What the Democrats won’t tell you about their health care reform costs

Sharon asked a simple question:

Why Don’t Democrats Just Admit…

The Baucus “bill” explodes the deficit, creates even more disincentives for doctors to treat Medicaire patients and RAISES BLOODY COSTS FOR EVERYONE???

To be honest, I am so tired of the lying going on with the so-called health care debate. Read this and remember the 14 despicable jerks who passed this monstrosity out of committee.

And her simple question has a simple answer: if the proponents told the truth about the costs, it would never pass.

The Hot Air story Sharon referenced goes over how the projected costs soar during the second decade, and notes the disingenuous way in which the first decade is priced out: since the bill wouldn’t actually be implemented for a couple of years, two zero-cost years are included in the first decade, making it seem like the real costs are lower. Ed Morrissey quoted Jeffrey Anderson, a senior fellow in health-care studies at the Pacific Research Institute, in The New York Post:

As the CBO notes, his bill would cut Medicare payments to doctors by 25 percent in 2011, then hold them at that level perpetually. In other words, given inflation, Baucus proposes endless cuts in what the program pays physicians and others.

Thing is, physicians are already reluctant to take Medicare patients, because Medicare payments are already too low.

Note this, from the Department of Health and Human Services:


CMS PROPOSES PAYMENT, POLICY CHANGES FOR PHYSICIANS SERVICES TO MEDICARE BENEFICIARIES IN 2010

The Centers for Medicare & Medicaid Services (CMS) announced today proposed changes to policies and payment rates for services to be furnished during calendar year (CY 2010) by over 1 million physicians and nonphysician practitioners who are paid under the Medicare Physician Fee Schedule (MPFS). The MPFS sets payment rates for more than 7,000 types of services in physician offices, hospitals, and other settings.

CMS is making several proposals to refine Medicare payments to physicians, which are expected to increase payment rates for primary care services. The proposals include an update to the practice expense component of physician fees. For 2010, CMS is proposing to include data about physicians’ practice costs from a new survey, the Physician Practice Information Survey (PPIS), designed and conducted by the American Medical Association.

The Medicare law requires CMS to adjust the MPFS payment rates annually based on an update formula which includes application of the Sustainable Growth Rate or SGR that was adopted in the Balanced Budget Act of 1997. This formula has yielded negative updates every year beginning in CY 2002, although CMS was able to take administrative steps to avert a reduction in CY 2003, and Congress has taken a series of legislative actions to prevent reductions in CYs 2004-2009. Based on current data, CMS is projecting a rate reduction of -21.5 percent for CY 2010.

As part of health care reform, the Administration supports comprehensive, but fiscally responsible, reforms to the physician payment formula. Consistent with this goal, the Administration announced in the FY 2010 President’s Budget that it would explore the breadth of options available under current authority to facilitate such reforms, including an assessment of whether the cost of physician-administered drugs should continue to be included in the payment formula. Thus, while working with Congress to develop a more appropriate mechanism for updating physician payment rates, CMS is proposing to remove physician-administered drugs from the definition of “physician services” for purposes of computing the physician update formula in anticipation of enactment of legislation to provide fundamental reforms to Medicare physician payments. While the proposal will not change the projected update for services during CY 2010, CMS projects that it would reduce the number of years in which physicians are projected to experience a negative update.

CMS is also proposing to stop making payment for consultation codes, which are typically billed by specialists and are paid at a higher rate than equivalent evaluation and management (E/M) services. Practitioners will use existing E/M service codes when providing these services instead. Resulting savings would be redistributed to increase payments for the existing E/M services.

Emphasis mine. Private insurance payers pay roughly 30% more than does Medicare, and, according to the American Medical Associations 2008 insurer study, Medicare denies a higher percentage (6.85%) of claims than do private insurers.

Of course, I documented earlier the fact that Medicare doesn’t pay its own way when it comes to hospital reimbursements, and now you can see that the government doesn’t pay its own way when it comes to paying physicians. If whatever health care passes the Congress keeps trying to save money by reducing payments to physicians, physicians will do the logical thing — the thing that many of them do now concerning Medicaid patients — and simply not accept them as patients. If we somehow force physicians to accept public-pay patients, we’ll eventually run into the same situation as our Canadian brethren: a shortage of medical personnel period, because they can’t make enough money.

It’s really pretty simple: the Democrats may have the political will and muscle to push some sort of health care “reform” bill through, but they are lying about the costs, and, deep down, they know they are lying about the costs. Perhaps they think that it’s just so important that knowingly lying about the costs is a price they are willing to pay to get it passed. But if it does pass, working men and women in this country will be poorer for it.

