The cost of health care reform

It has already been noted that the Congressional Budget Office is placing the cost of health care reform at $1 trillion. Doug Bandow points out that an outside group is assigning the legislation the even higher price tag of $4 trillion. Whether they are correct no one knows, but they are probably correct in placing the cost figure higher than the government, which has a history of consistently underestimating the costs of new social programs:

In fact, every federal social program has cost far more than originally predicted. For instance, in 1967 the House Ways and Means Committee predicted that Medicare would cost $12 billion in 1990, a staggering $95 billion underestimate. Medicare first exceeded $12 billion in 1975. In 1965 federal actuaries figured the Medicare hospital program would end up running $9 billion in 1990. The cost was more than $66 billion.

In 1987 Congress estimated that the Medicaid Special Hospitals Subsidy would hit $100 million in 1992. The actual bill came to $11 billion. The initial costs of Medicare's kidney-dialysis program, passed in 1972, were more than twice projected levels.

The Congressional Budget Office doubled the estimated cost of Medicare's catastrophic insurance benefit—subsequently repealed—from $5.7 billion to $11.8 billion annually within the first year of its passage. The agency increased the projected cost of the skilled nursing benefit an astonishing sevenfold over roughly the same time frame, from $2.1 billion to $13.5 billion. And in 1935 a naive Congress predicted $3.5 billion in Social Security outlays in 1980, one-thirtieth the actual level of $105 billion.

There is little reason to think that this time will be any different.