The Right Prescription

Just Walk Away

The Medicare mess alone disqualifies the Obamacare bills from further consideration.

By 2.2.10

Send to Kindle

In his State of the Union address, the President implored Congress not to "walk away" from healthcare reform. With Scott Brown's victory in Massachusetts, and growing skepticism among Americans, passage of a "comprehensive" healthcare bill is looking less and less likely every day.

And for good reason. The House and Senate versions of healthcare reform are nearly 2,000 pages long. Some of the most expensive provisions in the bills are effectively unfunded and will indeed exacerbate our federal fiscal catastrophe.

The most egregious example of this reckless spending is the infamous "Doc Fix" provision, which determines how and how much the government will reimburse physicians for services provided to patients on Medicare and Medicaid. This provision is only a one-year patch -- with the cost offset by taxes and reduced spending elsewhere. What about the other nine years? That, it seems, is the purview of S.1776 and, according to a recent New York Times piece, "Congressional Democrats have no plans to offset the cost of S. 1776, which is why they are eager to keep it separate from the broader health care legislation and avoid breaking the president's promise."

Remember President Obama's promise? "I will not sign a plan that adds one dime to our deficits -- either now or in the future. Period." Well, it seems that many in Congress are looking at the "period" and seeing an ellipsis. The Times continues, "Congressional Democrats insist that fixing the doctor payment formula should not count toward the cost of the big health care legislation, because it is a problem they inherited." Unlike the problem of the uninsured? Unlike the problem of preexisting conditions? Unlike the problem of the donut hole? Unlike the problem of (FILL IN THE BLANK)? And from whom exactly did they inherit the problem? LBJ? Sounds like a total ellipsis of the sum.

Honestly -- a healthcare bill that doesn't include Medicare payments to physicians? As my kids would say: "Word." And to quote Representative Charlie Rangel, supporters of the pending legislation "have a serious problem." The Quinnipiac poll has only 34% of respondents approving the bill. Americans smell something fishy. And they're right. Americans are wondering just how healthcare reform is going to impact them. And now that the voting public is paying attention, they don't like what they see. Because what they're seeing is whose going to pay.

The most high profile debate is about the 40% excise tax on "Cadillac" health plans. But consider just two of the ways Democrats are suggesting the public "pay" for healthcare reform:

• 2.35% increase in Medicare payroll tax on incomes over $200,000 for individuals and $250,000 for couples.

• $471 billion in cuts to Medicaid.

You're not hearing a lot about either of these because they tax the middle class and gut healthcare options for senior citizens. Not core Democratic Party talking points. You're not hearing about it is because Democratic lawmakers are horse trading behind closed doors. And in case you've forgotten, during the presidential campaign candidate Obama pledged that any negotiations on healthcare legislation would be broadcast on C-SPAN, "so the American people can see what the choices are," and "not conducted behind closed doors." "Such public negotiations," he said, were "the antidote" to "overcoming the special interests and the lobbyists who… will resist anything that we try to do." To quote another American media icon, Madonna -- "Not." Americans aren't stupid -- and Americans are paying attention.

Like this Article

Print this Article

Print Article
About the Author

Peter Pitts is partner/director of global health at Porter Novelli, a senior fellow at the Center for Medicine in the Public Interest, and a former FDA associate commissioner.