Moe Lane

Let us kill it with FIRE.

Background: the ‘doc fix’ is one of those things that happens in Dizzy City with alarming regularity.  Basically, it was set up in order to control Medicare costs by linking Medicare subsidies to doctors to annual growth; if costs rose too high, Medicare payments to doctors would shrink.  Nice feedback loop – only thing is, the first year it was supposed to come into effect (2002) the medical lobby started screaming, and it turns out that the medical lobby has a lot of money for lobbying.  So since then the government has been ‘fixing’ the ‘problem’ on a year by year basis so that Medicare payments to doctors would not be reduced (this cost the government $30 billion last year, by the way).  And if you’re wondering why they simply don’t fix the numbers permanently, or let the cuts go in fully… well.  It turns out that the CBO is required to assume that Congress is NOT going to extend the ‘doc fix’ until it actually does, which means that the budget (when we have one) can actually get away with not taking that $30 billion into account when it comes to calculating expenditures.  Thirty billion here, thirty billion there: add it all up and pretty soon we’re talking about real money.

With me so far?  Good.  So let’s kill the ‘doc fix.’

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Gee, no bias in this at all:

Gov. Scott Walker announced Wednesday that he won’t propose expanding Medicaid services in Wisconsin, breaking with other Republican governors who decided to accept federal money for an expansion as offered under the health care overhaul law.

And, from later in the article:

So far, six Republican governors have agreed to the Medicaid expansion, while fourteen have turned it down.

Which means that it was those six Republican governors that have been doing the breaking, Sparky. And every single one of ‘em is keeping close to the exit, setting it up so that the legislature could tell ‘em no, or both.

Sheesh. The media we have today!

More detail on what Walker’s doing. vlt.tc/pgtUsing exchange subsidies in lieu of Medicaid dollars.

— Ben Domenech (@bdomenech) February 13, 2013

(Reminded by the Morning Jolt) No, really, Guy Benson was right: it was brutal. Completely deserved, but brutal.

I’ll spare you a summary, as no actual semantic content was exchanged in this clip: Wolf Blitzer kept pointing out that nobody over 55 has no reason to worry about the Ryan plan, and Debbie Wasserman Schultz kept falling back into classic Zombie Mode.  Honestly, it lacked only the hands-outstretched and a moan of “Rrrrrrrryyyyyyyaaaannnnnnnnnnnnnnnnnn” to make it classic Romero on Debbie’s part.

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One of the more… interesting… beliefs that seems to have spread along the Online Left lately is that their forthcoming campaigning against Paul Ryan’s budget reforms (henceforth to be sneeringly dismissed as ‘Mediscare’) is a clear winner for them.  And if you ask them why, the members of the Online Left who are smart enough to avoid saying “Because we think that the population of the USA is made up primarily of idiots*” will instead say “Because we’ve been winning special elections with that issue.”

…Really?  OK.  Let’s look at the special elections for the 112th Congress, then.

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Odd in that it – like the May recess, come to think about it – came and went without a plethora of stories about how citizens flooded* town halls across the land to ritually burn the Republicans at the stake over Paul Ryan’s Medicare/budget reform plan.  Which is actually quite surprising, given that we were more or less promised Armageddon along those lines.  Almost as surprising as the lack of stories of Democrats capitalizing on their supposed killer political advantage by holding their own town halls.  Instead, we got… nothing much, really.  Dribs and drabs, but nothing special.

Then again, I lie: this is not surprising.  The Organized Left’s greatest problem is that it has everything that it needs for a populist movement except for actual people; and they’re constitutionally incapable of spawning protests that are organic, self-organizing, self-sufficient, and capable of growth.  And every time that they get distracted enough that protesting slips from from the top of their to-do list, it shows.

Moe Lane

*For a given value of ‘flooded.’  By Tea Party standards even the Easter ‘protests’ were more like a slow-draining sink.

Not exactly: the Politico reports that, in wake of forty-two Senators sending a letter indicating that Sir Donald Berwick is simply unacceptable for the job of Centers for Medicare and Medicaid Services (CMS) head*, Senate Democrats have made an answer to that by… giving up trying to get Berwick nominated.  There’ll be no fight, no confirmation hearing, no standing on what the Democrats consider ‘principle.’  They’ll just let him keep going until later in 2011.  I’m not fully checked out on the minutiae of recess appointments, but presumably the President can make another recess appointment for Berwick during the next time that the Senate is in recess for long enough.

