The Senate Finance Committee is expected to pass its health-care bill Tuesday, while the Congressional Budget Office reviews the three House variations this week. Democrats may be cheering, but the San Francisco Chronicle’s Carolyn Lochhead points out a few leetle problems with all the legislation:

None of the bills is likely to reduce the government’s costs. Democrats rejoiced when the Congressional Budget Office gave a green light to the Finance Committee bill, judging that it would reduce deficits by $81 billion over the next 10 years, with continued reductions after that, meeting Obama’s test that reform will “not add one dime to the deficit.”

But almost nobody believes that will happen because much of the savings would come from a familiar budget gimmick – a promise to reduce payments to doctors and hospitals. Congress, under Democrats and Republicans, has promised such cuts in the past and almost always reversed them.


Expanding preventive care has been billed as a way to reduce costs, but it is more likely to increase them.

The idea that preventing chronic disease would not save money seems counterintuitive. But Jay Bhattacharya, director of Stanford University’s Center for Primary Care and Outcomes Research, poses an example of a patient saved from a heart attack who later dies from a more costly cancer.

“People have to die of something,” he said. “If you save them from one thing, they’re going to die of something else, and that something else can be more expensive.”


The Senate Finance bill intends to reduce the burden of forcing employers to provide insurance, but it could wind up leaving low-income people jobless.

That’s because the bill requires firms that do not offer insurance to repay the government for subsidies their employees receive, giving firms a reason not to hire them, said the liberal Center on Budget and Policy Priorities.


Bipartisan alarm about forcing young people to buy costly insurance that they think they don’t need led the Finance Committee to gut fines on those who refuse to buy insurance. There would be no penalties at all in the first year and they would not exceed $750 even by 2017, less than the cost of just about any insurance policy.

Similar problems are in the House legislation, according to health care consultant Robert Laszewski. That means young people who are expected to enter the insurance pool and cut costs for everyone else may not sign up.

Finder’s fee: National Review Online’s John Hood, who adds: “[T]his is not to suggest that preventive care isn’t a valuable thing. The point is simply that it doesn’t pay for itself. There will never be a medical perpetual-motion machine, no matter how hard the Leader wishes it were so.”