Republicans See the First Entitlement Reform in Decades Over the Finish Line

There is a lot wrong with Washington. Of that there can be no doubt. But there is a good case to be made that there is more wrong with the press entrusted to cover our nation’s capital.

The perfect example (which in this case means the worst example) came last week when Congress passed one of the most significant bipartisan bills in recent memory and yet the media opted to spend much more time analyzing Hillary Clinton’s trip to Chipotle. No really.

The New York Times called Clinton’s order “above average,” a conclusion they came to by assuming she ordered certain things and then comparing the calories in her fantasy meal to the average American’s order. What’s next for the Grey Lady, listicles?

Sadly, that was far from the most ridiculous coverage angle. The Wall Street Journal attempted to asses whether her choice of Chipotle over the Taco Bell next door had political implications. Bloomberg did an in-depth interview with the Chipotle manager, which revealed she didn’t leave a tip (gasp!). POLITICO did a profile piece on the workers at the Chipotle and their take on the pay and working conditions in fast food. Vox chimed in to assess whether the food Chipotle serves is “really Mexican.” Fox News attempted to discern whether this was an attempt at Hispanic outreach after Rubio announced his candidacy. And CNN thinks that Hillary’s choice is a sign that McDonald’s is the “brand of yesterday,” and this shows her need to eat at places like Shake Shack and Panera in order to woo Millennials.

We literally know everything there is to know about Hillary Clinton’s trip to a random fast food restaurant, something she’s likely to do dozens more times over the campaign cycle, and yet I dare say that Americans know almost nothing about the first significant entitlement reform in decades: The long-term fix for Medicare’s physician payment rates.

I know, I know, just the sound of it is enough to make you yawn, but it’s important. Back in 1997 Congress passed a law to slow the growth of Medicare by tying how much the federal government reimbursed physicians to a formula based on economic growth. The problem is that health care costs have risen much faster than GDP, which led doctors to feel underpaid and threaten to leave the program unless Congress stepped in to undo those reductions.

Since 2002 Congress has stepped in 17 separate times to stop the payment formula from kicking in, which would have dramatically decreased pay. The longer Congress punted, the bigger the gap between health care costs and GDP, the bigger the potential cut that doctors faced, and the more money Congress had to find to fill the hole.

If that sounds like a lot of rigmarole just to keep up the façade that Medicare’s future funding was more sustainable than it was, you’re right. Fortunately, Republicans were able to negotiate a bill that would put the program on a more sustainable course, achieve long-term savings and shift Medicare’s incentive structure away from providing lots of unnecessary health care. Noam Levey reports for the LA Times:

In place of the old limits, the legislatCion allows fees to increase 0.5% annually over the next four years.

Potentially more important, the bill creates new incentives in Medicare to pay physicians based on their performance, rewarding doctors who hit quality targets and whose patients get healthier and effectively penalizing those who do not. . .

What emerged was a classic compromise that requires trade-offs from both parties.

To offset some of the more than $200-billion cost of the package, Democrats agreed to minor increases in cost-sharing for Medicare beneficiaries. . .

For their part, Republicans agreed not to offset most of the cost of the compromise, which was estimated to add about $140 billion to federal deficits over the next decade.

To many fiscal conservatives that last part will no doubt sound ominous. And it would be, if Congress hadn’t long ago committed itself to the charade that the punitive cuts to doctor payment rates were every going to be achieved. But they weren’t, and this long-term fix, though far from a perfect solution, is much better than the gimmicky offsets that Congress adopted in recent years to “offset” the costs.

“Make no mistake, this bill hasn’t fixed all of our fiscal problems or saved Medicare completely,” Speaker John Boehner frequently admits. “We all know that much more must be done to save our entitlement programs, but we have to start somewhere.”

“Conservatives should be happy we got this done, and confident Republicans will continue fighting to curb Washington’s worst habits for the sake of our children’s future,” Boehner continued.

So long as that promise is upheld then this bipartisan plan to come up with a long-term replacement for the doc-fix is a win by any metric. Now if only the bill signing could have been held at a Chipotle so it could have received some coverage.