This is toeing a bit beyond my technical competence, but it's important nevertheless. On the Democratic side, all the of plans are built off the same basic structure. While Obama's lacks a mandate and Hillary's is softer on small business and Edwards' was better on pharmaceutical issues, the differences are much less significant than the similarities -- and the similarities aren't accidental. Rather, all the plans are incarnations of Jacob Hacker's basic vision, which has been adopted by the Economic Policy Institute and promoted to the campaign's by the Campaign for America's Future. So, in a way, you can think of Hacker's plan, as released through EPI, as the ur-Democratic plan, the basic vision that's closest to what the mainstream of the party will push in 2009 (and for the record, it includes an individual mandate). In order to prepare for that battle, EPI and CAF asked the Lewin Group -- probably the most highly respected health care consultancy firm around -- to score the plan's costs and savings. And the results are very encouraging. The bottom line is that the Hacker structure covers just about everyone and saves huge amounts of money. At the start, bringing the changes to the system and the broad expansion of coverage to 46 million (or so) Americans means total federal spending increases by about $50 billion, but employer spending decreases by $10 billion, families save $22 billion, and states save about $20 billion. So it evens out. But that's only on day one. Then, over time, the new system does quite a bit to cut costs through "restricting provider payment increases, negotiating deeper drug discounts, and simplified administration." The bottom line of the report is that "under these cost controls, total national health spending over the 2008 through 2017 period would be about $1.04 trillion less than under current law over that same period." That's $1.04 trillion in savings even with 47 million more Americans covered and far less economic insecurity for the rest of us. That's $1.04 trillion that can be spent on infrastructure, on schools, on homes and televisions and groceries and wars and iPhones and whatever else we decide to fund. And that's a big deal. As we health wonks like to point out, reform isn't only a matter of justice and decency, it's also a matter of economics. Lewin's conclusions -- which apply with pretty fair specificity to the plans offered by both Clinton and Obama -- only further underscore the case.
