Sunday, November 01, 2009

Pyrrhic Victory ?

The Republicans were very happy that they managed to block the "doc fix" in the Senate (the "doc fix" is a fix for doctors not falsifying documents as in cooking the books). There are draconian cuts to Medicare payment schedules scheduled for each and every year and, traditionally, put off for a year. They serve to cook the books, since the CBO must forecast future deficits assuming that there will be draconian cuts next year.

The Democrats decided to do away with the budgetary scam with a permanent reform, so, of course, projecting Republicans claimed the Democrats were cooking the books. They declared that the illusory cost of admitting that the imaginary draconian cuts were never going to happen should be counted as part of the cost of health care reform. Their logic escapes me.

Furhtermore, they claimed that the doc fix was just a way to bribe the AMA and hospitals to support health care reform. This is, of course, true. However, the Republicans filibuster is not a rational application of this insight. The Republicans have angered health care providers and made sure that there is one bill a year which health care providers must support.

So how should the Democratic leadership take advantage of this very generous gift from the Republicans ?

Well they have lost one lately. The public option is now "level playing field" not "robust," that is the public insurance plan will have to negotiate rates with health care providers instead of being able to force them to accept medicare rates plus 5%.

So let's say that next years delay of the drastic medicare cuts is in the same bill as a reform allowing the public plan to pay medicare + 5% ? Now the people threatening to block everything are threatening to bankrupt hospitals (including all hospitals in all Dakotas). The bill is clearly plainly totally budgetary so it can be passed with 51 votes in the Senate. Amendments to strip the medicare + 5% provision would add to the deficit and would be out of order in the Senate.

It seems to me that the Republicans have something to teach Pyrrhus of Epirus.

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