- Tuesday, October 28, 2014

The lame-duck session of Congress doesn’t have to be lame and disappointing. Whether it’s the Republicans or Democrats holding their heads high after the election results are tallied late Tuesday night, there will be important work to do when Congress returns from the battlefields at home. At a minimum, Congress must renew the government funding resolution that runs out Dec. 11.

The prospect for mischief arises when members of Congress who have been tossed aside get to vote one last time. That’s how we got Obamacare four years ago. There’s no appetite for brinksmanship this year, which is an opportunity for both sides to come together and jettison a system everyone agrees is broken. The annual Medicare “doc fix” charade should be eliminated.

For more than a decade, Medicare payments to doctors have been a target for slashing. Physicians were poised to dump patients they could no longer afford to see, until at the last minute Congress saved the day with “the doc fix,” a Band-Aid funding remedy that has been applied 17 times to delay the cuts.

Though such cuts were never made, and likely never will be, the Congressional Budget Office treats them as if they’re real. It’s a gimmick that cooks the books to cover $180 billion over 10 years.

Democrats are OK with dispensing with the never-gonna-happen cuts outright, and the Senate has a bill to do that. What’s another couple of hundred billion when the nation is already $17.9 trillion in debt? Republicans want to use the issue to leverage modest spending restraint, insisting that Congress find hundreds of billions of dollars elsewhere in the budget. Many of these cuts are nonbinding promises to restrain spending in the ninth year of a 10-year budget. They’re as phony as “the doc fix.”

Medicare’s chief actuaries decided to quit playing along earlier this year. “It is a virtual certainty that lawmakers will override this reduction as they have every year beginning with 2003,” they wrote to explain why they’re finally ignoring the games on Capitol Hill and are offering realistic budget forecasts.

There’s plenty of harm in treating false cuts as real. Baking illusory reductions into the federal budget makes Medicare appear to be solvent, when it isn’t. That weakens the political case for making fundamental, and urgently needed, Medicare reforms.

The time and effort wasted on “the doc fix” is time not devoted to getting rid of Obamacare, coming up with a suitable replacement, expanding health savings accounts and providing the elderly with realistic alternatives to Medicare.

Members of Congress aren’t exactly in a hurry to fix something that has been useful for inside-the-Beltway fundraisers. Performing the annual drama encourages the health care industry to send more campaign contributions to urge a cancellation of the performance. The more money spent, the less likely the permanent fix will ever happen.

It’s no mystery why Congress has a 14 percent approval rating. The public deserves an honest, transparent budget that shows the true financial condition of both Medicare and the federal government. Republicans should oppose smoke and mirrors on principle.

The current “doc fix” expires at the end of March. Congress could surprise everyone by implementing a permanent solution before the end of the year. We’re not holding our breath.

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