Tag: max baucus

Frozen Minds on the Medicare Part B Premium Freeze

This week, Sen. Tom Coburn (R-OK) blocked an attempt by Sen. Max Baucus (D-MT) to move — without a recorded vote or CBO score – H.R. 3631, legislation to freeze Medicare Part B premiums. These premiums are automatically deducted from the Social Security checks of seniors, almost all of whom are enrolled in the Medicare Part B (Supplemental Medical Insurance) program.

Social Security recipients will not receive a COLA increase in their monthly checks beginning January 2010 because inflation between October 2008 and September 2009 was negative. But if Part B premiums increase, the dollar amount of their Social Security checks will decrease beginning in January 2010.

What would happen if the Part B premium were frozen for 2010? Seniors would get a double benefit. First they are gaining from a zero reduction in their Social Security checks even though inflation in 2008-2009 was negative. That means the purchasing power of their Social Security checks will be larger (assuming inflation remains low during the 4th quarter of this year).

On top of that, a frozen Part B premium would provide them with more generous Part B coverage because health care prices became more expensive during 2009 relative to other goods and services.

Senator Coburn’s action in blocking the premium freeze is courageous and correct. In a small but important way, it combats the busting of the federal budget by already generous Medicare Part B benefits that seniors receive — three-quarters of which are funded out of federal general revenues (that is, financed out of taxes paid by younger workers).

Note that the fiscal gimmickry this action prevents is not limited to seniors’ Medicare benefits. Some lawmakers on both sides of the aisle are intent on raiding the Medicare Improvement Fund (MIF) established in 2008 to offset cuts in future physician reimbursements. That fund is actually empty right now — it is not scheduled to receive monies until 2014. But an “advance funding” provision in its legislation would allow lawmakers to make transfers from the Treasury’s general fund as a stop-gap mechanism until MIF’s revenues become available.

Of course, when it comes time to deal with the issue of physician payment cuts, there will be zero dollars left in the MIF. They will have been used up to finance the 2010 Part B premium freeze — and Congress will turn to taxpayers and demand more money to bail out physicians.

Baucus Bill’s Spending Cuts Won’t Stick

Why? Just ask Sen. Evan Bayh (D-IN):

You can sort of see this coming. The savings from the pharmaceutical companies and the insurance industry, you can kind of count on that because they’re not very popular.

The hospitals are a different story.  People, you know, like their hospitals; they tend to trust their hospitals. The hospitals have pledged big savings. I can easily forecast at some point in the not-too-distant future the hospitals coming in and saying, “You know what, this isn’t working exactly the way we expected. Please spare us from this,” and them getting a good hearing in [Congress].

The same thing goes for physicians.

And the pharmaceutical companies.

And the insurance industry.

The Baucus “Failsafe” Is a Failsure

To reassure us all that Baucus 2.0 would not increase the deficit, its author Sen. Max Baucus (D-MT) included a “failsafe” provision: if the OMB director determines that the Baucus bill would increase the deficit in the following year, that determination would trigger automatic cuts in the bill’s health insurance subsidies.

Sooooo, would those automatic cuts operate more like the failed Gramm-Rudman-Hollings automatic cuts, or the failed sustainable-growth-rate automatic cuts?  Automatic spending cuts never work because today’s Congress cannot bind future Congresses.

The CBO estimates that, if the failsafe were to work, it would require 15-percent cuts in the bill’s new health insurance subsidies from 2015 through 2018.  But the agency essentially says the mechanism would be unworkable.

The failsafe is a failsure.  Baucus 2.0 would increase the deficit.

Transparent Health Care Legislating?

Will Americans get “quality time” with proposed health care legislation before it passes?

Some say no: The Senate Finance Committee recently turned back an effort to put Chairman Max Baucus’ bill online for 72 hours before the committee’s vote. The Committee is on the wrong side of history.

Transparency shifts power away from the center, so it’s favored by those out of power. It’s no wonder that Republican representative John Culberson, a member of the minority party, is putting H.R. 3400 (a significant health care bill) online for comment, using a tool called SharedBook.

Transparency won’t be a gift from government. It is something we have to take. That’s why I think the action lies in private efforts like OpenCongress, GovTrack, and (my own) WashingtonWatch.com. (Links are to sites’ H.R. 3400 pages.)

The public has a way of conforming their expectations to what’s possible, and transparent law-making is entirely possible today. Closed processes like the Senate Finance Committee’s consideration of health care legislation will not satisfy the public, and it will emerge from the committee with one strike against it irrespective of the merits.

That Costly Mandate

The Wall Street Journal notes that Sen. Max Baucus’s allegedly moderate health care plan “would increase the cost of insurance and then force people to buy it, requiring subsidies. Those subsidies would be paid for by taxes that make health care and thus insurance even more expensive, requiring even more subsidies and still higher taxes.” Other than that, it’s not so bad. The Journal also digs up a great graphic produced by the 2008 presidential campaign of a little-known Illinois senator named Barack Obama:

hillarycare

And speaking of health care mandates and how much they’re going to cost young people, as the Washington Post was yesterday, I just had lunch with Clark Ruper, program manager for Students for Liberty, who told me he’d be on the Newshour with Jim Lehrer on PBS tonight. In the interview he told them that as a young healthy person he has voluntarily chosen not to purchase health insurance and instead invests in his own savings. And he thinks a lot of young people make such choices and don’t want a government mandate requiring them to buy government-approved insurance. Check it out tonight on PBS.

Have the Democrats Outsmarted the Republicans on Health Care?

In their attempt to defeat Obamacare, Republicans have focused their criticism on the public option, painting it as the most objectionable feature of existing proposals. Senator Max Baucus, (D-Mont.), has now proposed a plan without the public option. This leaves the Republicans in an awkward position, especially since Baucus’s plan is projected to cost less than earlier proposals.

If Republicans oppose the Baucus plan, they surely risk the ire of voters who will be told during the mid-term elections, “The Republicans blocked a plan that would have covered the uninsured and reduced the deficit.”

The problem is, the public option was never the crucial issue; instead, it was the mandate to purchase insurance. Once government mandates insurance coverage, it gets to define what constitutes insurance, which means it can ban pre-existing condition clauses and the like. The mandate also”justifies” large subsidies for insurance, to avoid non-compliance with the mandate. So, an individual mandate, which the Baucus plan includes, implies a rapid takeover of the entire health care system by the federal government.

Something like the Baucus plan will pass. It will either cost far more than existing projections, if government administrators fail to impose the restrictions on reimbursements that generate the projected cost savings, or it will involve massive rationing of care.

The Democrats played it perfectly. The Republicans got sucker-punched.

C/P Libertarianism, from A to Z