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CMS: HR 3200 will bend the cost curve... upward


[chart stolen adapted from the incomparable Ian Welsh]

You've read/heard the phrase bending the [cost] curve [downward] once or twice by now, and in case you've been a tad confused [or not] about what that means, basically it's what Canada did in 1970 when single payer went completely nationwide there.

Up until then, Canada's health care system was practically identical to ours -- they lived about as long as us, they had similar infant mortality, they had the same kind of private insurance we do, they spent the same percentage of their GDP on health care, their health care spending was rising at the same rate as ours.

But a funny thing happened in the 1960s [isn't that the turbulent DFH decade that Obama doesn't want us to hearken back to?]. First it was Saskatchewan, then the rest of the country, removing the private insurance leeches industry from the business of providing essential medical care and replacing it with government-run health insurance. By 1970 the entire country had gone to single payer, and with this simple mechanism in place was able to more strongly control the rise in health care costs. Thus the dramatic bend in the curve at 1970 [another, uglier, but slightly more updated chart here].

Fast forward to the present, where CMS [home of Medicare and Medicaid] has done their own scoring of HR 3200 [the version that was reported out of the House Ways and Means committee]. You can dig through the CMS report here. While the estimated 11% lower premiums for the public plan [see pg 6 of the report] are worth celebrating, there's an interesting side note too. CMS estimates that total national health expenditure in 2019 would be 20.8% of GDP if we do nothing, but if we enact HR 3200, total NHE will be 21.3% of GDP in 2019. No that's not a typo on my part, CMS says so, check out Table 5 [page 25].

Just sayin.

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