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Medicare drug plan balloons

By Stephen Dinan

THE WASHINGTON TIMES

President Bush's budget next week will show the new prescription drug program costs $540 billion over 10 years, more than one-third higher than the $400 billion estimate Congress used in passing the bill in November.

"That really is a shocker," said Robert L. Bixby, executive director of the budget watchdog Concord Coalition. "It's a huge change. If a number like this had been floating around the Capitol last fall, it never would have passed."

Congressional Republicans, meeting for a legislative retreat in Philadelphia yesterday, were briefed on budget numbers by administration officials. On Monday, Mr. Bush will send his fiscal 2005 budget to Congress, having pledged to limit nondefense discretionary spending increases to 1 percent.

Part of that increase will be in the National Endowment for the Arts (NEA), which first lady Laura Bush announced yesterday will get an $18 million boost, a 15 percent increase over the $122.5 million approved for fiscal year 2004.

But the Medicare number promises to be a bigger problem as the budget debate unfolds. Some Republicans in the House only voted for the bill after being promised the costs wouldn't exceed $400 billion — something dozens of taxpayer-advocacy and policy-analysis groups said was inevitable.

"We told you so," said Robert E. Moffit of the Heritage Foundation, who said he expects the estimate to go higher with every new projection. "None of this bad news goes away. It gets worse."

The administration's higher estimate of costs comes from its Office of Management and Budget (OMB) from Medicare's actuaries. The lower estimate used by Congress last year came from the Congressional Budget Office (CBO).

Trent Duffy, a spokesman for the White House, said it is "the norm, not the exception" to have differences between OMB figures and CBO figures.

"This is ground-breaking legislation in a very unpredictable field, which is health care," Mr. Duffy said. "There are a lot of moving parts and variables, and the experts do their best, but the one thing we know about projections is they are typically wrong."

He said costs don't always exceed projections. He said the changes to Medicare as part of the 1997 Balanced Budget Act actually produced more savings than projected.

But other times, Medicare cost projections have been wildly low. When the initial program, hospital insurance, was instituted in 1965, the projected cost in 1990 was $9 billion. The actual cost in 1990 was $67 billion — more than seven times the estimate.

Then, in 1987, Medicaid's special hospitals subsidy was projected to cost $100 million per year by 1992, but the actual cost by then was $11 billion.

And when the 1988 Medicare Catastrophic Coverage Act was passed, the CBO put the five-year cost at $5.7 billion. Less than 12 months later, CBO estimated the price at $11.8 billion. Angry seniors protested the new law's provisions and it was repealed in 1989.

Democrats had fought last year for a broader and more-expensive Medicare bill. But yesterday, they said the new cost estimates don't mean the bill is better than expected.

"This new finding means an extra $49 billion in profits for drug companies, but the legislation still does nothing to reduce the exorbitant prices that drug companies charge," said Sen. Edward M. Kennedy, Massachusetts Democrat.

The Medicare numbers promise to complicate the pending budget debate, but Rep. Mike Pence, Indiana Republican and one of the conservatives who voted against the Medicare bill, said the bill should aid his cause.

"The silver lining of this disappointing news is it gives those of us fighting for a more frugal federal budget real ammunition," he said.

"It's not just conservatives. Even many moderates in the Republican conference are increasingly vocal about the need to return to our historic commitment for discipline in fiscal matters," he said.

Mr. Duffy at the White House said the budget Mr. Bush is submitting still reduces the deficit in the long term, even with the higher Medicare estimate.

"The president's budget will still show we can cut the deficit in half over five years if we restrain spending outside of homeland and national security and grow the economy."

He also said Mr. Bush will push for cost-containments that were lacking in the bill he signed.

"It was the administration and this president that were pushing for greater cost control in this bill up until the final hours," he said. "The president is committed to making sure cost controls are included in Medicare as we go forward. This is going to be a process."

As for the NEA increase, the White House had Mrs. Bush make the announcement.

