The Medicare prescription drug benefit has been passed but not forgotten. As the election approaches, Republicans will tell elderly voters what they’re getting. Democrats will tell them what they’re not getting.
But more interesting than any of this is what the taxpayers are getting. They are getting socked in the nose. The estimated cost of the Medicare drug program turns out to have been a fiction. And herein lies a tale more suited to A&E’s "Cold Case Files" than to C-Span.
The White House conceded in January that the Medicare drug benefit would cost far more than the earlier estimate of $400 billion over 10 years — something closer to $534 billion. The horror only grows. It seems that the higher number was known all along by a select few. The lowball figure was merely a device to trick lawmakers into passing the legislation.
Medicare’s chief actuary, Richard Foster, now says that his boss had threatened to fire him if he revealed the true estimate. Had his number, about $550 billion, come to light, the drug benefit bill would have died. Come November, President Bush would have had to face elderly voters empty-handed — which would not help him in the Florida count.
Cybele Bjorklund, a House Democratic aide in health policy, recalls first hearing of the higher estimate last spring. She asked Foster about it, but he would not comment, saying he feared for his job if he did.
Bjorklund tried to check Foster’s story with his supervisor, then-Medicare administrator Thomas Scully. She remembers Scully telling her that if Foster gave out the information, "I’ll fire him so fast his head will spin."
Scully denies having said that. As for giving Foster the boot, Scully says he was only kidding.
If Democrats exploit the scandal for political gain, one can hardly blame them. They have a good one. And there is no evidence that Foster acted out of partisan malice. His motive in speaking up seemed based on a simple wish to defend his integrity as a number-cruncher.
On one hand, it’s hard to see why the $534 billion number should have bothered Bush or the Republicans running Congress. After all, the utter collapse of their fiscal discipline is old news. They’ve been slashing taxes while spending more for some time now. So what’s $100 billion or $200 billion here and there? When you’re throwing an orgy, why fret over an extra plate of shrimp?
Or, as House Majority Leader Tom DeLay said on Wednesday, the actuary’s numbers are "irrelevant to the policy that we passed."
On the other hand, the leadership had to worry about those party-pooping deficit hawks. The Democrats wouldn’t flinch at the higher estimate. After all, they supported a Medicare drug benefit that was even bigger. But the handful of principled conservatives was another matter. That group might take the extra billions to heart.
Indeed, some Republican deficit hawks had vowed to oppose the Medicare drug bill because they thought $400 billion was too much spending. Several others were teetering on the edge. Because the vote was headed for a photo finish, Republican leaders kept the roll call open for almost three hours. That would give them more time to apply muscle. Had the $534 billion number been revealed, the bill would have sunk.
If anyone has a right to be hopping mad, it’s the fiscal conservatives.
There’s another appalling development. Rep. Nick Smith, a Michigan Republican, says he was offered a bribe for his vote. Smith, who is leaving office, says other lawmakers and interest groups promised to put money into his son’s campaign if he voted for the Medicare drug bill. To his eternal credit, Smith voted nay. (The House ethics committee is starting a formal investigation.)
Tricks, lies, bribery, intimidation — anything else? The Republican leadership really wanted that Medicare drug bill passed, didn’t they? And they succeeded. But they haven’t quite managed to put this nice little benefit for elderly voters behind them.
No, the drug benefit has moved from the debate phase to full-blown scandal. What the law gives in benefits is now about half as intriguing as how it was made. The issue lives, and is about to kick up its heels in the presidential campaign.
Froma Harrop is a Providence Journal columnist. Contact her by writing to
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