Sunday, November 10, 2013

The President Lied About Health Care (GW Bush, I Mean)

President Obama has certainly got himself into a pickle over his health care law, but that really shouldn't surprise anyone who's been paying attention to the issue since 2009 when the law was first formulated. Throughout its life, the ACA has been the bastard child of this administration. They haven't explained it well from the outset, let it meander all over the map when it was being debated (remember the special Nebraska amendment to the law?), didn't publicize the law's benefits, allowed the rabid opposition to define quaint terms such as "death panels" when referring to it, and now is struggling to fix a flawed website and clarify why the president would say that you could keep your insurance if you liked it when, in fact, you cannot.

Other than that, it's been smooooooth sailing.

But then I accessed my memory banks and remembered that our old pal GW Bush also had a health care rollout that was rocky from the start and involved the same kind of Congressional contretemps, but a more damnable set of lies and threats than the Obama Administration ever considered.

To start, here's a lovely, and angry, Forbes story from 2009 that not only criticizes the Obama health care law, but reserves special venom for the Bush Medicare Prescription Plan of 2003. The article is mainly about the deficit, but is instructive as it relates to our current debate:

Recall the situation in 2003. The Bush administration was already projecting the largest deficit in American history–$475 billion in fiscal year 2004, according to the July 2003 mid-session budget review. But a big election was coming up that Bush and his party were desperately fearful of losing. So they decided to win it by buying the votes of America’s seniors by giving them an expensive new program to pay for their prescription drugs.

Recall, too, that Medicare was already broke in every meaningful sense of the term. According to the 2003 Medicare trustees report, spending for Medicare was projected to rise much more rapidly than the payroll tax as the baby boomers retired. Consequently, the rational thing for Congress to do would have been to find ways of cutting its costs. Instead, Republicans voted to vastly increase them–and the federal deficit–by $395 billion between 2004 and 2013.

However, the Bush administration knew this figure was not accurate because Medicare’s chief actuary, Richard Foster, had concluded, well before passage, that the more likely cost would be $534 billion. Tom Scully, a Republican political appointee at the Department of Health and Human Services, threatened to fire him if he dared to make that information public before the vote. (See this report by the HHS inspector general and this article by Foster.)

That last paragraph is the most relevant. The Bush Administration knew that it was blatantly lying to the American public about the cost of the program, and its famous donut hole which forced seniors to pay thousands in out-of-pocket expenses (and which Obama's ACA gets rid of), and threatened to fire the hard-working, and correct, public servant who dared to make the lies public. An inquiry later in 2004 confirmed that Scully had indeed been threatened with his job.

The rollout of the Medicare Prescription Plan was similarly troubled, and of course there were calls to scrap it, but Representative John Boehner thankfully saw the benefits of the bill and asked the public for patience. Oh, how times have changed.

It's important for Democrats and other supporters of the ACA to see the long term benefits of the law and that it's working very well in states that have set up their own exchanges. If more states had done this, without the right wing hissy fits that are causing myriad problems, we would not be talking about a mammoth political problem. We would be talking about how seamlessly the program is working and how people were now getting insurance for less than they were paying, or were getting it for the first time, ever.

And if other governors were not callous, mean, thick-headed and, in some cases, not very bright, and took the Medicaid money that the federal government was offering, then even more poor people would be getting care. Because they aren't taking the money, many hospitals are finding that they can't take care of people who need their services. This is why the law will succeed and it will result in people asking for their coverage from the politicains who can't seem to do the right thing.

The lesson here is patience. The website will be fixed and the law will begin to help the very people it was meant to help. Like all laws, though, it will not help everyone, and there will be winners and losers. Right now, the losers have the spotlight. The winners will emerge later, but they will emerge.

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