By Kristina Wong

Sep 14, 2009 2:03pm

“Top Line” — Health Care Reform Without Adding to Deficit: Obama’s Impossible Dream?

ABC News’ Rick Klein reports: President Obama today reiterated his pledge that health care reform will “not add a dime to the deficit, now or in the future” — a critical component of his sales pitch to a public that’s growing increasingly concerned about government spending. But is that a promise he can keep? On ABCNews.com’s “Top Line” today, Douglas Holtz-Eakin, a former director of the Congressional Budget Office, said he doesn’t think so — not with health care spending growing far faster than the rate of new revenues. “I think the fundamental problem is that if you cover everybody, you put everyone in a system that is growing too rapidly in costs, and is added onto an entitlement problem where we already don’t have the revenues to pay for it,” Holtz-Eakin told us. “And so you build a big problem up front and there’s no way to unwind that quickly. A way to get there is to be more patient and sequential. Cover targeted groups like working uninsured and as you get savings, channel them back in and cover more people.” “But the political patience isn’t there for that. The promise has been made to cover everyone, and I don’t think it’ll ever add up,” he said. Democrats’ last best chance at producing a product that doesn’t add to the deficit is likely to come this week, as the Senate Finance Committee finishes its long-delayed draft of a health care bill. The CBO is expected to release its cost estimates of that bill this week as well. “They may be frustrated but this shouldn’t be a matter of surprise,” Holtz-Eakin said. “[CBO] put out in January their view of options that would change health care spending. They’ve worked with the staffs on all the drafts of the bills. They’ve talked about things that work [and] don’t work, nd so when they finally get down to putting out these final reports, everyone should know what’s coming. And what they’ll look at when they get a bill from the Senate Finance Committee is number one: How much does it cost? They’re not going to know for sure.” Holtz-Eakin, who was a top adviser to Sen. John McCain’s presidential campaign, also joked about what it’s like to see the president own ideas McCain once espoused, such as subjecting health insurance coverage to taxation, and the creation of “high-risk pools” for those with preexisting health conditions. “Democrats have been phenomenal advocates of most of the McCain plan,” he said. “They will in fact propose the entire McCain plan, and we’ll see how it happens. But substantively this isn’t the same proposal. . . . [T]hey’re going to make the effort to put out a bipartisan proposal in this way, but when the rubber hits the road it’s not there.” Watch the full interview with Doug Holtz-Eakin HERE. We also chatted with Politico columnist Roger Simon about the health care push and the latest trouble signs for the president in the new ABC News/Washington Post poll.

Click HERE to see the discussion with Roger Simon.  

User Comments

does joe wilson have to educate the president again on another falsehood? this dog dont hunt and when your in a hole quit digging. the majority of americans believe this will add to the deficit and so do the experts. please spare us from this nonsense and lets create some jobs. reform insurance please but table the public option stuff.you clowns in washington are wasting valuable time while unemployment soars.

Posted by: catman | September 14, 2009, 2:32 pm 2:32 pm

@catman – One day, you’ll be in the ICU getting health care you can’t afford. That day, you’ll be glad we took the time to design reform.

Posted by: Gerald | September 14, 2009, 2:38 pm 2:38 pm

Impossible dream? Not even close. Taxes are at historic lows – around the levels last seen in the roaring 20′s years of the robber barons. Return taxes to the level under Clinton (prudently – phase the back in), fund the government at levels at least close to every other first world nation on Earth, and it can provide first world nation services. That is, continue to provide first world nation services WITHOUT charging it to Reagan’s credit card (the national debt).

Posted by: jhw539 | September 14, 2009, 2:45 pm 2:45 pm

gerald i have an employee in the icu right now. i pay for excellent coverage for him and all my employess and gladly do so.. if the public option is forced i would be forced to go that route because of economics. what shape would my employee be in now while waitng for spinal surgery.instead they are running multiple tests to detrmine his sudden paralysis. i take care of my people and understand healthcare and the lack thereof.

Posted by: catman | September 14, 2009, 2:49 pm 2:49 pm

Let’s remember our history. When Bush chose to invade Iraq, there was little discussion about funding. Anyone who even considered such things was considered disloyal. When Bush ran the economy into the ground, we, the taxpayers, were told we must pay for the bailout. Again, no discussion about funding. Consequently, when we talk about healthcare, I feel free to ignore any argument about funding. The money will come from the same place that the money for Iraq came from, and with considerably more benefits going to this nation.

Posted by: Whylee98 | September 14, 2009, 2:50 pm 2:50 pm

I say just print the money or have China pay for our care.

