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  • Next Week's House Health Care Shell Game

    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.

    Posted in Obamacare [slideshow_deploy]

    10 Responses to Next Week's House Health Care Shell Game

    1. Bobbie Jay says:

      Who's threatening who? It seems there has to be some definite intimidating threats to members of congress refusing to watch out for the people, as this whole thing is a cover-up and impossible to succeed under freedom, liberty and equal rights. I don't like to think of people being so low, but we've experienced some in the highest of places, by name and face. I pray, members will have the courage to know what is right and do it for the people they serve.


    2. jim sardis,ms says:

      nobody,knows what happens to all the money that comes into the federal government to support health care.i am 68 and have Medicare and a plan 'd' for prescriptions.the part 'b' ' Medicare is about $100/mo. and the 'd' is about $44/mo.i only go to the doctor every 3 months for my prescriptions.Medicare takes in $1200 and i pay $135 deductible before Medicare pays anything.it take my first 3 visits to get the out of pocket deductible satisfied while Medicare has withheld $900 from SS.Medicare pays a total of $68 while taking in $1200.my prescriptions are less than half of what my premiums are.the problem with our system is that everyone not on Medicaid goes to the emergency room for health care and there is no money set aside to compensate for the indigent cost.the people going to the ER are not citizens or people unemployed or illegals earning under the poverty level working for employers that do not provide benefits.the seniors are paying for the problems because the government takes the money in advance from SS.the REFORM will bring in billions more money,cut payments to providers and the money will be wasted even more than now.the system needs fixing not reforming.someone needs to be accountable for all the revenue coming into the government and where it goes.more control= more waste.

    3. Jim says:







    4. Tim Az says:

      These bills legislate death and not much more. Kill them before they are born. And kill them when they are no longer an asset to the government. Listen up kids you're the ones who will have to run this gauntlet.

      How's that hope and change working out for you?

    5. Jeanne Stotler, Wood says:

      I am also on Medicare, it's not a gimme, After paying for that at 90+ a month, part D 44 a mo. I pay $166. for supplemental Ins. If this goes through my supplemental will go up so any way you look at it we the seniors are going to pay. Do not trust this administration it is out to bankrupt this country, Revolution in 2010, vote this congress out and that will render Obama helpless, 2012 get him out unless he is impeached.

      The Goverment cannot balance it's check book, all they know is spend and tax.

    6. carol, new orleans l says:

      The term "useful idiots" was applied to those who

      propagated and upheld communism and supported

      its oppressive regime. The marxist driven agenda

      being forced down our throats by members of congress and this administration must have these

      "useful idiots" to bash and squash any and all

      opposition. The downfall of these destructive

      lovers of all things government is that they do not know enough to know that their opponents are

      the ones who feed them and stand up for the very freedom that they have to continue speaking on behalf of a system that is and always will be a failure, outlined with brutality and misery and

      poverty for all in the end…we just happen to have Karl Marx ideologists in power right now.

      Obama's mentor was a communist, Valerie Jarrett's

      father a communist..their whole doctrine and prescription for our future is based on lies. Obama plays the part well and moves and speaks on

      cue. Real Americans who love this country will

      unite to vote these people out of office. Their

      power has made them drunk and like all drunks they

      are not aware of how they appear to those of us who live in the real sobering light of day. Utopia

      does not exist and all who would lead you down this path of belief are liars and above all fools.

      Weak leadership will only invite more challenges

      here at home. Green is the new Red for these

      "useful idiots". Remember this was a term used by

      the Stasi in Communist controlled countries. Do

      not be intimidated by such "useful idiots" right now. Once communist regimes take over totally a people, these "useful idiots" continue to be used as informants and enforcers as long as they stay in line. But one raised whisper of protest and the "useful idiots" are disposed of on the spot.

      I'm merely using history to shed some light on where we are headed under such leadership and representation.

    7. Lynn B. DeSpain says:

      Right! More lawyers are going to decide what is best for American Citizens, oh, and I forgot, Illegals too.

      Now to set everything straight, America can for the first time, Taxes disallowed because fraud has to be involved, will place its own citizens in jail for not purchasing a product!

      How's that for Freedom? They also seem to have not read any news lately, almost every State is letting what is called non-violent prisoners (Theives, robbers, and some rapist) go free because of over crowding!

      So now they will put an otherwise honest working American Citizen in jail for not buying insurance. Maybe that isn't so bad. Three hots and a cot. Free medical, dental, glasses. Free higher education. The wife and kids now get free housing, medical, dental, glasses, food, heat, and a higher education.

      Sounds like the Modern America to me, do nothing and get more for it!