30 Comments

  1. Here is the response I posted on Sharon’s blog, which I will also post here, because you Righties over here are just as hysterical as she is:

    Sharon, you are hysterical, for no good reason, and the rest of the Right here on your blog are joining you.

    Your links are not credible, and Harry Reid is, as usual, confused. And I include Douglas Douglas Holtz-Eaken as being not credible, who has become a Right wing extremist since leaving as director of the CBO.

    I will pick out just one example of the slippery wording in your “Hot Air” link:

    “Most astounding of all is what this Congress is willing to do to struggling middle-class families. The bill would impose nearly $400 billion in new taxes and fees. Nearly 90% of that burden will be shouldered by those making $200,000 or less.”

    Now if you can go from this obscure wording to what it would cost an average middle income family of 4, be my guest and let me know, after which I will send you some kudos.

    The current CBO is the only credible source for the cost of the Senate Finance Committee’s bill, the so-called Baucus Bill. Here is a summary of their findings:

    “A health-care reform bill drafted by the Senate Finance Committee would expand health coverage to nearly 30 million Americans who currently lack insurance and would meet President Obama’s goal of reducing the federal budget deficit by 2019, the nonpartisan Congressional Budget Office said Wednesday.

    The bill would cost $829 billion over the next decade, but would more than offset that cost by slicing hundreds of billions from government health programs such as Medicare and by imposing a 40 percent excise tax on high-cost insurance policies starting in 2013.

    All told, the package would slice $81 billion from projected budget deficits over the next 10 years, the CBO said, and continue to reduce deficits well into the future.”
    The emphasis is mine.

    Another very important point: We do not have a final bill yet. This Baucus Bill is only one of 6 or 7 different committee proposals. You know the process. If the final bill contains a robust public option, I would expect the cost projection to be lower due to the competition with the private insurers, meaning that it will be even easier to offset this cost in order to meet the Obama requirement of revenue neutrality.

    Before getting hysterical again, Sharon et al, won’t you please wait until we have a final bill with a final CBO estimate of the cost? Thank you!

  2. If this article doesn’t scare you…..then you need to read that new book, A Time To Stand by Oliver, cause more federal tyranny is coming if the health care isn’t stopped. It’s a modern day version of AMericans compared to the colonist who had to stand up to King George III. It’s insightful cause it’s based, in part, on real people/events in a small town that does stand up to present day federal tyranny. It’s a small town that could be your home town. Just read & see what’s in store for all of us if health care is passed.

    1. From bondage to spiritual faith;
    2. From spiritual faith to great courage;
    3. From courage to liberty;
    4. From liberty to abundance;
    5. From abundance to complacency;
    6. From complacency to apathy;
    7. From apathy to dependence;
    8. From dependence back into bondage’

    http://www.booksbyoliver.com

  3. Independent, we still have elections. If we are foolish enough not to educate ourselves and keep informed, then we deserve what we get. I am hopeful that this recession has awakened us to our shortcomings, hoping also that it is not too late.

  4. Perry:
    Independent, we still have elections. If we are foolish enough not to educate ourselves and keep informed, then we deserve what we get. I am hopeful that this recession has awakened us to our shortcomings, hoping also that it is not too late.

    If you say that Perry, why didn’t you know BO sought out radical students and Marxist Professors in College and said so by his own admission?

  5. Yorkshire: I know what Harry Reid said. I honestly think the man is confused. I go by what the non-partisan CBO says.

    I am unaware of what you say about Obama in his youth, over 25 years ago. That’s a long time in anyone’s life! But assuming he did, do you know why he did? I know he admits to a troubled youth. Perhaps this is one manifestation of it. I am speculating.

    That said, I do not see these “radical” tendencies in Obama now, as he is certainly only a tad left of center, in my view. The left is getting increasingly frustrated with him on certain issues, like adopting some of the Bush war policies with no explanation, like his continuing with the Bush rendition policy, like supporting the Patriot Act, like less transparency than expected. I’m surprised you war hawks have not come around to liking this President!

  6. Perry:
    Yorkshire: I know what Harry Reid said. I honestly think the man is confused. I go by what the non-partisan CBO says.

    Yeah, you’re right, Reid is only the leader of the Senate. What the hell does he know anyway.

  7. I love when idiots start throwing out “war hawk” crap like it actually deflates us “war hawk” types. The best way to have peace is to be ready, willing, and able to go to war and to win that war overwhelmingly. But idiots will never figure that part out.

  8. Perry opines:
    I am unaware of what you say about Obama in his youth, over 25 years ago. That’s a long time in anyone’s life! But assuming he did, do you know why he did? I know he admits to a troubled youth. Perhaps this is one manifestation of it. I am speculating.