"American arts are a reflection of our history and the creativity of the human spirit," Mrs. Bush said.

Even with the additional money, the agency still doesn't match the $175 million it received in 1992.

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Before throwing my considerable weight behind Art's candidacy, and I'm talking influential weight and not literal girth, I need some of his platform sketched out.

Do you intend to....

*Pursue legislation setting two-term limits on Congressmen? Career politicians have us on the fast track to destination ruin.

*Reduce the size of govt. by half? Disolving the Dept. of Education, Agriculture, INS, and the IRS? Introduce alternative and more effective ways to insure our kids the best education, our farmers with fair global agricultural trade, the protection of borders and the deportation of illegal aliens no matter the circumstance, and easing incredible tax burden faced by those who have invested an inordinate amount of sweat equity into being successful in their lives while being forced to pay the majority of the tax burden?

*Pursue legislation abolishing income taxes and championing the "fair tax" or Consumption tax to generate revenue to pay for social programs the govt. cannot now take from the masses who line up with their mouths open and hands out?

*Pursue corporate fraud and prosecute those who deceive Mr. Average Joe Investor?

*Reduce our troop deployments around the world, including the removal of troops from areas such as Germany and the reduction of troops in harms way in Iraq, Kosovo, and South Korea?

I've got more... but this should get Art manhandling his keyboard.

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Not sure how the consumption tax is UNFAIR. Of course, those determined to be under the adjusted "poverty" line would have to be credited in some fashion. I don't understand the hesitation behind the consumption tax, those of "wealth" would pay more in taxes based on luxury items and their means to buy consumberables. The key is that they pay more based on their ability to buy, not by some bureacrat in DC finding new ways to pay for studying how knats reproduce, or fund the promotion Wisconsin cheese, or paying for kids golf clubs and lessons in Florida. If you don't se the fairness in that... than you must be a liberal who believes YOU know best how to spend my money rather than me.

As for term limits, read a bit why don't you. It's these "career politicians" who vote not in the interest of their constituents.. but by party lines and for a means of keeping (or acquiring) power for their party. If that's doesn't step on the necks of Americans and spit in the face of our forefathers.... I don't know what does.

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Cskin,

Actually, since I'd never pay another cent in taxes to the US Government while creating a business that'll make me a billionare, maybe I should be for it. Oh, with the 'rebate' program your referring to, I'd get money from the governement.

As to your belief in term-limits, I would suggest you read. However, if after you read some more, you still support them then you'd best go hit whoever tried to teach you to read.

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Answer below :).

Originally posted by Cskin

*Pursue legislation setting two-term limits on Congressmen? Career politicians have us on the fast track to destination ruin.

Wholeheartedly agree. You can not have men who've never held a real job in the private sector admistering policy on the private sector. These men have to realize what they do has consequences. I do not, however, believe in term limits. I think people who have a hankering for public service should be able to go back to it. But, they must be removed after a single term and sent out into the real world where they will be required to work. The span of this work will be at least one half of the time they served, though I've considered making it a one for one ratio. In either case, after they have served the private sector, they can return for service for one term again, returning back and forth as often as they like. They simply must have some awareness of what it's like to be a person out in the world living under the oppressive nature of the government they've helped create.

*Reduce the size of govt. by half? Disolving the Dept. of Education, Agriculture, INS, and the IRS? Introduce alternative and more effective ways to insure our kids the best education, our farmers with fair global agricultural trade, the protection of borders and the deportation of illegal aliens no matter the circumstance, and easing incredible tax burden faced by those who have invested an inordinate amount of sweat equity into being successful in their lives while being forced to pay the majority of the tax burden?

This is a sprawling question and several of the messages in my coming platform will tie together. Let me give a brief broad stroke look.

Yes, the size of government will decrease. By MILLIONS of employees. Whole departments will be merged with others with huge portions of the work force slashed. This is America. We can't continue to feed governmental bloat and survive. So, how will I handle the immediate number of out of work citizens? Simple.

Tax reform.

