08 April 2010

Bald-faced from NRO

Paul Ryan and the hacks at National Review Online have been circulating the myth that Obamacare helps pay for itself via the "doc fix" (something that will be explained in a moment). Chait at the New Republic pointed out that this was very wrong. Jeff Anderson at NRO tried to reply, and has been caught in that rarest of things: an easily-demonstrable and easily-understood bald-faced lie.

So, what is the doc fix? I'll let Chait's original post explain:
In 1997, Congress changed the formula for reimbursing doctors under Medicare. Due to poor design, they created a formula that would impose massive reimbursement cuts that were never intended by Congress. As a result Congress has regularly restored the unintended cuts. Yet because the law remains on the books, the budget assumes the cut will go into effect every year even though it won't. In other words, the budget baseline is off by about $200 billion a year, which is the rough cost of filling in this hole.

... [T]his is not one of the costs of health care reform. It is a cost that would have happened regardless of whether health care reform passed. Moreover, the imaginary future savings of cutting physician reimbursement is not one of the cost offsets for health care reform. Over the next decade, the new law will create $800 billion in new obligations for the government and $938 billion in new savings.
So this is not too hard to understand. An analogous situation might be an office coffee donation box. Every day a supervisor takes out $0.25 to buy the coffee at the end of the week. This is silly but possible. So every day there's an expense of 25 cents from the box. But one day the supervisor wants a bagel. He puts $1.00 into the box himself, and then takes out $1.25 - the money he put in the box as well as the daily quarter deduction. Does that mean that the bagel really costs $1.25? No.

Jeff Anderson took issue with Chait's criticism, and replied to it. But it appears that while he was composing his reply, he must have realized that he was just completely wrong. We have to assume that, because he clearly and visibly tried to lie to cover the matter.

Here's part of what Anderson replies:
Chait adamantly denies that Obamacare is being credited for this “savings”: “The imaginary future savings of cutting physician reimbursement is not one of the cost offsets for health care reform. . . . The purported cut in physician pay is not part of those savings.”

The CBO begs to differ: “The provisions that would result in the largest budget savings include these: permanent reductions in the annual updates to Medicare’s payment rates for most services in the fee-for-service sector . . . yielding budgetary savings of $186 billion over 10 years.” That’s the physician pay cut.

As I write in IBD, “In other words, as the CBO makes plain, it’s scoring Obamacare from a starting point at which doctors’ pay hasn‘t yet been cut. It’s then crediting Obamacare for the cut, but not charging it for the fix.”

This is shameless house-of-cards financing, and the Obama administration’s messaging on it has been not only shameless but outright deceitful — and Representative Ryan has been doing a service in highlighting it.
Wow. We can see he's invoking the Congressional Budget Office, an institution whose name has become sacrosanct among the halls of debate for being neutral and competent. And apparently the CBO has said, almost flat-out, that Anderson and Ryan are right and that Chait is wrong.

Now, let's digress for a moment. If you follow politics, you know about spin and subtlety to some degree. When a politician says something offensive, they will reply not with, "I'm sorry I was so offensive," but with the more delicate "I'm sorry that so many people found this so offensive." That added clause makes this apology look less like an admission of guilt and more like a passive-aggressive bit of defensivemess. Most importantly, it's slight enough to make any critics seem like they're being petty if they attack it.

Or take the "private army" bit of nonsense from the radical right. Obamacare established an emergency health corps to help out in emergencies, but some nutjobs are claiming Obama is going to use it as a private army. That's idiotic and stupid and so on, but the law doesn't explicitly say they won't put Michelle Bachmann in a FEMA camp so it's hard to call them liars. At most, it can only be demonstrated that they're catastrophically wrong and stupid.

But in Anderson's reply to Chait, it seems like he couldn't find that wiggle room. Because he just lies.

Chait's reply reveals the glaring untruth. Now, there's no source for the CBO claim that Anderson makes. It's not in the CBO scoring of the Obamacare bill or any other scoring it did. So it's a pretty hard thing to find. But with help, Chait located the quote in a letter from the CBO to Sen. Harry Reid about the Senate healthcare bill (not Obamacare).

But how about that lie? Well, we see that Anderson wrote:
The CBO begs to differ: “The provisions that would result in the largest budget savings include these: permanent reductions in the annual updates to Medicare’s payment rates for most services in the fee-for-service sector . . . yielding budgetary savings of $186 billion over 10 years.” That’s the physician pay cut.
But the actual quote is:
Permanent reductions in the annual updates to Medicare’s payment rates for most services in the fee-for-service sector (other than physicians’ services), yielding budgetary savings of $186 billion over 10 years.

So by deliberately excluding an inconvenient four words, Anderson hoped to completely reverse what the CBO was saying. It is that relative rarity in political commentary - the unabashed and unashamed attempt to lie and hope the other guy never notices. Not entirely surprising from NRO, but still.

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