      And we elected these people because we thought they were smart. Damn, fooled us, huh?

    8. Arlyne Dreyer, Misso says:

      Mandatory medical screening for infectious diseases can be the main beneficial outcome here.

      Increasing funds for our elderly population would be a far better avenue for trickle down information, education, and treatment; and create a positive look to the furture in Medicine.

      Also doctors need to advocate more natural steps for treatment before invasive surgeries.

      I am also aplauded at the actual advertising for medical treatments on billboards, this is not only unethical, but unlawful too. (it use to be)

      Lowering the costs….can't we look at that first?

    9. Pingback: Deliberative Analysis has gone the way of everything else in this country-Down the Drain | Holeinthehull

    10. Dale Cord Redondo Be says:


      This has to be the email forward of the year! Please take a few minutes to read and absorb just what this woman had to say, and then hopefully everyone will pass it to their entire mailing list, and theirs to theirs until it circles the nation! Time is short and arrogance, stupidity and ignorance abound…

      The following letter read on Glenn Beck 's show, is rapidly circulating around the country. Americans everywhere identify with this 53-year-old woman.. She has given us a voice. Once you read this, you will want to forward it to all of your friends…

      GLENN BECK: I got a letter from a woman in Arizona . She writes an open letter to our nation's leadership:

      "I am a home grown American citizen, 53, registered Democrat all my life. Before the last presidential election I registered as a Republican because I no longer felt the Democratic Party represents my views or works to pursue issues important to me. Now I no longer feel the Republican Party represents my views or works to pursue issues important to me. The fact is I no longer feel any political party or representative in Washington represents my views or works to pursue the issues important to me. Instead, we are burdened with Congressional Dukes and Duchesses who think they know better than the citizens they are supposed to represent.

      There must be someone. Please tell me who you are Please stand up and tell me that you are there and that you're willing to fight for our Constitution as it was written. Please stand up now.

      You might ask yourself what my views and issues are that I would feel so horribly disenfranchised by both major political parties. What kind of nut-job am I? Well, these briefly are the views and issues for which I seek representation:

      One, illegal immigration. I want you to stop coddling illegal immigrants and secure our borders. Close the underground tunnels.. Stop the violence and the trafficking in drugs and people. No amnesty, not again. Been there, done that, no resolution.

      P.S., I'm not a racist. This is not to be confused with legal immigration.

      Two, the STIMULUS bill. I want it repealed and I want no further funding supplied to it.. We told you No, but you did it anyway. I want the remaining unfunded 95% repealed. Freeze, repeal.

      Three: Czars. I want the circumvention of our constitutional checks and balances stopped immediately. Fire the czars. No more czars. Government officials answer to the process, not to the president. Stop trampling on our Constitution, and honor it.

      Four, cap and trade. The debate on global warming is not over. There are many conflicting opinions and it is too soon for this radical legislation. Quit throwing our nation into politically-correct quicksand..

      Five, universal healthcare. I will not be rushed into another expensive decision that will burden me, my children, and grandchildren. Don't you dare try to pass this in the middle of the night without even reading it. Slow down! Fix only what is broken — we have the best health care system in the world — and test any new program in one or two states first.

      Six, growing government control. I want states rights and sovereignty fully restored. I want less government in my life, not more. More is not better! Shrink it down. Mind your own business. You have enough to take care of with your real [Constitutional] obligations Why don't you start there.

      Seven, ACORN. I do not want ACORN and its affiliates in charge of our 2010 census. I want them investigated. I also do not want mandatory escrow fees contributed to them every time on every real estate deal that closes — how did they pull that one off? Stop the funding to ACORN and its affiliates pending impartial audits and investigations. I do not trust them with taking the census with our taxpayer money. I don't trust them with any of our taxpayer money. Face up to the allegations against them and get it resolved before taxpayers get any more involved with them. If it walks like a duck and talks like a duck, hello. Stop protecting your political buddies. You work for us, the people. Investigate.

      Eight, redistribution of wealth. No, no, no. I work for my money. It is mine. I have always worked for people with more money than I have because they gave me jobs — and that is the only redistribution of wealth that I will support. I never got a job from a poor person! Why do you want me to hate my employers? And what do you have against shareholders making a profit?

      Nine, charitable contributions. Although I never got a job from a poor person, I have helped many in need. Charity belongs in our local communities, where we know our needs best and can use our local talent and our local resources. Butt out, please. We want to do it ourselves..

      Ten, corporate bailouts. Knock it off. Every company must sink or swim like the rest of us. If there are hard times ahead, we'll be better off just getting into it and letting the strong survive. Quick and painful. (Have you ever ripped off a Band-Aid?) We will pull together. Great things happen in America under great hardship. Give us the chance to innovate. We cannot disappoint you more than you have disappointed us.

