A health care shell game

The Democratic leadership in Congress has gone to extraordinary lengths to pretend the health care "reforms" they are trying to pass will reduce the federal deficit over the next decade. According to the official scorers of the Congressional Budget Office, the House bill that passed on Nov. 14 would save $138 billion over 10 years, while the Senate version now being debated would save $130 billion, in part by clamping down on Medicare spending.

The American public, according to several polls, doesn't buy it, and with good reason.

Congressional leaders decided not to include in their bills a necessary upward adjustment of federal health care spending known as the "doc fix." When that item is included, reports the CBO, the Democratic health proposals will add substantial sums to the deficit over the next decade and increasingly more in future years.

The "doc fix" is a tell-tale reaction to a previous congressional lid on health care costs. The reason Congress feels obliged to enact one this year is to relieve doctors from a law passed a decade ago that capped payments under Medicare and Medicaid.

The caps were set too low to maintain a supply of good doctors for the programs, so from time to time Congress has passed a temporary law to lifting them.

That temporary relief is about to expire in January when Medicare must slash doctor payments by 21 percent.

The House last week passed a "doc fix" bill to protect against such a drastic cut. The CBO estimates that the House version, which provides less than the amount needed to restore parity, will add $210 billion to federal health care costs over 10 years.

But days earlier the House reform bill cut Medicare provider payments by $440 billion over the same time period. The Senate bill proposes similar cuts of $331 billion. Needless to say, neither Democratic bill can guarantee that a future Congress will refuse to grant a new "doc fix" to override these "savings."

This is a legislative gimmick. Congress is trying to enact costly health insurance measures by disguising the impact on the nation's finances, cutting here, restoring there and cutting somewhere else.

Its actions resemble the three-shells-and-a-pea game played by hustlers upon the guileless. The game allows politicians to pose as watchdogs of the health care system while actually creating more trouble for Medicare. They pose as protectors of the public purse while actually incurring more debt.

It is a no-win proposition for taxpayers and people dependent on federal medical programs -- of which there will be many millions more if either of these bills becomes law.