Shorter Media: CBO, What CBO?

All summer, traditional media reporters hyperventilated [1] at every preliminary Congressional Budget Office estimate [2] of draft health care bills. [3]

Yet after the House bill was deemed by the CBO to be a deficit cutter, as was the Senate Finance Committee bill that is the basis for Sen. Reid's forthcoming version, the media are responding by going out of their way to find excuses to say health care reform would still cost too much.

Yesterday, W, Post's Fred Hiatt decreed that the House bill "could take America a step closer to bankruptcy," [4] waving off the CBO estimates because "the CBO is not allowed to count $250 billion in projected Medicare payments to doctors over the next 10 years" and " the CBO [is not] permitted to ask whether Congress will truly cut hundreds of billions of dollars from Medicare programs in coming years, as the House bill assumes." Hiatt's colleague, and actual health care expert, Ezra Klein was compelled to give a gentle rebuke: [5]

He's talking about, first, a fix to Medicare reimbursement rates that really isn't part of health-care reform, and, second, the capacity of Congress to make hard decisions about, well, anything. Fair points both, but neither here nor there when it comes to the House legislation.

Today, the New York Times ran a news article with a misleading headline, "Democrats Raise Alarms Over Costs of Health Bills" [6] -- uh, you mean the bill Democrats just passed? -- which complains that the House bill does not include "setting Medicare reimbursement rates for doctors and hospitals more rigorously and discouraging workers and employers from buying expensive health insurance policies that mask the true costs of treatment," and downplays the fact that the Senate Finance bill does include them.

(The latter proposal may be a cost saver, but there are other ways to cut costs without raising taxes on some middle-class households [7]. However, regardless of my view, it's certainly on the congressional table, so it's misleading to complain that it's not in the bill.)

Somehow the public option wasn't even mentioned in the article. Dean Baker took to task a separate NYT piece for treating the public option as the product of base ideology [8] and not a pragmatic way to reduce costs.

More notably, the White House's budget director was compelled to rebut the NYT on his blog [9], detailing all the cost containment strategies in both House and Senate versions:

Every two weeks or so, there seems to be a story ringing the alarm bells over the fiscal dimension of health reform.

As I've said time and again, the President is committed to signing a health reform bill that is deficit neutral in the first decade – and deficit reducing thereafter. The legislation under consideration in the Senate and the bill passed Saturday by the House both meet these tests.

But health reform effort must go beyond simply being deficit neutral over the first decade and deficit reducing thereafter; it must also begin the process of transforming the health care system so that it delivers better care, not just more care...

...The House and Senate versions of reform share a variety of measures that will help create this health care system of the future, which will help to contain health care cost growth while also providing Americans with higher quality care. In addition to historic investments in health information technology, research into what works and what doesn't, and prevention and wellness investments that were included in the Recovery Act, some of the key provisions under consideration in the health reform bills include:

* Changing the way we pay hospitals, to discourage mistakes and unnecessary readmissions.

* Creating incentives in the payment system to reward quality of care rather than just the quantity of procedures.

* Giving physicians incentives to collaborate in the coordination of patient care.

* Investing in research into what works and what doesn’t in health care.

* Reducing hospital-acquired infections and other avoidable health-center acquired conditions through rigorous reporting and transparency.

* Imposing a fee on insurance companies offering high-premium plans — which would create a strong incentive for more efficient plans that would help reduce the growth of premiums.

* Establishing a Medicare commission — which would develop and submit proposals to Congress aimed at extending the solvency of Medicare, slowing Medicare cost growth, and improving the quality of care delivered to Medicare beneficiaries.

Orszag then pointed to an open letter by prominent health care and budget experts proclaiming that the House bill [10], which does not include the specific provisions promoted by the NYT article, offered much cost saving potential:

[The bill t]akes initial steps to 'bend the cost curve' and thus might lead to even larger cost savings than official estimates suggest.

Surely, there are differences of opinion among experts about what cost containment strategies are the best. But these reporters appear to be continually moving the goalposts to adhere to a manufactured narrative that the health care bills would lead to reckless spending, to the point of severely downplaying factual information that would upset the narrative.

Not exactly the hallmark of objectivity and pragmatism.