Tuesday, November 30, 2010

Health Care; Does Anybody Really Care?

As we say on the farm, “the chickens eventually come home to roost.” So it is with the Obama health care plan. Last November I pointed out in my blog “Health Care Part II…” that there were two bills introduced by Rep. Nancy Pelosi covering health care.

The first was the bill itself which supporters argued would cost no more than $1 trillion. This was made possible by including cuts in payments to physicians and other medical service providers under SGR, the Sustainable Growth Rate provision of Medicare designed to control health care provider compensation costs. The second bill was H.R. 3961, the Medicare Physician Payment Reform Act.

In order to hit the President’s target, the first bill included the SGR payment cuts. The cuts under SGR would have taken reimbursement rates back to what they were in 1990. So through sleight of hand H.R. 3961, scored by the CBO at a cost to taxpayers of $200,000,000,000 (yes $200 billion) was also introduced. It reinstated the SGR cuts but was not considered part of health care; pardon me?

H.R. 3961 finally passed but by the time it did it had absolutely nothing to do with physician pay. Through the alchemy of the congressional rules process it became an act to “extend expiring provisions of the USA Patriot Improvement and Reauthorization Act of 2005…” So the funding to offset the SGR cuts was crammed into a Continuing Resolution delaying the 21% scheduled physician pay cut through February 2010.

On February 25, 2010 soon to be censured Rep. Charlie Rangel (highlighted in the afore mentioned blog) introduced another bill delaying the SGR adjustment to November 30, 2010 with a 2.2% increase in payments. The Department of Health & Human Services finally reported the cost of these adjustments for FY 2010 at $11.7 billion or $1 billion per month.

Today the can was kicked down the road again but only one month delaying the cuts to December 31, 2010. The leg is getting weak. And according to the recently released draft of the President’s Fiscal Commission the fix is now going to cost $276,000,000,000, 38% more than just a year ago.

So that we are all clear, the health care bill that was supposed to cost only $900,000,000,000 when it was passed in March is actually going to cost $1,176,000,000,000 at a minimum and that is after only 6 months.

Here come the chickens.