On health care, this Bush budget just tells me this President has given up.
To start with, he would let scheduled Medicare physician fee cuts simply take place. Those cuts, now estimated to be 8.5% on January 1, 2008, will under no circumstances take place at anywhere near that level (if at all) and everyone in Washington, DC knows that.
So why include this in your budget.
The Bush budget calls for more than $101 billion in five-year Medicare and Medicaid savings from not only doctors but also hospitals and nursing homes. His proposals would make a number of provider payment reductions permanent and would never pay providers a full inflation update--meaning they would fall further and further behind. Even members of his own administration are admitting the Democratic Congress is not going to even consider these ideas.
So, why include this in your budget?
The State Children's Health Insurance Program (S-CHIP) is seen as a huge bipartisan success for the 6.5 million kids it covers. What did the President propose? He would fund only part of it going forward--in fact a 4% decrease from 2007 funding. Both Republicans and Democrats in the Congress are not going to go along with that.
So, why include this in your budget?
My sense is that the President has given up on doing anything important on health reform. He is simply giving us a budget proposal that meets the overall objective of leaving office with the budget deficits falling. By creating this make-believe budget he can set overall spending and revenue targets--that contemplate his tax cuts remaining untouched--and say he laid out a workable budget plan.
So he can now sit back and say he hit the broader targets. Later when the Congress does what everyone knows they will do with health care spending he can say it was the "spendthrift" Congress--particularly the Democrats--that pushed the budget off his track toward a balanced budget.
Bush is just really giving up and sending all of these problems over to the Democratic Congress to make the real decisions.
The President is right when he says in his budget that both Medicare and Medicaid can not be sustained at these levels and are really going to be in trouble as the "baby boomers" start to retire in just a few years.
He also told House Democrats, at their retreat this weekend, that he wants to work with them on these hard health care issues before he leaves office.
Then why doesn't he?
You know, it's one thing for people to call you a "lame duck," it's another thing to act like it!