Tuesday, December 22, 2009

EBITDA: Estimates before I tricked the dumb accountants

The mad rush to pass health care reform before anybody has read the legislation is all about getting the foot in the door or the camel's nose under the tent, whichever you choose. From Paul Krugman to the Boston Globe, there's this admission that it's a stinker of a bill but we can fix it later.

Except that, if history is any guide, the political pressure on new programs is always towards expansion and never cost containment. Which is why the Senate had to resort to all kinds of trickery to make a laughably "deficit neutral" reform package. Here's Charles Krauthammer explaining the chicanery:

Number one, the only reason it ends up with a surplus is because it strips out - well, it assumes that there will be cuts in reimbursements for doctors of 21 percent next year with no increase over a decade. They're 100 percent certain that is not going to happen, but it's in the bill because [there will be] will be a separate provision that will strip it out. So once you calculate that in, you're already in the red.

Secondly, and this is the most important, it supposedly costs $850 billion over ten years. But 98 percent of the costs of the bill are in the last six years. So it's a trick. If you actually look at real charges, you start in 2014 when the benefits kick in and you go out ten years, then the cost is not slightly under $1 trillion. It is $1.8 trillion or $2.5 trillion, which means it will blow an enormous hole in the deficit.
In other words, once the four years of tax hikes to fool the CBO have passed and the program needs to stand on its own, the "deficit neutral" health care reform will be anything but. So far, Americans have been more difficult to dupe:

By 73-18 percent, voters don't believe President Obama will be able to keep his promise to overhaul health care without increasing the federal deficit and by 56 - 37 percent they don't want the overhaul if it will increase the deficit.
This debt explosion will be piled on top of this.

Extra - Now they tell us. The CBO says it's going to be really hard to make those Medicare cuts: "It is unclear whether such a reduction in the growth rate can be achieved."

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