Paul Jacob

There’s a big difference between the U.S. Congress passing legislation and a hustler playing three-card Monte on a city street: No citizen is forced to hand money over to the street hustler.

Yesterday, in an overwhelming 89 to 10 vote, the U.S. Senate passed a bill that the House is expected to agree to next week, sending it to President Barack Obama’s desk. At issue are several matters:

  • reversing (again) the cut in Medicare reimbursements to doctors,
  • extending this year’s payroll tax cut and
  • disallowing President Obama from procrastinating further on the regulatory permission for the Keystone XL oil pipeline to be built from Canada to the Texas gulf coast.

See if you can follow the shuffle on each of these three items in the legislation:

The Doctor Fix
Congress regularly cuts the rates for which Medicare will pay doctors for the care they provide patients. These reductions are enacted to save money. But doctors, like most of us, don’t work for free and don’t have to perform operations or provide care at prices that don’t allow them to make a profit. Having a health insurance program like Medicare that no doctor will accept wouldn’t provide much in the way of healthcare.

So, in its infinitely pandering wisdom, Congress regularly legislates reduced reimbursements for doctors treating Medicare patients to portray a sense of fiscal prudence, only to turn around later and reverse themselves by passing what they call a “doctor fix.” (Yes, Charlie Brown, you can have as much confidence in Congress as you have in Lucy.)

Those following the cards closely will remember that much of the $600 billion Obamacare was supposed to cut from Medicare over the next decade, which in fact allowed the Congressional Budget Office to score the 3,000-plus page bill as actually saving money, was in reducing what Medicare paid to doctors. But with typical Washington chutzpah, during the debate over Obama’s health care law, Obama signed legislation reversing a previously enacted cut in Medicare reimbursements to doctors.

The game continues with yesterday’s vote.

Paul Jacob

Paul Jacob is President of Citizens in Charge Foundation and Citizens in Charge. His daily Common Sense commentary appears on the Web and via e-mail.