Media falsely claim “doc fix” means health care bill does not reduce the deficit

Media figures have claimed that the health care reform bill does not actually reduce the deficit because Congress is “leaving out $208 billion for the Medicare doc fix.” However, there is no reason the “doc fix” should be included in the cost of health care reform since the issue predates the health care reform debate and will need to be resolved regardless of health care reform's outcome.

“Doc fix” will need to be resolved irrespective of health care reform

Klein: Doc fix will need to be resolved “irrespective of health-care reform's fate” and "[a]ttempts to lash the two together are nonsensical." The Washington Post's Ezra Klein explained that the so-called “doc fix” is a remedy to faulty legislation that will need to be passed irrespective of health care reform. From Klein's explanation:

For a longer explanation of this issue, head to this post. The short version: In 1997, Republicans passed the Medicare Sustainable Growth Rate into law. The provision created a simple equation meant to hold down Medicare costs and cut doctor payments when they rose. But the provision was passed when Medicare's costs were uncommonly low. Suddenly, SGR was forcing huge cuts rather than the modest adjustments that had been intended. So legislators began voting to delay implementation rather than cut doctor payments.

The first delay was passed in 2003, under Republicans. Then again in 2005, also under Republicans. Then in 2006, under Republicans. Then in 2007 and 2008, under Democrats. For those keeping count at home, this is a policy in a Republican bill that Republicans delayed three times and Democrats delayed twice. What's needed is to reform the system so we stop delaying it. And we will need to do that -- and this is important -- whether or not health-care reform passes.

Klein further stated that the problem necessitating the fix “predates health-care reform and exists irrespective of health-care reform's fate. Attempts to lash the two together are nonsensical.”

NY Times: “Doc fix long predates” reform and criticism is “pretty flimsy.” The Times' David Leonhardt described criticisms of the “so-called doc fix” as “pretty flimsy,” explaining that the fix would rectify an “accounting fiction” resulting from the 1990s legislation that has been repeatedly overridden since 2003. He wrote:

The current health care bills don't fix this problem. An early version of them tried to, which has led some people to suggest that the doc fix is a creation of this health reform effort. But it isn't. The doc fix long predates it. For reform to reduce the deficit relative to the status quo, it doesn't need to undo the doc fix -- any more than it needs to, say, cure cancer in order to improve the nation's health. The bill simply needs to improve the status quo.

Media figures claim the doc fix makes health care bill a “deficit buster”

Cavuto: Doc fix “could make this a deficit buster.” On the March 21 edition of Fox News' America's News HQ, Fox Business' Neil Cavuto stated, “I don't know whose math we end up believing here, but the Congressional Budget Office has signed off on this. We should stress that even though the CBO is saying that this is now going to be deficit-neutral, they don't have this -- these new goodies that they've added in there that accommodate doctors -- compensate doctors, I should say -- on Medicare cuts, which could make this obviously a deficit buster.”

ABC's Karl: “There's some interesting accounting here” since “the Medicare doc fix, for instance, is not in here.” On the March 21 edition of ABC's This Week, host Jonathan Karl stated, “I mean, there is some interesting accounting here. I mean, the Medicare doc fix, for instance, is not in here. That's a couple hundred billion dollars.” Guest and Fox News analyst Karl Rove subsequently said to White House adviser David Plouffe:

What about leaving out $208 billion for Medicare doc fix? What about leaving off $30 billion for the Medicaid doc -- for the doc fix? You've got two years' worth of a Medicaid doc fix. Are you telling me that in two years, you're going to cut overnight the docs -- the doc reimbursement and not pay it for the balance of the eight years of this program? Deal with the facts, David. Stop throwing around labels.