[142857] The Magic # The Republican dissects ObamaCare's real costs. DEMOCRATS STAY MUTE. / Courtesy of Miguel Uria

[142857]

REVIEW & OUTLOOK

MARCH 4, 2010

Paul Ryan v. the President1

The Republican dissects ObamaCare's real costs. Democrats stay mute.

“Every argument has been made. Everything that there is to say about health

care has been said, and just about everybody has said it," [President Obama

yesterday urging Democrats to steamroll his plan through Congress]. What

hasn't been heard, however, is even a shred of White House honesty about

the true costs of ObamaCare, or its fiscal consequences.

Nearby, we reprint Wisconsin Republican Paul Ryan's remarks at the health

summit last week, which methodically dismantle the falsehoods—there is no

other way of putting it—that Mr. Obama has used to sell "reform" and

repeated again yesterday. No one in the political class has even tried to

refute Mr. Ryan's arguments, though he made them directly to the President

and his allies, no doubt because they are irrefutable. If Democrats are willing

to ignore overwhelming public opposition to ObamaCare and pass it anyway,

then what's a trifling dispute over a couple of trillion dollars?

At his press conference yesterday, Mr. Obama claimed that [1] "my

proposal would bring down the cost of health care for millions—families,

businesses and the federal government." He said [2] it is "fully paid for" and

[3]"brings down our deficit by up to $1 trillion over the next two decades."

Never before has a vast new entitlement been sold on the basis of fiscal

responsibility, and one reason ObamaCare is so unpopular is that Americans

understand the contradiction between untold new government subsidies and

claims of spending restraint. They know a Big Con when they hear one.

Mr. Obama's fiscal assertions are possible only because of the fraudulent

accounting and budget gimmicks that Democrats spent months calibrating.

Readers can find the gory details in Mr. Ryan's pre-emptive rebuttal nearby,

though one of the most egregious deceptions is that the bill counts 10

years of taxes but only six years of spending.

The real cost over a decade is about $2.3 trillion on paper, Mr. Ryan

estimates, and even that is a lowball estimate considering how many

people will flood to "free" health care and how many businesses will be

1 http://online.wsj.com/article/SB10001424052748704548604575097602436388116.html

induced to drop coverage. Mr. Obama claimed yesterday that the plan will

cost "about $100 billion per year," but in fact the costs ramp up each year

the program exists. The far more likely deficits are $460 billion over the first

10 years, and $1.4 trillion over the next 10.

What Mr. Ryan calls "probably the most cynical gimmick" deserves special

attention, which is known in Washington as the "doc fix." Next month

Medicare physician payments are scheduled to be cut by 22% and deeper

thereafter, though Congress is sure to postpone the reductions as it always

does. Failing to account for this inevitability takes nearly a quarter-trillion

dollars off the ObamaCare books and by itself wipes out the "savings" that

the White House continues to take credit for.

Some in the liberal cheering section now claim that this Medicare ruse isn't

Mr. Obama's problem because it was first promised by Republicans and Bill

Clinton in 1997. But then why did Democrats include the "doc fix" in all

early versions of the bill to buy the support of the American Medical

Association, only to dump this pricey item later when hiding it would make it

easier to fake-reduce the deficit?

The President was (miraculously) struck dumb by Mr. Ryan's critique, and in

his response drifted off into an irrelevant tangent about Medicare Advantage,

while California Democrat Xavier Becerra claimed "you essentially said you

can't trust the Congressional Budget Office." But Mr. Ryan was careful to

note that he didn't doubt the professionalism of CBO, only the truthfulness of

the Democratic gimmicks that the budget gnomes are asked to score.

Yesterday Mr. Obama again invoked the "nonpartisan, independent"

authority of CBO, which misses the reality that if you feed the agency

phony premises, you are going to get phony results at the other end.

The President also claimed the reason his plan is in trouble, and the reason

Democrats must abuse the Senate's rules to ram this plan into law, is that

"many Republicans in Congress just have a fundamental disagreement

over whether we should have more or less oversight of insurance

companies." So most of Mr. Obama's first year in office has been paralyzed

over nothing more than minor regulatory hair-splitting. This is so

preposterous that the President can't possibly believe it.

Congress's spring break begins on March 29, and Democratic leaders plan

on jamming this monster through Congress before then. Americans have to

hope that enough rank-and-file Democrats aren't as deaf to fiscal honesty

as this President.

OPINION

MARCH 4, 2010

Dissecting the Real Cost of ObamaCare2

The President's own chief Medicare actuary says the Senate and House bills are

bending the cost curve up.

By PAUL D. RYAN

The following are remarks made by Congressman Paul Ryan of Wisconsin,

the ranking Republican on the House Budget Committee, about the cost of

the House and Senate health-care bills at President Obama's Blair House

summit on health care, Feb. 25:

Look, we agree on the problem here. And the problem is health inflation is

driving us off of a fiscal cliff.

