Savings from improved health could lower costs of reform

Washington -- A group of health care organizations has asked congressional leaders to advance health system reform by directing the Congressional Budget Office to change the way it estimates the cost of legislation.

The Partnership to Fight Chronic Disease -- a national coalition of hundreds of patient, medical professional, community, business and labor groups -- wants CBO to include potential cost savings that could stem from patients' improved health status when it calculates the cost of national health reform legislation. This could help make such legislation more politically feasible by lessening the need for Congress to find new sources of revenue or to cut other spending in order to adopt the legislation under budget restrictions.

The partnership sent an April 21 letter to House Speaker Nancy Pelosi (D, Calif.) and Senate Majority Leader Harry Reid (D, Nev.) asking them to direct CBO to factor in the cost of Americans' declining health under the current health system, the economic impact of a healthier population and projected savings beyond the CBO's usual 10-year window.

CBO traditionally has been reluctant to include savings when it estimates the cost of legislation. Senate Finance Committee Chair Max Baucus (D, Mont.), for example, said the agency doesn't calculate the potential savings from legislation that funds Medicaid and Medicare anti-fraud efforts. However, Baucus said the budget office has recently indicated it is relaxing its standards to account for such savings. A CBO spokesperson declined to comment.

Baucus acknowledged only a moderate amount of data exist on the potential savings of some of the reforms Congress is discussing, such as the implementation of medical homes. "It's hard to get numbers on these things, because this is fairly new."

Medical care costs for people with chronic diseases account for more than 75% of the nation's health spending, according to the Centers for Disease Control and Prevention.