WASHINGTON (CNN) - A bill to overhaul the nation's ailing health care system must avoid additional spending now, and also lower costs down the road, former Federal Reserve Chairman Alan Greenspan said Sunday.
Greenspan told the ABC program "This Week" that the federal debt was already getting too big, so reforming health care must do more than achieve what politicians call revenue neutrality - bringing in as much money as it costs.
"You cannot continue to increase the federal debt," Greenspan said. He noted that the Medicare program for senior citizens already requires long-term borrowing to cover the costs of benefits, describing it as a "huge fiscal hole out there."
"I would say revenue neutral is not adequate" Greenspan said. "In other words, we have to not only have a revenue neutral reform program, but simultaneously recognize that we have to address the longer term."
A compromise health care proposal debated in recent weeks by the Senate Finance Committee is expected to cost almost $900 billion over 10 years, but avoid increased spending by offsetting the cost with a combination of Medicare savings and new revenue-producing fees and taxes.
It was drafted by committee Chairman Sen. Max Baucus, D-Montana, after months of negotiations with five other panel members - three Republicans and two Democrats - and represents the only proposal so far with the potential to attract any Republican support.
Another Senate committee and three House committees have passed Democratic health care plans rejected by Republicans. The Senate Finance Committee is expected to vote on its measure on Tuesday, and then the Democratic leadership in each chamber will meld together single, separate proposals for floor debate in coming weeks.
If both the House and Senate pass their respective versions, a conference committee would then negotiate a final version that would require approval from both chambers before going to President Barack Obama for his signature.
Obama has made health care reform his top domestic priority this year. He and Democratic leaders want the bill to include a government-run public health insurance option as one choice for consumers currently unable or unwilling to obtain coverage, but Republicans unanimously oppose such a plan.
Of the five proposals in Congress, only the Baucus plan in the Senate Finance Committee lacks a public option. Instead, it would allow non-profit health care cooperatives that negotiate collective coverage for members to compete with private insurers to bring down costs for low- and middle-income Americans.
Appearing later on the ABC program Sunday, Sen. Charles Schumer, D-New York, said Democratic leaders would look for ways to have a public option included the final health care bill.
"The more the public looks at a public option, the more they like it," Schumer said, calling the idea the only way to bring real competition into consumer insurance markets. He said Democrats in Congress who hold a majority in both chambers "are going to come together" on some form of public option.
Another Democrat, Sen. Barbara Boxer of California, indicated on CNN's "State of the Union" that a public option compromise was possible.
Asked if she would vote for a bill that lacked a public option, Boxer said: "My vote will depend on the entire bill, and if there's no way to bend the cost curve and help people who have insurance in addition to those who don't, I'll vote no. But I'm very hopeful. There are very many ways to do this."
Republicans argue a public option would drive private insurers out of the market, leading to a government takeover of the health care system. Appearing with Schumer on the ABC program, Sen. John Cornyn, R-Texas, said it was a bad idea now and in the future.
"I think what's been proposed will make things worse, not better," Cornyn said.