WASHINGTON — Democrat Bob Kerrey and Republican Deb Fischer squared off Monday in their third and final debate of the Nebraska U.S. Senate race.
Many of their claims and arguments have been examined in previous World-Herald coverage, but a couple of issues cropped up that have yet to come under the microscope:
Fischer said during the debate that she supports repealing the federal health care law. In particular, she criticized its mandate that everyone obtain health insurance. The purpose of that mandate is to help pay for requiring insurers to cover people with pre-existing conditions.
Fischer said she believes the Senate would find a way to continue protections of those with pre-existing conditions without the individual mandate, and she cited a favorite Republican proposal for how to pay for it — tort reform. That generally refers to placing limits on medical malpractice awards.
“We can look for savings with tort reform because over a quarter of the medical procedures that are required now are unnecessary,” she said during the debate. “That's one way we can look for the money.”
It's generally accepted that physicians order unnecessary tests at times out of fear they might be sued for not doing enough to help a patient. It's commonly referred to as “defensive medicine.”
Independent studies have found that the practice could be reduced by capping malpractice damage awards and making other changes. Still, those studies have generally found that the bottom-line impact is limited.
Fischer's campaign cited as evidence of her statement a group called Patients for Fair Compensation, which says it has done surveys in which doctors reported 25 percent or more of their tests are unnecessary and extrapolated that to mean hundreds of billions in annual savings.
But most studies have found much less potential for savings.
For example, the Congressional Budget Office examined various tort reform proposals and found that they would reduce costs nationally by about a half-percent, or about $11 billion in 2009.
Kerrey said during the debate that the balanced budget proposal supported by Fischer would require “a trillion dollars' worth of cuts” to the federal budget and specifically cited Fischer's warnings about the impact of the so-called sequester, or automatic cuts, that were part of last year's debt ceiling deal.
Those cuts total $1.2 trillion over 10 years, and the first $110 billion round starts Jan. 1, split evenly between military spending and domestic programs.
“In her own words, she says the sequester that will cut our military is a bad thing because it will be bad for our military. Her proposal is 10 times worse,” Kerrey said during the debate.
Fischer has defended holding federal spending at 18 percent of the nation's economic output, referred to as the gross domestic product or GDP. And she supports legislation that includes various balanced budget amendment proposals that would cap spending at that level, which is the basis for Kerrey's assertions.
Still, his math has a couple of problems. Start with these numbers:
The Congressional Budget Office projects Fiscal Year 2013 GDP to be $15.86 trillion and federal spending at $3.55 trillion, or about 22.4 percent.
So reducing federal spending to 18 percent of GDP would mean a nearly $700 billion cut on top of the sequester.
No question that would be a massive reduction in government spending, but it would be less than a trillion dollars and only about seven or eight times as much as the sequester.
Also important is the question of whether Republicans' balanced budget proposals would take effect immediately.
The legislation Fischer supports leaves open the possibility of a cap higher than 18 percent and clearly envisions a gradual reduction in federal spending over the next few years.
For example, it would set a Fiscal Year 2013 cap of 21.7 percent of GDP, requiring about a $110 billion cut on top of the sequester.
The Kerrey campaign said Fischer has talked about the urgent need to get a balanced budget amendment in place. His campaign also suggested that whenever an 18 percent cap would be implemented, it would have a drastic effect on the military and government services.
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