Who was fooling whom on drug bill?


CHICAGO - The Medicare scandal goes like this: The Bush administration lied about what the new prescription drug coverage would cost, Congress was hoodwinked into passing it, and now all of Washington is shocked to learn that the price may be much higher than expected. It's a story that should infuriate taxpayers. The only problem is that it's mostly a fairy tale.

Not the part about the administration fibbing. I must report, not for the first time, that the president and his aides advanced their agenda partly by misleading the public.

While Congress was debating this new plan to help pay drug costs, Medicare administrator Thomas A. Scully insisted the tab would come to a mere $400 billion over 10 years. Meanwhile, he was threatening to fire Medicare's chief actuary, Richard S. Foster, if he was so rash as to inform Congress that its actual estimate was from $500 billion to $600 billion. Mr. Foster said he did provide the information to the White House, but no one there saw fit to alert the citizenry. Only after the bill had been signed into law did the administration admit the sad truth.

Mr. Scully was certainly doing his best to swindle Congress by any means necessary. But the truth is there were lots of people on Capitol Hill who were eager to be fooled. At a hearing the other day, Texas Republican Rep. Kevin Brady expressed a common sentiment when he told Mr. Foster, "I wish your information had been made public at the time." Mr. Foster didn't offer the reasonable response: Give me a break.

If there were people in Washington who believed this would not cost more than $400 billion, then there are people in Washington who believe there is major-league baseball in the Tampa Bay area. Everyone who was paying the slightest attention understood all along that the cost estimates were somewhere between unrealistic and preposterous. The numbers provided by the official bean-counters were a polite fiction allowing our leaders to pretend they were being fiscally responsible.

Experts who disagreed about everything else concurred on this point. "I don't know of any analyst, left, right or center, who thinks this $400 billion number is real," said Robert Moffitt of the Heritage Foundation, before the bill was enacted.

In reality, Congress normally doesn't even pay attention to administration cost estimates, preferring to rely on its own Congressional Budget Office. In this case, the CBO put the cost at $395 billion, a number it stands by today. So Congress could approve the measure without officially busting through the $400 billion limit it had imposed.

The bigger problem, though, was as obvious as a polar bear on the dance floor. Any time the government creates a big new benefit program, history suggests, it soon becomes a gargantuan new benefit program. That's what happened with the original Medicare system, which ended up costing seven times more than it was supposed to. Robert Bixby of the Concord Coalition, a fiscal watchdog group, notes what is almost an iron rule in Washington: "Entitlements don't shrink."

That looked especially true in this case, because the prescription drug coverage was stingier than most seniors would like, leaving retirees exposed to thousands of dollars in annual expenses. Once the program was in place, a lot of Democrats figured, it would be easy to expand. As Democratic Sen. Kent Conrad of North Dakota said in explaining why he was supporting a measure that was far less comprehensive than many in his party wanted, "It is a beginning."

The risk of runaway spending was no secret to members of Congress, some of whom had the nerve to recognize reality. Senate Budget Committee Chairman Don Nickles, an Oklahoma Republican, predicted that "the cost will greatly exceed the estimates." Sen. Judd Gregg, a New Hampshire Republican, called the bill "the largest tax increase that one generation has put on another generation in the history of this country."

Everyone also knew that Medicare was already overstretched. The Concord Coalition noted in November that the program was expected to double as a share of the economy in the next 30 years.

But did anyone care? Of course not. Politicians from both parties were eager to endear themselves to retirees and aging baby boomers. So they plugged their ears whenever they encountered tightwads who insist on living within our means.

Today, critics of the Bush administration complain it got its way by deliberately concealing vital facts, tricking innocent lawmakers into voting for a plan that would cost more than they ever dreamed. But if members of Congress were fooled, it's because they were fooling themselves.

Steve Chapman is a columnist for the Chicago Tribune, a Tribune Publishing newspaper. His column appears Tuesdays and Fridays in The Sun.

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