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A Man with a Plan

Obama seems to surmise that the American people have forgotten that he already had a plan and that it looked almost exactly like his "new" one.

8:30 AM, Feb 23, 2010 • By JEFFREY H. ANDERSON
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In his speech to a joint-session of Congress on September 9, President Obama introduced what he called "my plan" for "health care reform."  The next day, the Washington Post noted that "the president for the first time Wednesday embraced a set of ideas as 'my plan.'"  About the same time, Obama authored a health-care piece in which he referred to "my plan" eight separate times (nine, if you include a set-aside quote).

A Man with a Plan

Now, fast-forward about six months, to just three days before the made-for-TV "health summit," and, lo and behold, the president released -- as if for the first time -- a health-care plan. Is he kidding?

Sadly, he's not.  Instead, the president seems to surmise that the American people have forgotten that he already had a plan and that it looked almost exactly like...well, this one.  The colossal increases in federal spending remain (last projected by the Congressional Budget Office (CBO) to total $2.5 trillion in the bill's real first decade).  The cuts to Medicare Advantage (MA) remain (last projected by the CBO to tally $21,000 per MA beneficiary in the bill's real first decade).  And most of the political cronyism apparently remains -- like the "Gator Aid" deal, which would exempt seniors in South Florida from those MA cuts.  Also back for an encore are the tax increases that would funnel (at last count) $1.0 trillion (in the bill's real first dozen years) from American taxpayers, through the federal government, to private insurers -- alongside the mandate that Americans buy insurers' product.

To be fair, there are a couple of new wrinkles.  In exchange for these generous perks, insurers would have to go through another level of review before implementing any price-increases they might have planned.  State insurance regulators, such as the ones in California (hardly a conservative, free-market bastion) who didn't object to Anthem's rate increases, would now be subject to overrule by the federal government.  The U.S. Department of Health and Human Services (HHS), the department that (according to the Washington Post and 60 Minutes) already manages to lose $60 billion a year in taxpayer money to Medicare fraud -- compared to $8 billion in combined annual profits for America's ten largest private insurers -- would come to the rescue.  The costs to insurers from this extra bureaucratic hurdle would, of course, be passed on in higher premiums (and would probably even be factored into the rate-increase requests) -- except for when HHS refuses a rate-increase request, in which case the insurers would simply do what the government does when it wants to cut health costs:  ration care.

Another new wrinkle would be to increase Medicare taxes.  For the first time ever, a Medicare tax would be levied on the income of certain people (those folks who annoy Obama by making over $200,000) from investments, dividends, annuities, rentals, and royalties -- which the President lumps together and calls "unearned income."  But this tax-revenue would not be used to pay for Medicare, which desperately needs to be put on more solid financial footing.  Instead, this new Medicare tax would pay for -- you guessed it:  the president's plan, which would cut Medicare.

When the president first mentioned what he called "my plan" for "health care reform," it was in the wake of the August voter uprisings.  He spoke of it in the context of his broader message to Congress, which was that there was no need to let a little thing like voter dissatisfaction get in the way of a perfectly good plan.  This week's nearly identical plan comes in the wake of Scott Brown's victory in Massachusetts.  So disconnected from political currents does the President seem, one wonders whether this same plan (with a new wrinkle or two) will also be re-released -- and presented as brand-new -- in the wake of the November elections.

Jeffrey H. Anderson, the director of the Benjamin Rush Society, was the senior speechwriter for Department of Health and Human Services secretary Mike Leavitt. Read his "small bill" proposal here.

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