Posted by: Huh | September 14, 2009, 2:52 pm 2:52 pm

jhw539.. i agree their at historic lows and so are profits.so if its not adding to the deficits then taxes are going up. thats fine but lets have that debate now and see where this bill goes. be honest with the people and specifically tell themm how his will be paid for and see what the people think. sounds fair enough.

Posted by: catman | September 14, 2009, 2:57 pm 2:57 pm

Whylee98, Lets remember our history, when Johnson chose to invade Viet Nam, their was little discussion about funding. When Johnson created entitlements like Welfare,and medicare, taxpayers were just told we must pay for it. Now we are being told that the money will come from cutting fraud and waste in medicare but you are saying it is coming from the same place that paid for Iraq, who is correct, you or Obama.
The war on poverty did not work and it has cost alot more than Iraq.

Posted by: bob | September 14, 2009, 3:01 pm 3:01 pm

This administratino has SERIOUS issues with math.
They create Phantom statisitics, the so-called “saved-job” and then run around the country claiming they have “saved” some absoultely unprovable number of jobs.
They tell the country pass our plan and unemployment wont go above 8%. I guess they figure the American People cannot tell that 9.7% actually is GREATER THAN 8%!
For many months they have been telling us there were 45, 47, or 50 millino uninsured Americans. The President finally admitted the truth in his speech by publicly stating for the FIRST TIME that the number is 30 Million!
Now he tells us that he can find 500 Billion in waste over 10 yrs in Medicare and somehow find the rest he needs in taxing the top 1% or if he needs to, make budget cuts so that ANY healthcare Outline will be deficit-neutral.
One, when was the last time ANYONE’s 10 yr predictions either come in under or on the target? Yes, libbies I mean from BOTH parties!
Most people who have looked at this scheme acknowledge that yrs 1-10 are not even the biggest problem, its years 10-20 !!!!
amy, what you want to call partisan politics, scare tactics & lies, the rest of us call EXPERIENCE! We KNOW this scheme is not possible and we are calling him on it!

Posted by: Mike_C | September 14, 2009, 3:03 pm 3:03 pm

What difference does it make if he doesn’t keep that promise? What will the repercussions be? Only “haters” will call him out on it anyway, right? Why the rush to get this done? Surely, we can afford a little more time to get it right. It’s not like the “stimulus” bill that just had to be done right away! Our economy is already beginning to recover with a fraction of those “stimulus” dollars spent. I’m guessing the Liberals will spend the rest of it anyway (needed or not).

Posted by: s | September 14, 2009, 3:15 pm 3:15 pm

jhw539 – A noble concept but EVERY administration since Herbert Hoover has added to the debt of the federal government by spending more than they received in revenue. The practice of borrowing to balance the budget has got to stop, it is poor financial policy and eventually unsustainable. The politicians like to claim that they had a budget surplus at the end oy the fiscal year even if the surplus is less than what they borrowed in the first place. Raising taxes won’t help that much, the politicians need to stop their wasteful spending.
An example of governemnt spending can be seen with the Department of Energy which was established in 1977 under President Carter with the goal of reducing the countries dependance on foriegn oil. After over thirty years we are still dependant upon foriegn oil and look at all of the money spent on this well working department. I can’t imagine the government being able to do a better job on healthcare with their brilliant record with the Department of Energy. Other examples of governments ability to run large programs are Medicare where the unfunded benifits (benifits promissed to contributors) will cause the system to be broke in a few short years, Social Security is in slightly better shape than Medicare but not much.

Posted by: Sandcrab1612 | September 14, 2009, 3:18 pm 3:18 pm

“$900 billion is going to be “deficit neutral or I won’t sign the bill”. 1st, only $900 billion? 2nd, Cash for clunkers went from $1 billion to $3 billion within 10 days. We have serious credibility issues dealing with this administration. I don’t believe there is any way we will not raise taxes (or create new ones so we can say we didn’t raise “income” taxes). Be ready for new, hidden and reworded taxes.

Posted by: lfrichar | September 14, 2009, 3:19 pm 3:19 pm

The Iraqi war added trillions to the deficit and it did nothing to help Americans but Republicans are willing to accept that. Being assured of low cost healthcare coverage for all Americans is something that should be embraced. It doesn’t make sense that we can spend trillions to destroy a country (Iraq) and kill thousands and thousands of innocent people and then turn around and complain about spending a trillion to possibly save American lives.