But that’s not really the point; the point is that it’s clear that one thing is true in the 112th Congress that was also true in the 111th.  To wit: Democrats won’t fight.  Oh, sure, when they have the votes they’re the toughest guys in the room, and will be happy to walk all over you: witness that ludicrous strutting over passage of Obamacare back in 2009.  But the second that they don’t have a sure thing, Democratic politicians cave (see the defeat of the Obama tax hikes during the lame duck session).  They cave – or, as we’re seeing in the states, Democratic politicians run away.  Because Democratic politicians are cowards, from top to bottom.  And here’s the fun part: we know it.  Which is why those forty-two Senators sent the letter.  Which is why Senate Democrats caved on the cuts in the current CR.  Which is why they’ll break later on the budget.  They just don’t know how to be brave and fight for their beliefs**.

Poor things. (more…)

Witness this map.

It’s called the Dartmouth map, and as the New York Times and Hot Air notes, it was used by the Obama administration to argue that there were existing inefficiencies in the Medicare system that could be trimmed away, thus permitting a scenario where Medicare funding could be cut significantly while not sacrificing care (indeed, the map’s creators argue that it demonstrates that cutting Medicare will improve care). In fact, Sir Donald – that being the guy who loves the British Health Service to, ahem, death – is particularly enamored of this map:

Dr. Donald Berwick, nominated by President Obama to run Medicare, called it the most important research of its kind in the last quarter-century. In March, in response to the Congressional Democrats who would have otherwise withheld their support for the health legislation, the administration made a promise. It said it would ask the Institute of Medicine, a nongovernment advisory group, to consider ways of putting the Dartmouth findings into action by setting payment rates that would punish inefficient hospitals and reward efficient ones.

Just one small problem: it’s not actually a map of inefficient care. Just expensive care. More from the Times: (more…)

By almost 300 billion.

CMS: House health bill will hike costs $289B

The House-approved healthcare overhaul would raise the costs of healthcare by $289 billion over the next 10 years, according to an analysis by the chief actuary at the Centers for Medicare and Medicaid Services (CMS).

This would be infuriating, if I had taken seriously in the first place the notion that an interventionist, intrusive government program was capable of saving the taxpayer money.

Moe Lane

PS: For extra points, watch as the Democrats suddenly decide that CMS must be ignored.  As opposed to, say, 2004.

Crossposted to RedState.

He doesn’t think that he has to care.

And he wants to make sure that the pharmaceutical companies understand that, too. The House Energy Chair intends to retroactively remove what Waxman calls a ‘windfall’ involving Medicare D drug charges, and never mind what either the President or PhRMA thinks:

Drug makers contend they have already worked out a 10-year, $80 billion cost-savings deal with the White House and crucial Senate gatekeepers on the trillion-dollar health care overhaul. The industry says that trying to add Mr. Waxman’s provision could scuttle that agreement.

Putting aside the actual merits of the argument for a moment – I (and Hot Air) may have excellent reasons to assume that a Democrat posturing about ‘windfall profits’ is simply posturing, but it’s still an assumption – it’s instructive to see how little a powerful House Democrat fears the wrath of the White House on this issue.  Then again, this is what happens when you’re a President who hands off responsibility for a bill in the first place; the people who do the work naturally end up deciding that their opinions on its final form are more relevant than yours, and unless you have the ability to do something about it they’re going to show little reluctance in showing public defiance.  Given that the President just hit 50% on Gallup, and lacks any real experience in leading people who don’t want to be led, I’m not surprised that Waxman is doing this.

And this is why people say “If you want something done right, do it yourself.”  Cliche, yes, but cliches exist for a reason.

Moe Lane

Crossposted to RedState.

Eleanor Clift, in the process of depserately trying to encourage some strange alternate-world version of the President – one who actually believes in compromise and bipartisanship, and who might be willing to do some actual, unglamorous work - makes this howler:

Republicans stood together against Social Security and Medicare, and when those programs proved popular, opposing them left a residue of distrust for the GOP.

Don Surber snickers at that:

Not so. Jonah Goldberg reported: “The Social Security Act was passed in the House on April 19, 1935 by a vote of 372 yeas, 33 nays, 2 present, and 25 not voting. Eighty-one Republicans voted for it, fifteen against. Fifteen Democrats also voted against it. That’s over 80% Republican support.”

Also, Republicans backed Medicare in 1965, which was co-written by Republican Congressman John Byrnes. It passed 70-24 in the Senate and 307-116 in the House.

Goldberg link here, which was incidentally a correction of yet another liberal columnist getting the details wrong. Doesn’t anybody on the Left punditocracy do basic research anymore?

Moe Lane

PS: I’d discuss the central thesis of Ms. Clift’s article itself, except that I generally try to avoid theological disputes in religions that I don’t follow.

Crossposted to RedState.