22 October 2009

SGR Still Broken

It wasn't terribly surprising, since the signals had been plain for a couple of days, but the proposed fix for the Sustainable Growth Rate was defeated in the Senate yesterday.  All republicans plus about a dozen democrats voted against the repeal, so it wasn't even close.

Igor over at the Wonk Room points out that Mitch McConnell opportunistically and hypocritically criticized the dems for trying to deficit finance the SGR repeal, despite the fact that McConnell has repeatedly voted for deficit-financed single-year SGR patches.  McConnell also voted for the $1.1 Trillion deficit-financed Medicare Part D (the drug benefit).  Having said that, it is entirely right that it was a weak and irresponsible maneuver on the Democrats' part to try to repeal the SGR without finding an offset.  Just because their predecessors were criminally reckless with the nation's fiscal future should not give the Dems license to follow in their footsteps.  That's part of the reason that the GOP got thrown out -- people wanted responsible governance.  Obama has taken some positive steps in getting rid of Bush's accounting gimmicks.  For example, his budget outlooks have included the presumption that the SGR-mandated reduction in physician compensation would not actually happen, thus admitting that the deficit projections are worse than they actually were under Bush's projections, which assumed that Congress would allow the cuts to go forward.

However, Jon Chait at TNR is quite right that it's dishonest to attack this as a failing of "Obamacare."  It's a problem which predates Obama's administration by a decade, and even without the greater health reform effort, Congress was going to have to grapple with this sooner or later. 

It's to the credit of the Democrats' efforts that the House Bill, the much-maligned 1,000-page HR 3200 does include a repeal of the SGR, which to my understanding was fully paid for and not deficit financed.  Hopefully, when (if) the process advances to the point that there are House and Senate bills to reconcile, that component of the House bill will be adopted in the final legislation, or we will just go back to the high-drama, high-stakes annual game of "stop the SGR cuts."


  1. Shadowfax

    I am worried about your clinical abilities and diagnostic skills if you just now discovered that politicians are whores.

    The solution is to keep govt out of our lives to the greatest extent possible - otherwise, accept the fact that their "solutions" are all political and not from good policy perspectives.

  2. The proposed fix for the Sustainable Growth Rate was defeated in the Senate yesterday.

    It wasn't a "fix," SF. It was bribe (as is the HR 3200 provision) to keep the AMA quislings on board the Obamacare express.


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