Posted by: johnnyle | September 14, 2009, 3:45 pm 3:45 pm

Another reason why the American People do NOT TRUST the Congress to do the right thing with healthcare….
Simple example, BY LAW the profits that mounting up as the TARP monies are paid back are speficially to go to paying down the debt.
Then in July we have Bumblin Barney Frank pushing to change the law for his purposes…
Frank introduced the “TARP for Main Street Act of 2009,” a bill that would take profits from the program and immediately redirect them toward housing proposals favored by Frank and some fellow Democrats.
So again, what is promised, is not always what happens in the end. By the way, Barney Frank & his cronies playing social engineers in the housing market was a big contributer to the mess that exploded a year ago.
so much for the “Unhappiest man in Congress” learning his lesson!!!!!

Posted by: Mike_C | September 14, 2009, 4:00 pm 4:00 pm

“A noble concept but EVERY administration since Herbert Hoover has added to the debt of the federal government by spending more than they received in revenue.”
Sandcrab1612 | Sep 14, 2009 3:18:40 PM
Don’t be ignorant. The MASSIVE acceleration of deficit spending is quite clear. Look at the graph of the national debt. There is a clear break upwards starting from Reagan to today.

Posted by: jhw539 | September 14, 2009, 4:07 pm 4:07 pm

The problem with spending any trillion dollars is where the heck is it going to come from? Another of the many other obvious problems is that I can’t seem to find anyone that can offer any example of an efficiently run government program? My husband is disabled, I am self-employed and pay for my own insurance, we deal with social security and medicare – it is incredible how complex and difficult and confusing the rules to those games are (ever tried to just get a copy of your social security card – insane), and finally, if the government insurance programs are so wonderful – give us the same programs that the congress and the federal government has for its employees and call it a day.

Posted by: AMarinesMom | September 14, 2009, 4:13 pm 4:13 pm

jhw539 – I’m not looking at who raised it or at what rate just the fact that since Herbert Hoover it has being constantly going up which is wrong. ALL adminstrations are responsible for this irresponsible habit which needs to be stopped NOW.

Posted by: Sandcrab1612 | September 14, 2009, 4:59 pm 4:59 pm

When Federal Politicians decided alcohol had to go, first an Amendment to the Constitution had to be passed to permit Prohibition.
By what authority does the Federal Government presume to take on “Universal Health Care” without first passing an Amendment? Providing or regulating health care is not one of the 11 enumerated powers of the Federal Government listed under general welfare!
And what authority does the Federal Government have to require citizens to purchase a health care policy? If we the people allow this, what will be the definition of disposable income? What segment of the economy will demand government make us buy their product next?
Unemployment is 10% or higher and there is no free lunch. I challenge Washington to bring back and keep good jobs in the USA and there will be no uninsured problem! If they fail I am for Cap and Trade: hand the politicians there caps and trade them in for new ones!

Posted by: BenDoubleCrossed | September 14, 2009, 5:34 pm 5:34 pm

When Federal Politicians decided alcohol had to go, first an Amendment to the Constitution had to be passed to permit Prohibition.
By what authority does the Federal Government presume to take on “Universal Health Care” without first passing an Amendment? Providing or regulating health care is not one of the 11 enumerated powers of the Federal Government listed under general welfare!
And what authority does the Federal Government have to require citizens to purchase a health care policy? If we the people allow this, what will be the definition of disposable income? What segment of the economy will demand government make us buy their product next?
Unemployment is 10% or higher and there is no free lunch. I challenge Washington to bring back and keep good jobs in the USA and there will be no uninsured problem! If they fail I am for Cap and Trade: hand the politicians there caps and trade them in for new ones!

Posted by: BenDoubleCrossed | September 14, 2009, 5:38 pm 5:38 pm

congress do something please. create one stinking job please. just one. dont give me cap and bull. do something,pave this coutry from one end to the other. do something for the good of the working man or someone looking for work.if we were all working we wouldnt need all this crazy stuff. create an atmosphere thats pro jobs. please

Posted by: catman | September 14, 2009, 5:53 pm 5:53 pm

catman – To achieve a pro-jobs atmosphere htey need to reduce the corprate tax rates so that companies won’t have the incentive to move overseas where taxes are lower. Most politicians don’t look at it this way they just tax whoever regardless of the results. If corporate taxes were reduced or eliminated then companies would have funds available to expand resulting in more jobs for our citizens.

Posted by: Sandcrab1612 | September 14, 2009, 6:58 pm 6:58 pm

Obviously that promise cannot be met. You cannot offer promises wiyhout proper costing. The new health plan will go bankrupt within 5 years, or less.

