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The GOP budget, fiscal responsibility, and Part D

Rep. Paul Ryan (R WI) and the House Republicans are touting their budget as fiscally responsible and prudent. What Mr Ryan conveniently forgets, or more likely avoids, is this:
Eight short years ago he – and his GOP buddies – passed the single largest entitlement program since Medicare – the Medicare Part D drug benefit – with no dedicated financing, no offsets and no revenue-generators – the entire future cost – which is now around sixteen trillion dollars [see page 148] – simply added to the federal budget deficit.
According to Bruce Bartlett writing in the Fiscal Times, “By 2030, Part D alone will cost taxpayers 1 percent of GDP.”
There’s a legitimate argument that health reform is going to add additional cost, and will require additional revenue. Let’s accept the GOP’s claim that health reform will add $700 billion to the deficit. That’s one-twentieth of the deficit from Part D.
That’s right – Paul Ryan’s Part D added twenty times more to the Federal deficit than even he claims reform will. Yet the GOP budget he wrote doesn’t include any provisions to end, or fix, or reduce Part D.
Notably, the President’s budget proposal doesn’t address long term costs of Part D either – and yes, that’s a serious problem.
Folks, we have a BIG deficit problem. If we aren’t deadly serious about what we need to do, we’re screwed. Whether you’re a conservative or liberal, Glenn Beck-er or Rachel Maddow fan, red stater or blue stater, there are basic, immutable facts.
Part D’s $16,000,000,000,000.00 ultimate cost is one of the more obvious.
It would have been more than refreshing if Ryan and the Republicans’ budget was more financially responsible, more old-style fiscally-conservative-Republican. That would have been courageous – admitting he and his party made a mistake. Sure, they would’ve taken a hit from older Americans who love Part D, but true statesmen, real leaders know that tough, unpopular stands are necessary some times
Ryan’s blatant hypocrisy reveals that he – and his party – don’t care one whit about the deficit or budgets or fiscal responsibility. Nope, they just want to get re-elected.
What should we do?
Either a) end Part D or b) allow the Feds to use their buying power to negotiate with pharma. That alone would save about $20 billion a year.

Canceling Part D won’t happen; neither party is about to tell seniors they can’t have free medicine. If Ryan et al were really concerned about the deficit, they’d consider using the government’s buying power to reduce costs and thus lower the deficit. But of course they won’t; that would alienate big pharma and cut into their campaign contributions.

One thought on “The GOP budget, fiscal responsibility, and Part D”

  1. Joe,I agree with you that no one is addressing the very real cost of Part D and you correctly describe how it can be addressed and remain viable. However, Ryan’s budget also calls for massive increases in defense spending and if you read Rachel Maddow’s new book, ‘Drift’ it’s easy to see how much we can easily cut from our military budgets and not have any negative impact on our national security or defense. The billions of dollars wasted trying to bring Afganistan out of the 16th century are billions we can easily cut without any negative impact. To build water treatment plants that never work, or schools that are simply destroyed by the local governments, or roads that lead no where and serve no purpose to the nomadic tribes is in my opinion foolish and a waste of resources by a country that again foolishly believes the entire world should look like the U.S. with endless big box stores and ugly neon.

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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