Why Am I Not Surprised, Again?

John Hinderaker at Powerline produces confirmation of my biggest concern about the so-called financing of the health care reform legislation — banking on cost-saving in Medicare that I believe will be undone after this bill passes. John has posted a copy of a memo distributed to Democratic staffers. Here’s the key excerpt:

One of the many dishonest features of the Democrats’ effort to conceal the fact that their plan is a budget-buster is the assumption that reimbursements to physicians under Medicare will decline. This accounts for a large chunk of the Democrats’ “savings.” In fact, all knowledgeable observers understand that this alleged savings will be illusory because Congress will, in separate legislation, raise those reimbursement levels as in the past. The Democrats’ memo acknowledges the party’s dishonesty on this point, and urges its staffers to continue misleading the public:

Second, most health staff are already aware that our health proposal does not contain a “doc fix.” Some Republicans have repeated CBO’s November 18 letter that says “the sustainable growth rate (SGR) mechanism governing Medicare’s payments to physicians has frequently been modified … to avoid reduction in those payments, and legislation to do so again is currently under consideration in the Congress.” The inclusion of a full SGR repeal would undermine reform’s budget neutrality. So, again, do not allow yourself (or your boss) to get into a discussion of the details of CBO scores and textual narrative. …

As most health staff knows, Leadership and the White House are working with the AMA to rally physicians support for a full SGR repeal later this spring. However, both health and communications staff should understand we do not want that policy discussion discussed at this time, lest it complicate the last critical push to health care reform.

It couldn’t be clearer: the Democrats’ strategy is to mislead the American people about the nature, contents and fiscal consequences of their health care takeover.

That second paragraph in the memo, which I have highlighted, is what confirms my suspicions. That the discussions are already underway is disgraceful — on a par with the shenanigans surrounding the projected costs of Medicare Part D in 2003.

About a month ago, I had a conversation with a colleague working in the Executive Branch. He asked me how I could be for “fiscal responsibility” and yet not for the health care reform, since it lowers projected deficits over the next decade. I told him I will believe it when I see it, and in fact, to allay my suspicions, that the legislated expenditure increases on higher coverage ought to be conditioned on realizing those savings from Medicare. I hate to be this right.

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