The gridlock that has persisted on Capitol Hill in recent years has largely stemmed from fundamental disagreements over how to address our country’s major health and economic challenges.
Some very public disagreements have stalled progress on a variety of promising policy proposals, ranging from funding a modernization of our nation’s failing infrastructure to reauthorizing the Elementary and Secondary Education Act to sustaining funding for important obesity prevention measures across the age spectrum. While there’s no immediate hope that Congress will find its “kumbaya moment” and move such things forward this year, there are things that can be done to improve the infrastructure inside Washington in ways that will help give policy makers a clearer understanding of the long-term costs and benefits of these and other important legislative choices and thus hold promise for policy movement in the future.
Lest we underestimate the importance of what may seem to be dreary accounting in Washington, we should remind ourselves that in the last six months, reports from the CBO on the projected costs of proposals such as the minimum wage bill and the implementation of the Affordable Care Act have had tremendous influence on public perceptions of these proposals and programs. A “good” or “bad” CBO score can literally make or break a proposal.
Given the amount of debt our nation is currently carrying as a result of record deficits in recent years, it’s appropriate that the economic facts should sway views regarding the advisability of a policy proposal. The trouble is, our economic facts skew a bit myopic. Congress is not getting a consistently full picture of the long-term costs and benefits of most policy proposals; typically, the CBO issues assessments that cover five to 10 years. Why? The Budget Act of 1974 dictates that it be done this way, and while it doesn’t specifically preclude longer-term analyses, a dearth of resources at the CBO (as well as the fact that there isn’t always enough data to make accurate long-term assessments) sometimes makes it difficult to forecast too far into the future.
But in order to understand the return on investment to U.S. taxpayers of tackling challenges like infrastructure funding, improving education, and expanding obesity prevention, Congress really needs the long-term picture. Policymakers need to understand, among other things, what we will spend to treat the many chronic diseases that will continue to plague American adults and children if we do not build more infrastructure for people to be more active, provide greater opportunities for physical activity in schools, and effectively prevent and treat obesity. Today, many economists project that U.S. health care spending will be nearly $5 trillion by 2021, nearly double what it was in 2010 and 67 times what it was 40 years ago. Policies made 40 years ago—or perhaps more pointedly, those that were not made, like investments in obesity and other chronic disease prevention—certainly affected the state of things today, when obesity accounts for 10 percent of U.S. health care costs.
Being able to take a longer view of policy choices just makes sense. A 25- or 50-year assessment of a proposal should tell us as much about hidden long-term costs as it does about otherwise-unrevealed long-term benefits.
With Congress considering health and related policies that could affect our national economic mooring for a century or longer, it’s time to give the CBO the resources it needs to present long-term information to Capitol Hill decision-makers. A recent bill introduced by a bipartisan Wisconsin duo in the House, Reps. Reid Ribble (R) and Mark Pocan (D), proposes to create a new division within the CBO tasked with long-term scoring, and to elevate the head of that division within the CBO as a way to recognize the importance of the big picture.
Goudeseune is president and CEO of the American Council on Exercise and a member of the Board of Directors for the Campaign to End Obesity.