First, social security will cease to exist in the ponzi scheme it is now. It will NO LONGER be a pyramid scheme where working citizens pay for retired citizens. First, there will be an opt-out provision. For example. My wife and I contribute more than $30,000 a year to our respective retirement accounts through 401K, Traditional IRA and employee matching.

We don't need social security as a safety net. So, my government will allow individuals who contribute $3,000 (adjust for inflation) to their own retirement accounts as individuals (more for married couples) they will be able to opt out of payroll taxes for social security.

Here, though is the kicker. As you know, the federal government has somehow figured out a way to make private industry shoulder much of the cost of social security by forcing companies to match dollar for dollar what one of their employees pays in. No longer. Not only will these companies not be forced to match those who opt out, but they, those who can not opt out because they chose not to privately invest will not have the safety buffer of forced charity by their corporations.

This will put a remarkable influx of money into the economy. Prices will fall. And, the best part is, we will make it the case that this money that's no longer paid to the government in taxes MUST be used for the following things:

1. Matching of employee retirement accounts -- direct giving.

2. Hiring of new employees.

3. Capital investments, growing the business.

You will immediately create cash flow that is required to be used to fund private sector, for profit, economic growth and job creation. And while you'll add lockbox function to social security as it will remain, you've essentially saved social security, created jobs, and gotten America back on track quickly with smaller government and no lack of employment opportunities.

For the rest, I will protect our borders. I will not allow illegal immigrants. I will, however, EXPAND legal immigration. Currently we allow approximately 100,000 legal immigrants a year. Many thousands of these slots is not used in a given year. We will expand this number and encourage legal immigration. Do I need to answer more here?

*Pursue legislation abolishing income taxes and championing the "fair tax" or Consumption tax to generate revenue to pay for social programs the govt. cannot now take from the masses who line up with their mouths open and hands out?

Unfortunately I believe the ship has sailed in terms of income tax. It's been 100 years. I won't be able to unring the bell. People have grown to believe income tax is somehow a necessity in this society. It's sad, but true. I can't fight that dragon. What I can do is open people's eyes.

First, EVERY single person who makes dollar in this country legally, will pay taxes. No more free rides for 50 percent of the country. ALL people will pay something. But, I will immediately work on the mental aspect of taxes. Right now too few people really know exactly what they're paying out because of withholding. I will move to end withholding. I will make people write checks out when they send in their taxes. I want them to see the numbers on that check and be stunned. I want them to physically shake at having to pay the government at the end of the year. :).

As government will be dramatically decreased in size I will be able to lower tax rates. I am not opposed to a use tax. In fact, I can see a lot of merit in that. Everything you buy is taxed at 1 or 2 percent extra going directly to the government combined with no federal income taxes.

That would be nice. But, it's a HUGE responsibility to change the country's mindset after so many years of disinformation.

*Pursue corporate fraud and prosecute those who deceive Mr. Average Joe Investor?

Yes and no. Proving knowledge in corporate fraud as we know it is costly and difficult. So, why bother. Bush had an administrative stroke of genius. Forcing CEOs to swear on the accuracy of the earnings means if they are false, whether they knew it or not, they go to jail. It's a free mechanism. It's going to scare the hell out of CEOs. And you're going to see guys take a far better look at the numbers than ever before to avoid any possibility of being punished by this simple administrative trick. I think you'll largely see the sort of fraud under Clinton eradicated now. I will be very watchful over new forms of fraud though.

*Reduce our troop deployments around the world, including the removal of troops from areas such as Germany and the reduction of troops in harms way in Iraq, Kosovo, and South Korea?

Absolutely agree. Our military should not be the world's policeman. We shouldn't be fighting for humanitarian reasons all over the place. However, as long as the Middle East is as it is, I want a Cuba like presense in Iraq for all time. I want a base of operations for staging and attacking right smack dab in the Middle East for as long as fundamentalism is as rampant and dangerous as it is in this region.

