Health reform and the truth

Sen. Tom Cobern and Rep. Paul Ryan:

As Congress works to "make history" with health care reform, the American people have a far more sensible ambition for policymakers: get a grip on our unsustainable fiscal course.

By 2-to-1, Americans continue to believe that Congress should address the deficit first, then health care. Yet the best that Congress has come up with to address our entitlement and fiscal crisis is to create a costly new open-ended entitlement.

The American people suspect what we know to be true: Congress really has no idea how to pay for "reform," or anything else for that matter. Fiscal restraint remains off the agenda, while there is of course the desire to appear to be fiscally responsible.

Behind closed doors, negotiators have been performing budget gymnastics. House and Senate leaders have been fudging their cost estimates to meet the president's demand of not adding a dime to the deficit.

For instance, the bill won't be fully implemented until 2013, but tax hikes will take effect immediately. This gimmick will produce 10 years of revenues but only seven years of cost. Once fully implemented, however, the plan will cost nearly $2 trillion over 10 years — double the $900 billion touted as a passing grade from the Congressional Budget Office.

Still, congressional leaders are sticking to their talking point. "We're very excited by the CBO scores," Speaker Nancy Pelosi said gleefully when the plan's Enron-style accounting produced a positive score. The CBO, however, is less excited about Congress' fiscal management. As it recently told Congress, "Slowing the growth rate of outlays for Medicare and Medicaid is the central long-term challenge for federal fiscal policy."

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The politics of fraud is not sustainable. Eventually the inability to make payments will bump up against the programs ambitions and we will have to make much more difficult decisions about raising taxes and reducing benefits to people who have been made dependent by the scam.