by Bob Barr
as published in The Atlanta Journal Constitution
During my eight years in the House of Representatives, I saw plenty of deals being negotiated, renegotiated, confirmed, reconfirmed, removed, undone, re-done, and finally cast in stone. But, I have never seen deals like those secured by a handful of senatorial holdouts as the price for them to vote for the health care legislation being sought by the Obama Administration and which passed the Senate just before Christmas. The few Senators who held out til the last minute ought to be inducted into the “Let’s Make a Deal” hall of fame.
The list of pork the “Health Care Dealers” were able to wrest from the unsmiling grip of Senate Majority Leader Harry Reid was most impressive:
• The western cabal of Montana, North Dakota, South Dakota, Utah and Wyoming, benefitted from a lucrative provision that increased Medicare payments to hospitals and doctors in those states.
• $100 million will go to an unnamed health care facility in a state which has only one “public academic medical and dental school.” Both Pennsylvania and Connecticut potentially qualify for this largess. It will be interesting to see which of the two embattled Senators from those states — Republican-turned-Democrat Arlen Specter or veteran Democrat Chris Dodd – will prevail. The smart money’s on Dodd.
• Doctor-owned hospitals in Nebraska secured an exemption from conflict-of-interest rules contained in the legislation that apply elsewhere in the country, and which would otherwise severely limit the doctors’ ability to make referrals.
• Iowa’s senior Democratic Senator Tom Harkin made sure the Hawkeye State was not left out; hospitals in key Iowa counties will now qualify for enhanced Medicaid payments.
• A formula used to calculate Medicare payments to hospitals in low-wage areas was rigged so that hospitals only in Connecticut and Michigan, both “blue” states, would receive higher payments.
• The king of the health care lottery, however, was the final hold out — Nebraska’s Sen. Bill Nelson — who won a commitment in the final draft of the bill that will have the federal government forevermore pay the full cost of covering low income patients in his state added by the bill to the Medicaid rolls.
Not even the Congressional Budget Office (CBO) is able thus far to put a precise price tag on how much “Nelson’s Windfall” will cost all of us taxpayers over the long run. However, the CBO did surmise that the cost of just a handful of these parochial pork provisions cleverly woven into the many hundreds of pages of bureaucratic gobbledygook that is the health care legislation, added $1.2 billion to the overall price tag.
The president continues to maintain that this humongous piece of legislation will actually reduce the federal debt, which already exceeds $12 trillion. This is possible, the Wizard of 1600 Pennsylvania Avenue tells us, at least in part because new efficiencies and cost-cutting measures will result in huge savings. This is a claim made – but never fulfilled — by every president who ever has signed legislation creating or greatly expanding an existing government entitlement program.
The vehemence of the rhetoric in the final Senate debate was among the worst presented to the American people in many a year. Rhode Island Democrat Sheldon Whitehouse accused Republicans of behaving like “fanatics,” “right-wing extremists” and “Aryan support groups.” Republican Lindsey Graham of South Carolina compared the late-night vote buying entreaties master-minded by Majority Leader Reid & Company to “seedy Chicago politics.” And so it went.
What the final piece of legislation that emerges from the House-Senate conference committee in January will look like, is uncertain. What is certain, however, is that it will be deliberately complex, if not downright undecipherable, and massively expensive; and it will contain more quid pro quos than you could shake a stethoscope at.