Politics & Policy

Mediscam?

The drug bill cost more than the Bushies let on.

In previous columns, I have warned that George W. Bush is in danger of appearing Nixonian — that is, using Richard Nixon’s political methods, such as a willingness to subordinate everything to a re-election effort, including abrogation of one’s own principles; punishing staffers with genuine policy disagreements for being disloyal; and keeping secret information that might undermine decisions one has already made.

The clearest evidence yet of Bush as Nixon has arisen over the question of what the White House knew about the cost of the recently passed Medicare drug bill, when it knew it, and whether it actively suppressed information that might have caused the measure to fail in Congress. It is becoming harder and harder to believe that the administration was not knowingly engaged in deception in this matter. Increasingly, it appears that it knew perfectly well that the legislation would cost far more than $400 billion over 10 years — the most Congress was allowed to spend under its rules — and that it took extraordinary measures to suppress this fact.

The center of this situation is an obscure bureaucrat named Richard Foster, chief actuary for Medicare. It is his job to estimate spending for that program over long periods. Annually, he produces a report for Medicare’s board of trustees, based on many complex mathematical calculations, that lays out the program’s financial condition in excruciating detail. Foster’s latest report was delivered Tuesday, March 23. It showed serious financial deterioration, largely due to the addition of a large unfunded drug benefit.

According to the New York Times, Wall Street Journal, and Knight Ridder news service, Foster knew last summer that the drug bill being debated in Congress would cost somewhere between $500 billion and $600 billion. In its latest budget, the administration conceded that the figure is $534 billion.

The problem is that everyone knew that a bill with a price tag that large would never get through Congress. The version that did pass only made it through with two votes to spare in the House of Representatives (and only after the vote was held open for an unprecedented 3 hours, while arms were twisted to get the necessary votes). Most of the pressure was brought to bear on conservative Republicans reluctant to vote for so much new spending when the budget was already in deficit.

Reportedly, the last couple of votes were secured after legislators were warned that an even bigger Democratic bill would be enacted unless they agreed to the White House plan. This was utterly dishonest. In the event that the administration bill went down to defeat, the House leadership would simply have pulled it off the floor while something new was cooked up. There was zero chance that something like the $1 trillion Democratic alternative would ever have become law.

Another argument being made by the drug bill’s supporters is that only the Congressional Budget Office’s estimate of $395 billion was binding. The administration’s estimate would not have been official for legislative purposes. While this is technically true, it ignores the closeness of the vote and the fact that misgivings about the drug bill’s cost were the final sticking point. There is no serious political observer who does not think that disclosure of the administration’s $534 billion estimate would have killed the bill, at least temporarily.

This is why the apparent effort to squelch Foster is so scandalous. Reportedly, his boss, Medicare administrator Tom Scully, threatened Foster with dismissal if he communicated any information about his estimates to anyone on Capitol Hill without Scully’s authorization. Needless to say, such authorization was not forthcoming, because Scully knew perfectly well that it doomed the legislation — a high-priority White House initiative.

The administration has tried to portray this whole thing as a simple management issue. Generally speaking, career bureaucrats are not allowed to communicate with Congress officially unless through channels. However, the actuaries for Social Security and Medicare have long had a measure of independence, allowing them to give technical advice directly. Consequently, the effort to withhold estimates of the drug bill appear unusual and politically motivated to an extraordinary degree.

It looks as though Scully will be the fall guy for this scandal — which is convenient, since he has already left government. But the larger question of White House honesty still needs to be answered.

– Bruce Bartlett is senior fellow for the National Center for Policy Analysis. Write to him here.

Members of the National Review editorial and operational teams are included under the umbrella “NR Staff.”

Most Popular

U.S.

FBI to Interview Hunter Biden Business Partner

The FBI has asked Tony Bobulinski, former business partner of Hunter Biden, to sit for an interview on Friday, Senator Ron Johnson (R., Wis.) told reporters. Bobulinski was initially scheduled to give an interview on Friday to members of various Senate committees regarding his knowledge of business deals ... Read More
U.S.

FBI to Interview Hunter Biden Business Partner

The FBI has asked Tony Bobulinski, former business partner of Hunter Biden, to sit for an interview on Friday, Senator Ron Johnson (R., Wis.) told reporters. Bobulinski was initially scheduled to give an interview on Friday to members of various Senate committees regarding his knowledge of business deals ... Read More
Media

The Media’s Shameful Hunter Biden Abdication

In an interview with National Public Radio’s public editor today, Terence Samuel, managing editor for news, explained why readers haven’t seen any stories about the New York Post’s Hunter Biden email scoop. “We don’t want to waste our time on stories that are not really stories, and we don’t want ... Read More
Media

The Media’s Shameful Hunter Biden Abdication

In an interview with National Public Radio’s public editor today, Terence Samuel, managing editor for news, explained why readers haven’t seen any stories about the New York Post’s Hunter Biden email scoop. “We don’t want to waste our time on stories that are not really stories, and we don’t want ... Read More
Elections

Biden Wants It Both Ways

This week felt like a month. On the menu today: After President Trump asked, “Would you close down the oil industry?” Biden responded, “I have a transition from the old industry, yes,” and now Biden’s campaign insists the candidate didn’t mean it. Biden also insisted that he “never said I oppose ... Read More
Elections

Biden Wants It Both Ways

This week felt like a month. On the menu today: After President Trump asked, “Would you close down the oil industry?” Biden responded, “I have a transition from the old industry, yes,” and now Biden’s campaign insists the candidate didn’t mean it. Biden also insisted that he “never said I oppose ... Read More