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Bush's Medicare quagmire -- and the striking parallels to Iraq.
Apr 5, 2004 | Last year as the Bush White House tackled overhauling Medicare and invading Iraq, it used strikingly similar political methods for both. Today the two would-be victories have morphed into mirror-like crises and scandals. Both are subjects of widening investigations.
If both the Medicare bill and the war in Iraq had gone as the White House planned -- seniors cheering the new drug prescription plan as Iraqis were supposed to welcome U.S. troops into Baghdad like it was Paris 1944 -- Bush's reelection campaign would be a formality.
"Medicare and Iraq tell us all we need to know about the White House," says Rep. Robert Wexler, D-Fla. "They operate behind a series of misrepresentations, followed by coverups."
Bush's Medicare program and the Iraq war both fit a striking pattern: The real motives were clouded in secrecy and false claims; the true costs distorted; administration officials pressured not to reveal true information; and the White House has relied on taxpayer-funded propaganda operations to try to prop up both.
The Medicare bill was supposed to be "one of the crowning achievements" of the Bush administration, the conservative Washington Times recently noted, but "so far it has turned out to be one of the messiest policies, being attacked on several fronts." Just as support for Bush's Iraq policy erodes over time, polls show senior citizens are increasingly uneasy with the new Medicare plan the White House insists will save them money on prescription drugs.
There are now three separate government investigations looking into the passage of the Medicare bill, including one bribery charge. Meanwhile, the U.S. intelligence regarding Iraq, and the countless administration pronouncements about Saddam's mighty arsenal, proved to be so badly off the mark that President Bush was forced to appoint an independent commission to study what went wrong. And a special prosecutor is investigating who committed the crime of making public the identity of covert CIA operative Valerie Plame to conservative columnist Robert Novak -- "two senior administration officials," he wrote -- an outing that was an attempt to discredit Plame's husband, former ambassador Joseph C. Wilson IV, who had proven that Bush's claim in his State of the Union address about Saddam Hussein seeking uranium to build nuclear weapons was false.
Today, the battle over Medicare is becoming intense and bruising, like the one over Iraq. "I think the very size of the legislation, the closeness of the vote, and perceived politics at stake, all added a level of bitterness that was very unusual. It's entered into the realm of the dark legend, even by Washington standards," says Robert Moffitt, director of health policy studies at the Heritage Foundation, a conservative think tank that opposed the legislation on the grounds that it was too expensive. "I've never seen anything like it."
Moffitt says fiscally conservative Republicans, who traditionally would have opposed the Medicare bill -- the biggest expansion of an entitlement program in nearly 40 years -- are fuming that the actual price of the Medicare bill was suppressed by the administration. "They had grave reservations about voting for it," he says. "They were told repeatedly by the Republican leaderships, 'It's a fiscally responsible bill, we promise you.' Now there's a lot of buyer's remorse up on the Hill."
Indeed, one of the most striking similarities between Medicare and Iraq is the central allegation that the administration intentionally withheld the actual price tag from lawmakers until after they had voted.
Last November, in an extraordinary vote held open for an unprecedented three hours by the speaker of the House, the Republican leadership, after leaning on its members, eked through passage of the historic Medicare bill by a count of 220-215. (Most Democrats opposed it, calling the bill a giveaway to the pharmaceutical industry.) Pivotal to passage were reluctant yes votes by 13 conservative Republicans who had initially balked at the $395 billion price tag. During the pre-dawn hours of the Nov. 22 Medicare vote, they were eventually persuaded to vote yes. Bush signed the bill into law in December.
The following month, the administration announced the program would actually cost $534 billion to implement, nearly 40 percent more than advertised. "Had people known that real price, the bill wouldn't have ever made it to the House floor for a vote," says Rep. Rahm Emanuel, D-Ill. (Similarly, the administration refused to even submit an estimate for the war while Congress was debating whether to give the president authorization to use force.)
Then, last month, Richard Foster, the chief actuary at the Centers for Medicare and Medicaid Services, the top independent Medicare cost analyst, revealed he had been threatened by the Bush administration that he would be fired if he told Congress the true cost of the policy. He received orders in June 2003 from his boss, Thomas Scully, the Bush-appointed director of the Medicare program, instructing him to ignore information requests from members of Congress who were drafting the drug bill. In the past, lawmakers had free access to the actuary's estimates. And they assumed they were getting a true statistic as they considered the bill this time.
The Wall Street Journal first reported March 18 that Foster received a note from Scully's aide ordering him to answer the Republicans' questions but warning him not to respond to Democratic queries -- "with anyone else until Tom Scully explicitly talks with you -- authorizing release of information. The consequences for insubordination are extremely severe."
One Democratic staffer on the Hill who worked on the Medicare bill has told reporters she confronted Scully months prior to the vote about not being able to get Foster's independent estimates and was told, "If he gives that [information] to you, I will fire him so fast his head will spin."
Foster says he and others knew months before the November vote that the real cost would be more than $500 billion, which would have likely killed the bill's chances for passage. He told the Washington Post he thought Scully was working at the behest of the White House to hide the real Medicare costs. A White House spokesman has insisted that Bush didn't learn about the higher estimate until after the Medicare legislation was signed into law.
One man who could likely answer that question is the president's chief healthcare advisor, Douglas Badger. Foster believes Badger knew about the higher estimates, which suggests that the administration's most senior officials also knew. But last week the White House refused to allow Badger to testify under oath before Congress. Scully, for his part, also refused to testify in person before Congress.
The Department of Health and Human Services' Inspector General is now investigating Foster's claim that he was threatened with dismissal for doing his job.
If Foster was nervous about his job, he needed to look no further than the build-up to the Iraq war for an example of professional retribution taken out on government officials who crossed the White House over the sensitive issue of costs. During September 2002, Bush's former White House economic advisor, Larry Lindsey, in an interview with the Wall Street Journal said the war might cost between $100 billion and $200 billion. The sky-high estimate set off a storm of controversy and was soundly dismissed as folly by Lindsey's administration colleagues.
Three months later Lindsey was forced out of his White House post. Today, his estimate stands as the most accurate offered up by anyone associated with the administration. To date, the White House has sought more than $150 billion to pay for the war, according to the Washington Post.
The radical way the Medicare bill was rammed through, with Democrats shut out of the legislative process, was an exercise of partisanship on steroids, say critics. "The process reflected the fact Republicans run the government, the House, the Senate, the courts, and it's given them a sense of arrogance. It's a power that's made them act in ways never been permitted before," says Waxman. "Thirty years ago it was unthinkable to hold an open vote for three hours. And even Nixon during Watergate wasn't offering bribes to party members for their vote."