    That said, I do not see these “radical” tendencies in Obama now, as he is certainly only a tad left of center, in my view. The left is getting increasingly frustrated with him on certain issues, like adopting some of the Bush war policies with no explanation, like his continuing with the Bush rendition policy, like supporting the Patriot Act, like less transparency than expected. I’m surprised you war hawks have not come around to liking this President!

    Out of school and to community organizing the Saul Alinsky way. Yup, nothing radical there. Yup, working with ACORN training community organizing in the Saul Alinsky way. Wow, what a rightwinger! Has a few of his “advisers” who think Mao is a great philosopher. You know that fun guy who overthrew the government of China to establish that Communist Utopia that murdered 70million Chinese. Made Hitler look like a slacker. You’re right Perry, just a degree left of Center. Practically a rabid rightwinger.

    On military, so far, cut the budget, blows off McChrystal, and recently diverted money from the Army’s Operation and Maintenance Budget for some Kennedy monument. Real pal of the military. As far as carrying on Bush’s war policy, what else could he do? He could just pull out to please the Left, then take the consequences of complete chaos in SW Asia. Let the Taliban and Al-Q get Pak’s nukes. More terrorism here. Real hard thinking there.

  9. Yorkie, as I have pointed out several times in several threads, Perry has not seen and has not heard a vast amount of information because Perry refuses to see and refuses to hear that vast amount of information. He demands proof, but again, as he pointed out, refuses to see and refuses to hear the proof he demanded he be given. He is a “Helen Keller” partisan out of a concerted effort to be a “Hellen Keller” partisan.

  10. Perry:
    Yorkshire, you’re off tonight as well. Must be the weather!

    I think you might have something there. Cold, rainy all for three days. Then out of nowhere, the awfulritis hit the thumb hard, so I hit the percoset hard. Brings out the other me, whoever he is. ;-)

  11. Sorry to hear about your arthritis, Yorkshire; something we have in common! Believe it or not, minocycline, an antibiotic taken daily in low dose, helps to control mine, and simple advil, when things get rough, takes the edge off of the pain!

  12. Perry:
    Sorry to hear about your arthritis, Yorkshire; something we have in common! Believe it or not, minocycline, an antibiotic taken daily in low dose, helps to control mine, and simple advil, when things get rough, takes the edge off of the pain!

    What also helps is to get a plain white sock, fill it with rice, tie up the end, put it in the microwave for a minute or so, and it’s a quick heating pad for about 15 minutes. I’m think of doing three socks sewn together to make like a mit, and stick my whole hand in it.

  13. Another very important point: We do not have a final bill yet. This Baucus Bill is only one of 6 or 7 different committee proposals. You know the process. If the final bill contains a robust public option, I would expect the cost projection to be lower due to the competition with the private insurers, meaning that it will be even easier to offset this cost in order to meet the Obama requirement of revenue neutrality.

    Perry, you seem to be awfully naive and trusting when it comes to believing these politicians.

  14. Perry wrote:

    The current CBO is the only credible source for the cost of the Senate Finance Committee’s bill, the so-called Baucus Bill.

    What a great way to stifle controversy, declaring that the “official” figures are the only ones which count.

    Tropuble is, we remember the “official” figures about the Medicare Part D bill, and how they proved to be utterly worthless. There is no particular reason to assume that the official figures are any more reliable today than they were in 2003.

    Eric said:

    Perry, you seem to be awfully naive and trusting when it comes to believing these politicians.

    I’m guessing that Perry isn’t particularly naïve and trusting when it comes to believing Republican politicians. I’d guess that he was completely mistrustful of the Bush Administration’s cost projections for the Iraq war, for example.

  15. The 2010 defense budget is $620 billion. Any ideas what you conservatives would want to cut from it to help balance the budget?

  16. mike g, you are using false premises like most liberals do. Let’s start by cutting the unconstitutional EPA, OSHA, Medicaid, Medicare, Social Security, SCHIP from the federal budget and go from there. Davey Crockett already preemptively back-slapped you. You just didn’t realize it.

  17. What’s the false premise? That the 2010 “defense” budget is $620 billion? You’re free to debate the number but I suspect that you’re using words/concepts that you don’t understand. If you call a belief that the defense budget should never ever be cut and forever expanded a “premise” then I suppose you’d have a point. Honestly, JH, don’t tell me my premises are false unless you can explain why.

    Anyway, I think I’ve made my point; that “conservatives” are only interested in balancing budgets when there’s some political points to be scored by talking about them. When it comes down to actually tightening the belt it’s always someone else who has to make the sacrifices.

    And as far as responding to your fevered, AM radio informed opinions on what is and is not constitutional I’m afraid I’ll have to pass. You Johnny Rebs are strangers to reason on the matter.

