Medicare: A Question of Credibility
Secret documents. Back room deals. Intimidation. Misinformation. Threats. Exclusion. Bribery. Propaganda. Lying. Am I referring to the KGB? The Chinese authorities? Napoleon's France? A medieval court? Imperial Rome? No.
Elements of a government scandal? Maybe.
All of these things played a significant role in the narrow passage of the "Medicare Prescription Drug, Improvement and Modernization Act of 2003." You may wonder who, here in the United States of America, the freest country in the world, would employ such tactics to pass a controversial Medicare law. The Bush Administration, that is who. The White House position of "win at any cost" eventually did lead to the new law; but what was the cost?
The cost has been the credibility and reputation of not only the Bush Administration, but that of Congress and the entire law making process. The American people must ask themselves in disgust, "Is this how my government actually works?" This is shameful.
Everyone knew a Medicare prescription drug benefit was going to be expensive, very expensive. To the end, the Bush Administration assured Congress that their plan would cost $400 billion, no more. However, it has since been discovered that the White House knew, at least six months before the vote, their bill had a price tag almost $140 billion higher than that figure.
Further, it has been reported that CMS Administrator Tom Scully threatened to fire the chief actuary responsible for calculating the cost, Richard Foster, if he made this information available to congressional Democrats. At the time, Mr. Scully was negotiating with health care interests that had large financial stakes in the Medicare bill, not only about the bill, but for his next job!
That is not to say Mr. Scully was in this alone. Last month, Mr. Foster told members of the House Ways and Means Committee that he had shared with Doug Badger, President Bush's health policy adviser, and James Capretta, associate director of the Office of Management and Budget, his analysis that the Medicare legislation would exceed its target spending goal.
Not only was this underhanded and deceitful, according to the Congressional Research Service (CRS), this gag order was against the law.
According to the report, Congress's "right to receive truthful information from federal agencies to assist in its legislative functions is clear and unassailable." Since 1912, federal employees' ability to communicate with Congress has been guaranteed by law. More recent appropriations laws have "reaffirmed and strengthened" those protections.
Reflecting on a Supreme Court ruling on the issue, the CRS report states, "Political gamesmanship must yield to the clear public interest of providing . . . Congress with accurate and truthful information" which they utilize to write our nation's laws. Mr. Scully's order "would appear to violate a specific and express prohibition of federal law."
In March 2004, Bush administration officials implied they would provide the actuary's cost estimates to Congress. "We have nothing to hide, so I want to make darn sure that everything comes out," HHS Secretary Tommy G. Thompson said on March 16.
A month later, however, the Bush Administration refused to provide the documents to Congress. (Still waiting for a copy of the letter).
William Pierce, a spokesman for the Department of Health and Human Services, said on Monday that Mr. Scully's action was being investigated by the HHS inspector general. However, he further said that the department is "focusing on instituting the new Medicare law and not on the Scully-Foster controversy" (Philadelphia Inquirer, 5/4) and that that "we are looking to the future, not the past" (NYT, 5/4).
Mr. Pierce, are we to understand that this "controversy" is of no consequence to HHS?
When was the Republican congressional Leadership aware of this new substantially higher projection? Were they going to make it public so Congress could have an honest debate on the bill? The Administration kept it a secret from everyone, especially fiscally conservative members of their own party.
Democratic members of the conference committee were excluded from the meetings on controversial issues which yielded the final form of the bill. No one knows what was said behind those closed doors.
Strangely, the AARP, a strident and respected advocate for seniors that had been fighting for meaningful prescription drug coverage for many years, decided to endorse the Bush Administration's Medicare plan after repeatedly insisting that it was not good enough for America's seniors. Suddenly, concerning a prescription drug benefit, something was better than nothing. In this particular case, I do not think AARP could be more wrong.
The vote on the Medicare bill, taken in the dead of night, was one of the longest in congressional history. A normal vote is open for 15 minutes. However, after 15 minutes; after 30 minutes; after an hour, the bill was failing. The leadership held the vote open for three hours in order to secure passage.
So why did people change their votes? Well maybe because the proponents of the bill openly strong-armed members; or perhaps because, in violation of the standards of the House, Secretary of HHS Thompson was on the floor during the vote. In fact, one Member reported that he was offered a bribe to vote for passage of the bill and then threatened when he refused the bribe on the floor of the House of Representatives.
The questionable tactics continue, even after the new Medicare bill was signed into law. More than $80 million in taxpayer money has been set aside for advertisements about the new drug benefit. However this campaign has resembled partisan propaganda more than educational materials. After a review, the General Accounting Office declared the ads technically legal despite "notable omissions and other weaknesses."
Sadly, this bill's journey has been a prime example of how not to govern. We are now left with bad health care policy and a system with damaged credibility.
I am appalled that the Bush Administration has employed these underhanded and deceitful tactics. This episode has brought disgrace to our government institutions and to the concept of good governance. Is this standard operating procedure for the President? Americans should not and cannot stand for this.
Everyone has heard the old adage: "Never trust a politician." Perhaps President Bush has proven the adage true.
Win at any cost is not a philosophy in the best interest of the American people. As we can see, the cost is too high.
Rep. Bill Pascrell Jr., D-Paterson, represents the 8th Congressional District.