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Health care costs that count in the Senate Finance bill

Yes, the plan might reduce the deficit. But it restricts a proposed commission that could trim trillions from a much bigger problem - unmet Medicare obligations.

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The fiscal report card on the cost of the Senate Finance Committee's healthcare bill could make a legislator burst with pride.

Not only does the bill's projected total cost of $829 billion come in under President Obama's $900 billion 10-year upper limit, it is estimated to also actually reduce the federal deficit by $81 billion in the decade that starts next year, and probably longer than that. So, at least, concludes the nonpartisan Congressional Budget Office (CBO) this week.

But let's take out the wide-angle lens and view the bigger picture. The United States faces unmet obligations under Medicare – the government healthcare program for seniors – of nearly $40 trillion. Removing $81 billion from that mountain is a bit like using a toy backhoe instead of a Caterpillar earthmover.

The idea of even tinkering with Medicare brought howls of outrage from Americans at town-hall meetings this summer. And yet, solving the country's crisis of escalating healthcare costs is impossible without reforming Medicare, which accounts for the bulk of government spending on healthcare.

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