The Obamacare Shell Game?

The latest, hottest attack on health care reform is that it's based on an accounting scam. National Review calls it "taking Obamacare off the books." The Heritage Foundation warns of the "Obamacare Shell game." What's going on here? What's going on is a perfect metaphor for how Obama and the republicans are treating fiscal policy.

More than a decade ago, Congress tried to control Medicare costs by restricting payments to doctors. But the reimbursement cut has proven unpopular. So every year, Congress appropriates more money to fill the hole and keep the doctors happy. Yet the pay cut remains on the books. So, admitting the obvious fact that the reimbursement cuts will never happen would, officially speaking, cost $247 billion over ten years.

Everybody agrees that it's a sham. Since the Democrats are trying to reform, and trim, how much Medicare spends, they planned to wipe the slate clean and just admit the obvious reality that the $247 billion is going to get spent.

Conservatives are attacking this as proof that health care reform is based on fraudulent accounting. See -- they're spending money they don't pay for! National Review calls this "offloading $247 billion in Obamacare costs onto a separate, standalone, unfinanced piece of legislation." But it's not "Obamacare costs." It's money that would get spent whether or not health reform happens. It would be fair to make this charge if Obama were using these illusury savings to cover the cost of the new spending in his health care reform, but he isn't.

So why is Obama getting attacked so bitterly over this? Because he's acknowledging it. It's the same thing that's happened to fiscal policy since he took office. The Bush administration hid the true iscal picture with a plethora of accounting gimmicks -- keeping all war costs out of the budget, pretending the middle-class tax cuts would expire, and on and on. Obama has tried to make the budget reflect reality. Alas, reality is a bummer. (And yes, the long-term deficit is entirely the fault of policies Obama inherited.) So Obama gets attacked for a "shell game" when all he's really doing is admitting the shell game that's been going on for years.

People have made this point before, but the conservative attacks on health care reform's fiscal responsibility are beyond hypocritical. George W. Bush and the Republicans created a new health care entitlement in 2003 that was completely unfinanced. Not a dime was paid for. The Democrats have decided to completely finance every cent of health care reform, and they're taking a hundred times more flack for fiscal irresponsibility than the Republicans ever did. There's a lesson here, and "fiscal responsibility pays" isn't it.

COMMENTS (3)

10/19/2009 - 8:24pm EDT |

This is so typical of slanted journalism. I've been alerting you guys since first score of Baucus-before the vote-that Baucus conventiently left out of his bill the $250 billion for the physicians. I reminded you that HR3200 cancelled the SGR reductions. I told you that Baucus then costs over $1.0 trillion.

That's why it's a shell game-if you're going to "attach" new taxes to health care (meaning, since taxes are fungible, they don't attach to any bill), then how can you seperate SGR and health care reform?

All Bush's tax cuts expire in 2010-that's what was negotiated, that's what the law says. If Obama wishes to propose new tax cuts-fine-but you can't say that their expiration ... view full comment

10/20/2009 - 12:05am EDT |

Well, here's something new:

The liberals attack the conservatives for doing what they do themselves. And then the conservatives turn around and attack the liberals in kind.

New as in ancient history.

The shell game.

The shell game?

The shell game is what happens when they do things together on "projects" immensely more consequential than this. Please, where is the gap between the Bush administration and the Republican Congress and the Democrats in office now? That's the shell game, of course.

What's $247 billion over ten years next to that? What's $247 billion next to the trillions and trillions of dollars that, working hand in hand, Paulson and Geithner funneled to Wall Steet; and to the milita ... view full comment

10/20/2009 - 12:25am EDT |

lobo:

I agree, part of why GOP lost over recent elections is because they spent like you progressive fools. We are better than that.

george:

Yeah, they had this scam going with K Street. Just like the "progressives". The government will spend and spend and spend on whatever it takes to make Wall Street happy. And then Wall Street will fund their political careers so the scam never really ends. It just switches from party to party doesn't it? So, how exactly are you better than that?

And why don't you elaborate on precisely what the government should spend money on and what it should not. Let's scrap the political rhetoric [the bullshit of political expediency when push comes to shove] abo ... view full comment

get the magazine

Intellectual rigor. Honest reporting. Influential analysis. Don't miss another issue of the magazine considered "required reading" by the world's top decision-makers. Subscribe today.

Get our newsletters

Get Our Feed