Further Debunking GOP Talking Points On The Medicare Payment Formula and Health Care Reform

Yesterday I noted a rather bogus attack on health care reform in one editorial based upon not including a fix to the Medicare payment formula in the costs of health care reform.  As I described in the previous post, this is a long standing accounting trick used since the Republicans were in office and the costs of fixing this are unrelated to any added costs to the budget of health care reform. Jonathan Chait discussed this later in the day. He notes that conservatives are picking this up as their latest dishonest talking point to attack health care reform. He also notes the hypocrisy of Republicans in raising this:

Since the Democrats are trying to reform, and trim, how much Medicare spends, they planned to wipe the slate clean and just admit the obvious reality that the $247 billion is going to get spent.

Conservatives are attacking this as proof that health care reform is based on fraudulent accounting. See — they’re spending money they don’t pay for! National Review calls this “offloading $247 billion in Obamacare costs onto a separate, standalone, unfinanced piece of legislation.” But it’s not “Obamacare costs.” It’s money that would get spent whether or not health reform happens. It would be fair to make this charge if Obama were using these illusury savings to cover the cost of the new spending in his health care reform, but he isn’t.

So why is Obama getting attacked so bitterly over this? Because he’s acknowledging it. It’s the same thing that’s happened to fiscal policy since he took office. The Bush administration hid the true iscal picture with a plethora of accounting gimmicks — keeping all war costs out of the budget, pretending the middle-class tax cuts would expire, and on and on. Obama has tried to make the budget reflect reality. Alas, reality is a bummer. (And yes, the long-term deficit is entirely the fault of policies Obama inherited.) So Obama gets attacked for a “shell game” when all he’s really doing is admitting the shell game that’s been going on for years.

People have made this point before, but the conservative attacks on health care reform’s fiscal responsibility are beyond hypocritical. George W. Bush and the Republicans created a new health care entitlement in 2003 that was completely unfinanced. Not a dime was paid for. The Democrats have decided to completely finance every cent of health care reform, and they’re taking a hundred times more flack for fiscal irresponsibility than the Republicans ever did. There’s a lesson here, and “fiscal responsibility pays” isn’t it.

Republicans also have a poor case of questioning the integrity of the Democrats when we compare what how George Bush not only created the Medicare D program without providing for funding, but also acted to suppress information on the actual cost. The Bush administration even went as far as threatening to fire a Medicare actuary if he testified before Congress about the actual cost.

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  1. 1
    Eclectic Radical says:

    The sad fact is that most American voters don’t want ‘fiscal responsibility’, which means either cuts in programs they like or tax increases, but the Republican shell game of ‘borrow, spend, pretend tax cuts will pay for it all.’
    They have been sold a bill of goods by right-wing ‘economists’ or by political hacks mangling the work of real economists.

  2. 2
    Eclectic Radical says:

    I absently read Michelle Malkin’s ridiculous claim this was an attempt to ‘bribe’ doctors.
    She includes the full list of senators who voted for and against cloture on this. 11 Democrats (some of them who were elected promising to support things like health care reform) voted against it. One Republican voted for cloture.
    This is why health care reform is so difficult, far more than any of the actual Republican lies. The inability of Democrats to stick to0gether.

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