Next week, the House of Representatives is scheduled to take up a bill (H.R. 3961) which would enact a permanent “fix” to the unquestionably flawed Medicare physician payment update formula. The Congress created a formula for physician Medicare payment that would automatically cut doctor payments, but has routinely acted to prevent its own handiwork from going into effect each year. So, under current law, any permanent fix would sharply increase Medicare spending.
According to the Congressional Budget Office (CBO), the bill would cost an additional $210 billion over the next ten years. In fact, the measure was originally included in earlier versions of the House health care bill , but it was later carved out of the legislation in order to reduce bill’s ten year cost and make the Congressional leadership’s health care agenda appear more fiscally responsible than it is. The Senate leadership tried to pull a similar stunt a couple of weeks ago, got called on it in the press, and the ploy failed.
The Congressional leadership has been trying every budget gimmick in the book to disguise the true cost of their health care agenda. One of the major tricks is to latch onto their health bills’ net cost instead of its gross cost after a full ten years of spending. Under the House legislation, for example, the taxes are front-loaded, but the heaviest spending is back-loaded, so, on paper, budget scorekeepers show lower costs and less of an impact on the federal deficit in the first ten years than they otherwise would.
But pulling billions of dollars in new spending from the health care legislation — intending to pass those provisions separately without paying for them— is perhaps the biggest trick that Congressional leaders are trying to play. As noted, Senate Democrats –under the leadership of Senator Reid– thought they could pass the “doc fix” (to prevent cuts to doctors’ Medicare reimbursement rates) while adding billions to the deficit before voting on a larger health care reform package. It failed. Republicans and 13 moderate Democrats weren’t going to let the Senate impose even heavier burdens on current and future generations of taxpayers.
Now, after the passage of its Godzilla-like health care bill (H.R. 3962) this past weekend, the House of Representatives will soon become center stage for the attempt at the same type of Senate-style deficit-increasing deception. As noted, the CBO estimates that the “doc fix” in the House bill (HR 3961) would cost taxpayers $210 billion in the first ten10 years Since this would be an increase in the cost of services in Medicare Part B services, the part of Medicare that pays doctors, it would also mean an increase in seniors Medicare Part B premiums. In its November 4, 2009 budget estimate of H.R. 3961, CBO estimates that over the period 2011 to 2019, Medicare Part B premiums would increase by $49 billion.
These ten year costs, of course, are only the tip of the proverbial fiscal iceberg. The year-by-year costs accumulate over time. Assuming that the House does not provide for permanent offsets- other spending cuts- to cover the additional Medicare spending for the “doc fix”, the impact would be enormous—potentially adding trillions more to Medicare’s already massive long-term unfunded obligation.
Co-authored by Greg D’Angelo.
You have to read all the way to page A-25 in today’s New York Times to learn about it, but the Senate took its first floor vote on Obamacare yesterday and the White House lost. Big. The NYT reports: “Democrats lost a big test vote on health care legislation on Wednesday as the Senate blocked action on a bill to increase Medicare payments to doctors at a cost of $247 billion over 10 years. The Senate majority leader, Harry Reid, Democrat of Nevada, needed 60 votes to proceed. He won only 47. And he could not blame Republicans. A dozen Democrats and one independent crossed party lines and voted with Republicans on the 53 to 47 roll call.”
As we reported on Monday and Tuesday, yesterday’s “doc fix” vote was part of a White House Chief of Staff Rahm Emanuel strategy to smooth passage of President Barack Obama’s $1 trillion-plus health care overhaul by transferring a quarter of its cost into a separate, and completely unpaid for, bill. This transparently dishonest shell game was too much for honest Democratic Senators like Evan Bayh (D-IN), Kent Conrad (D-ND), Russ Feingold (D-WI), Claire McCaskill (D-MO), Bill Nelson (D-FL), and Ron Wyden (D-OR). Wyden told the NYT: “On the eve of a historic debate on health care, it’s essential to show a commitment to real reform,” which includes fiscal responsibility.
Yesterday’s vote marks a significant failure of the Left’s special interest approach to passing Obamacare. From the beginning, the White House thought that if it bought off all of the business interests involved (the American Medical Association, the drug industry, health insurers, hospitals, etc.) opposition to the plan would wither. In one sense, the plan worked. USA Today reports PhRMA, Pfizer, America’s Health Insurance Plans, and the Federation of American Hospitals have all ponied up millions of dollars for lobbying and television ads in support of Obamacare.
But all these special interest television ads failed to rid Americans of their common sense objections to Obamacare’s government takeover of health care. Gallup reports today that Americans now more than ever believe the costs their family pays for health care will get worse if Obamacare passes. And more Americans now believe that Obamacare will lower the quality of care they receive, reduce their health care coverage, and complicate the insurance company requirements they have to meet to get certain treatments covered.
Instead of the massive overhaul being pursued by the White House, a solid majority of Americans tell Gallup they want to see Congress move in the opposite direction. By 58% to 38%, Americans would generally prefer to see Congress deal with health care reform “on a gradual basis over several years” rather than “try to pass a comprehensive health care reform plan this year.” Bipartisan, fiscally responsible, reform such as equalizing the tax treatment of health insurance purchases, freeing customers to purchase health insurance across state lines, and allowing states more flexibility on Medicaid spending are readily doable. And that is what the people want.
Quick Hits:
- In a violation of laws against government-funded propaganda, the official, taxpayer funded, Department of Health and Human Services website urges Americans to to send an e-mail to President Barack Obama praising his health care reform plan.
- According to a new report, 7 months after President Barack Obama’s $787 billion stimulus became law, 49 of 50 states have lost jobs and America is now over 6 million jobs shy of White House promises.
- The Obama administration’s wage control czar plans to order companies that received bailout money to slash pay for each of the companies highest paid employees by an average of 50%.
- The drug and insurance industries have spent millions of dollars lobbying Congress in favor of Obamacare.
- Windmills’ propensity to kill bats is pitting endangered species advocates against climate change scaremongers.