The Inescapable Allure of the Public Option

As we near the finish line on health care "reform" legislation, the Dems are converging on various flavors of "public option." The pundits are all weighing in on the political considerations driving this move (mollify the MoveOn wing of the party), and no doubt that has its role. But the real reason it has come down to the public option is that the public option is the only type of plan that Congress can rig to appear as if it is saving the taxpayer money. Only in a public option can Congress get the CBO to score fictitious savings that are written into law by fiat. For example, legislating a schedule of reimbursement decreases to health providers year after and then counting those "savings" as offsetting the massive costs of their plans.

I think almost all Americans know that such savings will never materialize. And in case anyone had any doubts just look at the "Doc Fix" bill that went down to defeat last week. The Doc Fix bill was a brazen attempt by the Dems to buy off doctors by cancelling out years of legislated reductions (aka "savings" of $250B) in payments to health providers. Year after year, Congress backs out the phony savings promised when they passed the bill, under pressure from reality as well as from special interests:

"Since its enactment in 1997 the so-called 'sustainable growth rate' mechanism [aka "savings'], which uses a complex formula to establishes annual target costs for physicians' services under Medicare, has not kept up with actual costs.

That's required Congress to step in almost annually with one-year fixes to prevent doctors from facing ever-bigger potential cuts in payment rates. The cut that loomed for doctors in 2010 was 21 percent. Without a permanent redo of the payment formula, Congress would presumably have had to continue to do one-year fixes, something that would also have cost money and that doctors hated because of the uncertainty involved."

Rural legislators hated these legislated "savings" because it had the effect of greatly diminishing the supply of and access to quality health care in their rural districts.

For the "savings" to ever become real would require Congress and the President, year after year, to have the discipline and the integrity to follow through with the painful choices that need to be made, and resist the temptation to cave to special interests or to buy votes by reneging on their responsibilities. The sad history of our Congress clearly argues against our ever seeing any savings.

The Congress is not serious about fiscal responsibilities. It is telling you so by cancelling out Medicare "savings" at the same time it is telling you its new health care plan will be paid for through "savings" in Medicare. And the President is going along with this charade, all the while accusing his opponents of intellectual dishonesty. How stupid do they think we are?