  18. The 2010 defense budget is $620 billion. Any ideas what you conservatives would want to cut from it to help balance the budget?

    I’m less up on our current military structure than I used to be, but as a general rule I’d say that much of what was built to fight the Cold War can probably be phased out. We could probably cut back a few carriers, missile subs, long range bombers and the like. Spend more money on drones, Special Forces (Navy SEALs, Delta Force, etc.), the Marine Corps, and so on, which is to say, focus the spending on what we’re actually doing the fighting with.

  19. I wrote about the budget here:

    http://iowaliberal.com/?p=4018

    There are some changes along the lines of what you said; National Guard equipment spending has been boosted from $600 million to $6.9 billion. $2 billion to develop defenses against improvised bombs and $1.57 billion for defenses against chemical and biological weapons. These are items that I think are justifiable though like you I don’t understand the point (besides Jack Murtha style pork) of spending billions on developing and maintaining systems that address no potential threat.

  20. Democrat version of spending cuts: Slash defense spending, increase so-called entitlement spending faster than inflation but not as fast as their great dream of increase. When a Conservative or a Republican says to increase defense spending, the Democrat automatically claims the Conservative or Republican is not for fiscal responsibility, as if that is the only spending in the federal budget.

    Tell me, according to the US Constitution, who is responsible for writing laws? EPA? OHSA? IRS? Social Security Dept? Dept of Labor? Department of Ed? No, none of those. And yet they do. And that’s unconstitutional.

  21. Here you go, John. I’ve pointed Dana at this before; he’s been conspicious in his inability to deal with it.

    Given a simple budget simulator – one that actually takes into account what costs what – why don’t you actually put some figures to your puffery. Run through it, and tell us what you did to balance the budget – with figures.

  22. >Democrat version of spending cuts: Slash defense spending, increase so-called entitlement spending faster than inflation but not as fast as their great dream of increase.<

    So I see that you’ve taken a pass on explaining to me exactly how my premises are faulty and have instead stuck to making simplistic generalizations about the spending habits of the insidious librulz. I’ll take that as a white flag.

    And what’s with this bizarre constitutional red herring you keep clinging to? Why can’t you just come out and admit that you’re simply not serious about cutting the parts of the budget that demand the most tax dollars and you’re only interested in sounding patriotic and tough?

  23. Defense spending, which is part of the Constitution is roughly 1/3 of the budget. Social spending, which is not part of the constitution, has never had a cut that I am aware of.

    Carter, Clinton, and now Obama have given the DoD real cuts in the budget. Social spending, has never seen spending only increase by inflation. Always more than inflation while at the same time calling them cuts. Republicans have suggested holding the social spending to the inflation rate but were accused of starving the children with such big “cuts”. And flat-lining the spending was loudly decried as draconian.

  24. John Hitchcockamania claims:“Let’s start by cutting out the unconstitutional EPA, OSHA, Medicaid, Medicare, Social Security, SCHIP from the federal budget and go from there.”

    Unconstitutional??? Excuse me, Yorkshire, but I am just going to have to say it: John, you are an idiot!!!

    If these programs were ‘unconstitutional’, then your werewolf brethren on the Right would have had them up before the SCOTUS long ago!

    Not only that, have you considered how foolish your proposition would be? You aren’t even in touch with reality, which has been more than obvious.

  25. >Defense spending, which is part of the Constitution is roughly 1/3 of the budget.Carter, Clinton, and now Obama have given the DoD real cuts in the budget.Social spending, has never seen spending only increase by inflation.<

    And maybe someday Bill Clinton and Newt Gingrich will pass the Welfare Reform Act of 1996.

    Again, I’d be interested to hear what this “false premise” of mine is that you referred to previously. Face the facts, JH; you’re only interested in the budget insofar as it gives you the opportunity to beat up on people that can’t defend themselves.

  26. >Republicans have suggested holding the social spending to the inflation rate but were accused of starving the children with such big “cuts”.

    Oh how quickly the Johnny Rebs forget about Medicare Part D.

    >Defense spending, which is part of the Constitution is roughly 1/3 of the budget.Carter, Clinton, and now Obama have given the DoD real cuts in the budget.

    http://www.americanprogress.org/issues/2009/04/fact_sheet_defense.html

    http://www.defensenews.com/story.php?i=4318241

    Obama’s budget actually represents an increase.

  27. >Unconstitutional??? Excuse me, Yorkshire, but I am just going to have to say it: John, you are an idiot!!!

    JH doesn’t know the difference between a standing army and a militia nor is he aware of the Founding Fathers absolute abhorrence of the latter. Hence the constant sloganeering about “BUT TEH CONSTITUTION!! THE CONSTITUTION!!”

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