You may have never heard of the so-called "doc fix," as it's one of those Washington phenemona that normal people have neither the time nor the inclination to care about.
But know this: It's the central feature of a an attempt by the political class to pull the wool over your eyes concerning the true cost of Medicaid. The fact that Congress yesterday put a stop to it is a rare exercise in honesty, but it doesn't change a horrible policy. It just stops the sham of trying to pretend it doesn't exist.
In 2002, Congress passed a change in the way doctors are reimbursed for their treatment of Medicaid patients. The change was designed to lower the cost of Medicaid and lower the deficit.
There's one problem, though: The change would have put most Medicaid doctors in a position of losing money for every Medicaid patient they treated, which would have meant it wouldn't be long before almost no doctors would accept Medicaid patients. Recognizing this, Congress proceeded to pass a subsequent bill every single year that spent additional money to reimburse the Medicaid doctors properly for their services. This became known as the "doc fix," and it became assumed that every year Congress would pass it, lest they face a massive exodus of doctors from the Medicaid system.
In other words, the 2002 bill was a complete sham, and every Medicaid budget that's ever been presented at the start of a fiscal year since then has also been a sham, because they were all based on the assumption that there would be no doc fix - which everyone of course knew there would be.
So when they told you the deficit would be a certain number, they knew it would not be that number at all because they knew they were going to pass the doc fix. They just pretended not to know that when they rolled out their initial budgets. Republican administration, Democrat administration, Republican Congress, Democrat Congress . . . it made no difference. They kept up the doc fix charade year after year.
There was a huge controversy when ObamaCare passed because Republicans wanted the CBO to include the doc fix in the cost projections. Democrats, who ran Congress at the time, demanded that the CBO pretend the doc fix didn't exist, and the CBO knew who called the shots. They pretended.
Anyway, Congress is going to continue spending this money, but one cheer to them for the fact that as of now they're no longer going to pretend otherwise:
House Speaker John Boehner, R-Ohio, who crafted the compromise bill with House Minority Leader Nancy Pelosi, D-Calif., called the reform's passage "a big deal."
"For the first time in nearly two decades - and without raising taxes - Congress has come together in a bipartisan way to pass meaningful entitlement reform," Boehner added. "And while much more must be done to rein in unsustainable entitlement spending, this agreement represents an important step in the right direction."
Meaningful entitlement reform? Yeah . . . I don't think so. They're not actually going to do anything different. They're just going to change the official formulas so they don't have to go back in and "fix" them every year. In other words, they admitted that the 2002 "reform" was no reform at all but a big scam, and they're ending the scam. From now on they'll admit Medicaid is a huge budget buster. Wonderful. Real reform would fix it so that it no longer is.
If this is what John Boehner considers "meaningful entitlement reform," it's all the more reason he should no longer be Speaker of the House. And any time you can get this kind of bipartisan agreement on a bill in Congress, you can be pretty sure the only people who benefit from it will be the members of Congress themselves.