The United States has wiped out fascism and communism. We must stay strong in the fight against fundamentalism as well. It's the next great danger to the world. It has the power to unite. We need to make sure they know we have the power to destroy quickly and without hesitation in response.

I've got more... but this should get Art manhandling his keyboard.

How'd I do?

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RC,

I think it's difficult to say a use tax is unfair. If you use something, you pay taxes. That seems probably the most fair sort of tax in the world. Or, it would be as long as you don't let anything out -- like food or milk -- and it covered the entire tax base and not just the 50 percent who can't seem to fight back.

You'd have to explain why use taxes are unfair so I understand better?

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Art,

In truth, I've never seen a tax system proposed that is truly fair.

To be called a fair tax, the tax must meet certain requirements, the consumption tax does not meet them. The consumption tax treats individuals differently (the consumption tax admits this by agreeing to a kind of rebate system), is subject to arbitary whims (for example, does a church have to pay?), requires expensive collection method and is invasive (especially if you wish to deal with the first two problems). However, you could attempt to provide me with an argument as to why this is the least unfair tax (I've not been presented a convincing one).

I am also against any consumption tax as long as the 16 ammendment exists (even if it is overturned albiet then only cautious). Read Mr Hamilton's response in Federalist #86 (I believe) if you need to understand my retinence further.

As to term-limits, that was what I was willing to 'give up on' in order to get the consumption tax taken off the table (hey, we are talking politics and this is political strategem that goes back to Macheovelli). I have no qualms about this because I do not believe anyone could succeed in getting the term-limits passed without damaging the constitution (something I'm certain you'd be unwilling to do). Also, if you pursue things that reduce the size and power of the central government, you go a long way in reducing the attraction of a career in politics.

I also believe that while term-limits may make you more electable (as POTUS you'd be able to deflect any failure here for sure), support of a consumption tax would make you suseptable to demonization from all sides. Although, attempting to reduce the size of government may also open you up for the same thing (especially by the left) but I think you can deal with that and it is something that all true liberals can support.

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Originally posted by Art

Yes and no. Proving knowledge in corporate fraud as we know it is costly and difficult. So, why bother. Bush had an administrative stroke of genius. Forcing CEOs to swear on the accuracy of the earnings means if they are false, whether they knew it or not, they go to jail. It's a free mechanism. It's going to scare the hell out of CEOs. And you're going to see guys take a far better look at the numbers than ever before to avoid any possibility of being punished by this simple administrative trick. I think you'll largely see the sort of fraud under Clinton eradicated now. I will be very watchful over new forms of fraud though.

You think? As one who has devoted many (many many) unproductive hours in pursuit of Sarbanes-Oxley requirements (and will spend many more this year), I developed a more cynical view. That is, the ultimate product will actually provide the reverse, an almost perfect blanket exoneration of the guy at the top. After all, he just spent millions having everyone in the entire corporation vouch for the accuracy and integrity of company financials. I'll be interested to see if anyone ever gets convicted of anything under this rule in the absence of evidence o outright fraud.

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Jimbo,

Evidence of outright fraud is what's required right now. As we speak. By forcing CEOs to vouch for the accuracy of their records, you absolutely remove that element from the equation. You no longer would have to prove outright fraud. You'd simply have to prove the records were inaccurate and the CEO has sworn they were accurate. No outright evidence of fraud is even necessary now. This has been the problem with the system and the fraud that Clinton fostered and allowed to fester.

Under the new administrative trick, the CEO of EACH of these companies would already be in jail. The government doesn't have to prove anything anymore. They have forced the CEO to say he is personally aware of his companies earnings reports and therefore his personal well being is tied to that accuracy. Now, if HE can prove he was lied to in a conspiracy below him, he could be safe. But the burden has shifted from the government to the CEO.

And it cost us nothing to implement. Sarbanes-Oxley has nothing to do with the administrative trick the President enacted. I can see from my basic understand of Sarbanes-Oxley that like most governmental legislative reactions to a crisis that it will accomplish nothing.

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