Sunday, August 9, 2009

Damagin' Doug Piles On

I've written a few times on the nerdfight between the Congressional Budget Office's "Damagin'" Dough Elmendorf and the Office of Management and Budget's Peter "the Piper" Orzag over the costs of ObamaCare. The last time we encountered these guys, Elmendorf had just crushed Orzag's claims that a new "Medicare Commission" would magically solve ObamaCare's crippling budget forecast.

Orzag has not been heard from since. (I'm kidding... kinda.)

And yet, Elmendorf's onslaught continues today with this 7-page dismantling of the President's bold claims that ObamaCare's "prevention" and "health" programs would create massive long-term savings for the US health system. In a letter to Congressman Nathan Deal (R-GA), ranking member on the House Health Subcommittee, Elmendorf made clear that no such savings exist, and in fact the prevention/health programs will raise costs:
Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.


More generally, however, designing government policies that are effective at inducing people to be healthier is challenging. Even successful efforts might take many years to bear fruit and could involve significant costs. Moreover, many employers already support some wellness services for their employees, and new government efforts to encourage such services could end up paying for services that some individuals are already receiving — which would add to federal costs but not reduce total future spending on health care. As with preventive medicine, the net budgetary effect of government support for wellness services depends on the balance of two factors — the reduction in government spending for people who reduce their future use of medical care and the costs to the government of providing or subsidizing wellness services.
Damagin' Doug wins again. I just hope Orzag's on vacation or something.

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