      Eleven, transparency and accountability. How about it? No, really, how about it? Let's have it. Let's say we give the buzzwords a rest and have some straight honest talk… Please stop trying to manipulate and appease me with clever wording… I am not the idiot you obviously take me for.. Stop sneaking around and meeting in back rooms making deals with your friends. It will only be a prelude to your criminal investigation. Stop hiding things from me..

      Twelve, unprecedented quick spending. Stop it now.

      Take a breath. Listen to the people. Slow down and get some input from nonpoliticians and experts on the subject. Stop making everything an emergency. Stop speed-reading our bills into law. I am not an activist.. I am not a community organizer. Nor am I a terrorist, a militant or a violent person. I am a parent and a grandparent.. I work. I'm busy. I am busy, and I am tired. I thought we elected competent people to take care of the business of government so that we could work, raise our families, pay our bills, have a little recreation, complain about taxes, endure our hardships, pursue our personal goals, cut our lawn, wash our cars on the weekends and be responsible contributing members of society and teach our children to be the same all while living in the home of the free and land of the brave.

      I entrusted you with upholding the Constitution. I believed in the checks and balances to keep from getting far off course. What happened? You are very far off course. Do you really think I find humor in the hiring of a speed reader to unintelligently ramble all through a bill that you signed into law without knowing what it contained? I do not.

      It is a mockery of the responsibility I have entrusted to you. It is a slap in the face. I am not laughing at your arrogance. Why is it that I feel as if you would not trust me to make a single decision about my own life and how I would live it but you should expect that I should trust you with the debt that you have laid on all of us and our children. We did not want the TARP bill… We said no. We would repeal it if we could. I am sure that we still cannot. There is needless urgency and recklessness in all of your recent spending of our tax dollars.

      From my perspective, it seems that all of you have gone insane. I also know that I am far from alone in these feelings. Do you honestly feel that your current pursuits have merit to patriotic Americans? We want it to stop. We want to put the brakes on everything that is being rushed by us and forced upon us. We want our voice back. You have forced us to put our lives on hold to straighten out the mess that you are making. We will have to give up our vacations, our time spent with our children, any relaxation time we may have had and money we cannot afford to spend on bringing our concerns to Washington . Our president often knows all the right buzzwords like unsustainable. Well, no kidding. How many tens of thousands of dollars did the focus group cost to come up with that word? We don't want your overpriced words. Stop treating us like we're morons.

      We want all of you to stop focusing on your reelection and do the job we want done, not the job you want done or the job your party wants done. You work for us and at this rate I guarantee you not for long because we are coming. We will be heard and we will be represented.. You think we're so busy with our lives that we will never come for you? We are the formerly silent majority, all of us who quietly work, pay taxes, obey the law, vote, save money, keep our noses to the grindstone… and we are now looking at you.

      You have awakened us, the patriotic freedom spirit so strong and so powerful that it had been sleeping too long. You have pushed us too far. Our numbers are great. They may surprise you. For every one of us who will be there, there will be hundreds more that could not come. Unlike you, we have their trust. We will represent them honestly, rest assured. They will be at the polls on voting day to usher you out of office.

      We have cancelled vacations. We will use our last few dollars saved. We will find the representation among us and a grassroots campaign will flourish. We didn't ask for this fight. But the gloves are coming off. We do not come in violence, but we are angry. You will represent us or you will be replaced with someone who will. There are candidates among us who will rise like a Phoenix from the ashes that you have made of our constitution.

      Democrat, Republican, independent, libertarian. Understand this.. We don't care. Political parties are meaningless to us Patriotic Americans are willing to do right by us and our Constitution, and that is all that matters to us now.. We are going to fire all of you who abuse power and seek more. It is not your power. It is ours and we want it back. We entrusted you with it and you abused it. You are dishonorable. You are dishonest.. As Americans we are ashamed of you. You have brought shame to us. If you are not representing the wants and needs of your constituency loudly and consistently, in spite of the objections of your party, you will be fired. Did you hear? We no longer care about your political parties. You need to be loyal to us, not to them.. Because we will get you fired and they will not save you.

      If you do or can represent me, my issues, my views, please stand up. Make your identity known. You need to make some noise about it. Speak up. I need to know who you are. If you do not speak up, you will be herded out with the rest of the sheep and we will replace the whole damn congress if need be one by one.

      We are coming. Are we coming for you? Who do you represent? What do you represent?

      Listen. Because we are coming. We the people are coming.

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