Ye Olde Shenanigans: Split the good from the bad, sweep under the rug
But there is another devious plot afoot. In the Senate, Obamacare has been split in two. The best way for me to tell you about it is.. because I am short on time.. posting this whole article from the WSJ:
The Doctor Fix Is In
Adding lots of 'dimes' to the deficit.
President Obama has made serial promises that he will not sign a health-care bill that "adds one dime to our deficits, either now or in the future, period." This was never plausible, but now we can begin to understand what he meant: Democrats plan to make ObamaCare "deficit-neutral" by moving nearly a quarter-trillion dollars off the books, in the fiscal deception of the century.
Later this week, or maybe next, Senate Democrats plan to vote on a stand-alone bill that strips a formula that automatically cuts Medicare physician payments out of "comprehensive" health reform. Rather than include the pricey $247 billion plan known on Capitol Hill as the "doc fix" as part of ObamaCare, they'll instead make this a separate contribution to the deficit, without compensating tax increases or spending cuts. Majority Leader Harry Reid explained at a press conference last week that "All we're doing is wiping the slate clean by adjusting the baseline to what is current policy. This is not new policy."
Wiping the slate is right.
It's true that Congress likes to pretend that the "sustainable growth rate," or SGR, is real. Created in 1997, the SGR slashes Medicare reimbursements if costs rise too steeply, as they always do. In January, doctors fees are scheduled to fall by 21.5%, and 40% over the next five years. That would force many doctors to stop seeing Medicare patients, so Congress intervenes every year and temporarily overrides the cuts.
The American Medical Association's asking price for supporting ObamaCare is scrapping the SGR. House Democrats did just that, but it pushed the total cost of their bill above $1 trillion, a political red line. The Senate Finance Committee chose the subterfuge of fixing the problem for only one year, which is how Chairman Max Baucus could claim he had done the miracle-work of designing an entitlement that reduces the deficit over 10 years. The AMA wasn't pacified.
So now Democrats are simply going to "untether" this spending on doctors from ObamaCare, hiding even more of its true costs. At a meeting on the Hill last week, Mr. Reid and White House Chief of Staff Rahm Emanuel made the quid pro quo explicit, telling the AMA and about a dozen specialty societies that in return for this dispensation they expect them to back ObamaCare, no questions asked.
It turns out the AMA is a cheap date. President J. James Rohack now looks ready to embrace whatever else Democrats offer up, even though the new bill only delays the SGR cuts for 10 years instead of doing away with the formula permanently. Never mind that the AMA's other legislative priority—tort reform—is dead on arrival. ObamaCare is stocked with other provisions that punish doctors, such as a Medicare commission tasked with cutting spending but barred from raising the eligibility age or reducing benefits. In practice, this means it will only be allowed to crank down Medicare's price controls on providers.
Like other industry lobbies, Mr. Rohack seems prepared to trade away his members for a sack of magic beans. We agree that the SGR is a farce that nonetheless has very damaging effects on physician practices, but the least the AMA can do is use its political leverage for something more lasting than a 10-year promise that is bound to be revoked when ObamaCare's costs run off the rails.
The press corps will mostly ignore all of this because it is complicated and boring policy, as opposed to the epic drama of Anita Dunn vs. Glenn Beck. This doctor maneuver is such a cleverly dishonest solution to their many contradictory promises that we're surprised Democrats didn't think of it sooner.
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