What’s $1 Trillion Get You These Days?

When the hubbub of Independence Day weekend dies down, you can expect the criticism over the price tags of health care reform bills currently in Congress to ramp up.  I would have thought the criterion would have been “Does this increase coverage, make health care more affordable, and reduce the chance that those needing medical care will go into bankruptcy – including those who have insurance?” not "So how much does this cost and will I look stupid on TV trying to defend it?"  Shows what I know.  But, you know, in this day and age, what’s $1 trillion between friends?

Keep in mind that all of the Congressional Budget Office estimates you’ll see for any bill will be spread out over 10 years.  So the $600 billion for the Senate Health, Education, Labor and Pensions draft (which doesn’t take into account Medicaid expansion) translates to about $60 billion per year.  On the other end, the original $1.6 trillion price tag for the Senate Finance Committee draft is really around $160 billion a year.  Considering this country’s total yearly health care expenditure (public and private) is $2.4 trillion, we’re talking chump change – 2.4 to 7% of the total each year.

But still, those who want to sink the plan as too expensive will come up with some fairly wacky analogies to suggest $1 trillion is a big, wasteful amount of spending.  My favorite so far comes from Senate Minority Leader Mitch McConnell, who came up with this gem: “To put a trillion dollars in context, if you spend a million dollars every day since Jesus was born, you still wouldn't have spent a trillion.”  Sassy!

But maybe we should pay attention.  After all, if there’s a political party that knows how to spend a lot of money quickly, it’s our esteemed minority party:

• The prescription drug program Medicare Part D is estimated to be $1.2 trillion over the next 10 years.  And that’s just adding one benefit to a segment of the population who already had coverage.
• The Bush tax cuts – those things we absolutely had to have while fighting two wars and increasing domestic spending – are estimated to cost $1.8 trillion by the time they expire next year.  (And even at the time they were enacted, we knew they would cost at least $1.3 trillion.)
• Remember the good old days, when the Iraq War was only going to cost $60 to $95 billion?  Apparently we were a little bit off.  The total cost so far for operations in Iraq and Afghanistan over the past 8 years are already over $870 billion.  We should hit $1 trillion easy this year.
• And then there was that time in 2003 when the Department of Defense lost $1 trillion worth of assets.  File under, “time to get a new accountant.”

2008 of course was the year we stopped being freaked out about spending hundreds of billion dollars in a single year.  After all, with a deficit that under the best of circumstances had been in the $300-$500 billion range each year for several years, why the hell not?  The famous TARP program from President Bush and former Secretary Paulson came in at $700 billion, which seems downright paltry by comparison.  It certainly was for Sen. John McCain in September of 2008, who actively advocated for spending $1 trillion immediately and without Congressional buy-in:

But I'm going to go out on a limb and say he'll be one of the loudest voices saying we can't afford quality, affordable health care for all this year.

Just food for thought the next time someone tells you that the fact that 60% of all personal bankruptcies involve medical debt (and 78% of those were people who had insurance) isn’t worth $60 billion to $120 billion per year.