Policy

Obama: "When Medicare was started, it was a small program. It grew." You don't say!

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Don't you just love it when Obama gets his compromise on? From today's presser:

It's a big, diverse country and people have a lot of complicated positions. It means that in order to get stuff done, we're going to compromise.  This is why FDR, when he started Social Security, it only affected widows and orphans.  You did not qualify.  And yet now it is something that really helps a lot of people.  When Medicare was started, it was a small program. It grew.

I take it Obama intends this as a defense of political compromise and starting small. He's doing that bipartisan thing he does, where he explains how the system works, the limits it imposes, and how he plans to work for the good within it anyway. If you like presidents who, as Obama said, "get stuff done," you are probably eating this like extra buttery movie-theater popcorn, (which, like lots of presidential rhetoric, is a form of cheap junk food doused in gooey, goopy flavoring that always ends up costing way too much money – but somehow lots of people love it anyway).

The growth of Medicare, though, is hardly something to brag about.

Sure, Obama is right on the facts: The program started far smaller than it is now, and it grew – and grew and grew and grew, like some mutant, money-sucking,  fairy-tale beanstalk that no one in Congress had the strength to cut down. The rapid growth wasn't just some manageable result of the program becoming a more mature, either.  Instead, it was wracked by serious cost problems from year one. Those cost problems became a significant public policy issue – enough to attract Senate committee attention – within just three years of starting operation.

Cost estimates prepared by the House Ways and Means Committee assumed that if 95 percent of eligible seniors signed up in the first year, the maximum total cost would be about $1.3 billion. They were right about the high enrollment figure. But total cost? Not so much. The program's first year cost was $4.6 billion –nearly four times as high as projected. That wasn't a one-time spike either; from there on out, total spending continued to pull away from the estimates. In 1970, for example, the committee had projected that hospital spending alone would amount to just $3.1 billion. Instead, the tally came in at $7.1 billion. In 1975, hospital spending was expected to come in around $4.2 billion. The actual price? $15.6 billion.

Since then, bureaucrats have tried a slew of complex schemes to keep payments in check. But in the long run, none have really worked; Medicare continues to snarf down money while screaming "Feed me, Seymour!" at any Congress-person within earshot. Now even entitlement-hating Republicans are terribly, terribly afraid to touch it. Which is why ObamaCare includes an independent board tasked with capping Medicare spending at just above the growth of GDP. Maybe it will work this time! Right?!!?!?