ACTUALLY WE RANK # 37 …………..

President Obama tried to sell his health care overhaul in prime time, mangling some facts in the process. He also strained to make the job sound easier to pay for than experts predict.

• Obama promised once again that a health care overhaul “will be paid for.” But congressional budget experts say the bills they’ve seen so far would add hundreds of billions of dollars to the deficit over the next decade.

• He said the plan “that I put forward” would cover at least 97 percent of all Americans. Actually, the plan he campaigned on would cover far less than that, and only one of the bills now being considered in Congress would do that.

• He said the “average American family is paying thousands” as part of their premiums to cover uncompensated care for the uninsured, implying that expanded coverage will slash insurance costs. But the nonpartisan Kaiser Family Foundation puts the cost per family figure at $200.

Obama claimed his budget “reduced federal spending over the next 10 years by $2.2 trillion” compared with where it was headed before. Not true. Even figures from his own budget experts don’t support that. The Congressional Budget Office projects a $2.7 trillion increase, not a $2.2 trillion cut.

With the health care debate on Capitol Hill raging on, President Barack Obama held a prime-time news conference July 22 to make his pitch for a health care bill once again to the American public. Among his facts and figures, we found some false and questionable statements.

Paying For It

Obama promised that a health care overhaul “will be paid for.” Thus far, that’s been a tall order.

The House bill doesn’t pay for itself, adding a net $239 billion over 10 years to the federal deficit, according to an analysis by the Congressional Budget Office and Joint Committee on Taxation. The Senate Health, Education, Labor and Pensions Committee bill is much further away from covering its costs. The CBO estimated that legislation would bring a net deficit increase of $597 billion over 10 years. The Senate bill, CBO said, only produced net savings of $48 billion (compared to current law), while the House came up with more money, saving $219 billion and bringing in $583 billion in federal revenue over that 2010-2019 period.

As the Committee for a Responsible Federal Budget, a bipartisan group, said in a report released this month, it’s tough to save money while greatly expanding health care coverage at the same time:

CRFB: More access and broader coverage do not save money, however. Greater coverage will increase health spending. Unless major changes are successfully implemented in health care delivery and payment systems, costs will continue to rise from a larger base at a rapid pace. Moreover, potential savings are speculative, while costs are far more certain. That imbalance suggests that unless there is broad popular support for the measures that will be required to achieve savings, the nation’s health care bill could become that much more unaffordable.

Obama went on to say that “the entire cost of that has to be paid for and it has got to be deficit-neutral. And we identified two-thirds of those costs to be paid for by tax dollars that are already being spent right now.”

“Identified” is the key word – the White House may have pinpointed ways it says can save that much, but whether the president can make these happen is an open question. Obama has spoken before about saving around $650 billion (about two-thirds of a cost of $1 trillion over 10 years) by cutting spending, largely in Medicare. But proposed cuts in payments to insurers and hospitals are likely to draw strong opposition from lobbyists and lawmakers. And Obama admitted last night that legislators hadn’t adopted his proposals: “Not all of the cost-saving measures I just mentioned were contained in Congress’ draft legislation,” he said – but he remained optimistic, adding that “even though we still have a few issues to work out, what’s remarkable at this point is not how far we have left to go, it’s how far we’ve already come.”

Obama detailed a few of his Medicare savings proposals last night and went into greater detail in a speech June 15 at the American Medical Association conference. Some of the ideas are backed up by independent studies, at least in theory: Obama proposes introducing a competitive bidding process for Medicare Advantage, a program through which private insurers offer Medicare coverage and get higher payments from the government than standard Medicare reimbursements. Last night, he said it would save “over $100 billion of unwarranted subsidies that go to insurance companies”; he’s said before that it would save $177 billion over 10 years. And the CBO has estimated such a proposal could save nearly that much, $159 billion over 10 years.

Other proposals are more vague: Obama has called for adjusting Medicare payments to “reflect new advances and productivity gains in our economy,” which, he told the AMA, would “create incentives for providers to deliver care more efficiently,” saving about $109 billion over 10 years.

As CBS News anchor Katie Couric recently asked Obama, “[A]ren’t a lot of these cost savings, Mr. President, theoretical?. … [T]here are no guarantees these projected savings will really happen.”

The president dodged the question: “Well, here’s what we know. Here is a guarantee: If we do nothing, then health care inflation is going to keep on going up at 8 percent, 9 percent, 10 percent a year. … If we take these actions, we are confident that we can actually see some serious reductions in health care inflation.”

Beyond paying for a health care bill, however, Obama has said an overhaul of the system will actually save money – or at least save money compared with what health care spending would have been without changes to the system. In his press conference, Obama said “the bill I sign must also slow the growth of health care costs in the long run.“ What Congress has proposed so far doesn’t do that, either.

CBO’s analysis of the House bill does recognize specific savings that the legislation will reap from changes to Medicare, but also highlights some increases the bill would make in Medicare spending as well. Overall, that bill and the Senate’s don’t control the rising costs of federal health programs, according to CBO Director Douglas Elmendorf, who told the Senate Budget Committee last week that the bills didn’t have “the sort of fundamental changes” that would change the cost curve. On the contrary, he said: “The curve is being raised.

Obama: And we know that we’re spending on average, we here in the United States are spending about $6,000 more than other advanced countries where they’re just as healthy.

In fact, the U.S. spends nearly $7,000 per person total, or nearly $2,500 more than the next highest-spending country, according to the most recent completed data from the Organisation for Economic Co-Operation and Development.

We contacted the Office of Management and Budget, where an official told us that Obama’s figure represents costs per family, not per person. Obama didn’t specify that, and the authoritative OECD figures on which he relied don’t offer a per-family cost. The OMB official said the administration multiplied the per-capita spending by 3.3 to get a family figure (roughly the average number of persons living in family households). This yields closer to an $8,000 difference than $6,000, however, so we’re still unsure of how Obama got his figure. In any case, using a per-family figure without identifying it as such is misleading, since millions of Americans live alone, and per-capita spending is the standard used for making such comparisons.