Time to End the Big Health Care Shell Game

Published October 26, 2009

Washington isn’t in the business of common-sense health care reform. It’s in the shell game business, and business is booming.

This week, House Democrats under Speaker Nancy Pelosi (D-CA) considered rebranding the government-run health care plan with that troublesome name–the so-called public option–as something more pleasant. Even Sen. Olympia Snowe (R-ME), the lone Republican to vote for any of the Democrat reform packages in committee, said this week she will support a filibuster of any legislation that includes a public option.

Clearly, proponents of the public option need some new material. So they reportedly plan to reposition this grand idea as “Medicare Part E”–“Medicare for Everyone.”

How will the Democrats pay for such a costly expansion of government health care? That’s the best part: In addition to the billions in new taxes and fines they expect to take from taxpayers, insurers, and industry, the largest part of funding for “Medicare for Everyone” would come from Medicare itself.

Current Senate health care legislation is based on estimates that as much as $400 billion is hiding in the waste, fraud, and abuse in the current program. Common sense suggests a program throwing $400 billion down the hole isn’t one you ought to expand–but this is Washington we’re talking about.

The other portion would come from automatic reductions in Medicare payments to doctors, reductions Senate Majority Leader Harry Reid (D-NV) tried unsuccessfully to stick under a shell this week.

Nearly all the viability of President Barack Obama’s health plan is based on fuzzy math, which includes in hard estimates the kind of scheduled cutbacks Capitol Hill rarely allows to go through as planned.

This week, thanks to a dozen Democrats and Independent Sen. Joe Lieberman, Reid couldn’t even marshal 50 votes for disguising the true cost of this health care plan by freezing payments for 10 years, effectively moving $247 billion off the books. These Senators should be applauded for rejecting Reid’s shell game. If you’re going to charge the American people a trillion dollars for something, you should at least be honest about it.

Unfortunately for the White House, Reid, and Pelosi, putting a stop to the shell game means another rift in the fragile coalition of industry support they brought together after months of glad-handing and arm-twisting. While PhRMA, Pfizer, Amgen, America’s Health Insurance Plans, the American Medical Association, and the Federation of American Hospitals have spent millions on lobbyists and advertising supporting this health care plan, they were all essentially paying protection money to make sure they won’t be the ones stuck with the tab. Increasingly, it looks as if their efforts were for naught.

These games aren’t limited to Capitol Hill’s approach to budgets and deficits. Upon closer inspection, the entirety of President Obama’s plan can be seen as a shell game: taking money from young people and those for whom advanced insurance plans make the least economic sense, shifting those funds into the government pocketbook, and then allowing Washington bureaucrats to redirect the money toward whichever population they see fit.

Washington is going to try to keep this game going, as cost-shifting to the next generation has paid off for them in the past. But we should have no illusions about what the Capitol Hill leadership is trying to force on us. There’s not one bit of common sense buried in this shell game–just kickbacks for special interests, taxes on middle-income families, and what may turn out to be the costliest set of misbegotten policies ever assembled.

Yes, America, you can have free health care–just as long as someone else pays for it.
Benjamin Domenech ([email protected]) is a former political appointee at the Department of Health and Human Services and managing editor of Health Care News.