Favorite

What’s a trillion? 

If a number can trump a national consensus, a trillion seems to be the magic figure. When the Congressional Budget Office scored one of the two Senate health insurance plans at a budget cost of $1 trillion over 10 years and the other at $1.6 trillion and both plans left out a few million of the uninsured, opponents said it was time to close the shop.

If it's going to add a trillion to two trillion dollars over a decade in either debt or taxes, the Republicans and a few querulous Democrats said last week, we had better wait a few years or else do something small and piecemeal.

But trillions may not panic people the way the word once did. They have seen it a lot in the past decade when it was the Republicans who were running up the numbers. President Bush's tax cuts are adding nearly $2 trillion to the national debt over the decade and all we got from them was a shipwrecked economy. You may remember when President Bush said in 2004 that his Medicare prescription drug program would only add $500 billion to the national debt over its first 10 years. Wait, the White House budget office said two years later when the program got started, make that only $1.2 trillion.

The difference is that President Obama insists on paying for universal health coverage up front, through taxes and savings in current health outlays, and the House and Senate committees are all intent on paying the bill. A New York Times-CBS News poll last week showed that a vast majority of Americans wanted the health-care system overhauled so that every person was insured and costs were reined in, and most accepted the idea that there would need to be new taxes to do it. A stunning 72 per cent, including half of Republicans, thought there should be a Medicare-like public insurance option that competed with private insurers and kept costs down.

So why should a 10-year projection of $1.6 trillion — $160 billion a year — be a deal-breaker as the opponents were saying? It's not so hard to get there.

Even John McCain had a tax remedy. His health-care plan during the presidential campaign included repeal of the exclusion of employer-provided health benefits from a person's taxable income for income and payroll tax purposes, which would produce perhaps $180 billion a year. That is $1.8 trillion or so over 10 years. Sharply restricting the tax break was first recommended by a task force of President Bush. Half of this government subsidy goes to people earning more than $75,000 a year and a fourth to those earning more than $100,000 a year. The tax break is particularly regressive — the higher your income the greater the government subsidy.

Repealing it would be a hard pill for Democrats to swallow — unions oppose it and there is legitimate worry that it might cause many employers to end coverage altogether — but limiting the exclusion to the $13,000 value of the standard federal employee health plan would produce some fairness and still raise $400 billion. That would go a long way toward expanding Medicaid to families earning less than twice the federal poverty line ($19,300 for a family of four). That is about two-thirds of the 46 million uninsured.

President Obama ecstatically announced a “historic agreement” with the pharmaceutical industry to slash the cost of prescription drugs for Medicare beneficiaries who find themselves in the “doughnut hole” — those whose subsidized purchases reach $2,700 in a year. While that is good news for millions of the elderly poor who may now be able to continue the drugs during the closing months of a year it won't save the government much. The pharmaceuticals were worried that they might be required to do much more.

The Center for Budget and Policy Priorities recommends a number of steps to cut tens of billions a year from Medicare and Medicaid outlays that Congress ought to include in the health plan. Drug makers under federal law must pay rebates to the federal and state governments for drugs that Medicaid dispenses, which ensures that Medicaid pays no more than private purchasers. The minimum rebates have not changed in 15 years and ought to be increased, which would save tens of billions of dollars over 10 years.

If Congress required drug companies to provide the same rebates for drugs to dual eligibles (Medicaid and Medicare) under the Medicare drug program as Medicaid requires the government would reap a savings of $86 billion over 10 years.

Those are just for starters. There ought to be nothing daunting about a trillion dollars, or two, over 10 years when it is simply a reshuffling of the $2.5 trillion that the nation already spends yearly with so few results.