Mr. President, you said health-care reform is budget reform. You're right. We

agree with that. Medicare, right now, has a $38 trillion unfunded liability. That's

$38 trillion in empty promises to my parents' generation, our generation, our kids'

generation. Medicaid's growing at 21 percent each year. It's suffocating states'

budgets. It's adding trillions in obligations that we have no means to pay for...

Now, you're right to frame the debate on cost and health inflation. And in

September, when you spoke to us in the well of the House, you basically

said—and I totally agree with this—I will not sign a plan that adds one dime

to our deficits either now or in the future.

Since the Congressional Budget Office can't score your bill, because it

doesn't have sufficient detail, but it tracks very similar to the Senate bill, I

want to unpack the Senate score a little bit.

And if you take a look at the CBO analysis—analysis from your chief actuary

—I think it's very revealing. This bill does not control costs. This bill does not

reduce deficits. Instead, this bill adds a new health-care entitlement at a time

when we have no idea how to pay for the entitlements we already have.

Now let me go through why I say that. The majority leader said the bill

scores as reducing the deficit $131 billion over the next 10 years. First, a

little bit about CBO. I work with them every single day—very good people,

great professionals. They do their jobs well. But their job is to score what is

2 http://online.wsj.com/article/SB10001424052748703807904575097394068626652.html?

mod=WSJ_Opinion_LEFTTopOpinion

placed in front of them. And what has been placed in front of them is a bill

that is full of gimmicks and smoke-and-mirrors.

Now, what do I mean when I say that? Well, first off, the bill has 10 years of

tax increases, about half a trillion dollars, with 10 years of Medicare cuts,

about half a trillion dollars, to pay for six years of spending.

Now, what's the true 10-year cost of this bill in 10 years? That's $2.3 trillion.

[The Senate bill] does [a] couple of other things. It takes $52 billion in

higher Social Security tax revenues and counts them as offsets. But that's

really reserved for Social Security. So either we're double-counting them or

we don't intend on paying those Social Security benefits.

It takes $72 billion and claims money from the CLASS Act. That's the longterm

care insurance program. It takes the money from premiums that are

designed for that benefit and instead counts them as offsets.

The Senate Budget Committee chairman [Kent Conrad] said that this is a

Ponzi scheme that would make Bernie Madoff proud.

Now, when you take a look at the Medicare cuts, what this bill essentially

does [is treat] Medicare like a piggy bank. It raids a half a trillion dollars out

of Medicare, not to shore up Medicare solvency, but to spend on this new

government program.

...[A]ccording to the chief actuary of Medicare... as much as 20 percent of

Medicare's providers will either go out of business or will have to stop

seeing Medicare beneficiaries. Millions of seniors... who have chosen

Medicare Advantage will lose the coverage that they now enjoy.

You can't say that you're using this money to either extend Medicare solvency

and also offset the cost of this new program. That's double counting.

And so when you take a look at all of this; when you strip out the double-counting

and what I would call these gimmicks, the full 10-year cost of the bill has a $460

billion deficit. The second 10-year cost of this bill has a $1.4 trillion deficit.

...[P]robably the most cynical gimmick in this bill is something that we all

probably agree on. We don't think we should cut doctors [annual federal

reimbursements] 21 percent next year. We've stopped those cuts from

occurring every year for the last seven years.

We all call this, here in Washington, the doc fix. Well, the doc fix, according

to your numbers, costs $371 billion. It was in the first iteration of all of these

bills, but because it was a big price tag and it made the score look bad,

made it look like a deficit... that provision was taken out, and it's been going

on in stand-alone legislation. But ignoring these costs does not remove

them from the backs of taxpayers. Hiding spending does not reduce

spending. And so when you take a look at all of this, it just doesn't add up.

...I'll finish with the cost curve. Are we bending the cost curve down or are

we bending the cost curve up?

Well, if you look at your own chief actuary at Medicare, we're bending it up.

He's claiming that we're going up $222 billion, adding more to the

unsustainable fiscal situation we have.

And so, when you take a look at this, it's really deeper than the deficits or

the budget gimmicks or the actuarial analysis. There really is a difference

between us.

...[W]e've been talking about how much we agree on different issues, but

there really is a difference between us. And it's basically this. We don't think

the government should be in control of all of this. We want people to be in

control. And that, at the end of the day, is the big difference.

Now, we've offered lots of ideas all last year, all this year. Because we

agree the status quo is unsustainable. It's got to get fixed.

It's bankrupting families. It's bankrupting our government. It's hurting

families with pre-existing conditions. We all want to fix this.

But we don't think that this is the... the solution. And all of the analysis we

get proves that point.

Now, I'll just simply say this.... [W]e are all representatives of the American

people. We all do town hall meetings. We all talk to our constituents. And

I've got to tell you, the American people are engaged. And if you think they

want a government takeover of health care, I would respectfully submit

you're not listening to them.

So what we simply want to do is start over, work on a clean-sheeted paper,

move through these issues, step by step, and fix them, and bring down

health-care costs and not raise them. And that's basically the point.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://lists.cubacubana.net/pipermail/142857/attachments/20100305/22212429/attachment-0001.html