Next Week’s House Health Care Shell Game
Posted November 10th, 2009 at 12:24pm in Health Care 
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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.
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8 Responses to “Next Week’s House Health Care Shell Game”
Bobbie Jay on November 10th, 2009 at 12:24pm said:
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.
GOVERNMENT RUN HEALTH CARE IS NOT RIGHT FOR ANYBODY OF THIS MAGNITUDE!
jim sardis,ms. on November 10th, 2009 at 12:24pm said:
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.
Jim on November 10th, 2009 at 12:24pm said:
I AM TOTALLY AMAZED AT HOW IGNORANT MANY
AMERICANS ARE. THESE LIBERALS ARE ALL LIARS.
WE “KNOW’ CLINTON IS AND SO ARE OBAMA “NO
PORK IN THE STIMULUS BILL”, ONLY 8,000, AND
PELOSI ET ALL. ACTUALLY 99.9% OF WHAT THE TELEPROMPTER-IN-CHIEF HAS SAID IS UNTRUE. BUT, TOO MANY IDIOTS BELEIVE THEM. GOD HELP
US.!!!!!!!!!!!!!!!!!!!!!!!!!
Tim Az on November 10th, 2009 at 12:24pm said:
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?
Jeanne Stotler, Woodbridge on November 10th, 2009 at 12:24pm said:
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.
carol, new orleans la on November 10th, 2009 at 12:24pm said:
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.
Lynn B. DeSpain on November 10th, 2009 at 12:24pm said:
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?
Arlyne Dreyer, Missoula, MT on November 10th, 2009 at 12:24pm said:
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?