Authored by: Donovan Slack
Published by: Green Bay Press-Gazette
April 9, 2014

WASHINGTON —Rep. Reid Ribble calls himself a “budgeteer” and can often be heard ruminating on the fiscal benefits of such banal-sounding topics as inter-modal transportation.

So when the Green Bay-area Republican decided to tackle the issues of chronic diabetes, obesity and Alzheimer’s, he approached it as a number-cruncher. The product of his work —the “Long-Term Studies of Comprehensive Outcomes and Returns for the Economy Act” —was slated to be introduced Wednesday.

The bill would provide $5 million annually to create and run a division within the Congressional Budget Office that would focus on predicting the costs —and benefits —of legislation in the long term, say 20, 30 or even 40 years out. The intent is that those predictions would show that investing in areas like medical research pays for itself in the long run.

Now, the CBO usually issues cost and benefit estimates for only the next 10 years. With the GOP-controlled House committed to passing only bills that have so-called “pay-fors” —some way to offset their cost —Ribble’s bill could provide the impetus to ensure more federal funding for medical research.

“Part of the problem of expanding the funding for that is that there’s no pay-for. I keep hearing, ‘Well you’ve got to have a pay-for, you’ve got to have a pay-for,’” Ribble said. “I keep saying, ‘Well, the pay-for happens when you cure the disease.’”

It is a message Democrats, including President Barack Obama, have been pushing for years, and Ribble’s legislation has attracted support from Madison Democratic Rep. Mark Pocan. The two unveiled the bill during a joint conference call Tuesday.

Pocan said it was “Wisconsin common sense” that brought them together on the initiative.

“This is a bill that provides benefits for both the economy and the long-term health of our country,” Pocan said. “It’s making sure that we can get a long range idea of what investments now really do.”

To Americans outside the Beltway, congressional budgeting and scoring —assessing the true cost of a proposal —may seem like meaningless concepts. But in truth, they are critical to how American taxpayer dollars are spent. Or saved. The Congressional Budget Office is a nonpartisan agency tasked with telling lawmakers how much legislation will cost before they pass it. The office’s pronouncement can kill a bill or propel it to passage.

The office currently issues cost estimates that go beyond 10 years only on select occasions. On an analysis of a 50-cent increase in the federal cigarette tax, the office projected the impact over 70 years. (Its finding: very little impact. Over the first 50 years, the government would collect more money through the tax but after that, the added costs of providing benefits to people living longer because they quit smoking outweighed the revenue.)

So the reasoning behind Ribble’s and Pocan’s bill seems sound enough. Ribble’s office cites support from more than 50 economists across the country. But the practicalities are more complex, according to some analysts.

It’s too hard to predict what medical research will produce or when, said Paul N. Van de Water, a senior fellow at the Center on Budget and Policy Priorities.

“I would say it’s all but impossible to estimate what kind of a payoff an infusion of money is likely to produce,” said Van de Water, a former assistant director at the Congressional Budget Office.

Still, other budget experts say making longer term predictions, not just about medical research, but with other areas of federal spending, would be helpful for lawmakers and the country as a whole.

“There’s such a bias right now toward the short term, this is a really important step,” said Maya MacGuineas, president of the nonpartisan Committee for a Responsible Budget. “A long-term analysis would be good both for fiscal issues in the budget and promoting smart investments and policies that would grow the economy.”

Ribble argues that the expertise is available to make the predictions on medical research that the bill would require. The federal government regularly makes such projections for programs like Social Security. And he says the rapid increase in health care costs in recent years demands that something be done. He said a majority of the money spent by the federal government on health care goes to treating patients with chronic illnesses.

“To the degree that we can reduce those costs by finding cures for some of these, that cost no longer gets transferred by shifting the costs to other parts of the health care system,” he said. “They essentially just go away. And I think our biggest opportunity to bend the cost curve down is to continue our efforts in finding cures, and I’m going to be supportive of that because it’s got to be part of any long-term health care reform.”