 

Favorite

Sign up for the Daily Update email

Comments

Subscribe to this thread:

Add a comment

More by Ernest Dumas

  • Inhuman America

    Our history has included some evil passages — slavery and white supremacy, the forced removal of Native Americans from their homes, the imprisonment and dispossession of Japanese Americans during World War II, the torture of prisoners in latter-day wars — but it is also a part of our history that we came to officially regard them all with shame, as offenses to the human rights that were our original values.
    • Jun 21, 2018
  • Legislative boodlers

    Which sounds like the best use of your taxpayer dollars: helping pay for medical care for unemployed people, or bribing and lobbying legislators and other government officials to bestow millions of your tax dollars on a corrupt organization that claims it helps poor people who have drug problems or disabilities?
    • Jun 14, 2018
  • Scary Granny Pelosi

    Nancy Pelosi has replaced Barack Obama as the all-purpose bete noir of Republican politicians, including Arkansas's, but will she be as potent as the black president?
    • Jun 7, 2018
  • More »

Readers also liked…

  • Along the civil rights trail

    A convergence of events in recent days signaled again how far we have come and how far we have yet to go in civil rights.
    • Jan 18, 2018
  • The Oval outhouse

    One thing all Americans finally can agree upon is that public discourse has coarsened irretrievably in the era of Donald Trump and largely at his instance.
    • Jan 18, 2018
  • Shrugging off sulfides

    The Arkansas Democrat-Gazette reported a shocker on its front page Sunday. The rotten-egg odor from the Koch brothers' sprawling paper plant at Crossett is still making people sick, but the state's pollution control agency is unaware of the problem.
    • Mar 29, 2018

Latest in Ernest Dumas

  • Inhuman America

    Our history has included some evil passages — slavery and white supremacy, the forced removal of Native Americans from their homes, the imprisonment and dispossession of Japanese Americans during World War II, the torture of prisoners in latter-day wars — but it is also a part of our history that we came to officially regard them all with shame, as offenses to the human rights that were our original values.
    • Jun 21, 2018
  • Legislative boodlers

    Which sounds like the best use of your taxpayer dollars: helping pay for medical care for unemployed people, or bribing and lobbying legislators and other government officials to bestow millions of your tax dollars on a corrupt organization that claims it helps poor people who have drug problems or disabilities?
    • Jun 14, 2018
  • Scary Granny Pelosi

    Nancy Pelosi has replaced Barack Obama as the all-purpose bete noir of Republican politicians, including Arkansas's, but will she be as potent as the black president?
    • Jun 7, 2018
  • More »

Most Viewed

  • Where's the outrage?

    Am I the only person, apart from federal prosecutors, outraged about the criminal enterprise that inveigled itself into a privileged position as an Arkansas taxpayer-financed human services provider to the tune, today, of $43 million a year?
  • The battle over Issue 1

    The odds are that the most spending in a statewide campaign in Arkansas this year will not be for a constitutional office, but instead in a battle over a proposed state constitutional amendment.
  • Where's the outrage?

  • Trump doctrine

    Let's face it: President Trump enjoys hurting and humiliating people, and that's the thing some of his loudest supporters like about him. Making women and children cry makes him feel manly and powerful. The more defenseless, the better. He particularly enjoys punishing racial minorities.
  • Inhuman America

    Our history has included some evil passages — slavery and white supremacy, the forced removal of Native Americans from their homes, the imprisonment and dispossession of Japanese Americans during World War II, the torture of prisoners in latter-day wars — but it is also a part of our history that we came to officially regard them all with shame, as offenses to the human rights that were our original values.

Most Recent Comments

  • Re: Him, again

    • That's why it is better to bag babes at the bigger libraries. You get a…

    • on June 20, 2018
  • Re: Legislative boodlers

    • The U6 unemployment rate is still at 8%, partly because they can get benefits and…

    • on June 19, 2018
  • Re: Him, again

    • Regardless of my success or lack of it, I've been way ahead of Trump all…

    • on June 19, 2018
 

© 2018 Arkansas Times | 201 East Markham, Suite 200, Little Rock, AR 72201
Powered by Foundation