Posted by: Kottaras | September 14, 2009, 7:06 pm 7:06 pm

Caution, has our congress ever done anything without increasing spending?
Has it suddenly received an IQ transplant?
Obama has failed on other promises on spending, remember no earmarks? Then the stimulus didn’t need earmarks it included all that had been septic from being held in the dark!

Posted by: Ed Taylor | September 14, 2009, 7:39 pm 7:39 pm

Several years ago, state Senator Sheila Kuehl proposed a single-payer health care system for California. UTLA, the teachers’ union of the Los Angeles Unified School District, conducted a study. UTLA determined that with a single-payer system, LAUSD would save between $ 100,000,000 to $ 200,000,000 a year.
Consider how much money governments of all levels could save, if they could enroll all of their public employees in a public option. Tax dollars would be spent on health care – not pay-offs to Wall Street, bloated CEO salaries, lobbyists and political campaign contributions. Multiply the annual savings of LAUSD across the country and you’ll see what I mean.

Posted by: William Joseph Miller | September 14, 2009, 7:55 pm 7:55 pm

The public does not understand that the costs of Obama’s health care are to be spread out over a 10 year period. Here are some cost cutting measures that would in fact save the tax payers money.
First of all because everyonewill access to primary care, a lot of illnesses can be caught before they become serious. Prevention is always the best medicine. And our health care system right now is based on treatment NOT prevention. That’s one big reason for its massive expense.
We could cut a lot of health care costs simply by changing our diet. We could reduce our consumption of saturated fats and sugars. We could also slash our consumption of red meat and processed meat, both widely known carcinogen. We can try this voluntarily – or we could perhaps have the government step in. Eliminating government subsidies for beef and pork producers would not only cut our health care costs but also help balance the budget.
We also need to de-carbonize our economy. The first economy to free itself from fossil fuels will be the dominant economy of the 21st century, and already Europe, China and even the Arab shiekdoms of the Persian Gulf are ahead of us.
In addition, freeing ourselves from fossil fuels will cut our medical bills. Many urban areas are plagued by asthma, caused by air pollution. Coal mining often involves mountain top removal which dumps toxic chemicals into watersheds and poisons the drinking water of millions of people. The same could be said about our agri-business which rely on pesticides which also seep into aquifers and water supplies.
According to a report I got from USW@Work, between 30,000 to 50,000 American workers are injured or disabled each year through work place accidents. Empowering OSHA to do its job would help cut down this statistic. We also need to staff the NLRB because ding-wing senators are obstructing Obama’s nominations. We also need to pass the Employee Free Choice Act. All of these measures would ensure greater work place safety and cut down on our nation’s medical bills.
Finally, we need to force the rich to pay higher taxes. We have given the rich tax breaks since the Reagan era, and all they have given us the war in Iraq and the bank crisis. Instead of produceing more jobs, they have off-shored jobs overseas, or they have imported “guest workers” or undocumented immigrants to take jobs that belong to Americans. It’s time they paid for their irresponsible behavior through larger taxes.
The big problem with Congress and much of the public is their inability to see how various phenomena are inter-related. Yes, Obama’s health care proposals are cost-effective. But we need to think beyond the box. The proposals I’ve outlined represent this sort of thinking.

Posted by: William Joseph Miller | September 14, 2009, 8:20 pm 8:20 pm

William Joseph Miller – If your argumnet were to hold water how come two non-partison groups; the Congressional Budget Office and the Congressional Research Office both say that Obamacare will increase the debt of the government and will not improve healthcare. The Congressional Research Office even said that with coverage for everyone and no limits on coverage as proposed the government would go broke paying for healthcare. When both of these groups agree that Obamacare will not increase the debt of the federal government and will actually make an improvement on healthcare I will begin to listen to the propasals. As long as the proposals are for a system which will cause an increase in the debt and will not improve healthcare then the folks in Congress need to start over if they are serious about making any changes in an area where it is debatable that they have no authority under the Constitution.

Posted by: Sandcrab1612 | September 14, 2009, 8:51 pm 8:51 pm

Obama will be long gone when everyone will be screaming that the system now on the table has sent the country broke. Then what? A new system to fix this new one, if it ever gets through.

Posted by: Kottaras | September 14, 2009, 9:11 pm 9:11 pm

Yes, yes, let’s tax Americans to the same degree that Europeans are taxed. Those economies are doing so well for their people with their entrenched double digit unemployment. Their health care is so wonderful, too. Wait, wait, wait. Deny, deny, deny.

