs to revise the methods it uses to make predictions about costs.
Disclaimer: NORC is an old client of mine.
I don’t honestly know whether the bills working their way through the Congress will decrease costs, increase costs, or leave them the same. That they’ve been talking about raising taxes to pay for the new plans strongly suggests to me that costs will go up. I also don’t know whether the bills will reduce the rate of increase in healthcare, further increase it, or have no effect at all. However, promising that healthcare consumers will not have to change their behavior at all, as the Administration has, strongly suggests that the bills do not implement serious systemic change and I honestly don’t know how we’ll change the trajectory of healthcare costs without serious systemic change.
The CBO may be a poor tool but, unless you’d prefer the Center for American Progress or the American Enterprise Institute, it’s as good a tool as we have for predicting the effects of bills passed by the Congress. Should the CBO improve its methods? Of course. That doesn’t mean that it’s wrong now or that we should discard its findings altogether. Furthermore, unless you can draw a specific connection between the way that the CBO does its predictions now and the way it did them 10, 15, or 20 years ago, it’s fallacious to point to those past inadequacies as gauges of current or future performance.
Should we be skeptical of the CBO? Definitely. Should we reject its findings outright? Equally definitely not.
