Thursday, October 22, 2009

Paging Dr. Reid

Wow, Wednesday was a bad day to be Harry Reid. Well, just about any day is a bad day to be Harry Reid, when life is a constant struggle just to get people to take you seriously because you remind them of the guy from those old Peppridge Farm commercials - without the sittin' on a rocking chair in ma back porch country charm - but I suspect, especially this weekend, Reid isn't feeling that "Riunite on Ice- Ooooh that's nice" feeling.

Despite holding the balance of power in the Senate, Reid lost the first fight in a series of upcoming battles Wednesday, when 12 Democrats broke rank and aligned themselves with every single member of a strongly united Republican party, and voted down the so called "doctor fix" that would have added 247 billion dollars to the tag of President Obama's already astronomically priced health care bill.

What is significant about the loss is that it was a surprising illustration of just how legislatively shaky Obamacare is. As Yuval Levin wrote in NRO's The Corner last evening, Reid and the President are facing more than just an increasingly skeptical public:

"The problem for Reid is more than substantive — more than unhappy doctors and an unhappy AMA. The biggest problem is the danger of losing the confidence of his Democratic senators. Passing health-care reform remains an extremely difficult challenge: There are two Senate bills, with very significant substantive differences between them, which need to be combined, voted on, then merged with an even more different House bill, and voted on again. Each of these votes would require the support of just about every (if not indeed every single) Senate Democrat, and each would be a very tough vote for one or another group in their caucus. It is an exercise in serial needle-threading that will call for an extraordinary degree of discipline by the Senate Democrats — a group not known for discipline."

The administration spent the better part of Thursday trying to spin the situation in a number of bizarre and comic ways, until deciding the official talking point would be that they had planned this defeat all along to show the world what a bunch of puppy-kicking buzz-kills the GOP are. Yes, that's right - They're saying they held a vote so they could lose on purpose.

By Friday, even the bill's co-author, Rep Peter Stark ,was distancing himself from the enitre mess, after the reason for the unexpected defeat became apparent - a damning audit performed by the Chief Actuary at the Centers for Medicare and Medicaid Services. The report concluded that:

- Total national health spending would increase by $750 billion over the next decade. (So much for “bending the cost curve.”)

- The overall cost of the House bill will be $1.2 trillion over the period between 2010 and 2019. By 2019, the annual cost of the entitlement expansions would be $236 billion, rising at a rate of 9 percent annually. After all this spending, there would still be 23 million uninsured residents in 2019.

- The president’s signature initiatives to slow the pace of rising costs — comparative effectiveness research, prevention and wellness efforts, and payment changes in Medicare — won’t work as advertised. The savings are almost non-existent.

- The cuts in Medicare Advantage plans would result in “less generous benefit packages” for millions of seniors. The actuaries estimate the House’s Medicare Advantage cuts, which are unlikely to change in any new version of the bill, would force about 8.5 million seniors out of the coverage they would prefer and back into the traditional program. (So much for “keeping the coverage you have today.”)

- Democratic proposals to impose arbitrary, across-the-board payment rate cuts for hospitals, nursing homes, and home health agencies based on presumed “productivity gains” are unlikely to work as planned. The actuaries suggest that some institutions won’t be able to hit the targets because health care is more labor intensive than other sectors of the economy. Consequently, the cuts could force some organizations to leave the Medicare program, thus “possibly jeopardizing access to care for beneficiaries."

Pelosi and company are promising a new and improved bill that will ring in at just under $900 billion - news that is unlikely to win too many fans.

President Obama's health care scheme is slowly going the way of his Secretary of State's own failed attempt so many years ago. Hopefully, Americans will soon be able to breathe a sigh of relief.



(Breakdown of the CMS's findings were derived from an assessment by James C. Capretta)

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