Posted by: pam | September 15, 2009, 12:51 am 12:51 am

loook… i dont care what BO said in his speech, this community agitator will say ANYTHING to get this swill passed. but to the inteeligent observer, there’s no WAY this plan will not ruin the country financially AND provide sub standard care. I mean, what has the gov’t undertaken thats been a success story (social security, fannie maethe post office amtrak???). where has socialized medicine succeeded world wide? NOWHERE. so why do we hard working non-union members want this garbage..fact is we DONT. BO for all his flahsy empyt rhetoric is playing to his special interestes.. namely UNIONS. look at this trade war he just got us into with china over tires.. this was at the request of the steel union. OMG our country ins in for a long 3 1/2 yrs with this clown at the helm

Posted by: realman1963 | September 15, 2009, 5:33 am 5:33 am

The health care bill IS NOT about providing us with better health care it is about goverment gaining control of our lives. Read the 1,000 pages in the bill, the lawmakers didn’t.

Posted by: A L Gibson | September 15, 2009, 12:19 pm 12:19 pm

The costs will be covered (as President Obama and Senator Baucus have planned) by the “particpants” in the health care exchange..The insurance and pharmaceutical companies will keep digging deeper since they will have more to give however many hospitals can’t dig deeper..there articles today regarding the lack of primary care docs and facilities however that will change because many of todays hospitals will become something else..Besides covering the uninsured ,it was critical that we change they way we deliver health care..either by choice or by necessity..

Posted by: notmd | September 15, 2009, 12:55 pm 12:55 pm

Gerald
To have what you and other like you want you better beak open your piggy banks and your children’s as well because they will have no need for a place to put money saved, they will have none left to save.
This administration has no idea what they are talking about when it comes to cost, that is already well documented. Their cost predictions on health care are way understated and will literally break this country financially. I suggest we stop the pork ear mark spending, stop funding ACORN and invoke tort reform in our civil system allow nationwide competition in health insurance companies, see how much we save and if we can afford it then. Obama makes it sound like the sky is falling. None of the current proposals would even take effect until 2013. Hmmm,
that’s one years after he would run for his second term maybe that’s why there is such a rush.

Posted by: excop | September 15, 2009, 2:05 pm 2:05 pm

As I read the blog messages I see the same US vs Them that exist in congress and throughout our political system. Now it has even spread to many of the people. There is nothing wrong with our system of government…it’s the people running it. It matters not whether your talking about the democrat or republican parties there is corruption everywhere. WE the people need to have enough sense to figure that out and remove those people from office in both parties that are not honest and forthright with the people. They are not empowered to impose their will on the people. They are empowered by the people to represent the people, meaning to support and carry out the will of the people. Lets take the immigration issue , neither party wants to enforce our immigration law and do what is in the best interest of the American people who have built this country. Instead they allow illegal aliens ( yes I said illegal Aliens not undocumented immigrants) to enter this country, stay and take advantage of what we have built and do so at our expense. This is being allowed for two reasons…cheap labor to further pad the pockets of big business and to secure the hispanic vote to the benefit of politicans. To many of these illegal aliens we are providing welfare, free school lunches, free medical care and other benefits. The cost of this health care to illegal aliens is a large part of the cost increase we have seen in medical care and health insurance over the past decade. Hospitals provide the health care free to the illegal aliens, then raise their prices for services to recover the loss. The higher cost is then imposed on the patients they serve who have insurance. Insurance companies then increase the cost of premiums to cover their additional expense. We the consumer have no one to pass the cost on to.
The big spending of this congress and presidential administration will cost us all. Imposing tax on the rich is a political shell game. The rich are the people of own the businesses in this country if fees and tax increases are place on them, they will pass this cost on to you and I as increased cost for goods and services. For this reason it makes no sense for the middle or low income people to support any of this. It is pose to us as a free benefit but in the end it is not, you will pay more for electricity, gas, bread etc, but we will be the ones to pay for it not the rich or big business. Anyone who cannot figure this out probably bought a new car under cash for clunkers. Health care reform and Cap and Trade as being proposed by congress and this administration will increase the cost of living of the middle and low income buy several thousand dollars a year….You must remember folks, nothing is free. The government has no money except what it takes from it’s people.

Posted by: excop | September 15, 2009, 3:06 pm 3:06 pm

In response to Whylee98, printing out more money would cause even more problems for the country. With a fiat currency, the more of it you print the less its worth. Our money barely has any value as it is; would you really want to make it worth less?

Posted by: brownbaby | October 27, 2009, 10:37 am 10:37 am

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