The Democrats' fickle-and-dime health strategy

By Dana Milbank
Washington Post Staff Writer
Wednesday, October 21, 2009

"Iwill not sign a plan that adds one dime to our deficits, either now or in the future -- period," President Obama told Congress in a health-care address last month.

Well, that depends on what the meaning of "plan" is.

Senate Democrats wanted to protect doctors from scheduled cuts in Medicare payments over the next 10 years, but there was a problem: Doing so would add a quarter of a trillion dollars to the federal deficit, making mincemeat of Obama's promise. So Democrats hatched a novel scheme: They would pass the legislation separately, so the $250 billion cost wouldn't be part of the main reform "plan," thereby allowing the president to claim that that bill wouldn't increase the deficit.

Republicans, who had been losing traction in their effort to fight a health-care overhaul, could hardly believe the gift the majority had given them.

"I have never witnessed something more sinister!" an agitated Sen. Bob Corker (Tenn.) declared on the Senate floor Tuesday morning. Citing a report that the "doc fix," as the $250 billion measure is called, was created to buy the American Medical Association's support for the main health-care bill, Corker accused the AMA of prostitution. "We all know that the selling of one's body is one of the oldest professions in the world," Corker said. "The AMA is engaged in basically selling the support of its body."

While Corker was on the Senate floor suggesting that the Democrats were johns paying for sex, Jon Kyl (Ariz.), the second-ranking Senate Republican, preferred a reptilian metaphor. "They thought they were getting a problem off the table, and instead they grabbed a rattlesnake by the tail and don't know how to let go," he told reporters as he headed to a lunch with his GOP colleagues in the Capitol.

Around the corner, John Cornyn (R-Tex.), the man in charge of the Senate Republicans' 2010 campaign, opted for numismatic imagery. "This, of course, violates one of the president's first principles, when he said he won't sign any health-care bill that adds one dime to the deficit," he reminded reporters. "This adds a lot of dimes to the deficit." Two and a half trillion, in fact.

The sponsor of the doc fix, Sen. Debbie Stabenow (D-Mich.), seemed unconcerned that the fix had put the party in one. "It really is about honest budgeting," she said at a news conference Tuesday morning. On one side of her stood the AMA president. On the other side was a poster framed by a flag. One of its bullet points: "Honest budgeting."

Honestly? A decade ago, Congress passed legislation designed to limit health-care costs by slowing the growth of Medicare payments to doctors. Each year, Congress passes a "patch" to prevent the cuts from taking effect. Stabenow proposed to make this system "honest" by eliminating the cuts permanently.

Medicare is hurtling toward insolvency, but Stabenow would essentially repeal past cost-cutting efforts. And even granting that it's a good idea not to cut Medicare payments to doctors, it's a strange interpretation of honesty to separate this $250 billion cost from the health-care bill and then claim that the other bill doesn't raise the deficit.

To be sure, stranger things have happened on Capitol Hill. On Tuesday morning, for example, a group of pranksters called the Yes Men -- the same ones who held a phony U.S. Chamber of Commerce news conference on Monday -- showed up dressed in brown inflatable balls five feet in diameter called SurvivaBalls. Three of the SurvivaBalls, attempting to draw attention to global warming, broke through a chain on the Capitol steps. When a police officer attempted to remove the intruders, one of them rolled all the way back down the steps. "See? I'm fine. I'm okay," the SurvivaBall called out when he landed. "The SurvivaBall will protect us. We will survive climate change."

But in the self-injury department, the Democrats' doc fix outdid even the SurvivaBalls. After a party lunch Tuesday afternoon, Senate Republicans were jubilant as they derided Stabenow's plan. "Finally we're coming to the first vote on health-care reform, and what do the Democrats propose to do?" Sen. Lamar Alexander (Tenn.) asked at the microphones. "They propose to raise the national debt by . . . a quarter of a trillion dollars, plus $50 billion interest."

Sen. Harry Reid (D-Nev.), the majority leader, was rather less energetic when he appeared at the same microphones a few minutes later. He had already had to cancel a Monday-night vote on the doc fix because various Democrats, including Budget Committee Chairman Kent Conrad (N.D.), opposed it. Reid had hoped to bring the issue up for a vote on Tuesday, but it quickly became clear that he still didn't have the votes. In his opening statement, Reid didn't even mention the doc fix.

Fox News's Trish Turner pointed out that Democratic Whip Dick Durbin (Ill.) had acknowledged that there aren't enough votes for the fix and that others were talking about scaling back the plan. "Will you talk about the status?"

"You seem to have all the information now, so why do you need anything?" was the extent of Reid's answer.

Another reporter asked whether Democrats could "still say health-care reform is paid for if you pass a quarter-trillion-dollar doc fix and don't pay for it."

Reid sought the protection of Obama, saying that "the White House favors what's on the floor now." Then he hinted that he wouldn't hold out for Stabenow's plan, floating the possibility of "a one-year fix."

Of course, that would be the same gimmick Congress has been using for years. But in politics, a lot of small gimmicks are easier to justify than one big gimmick.

© 2009 The Washington Post Company