If only wishing would make it so

by Russ Roberts on December 1, 2009

in Health

The AP reports:

Sen. John McCain, R-Ariz., attacked the legislation as a “monstrosity” that employs “Bernie Madoff accounting, Enron accounting” as he offered the first GOP amendment. McCain’s amendment would strip out more than $400 billion in Medicare cuts to home health providers, hospitals, hospices and others – a pitch to seniors, who polls show have deep concerns about the legislation.

Yes, the accounting is dishonest. So let’s make sure the planned cuts in benefits don’t happen. And let’s buy off the seniors. Keep them quiet.

Democrats planned to go on the offense on the same issue Tuesday with an amendment underscoring benefits to seniors and guaranteeing that basic Medicare benefits would not be touched.

And the Democrats join in with their bid to make sure that nothing ever ever goes down, only up.

Sen. Barbara Mikulski, D-Md., made a bid for support from women Monday with an amendment to reduce copays and deductibles for preventive services such as mammograms.

Great strategy. Get the women behind it. And add yet another provision that increases the demand for health care and drives up its price.

Alluding to outrage earlier this month after a government-appointed panel said that women generally should begin routine mammograms in their 50s rather than their 40s, Mikulski said that under her amendment, “if your doctor says you need one, you’re going to get one.”

That’s right. No sacrifice. Ever. That is the specialty of the politician. Sell that free lunch. And this is to assuage any fears that the government would ever suggest a particular course of treatment once the government is paying for everything. Don’t worry about that. That only happens in other countries.

Votes on amendments are expected to begin Tuesday. “We have an historic need and we have an historic opportunity. We have an opportunity to enact groundbreaking reform that will finally rein in the cost of health care,” said Sen. Max Baucus, D-Mont.

They are going to rein in the cost of health care by expanding the demand for health care. When they’re done with that achievement, they can create food without calories, the fuel-free car, and the honest politician.

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  • Barbarossa
    Don, I have to say, your wit and your sarcasm are superb in this one :-). I particularly love "food without calories." Solid gold.
  • Marcus
    "McCain’s amendment would strip out more than $400 billion in Medicare cuts to home health providers"

    I'm wondering what that means precisely and what it is that Democrats have against home health care providers? Why single them out?
  • kebko
    When the mammogram report came out recently, the general reaction I heard was that "experts" didn't want to accept the finding, because it might mean that insurance companies would stop paying for mammograms that the study showed were not beneficial.
    So, following the logic, these "experts" were saying that they didn't want the insurance companies to use actual science & risk/benefit analysis as a basis for their standard of care. Of course, if the study had shown that mammograms were important, then the insurance companies would have been inhumane monsters if they ignored the science.
    In healthcare, it's ok to harm consumers, as long as you spend money while you're doing it.
  • Sara
    All of these things were going to happen anyway. There was no way they were ever going to make the cuts to medicare. They put them into the bill solely to get a 'good' CBO score. So these amendments actually make the bill more honest. Let them ratchet the bill up to the 2+ trillion dollar monstrosity it really is and try to sell it to the public honestly. The public deserves to know what they're really getting, and if they still want it they'll "deserve to get it good and hard."
  • Babinich
    Russ says:
    "They are going to rein in the cost of health care by expanding the demand for health care."

    danielkuehn answers:
    "The smell test seems so basic on this one - I'm not sure why everyone buys into this line."

    Because Congress does not have the intellect or the virtue required to legislate.

    http://online.wsj.com/article/SB124277530070436...

    To quote Hayek: "Economic control is not merely control of a sector of human life which can be separated from the rest; it is the control of the means for all our ends."

    Time will show that costs will rise...
  • danielkuehn
    It's an interesting WSJ article to link, because I'd make the case that it's precisely for the sake of profits (and not for headlines) that there is even a mandate in the bill.
  • danielkuehn
    "And the Democrats join in with their bid to make sure that nothing ever ever goes down, only up."

    :) you can't at least give them credit for the cuts they do include? You even mention the "planned cuts" in your immediately prior comment!

    "They are going to rein in the cost of health care by expanding the demand for health care."

    The smell test seems so basic on this one - I'm not sure why everyone buys into this line. The whole "thinking like an economist" that professors always talk about seems so cliche... until you listen to the way other people talk and realize that it actually is pretty unique.
  • CTD
    Don't be obtuse. The referenced "cuts" have been "required" for a decade now. Congress just delays them every year. Those Medicare reimbursement cuts are never going to be made. And everyone knows it.
  • danielkuehn
    They'll be made. The U.S. government is eventually going to default if they're not made. The question is when. My understanding is that this is more than just the annual SGR. Maybe it won't be made in this reform process - maybe they will balk eventually. I'm not saying Congress is guaranteed to follow through. I'm just wondering why the hell you would criticize that provision in the bill BEFORE they delay it. Seems to me you should be celebrating the provision, doing everything you can to warn them to follow through on the provision, and only criticize them when they don't.

    But I suppose supporting that provision would necessitate finding something redeemable in the health reform bill, and putting an implicit stamp of approval on socialized medicine for the elderly. I'm guessing that has more to do with the uproar than a real dedication to Congress making cuts.

  • Mark
    ":) you can't at least give them credit for the cuts they do include? You even mention the "planned cuts" in your immediately prior comment!"

    Dan rides in to the Dem's defense! My hero!
  • Barbarossa
    You mean "Democrats" ("whatever that means").
  • Mommsen1625
    There will never actually be any cuts (until the system goes into catastrophic failure); that is an accounting gimmick. All the major accounting entities both inside and outside government repeatedly state that any claims of cuts, savings, etc. are predicated on certain future changes which are not within the behavioral norms of the Congress or the Presidency.
  • danielkuehn
    They don't have a great record for making cuts stick, you're right. That doesn't mean we don't need them. Fine - have the CBO score a bill without the cuts so the public knows how important it is to actually keep entitlement programs under control. That seems better than dismissing the bill that actually makes the cuts! I don't see what that sort of dismissal does except score partisan points. By all means, let's illuminate the costs of not making the cuts.
  • CTD
    "have the CBO score a bill without the cuts so the public knows how important it is"

    The CBO must score bills based on current law, as it is. Not based on what the law as it almost surely will be. As has been pointed out, it's an accounting trick to mask the cost of this monstrosity.
  • Mommsen1625
    Fine - have the CBO score a bill without the cuts so the public knows how important it is to actually keep entitlement programs under control.

    Ha ha ha ha. The CBO can score a bill any way it wants to; that has zero effect on the future actions of Congress.

    I don't see what that sort of dismissal does except score partisan points.

    It illustrates the reality of the nature of our government. That's square one. Without that, you get nowhere. Of course very few in government or in the chattering classes want to actually talk about that sort of thing. This is the Brezhnev era of American politics.
  • danielkuehn
    I'm not understanding your point... so we shouldn't quantify the cost of doing nothing because it's futile? We shouldn't celebrate proposed cuts because they're a mirage? I agree completely that Congress constantly back-pedals on Medicare cuts. I'm not sure where you're going with that... or are you just pointing that out several times in a row?
  • Mommsen1625
    ...so we shouldn't quantify the cost of doing nothing because
    it's futile?

    Until we deal with our Brezhnev era, hole in the sand approach of our politics, yes. The American system of government is fundamentally corrupt and broken.
  • Methinks1776
    And the Democrats join in with their bid to make sure that nothing ever ever goes down, only up.

    Oh, well this is where I completely disagree with you. The standard of living and quality of healthcare will go waaaaaaay down.

    This would be unbelievable if it weren't so typical.
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