What Simpson-Bowles has to say about health care spending reform (it's not what you think)

David Fitzsimmons va politicalcartoons.com

"I'm a Very Serious Person', and I want to ameliorate the crushing debt threatening our children. Entitlements are the biggest threat, so we need to get rid of Obamacare and instead implement Simpson-Bowles."

Please note that any dialogue remotely resembling the above qualifies you for the pundit trash heap. It means you have no idea what you are talking about, and likely have no interest in remedying it. Then again, that's a generic pundit job description, isn't it?

But, still... there are are issues on the table about the fiscal cliff and entitlements, so let's take a walk down Memory Lane with Alan Simpson and Erskine Bowles' commission.

In December of 2010, the blue ribbon debt reduction commission (aka National Commission on Fiscal Responsibility and Reform) chaired by Simpson and Bowles, couldn't get enough votes from commissioners (they needed 14 and got 11) and therefore never issued an official report (for example, Dick Durbin and Tom Coburn voted for it, Paul Ryan and 7 others voted against it.)

Undeterred (and subsequently backed by corporate funds), Simpson and Bowles issued a 66 page report anyway. It's called, portentously enough, The Moment of Truth (.pdf).

The funny thing is, though, when you look to see what the report actually said about health care costs, they whiffed on their moment of truth. The commission report said almost nothing except "let's see what Obamacare does, and if that's not enough to enact savings, we can and should do something else (more on that in a moment.) But don't take my word for it, let's look at their exact language (page 41):

Commission members, and virtually all budget experts, agree that the rapid growth of federal health care spending is the primary driver of long-term deficits. Some Commission members believe that the reforms enacted as part of ACA will 'bend the curve' of health spending and control long-term cost growth. Other Commission members believe that the coverage expansions in the bill will fuel more rapid spending growth and that the Medicare savings are not sustainable. The Commission as a whole does not take a position on which view is correct, but we agree that Congress and the President must be vigilant in keeping health care spending under control and should take further actions if the growth in spending continues at current rates.

Get that? "Some say" Obamacare will work to cut costs, "some say" it won't. We don't know. But we should wait and see on whether it does.

It's for that reason that Paul Krugman, writing about Simpson-Bowles, concludes:

It offers nothing on Medicare that isn't already in the Affordable Care Act.

This is no surprise. Back in August 2011, I wrote two posts about Medicare. In Medicare: Why is it on the table? we discuss the demographic time bomb pushing costs up (the number of Medicare recipients nearly doubles by 2035). In Medicare: What can we do about it?, we review savings for Medicare built into ACA:
From Center for American Progress From that and from the actual commission report, we can only conclude:

Actual S-B Position 1:

' Simpson-Bowles recommends finding out whether ACA helps to control costs before implementing anything else to cut Medicare and Medicaid. If you support Simpson-Bowles, you support waiting on discussing Medicare and Medicaid cuts.

I'll bet you didn't know that, and I am certain the pundits didn't, either. But when Republicans have a fit about Obama taking a hard line on this in fiscal cliff discussions, just remember that Republicans Tom Coburn, Judd Gregg and Mike Crapo'all who voted for the report'and other Very Serious People' in Washington, including Alice Rivlin and Simpson and Bowles themselves, agree with Obama's position.

But wait, there's more below the fold...