The New Health Dialogue

Imagine if the Democrats had tried to pass a $1.2 trillion health care bill that was not paid for...that just dug deep down into that deficit. Imagine the outcry.

As Jacob Weisberg writes in Newsweek essay entitled "Do As We Say, Not As We Do," that's pretty much what the Republicans did in the 2003 Medicare Modernization Act. That legislation added prescription drug coverage for seniors and handed a big chunk of taxpayer change over to the newly created Medicare Advantage private insurance program. And it wasn't paid for.

He writes:

In their 2009 report to Congress, the Medicare trustees estimate that the cost of Medicare Part D is as high as $1.2 trillion. That figure -- just for prescription drug coverage that people over 65 still have to pay a lot of money for -- dwarfs the $848 billion cost of the Senate bill...And unlike the Democratic bills, which the Congressional Budget Office says won't add to the deficit, the bill George W. Bush signed was financed entirely through deficit spending...Of the 28 remaining Republicans who were in the Senate back in 2003, 24 voted for the Medicare prescription drug benefit. Of 122 Republicans still in the House, 108 voted for it...what happened the last time they were in charge gives the lie to the claim that they object to expanding government. What they object to is expanding government in a way that doesnt help them get reelected.

 We could add a few other points.

• The Medicare drug benefit had money for comparative effectiveness research -- which many Republicans now equate with rationing.
• The CMS Actuary had very critical estimates of the drug bill before passage. They were stifled. This time, the CMS estimates have been made public, even when they aren't too kind too the Democratic health bill.
• And... drumroll please -- the Medicare drug benefit  had a fallback -- aka trigger -- for a public plan that would compete if private plans didn’t provide enough coverage and competition.