Dollars to doughnuts

Number crunching is so terribly dry and for most people, boring. WaPo puts Washington’s calculations of health care costs and savings into interesting perspective here.

Phil Ellis may be the most powerful guy you’ve never heard of in the health-care debate. A senior analyst with the Congressional Budget Office, Ellis is the man who has to decide what it would cost to rebuild the health insurance system. He has essentially condemned two legislative proposals by slapping them with trillion-dollar price tags. A third plan rocketed to prominence after he said it would cost much less.

In the coming weeks, Ellis’s judgments will shape the fate of President Obama’s reform effort…

As Democrats embark on a plan to reorder one-sixth of the U.S. economy, the CBO is the umpire, charged by Congress with assessing the effect on the federal budget and the potentially profound impact on American lives. The Senate majority leader has vowed to hold no vote on a health plan until the CBO passes judgment. But the agency, while almost universally praised for honest and impartial analyses, does not have a crystal ball.

“Everyone in the process — especially the CBO — knows that it is very, very difficult to make these estimates and that they’re no more than very educated guesses,” said Alice Rivlin, who served as the CBO’s founding director in 1975. “But if you didn’t have this process, we know that the consequence is that everyone would want to spend money and not pay for it.”

What refreshing honesty about a process usually muddled in dense and incomprehensible bureaucratese.

It gets better. Bring these calculations into your own household…

Much of what the CBO does is akin to trying to forecast your grocery bill in 10 years. First, it establishes a baseline: Your history of spending $200 a week at Safeway projected into the future with adjustments for inflation and expected demographic trends (i.e., more children, larger pets). Then it factors in proposed policy changes: Say you want to eat only organic and enroll your husband in Jenny Craig. Costs for meat, produce and dairy would go up, but spending on toothpaste and Saran Wrap would be unaffected. Meanwhile, the extra $70 a week for diet food would be partially offset by lower spending on Cheetos and frozen pizza.

The CBO has plenty of data to help make such calculations, including projections for inflation and the price of organics. But it would have to make some judgment calls: Is it reasonable to assume that Krispy Kremes are off the table? Or is it safer to budget for a dozen doughnuts once a quarter? And even the most careful estimate can be blindsided: What if the baby you projected to arrive in 2012 turns out to be twins in 2010?

Then you would be doubly blessed. And the government would have two more taxpayers for that future tab. And if the household wants some favorite comfort foods around in the meantime, factor in the doughnuts.

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