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What is the Latest Budget Gimmick in the Health Care Charade?

This 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 formula. Currently, the government formula underpays doctors, so doctors have to charge all Americans more to make up for the money lost through the broken Medicare system. While fixing the Medicare payment formula is a good idea, it is reckless to not offset the increase in Medicare costs with spending cuts.

According to the Congressional Budget Office (CBO), the bill would cost an additional $210 billion over the next 10 years. In fact, the measure was originally included in earlier versions of the House health care bill, but was later carved out of the legislation in order to reduce the bills cost and make the Congressional leaderships health care agenda appear more fiscally responsible than it is.

The Costs of the House-passed Health Care Bill

Congressional leadership has been trying every budget gimmick in the book to disguise the true cost of their health care agenda. 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 even with those gimmicks, the bill that passed the House on November 7 would put the government in control of over half of all health care spending and will cost $2.4 trillion over the next ten years. It would dramatically shift Americas health care system from one that is largely private to one that is subordinated to government control.

The Costs of the Latest Doc Fix Bill

To help hide the costs of a government-run health care system, Congress took out the doc fix portion of the health care bill from the House-passed bill and is now attempting to pass it as a separate bill. Senate Democrats tried the same trick before voting on a larger health care reform package a few weeks ago. Luckily, the Senate bill failed. But now, after the passage of its Godzilla-like health care bill (H.R. 3962), the House of Representatives will soon attempt the same 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 10 years. Since this would be an increase in the cost of Medicare Part B services, the part of Medicare that pays doctors, it would also mean an increase in the Medicare Part B premiums that seniors must pay. In its November 4, 2009 budget estimate of H.R. 3961, the CBO estimated 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 will accumulate over time. Assuming that the House does not provide for other spending cuts to cover the additional Medicare spending for the doc fix, the impact would be enormous potentially adding trillions more to Medicares already massive, long-term unfunded obligation.

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