Health Care And Deficit Madness

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JONATHAN CHAIT MARCH 7, 2011

Health Care And Deficit Madness

The long-term budget deficit is primarily a function of explosive health care cost growth. We have a new law in place attempting to resolve the problem. The Republican Party is working feverishly to undermine that law. One of the oddities of the current moment is that the political class (though not the public as a whole) is laser-focused on the budget deficit as the central problem in American life, yet the discussion of the deficit is taking place as though none of the above facts were true. On national television, Mitch McConnell is sadly proclaiming that the administration is not serious about the long-term deficit.

Meanwhile, Michael Millenson reports from a health care conference at which some Republican staffers spoke:

The Prevention and Public Health Fund? "You mean, the prevention health slush fund, as we like to refer to it?" replied a GOP staffer.

The Innovation Center at the Centers for Medicare & Medicaid Services? "An innovation center at CMS is an oxymoron," responded a  Republican aide, before adding a personal barb aimed at the attendees: "Though it's great for PhDs who come to Washington on the government tab."

There was also no reason the government should pay for "so-called comparative effectiveness research," another said.

"Everything's on the chopping block," said yet another.

Everything? At HIMSS, where GOP staffers also spoke, attendees were chagrined to learn that "everything" applied to them, too. The subsidies for health information technology that were part of the American Recovery and Reinvestment Act were targeted in legislation introduced in late January by Rep. Jim Jordan, R-Ohio, chairman of the Republican Study Group. His bill would repeal this funding and eliminate all remaining stimulus spending, including about $45 billion in unspent health IT funds.

Those focused on the substance of health policy might be forgiven for feeling blindsided. After all, the McCain-Palin health policy platform in the 2008 presidential election called for coordinated care, greater use of health information technology and a focus on Medicare payment for value, not volume. Once-and-future Republican presidential candidates such as former governors Mike Huckabee (Ark.), Mitt Romney (Mass.) and Tim Pawlenty (Minn.), as well as ex-Speaker of the House Newt Gingrich, have long promoted disease prevention, a more innovative federal government and increased use of information technology. Indeed, federal health IT "meaningful use" requirements can even be seen as a direct consequence of Gingrich's popularization of the phrase, "Paper kills."

It's hard to capture the sheer absurdity of the situation. You have Republicans attempting to kill even no-brainer reforms to curtail the single greatest cause of skyrocketing spending. That's crazy enough. On top of that, they're doing so while lambasting the administration that pushed for these reforms for failing to address the deficit. And meanwhile, groups that are driving the deficit discussion are handing out fiscal responsibility awards to the Republicans behind this approach.

To be sure, we need to do more about the long-term deficit. But the entire discussion is ignoring the fact that one party is working very hard to make things vastly worse.

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posted in: jonathan chait, public health fund, medicare, republican party, michael millenson, mitch mcconnell

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