Lobbying Reform and Other Fantasies

Now that people have taken a look at Hastert's proposed reforms, it becomes clear that the big problem with the current arrangement is that it didn't require that actual money change hands.

According to lobbyists and ethics experts, even if Hastert's proposal is enacted, members of Congress and their staffs could still travel the world on an interest group's expense and eat steak on a lobbyist's account at the priciest restaurants in Washington.

The only requirement would be that whenever a lobbyist pays the bill, he or she must also hand the lawmaker a campaign contribution. Then the transaction would be perfectly okay.

The proposal leaves 'campaign finance' alone, so that as long as any activity is labelled a campaign fundraiser, it's full speed ahead.

Meanwhile, across town at the White House, they've gotten the message that the horror stories about the transition to the new Medicare drug coverage need some attention. According to administration standard operating procedure, they are rushing into action, not to actually fix it, but to talk the press into submission.

President Bush's top health advisers will fan out across the country this week to quell rising discontent with a new Medicare prescription drug benefit that has tens of thousands of elderly and disabled Americans, their pharmacists, and governors struggling to resolve myriad start-up problems.

What will these advisers be doing? Manning pharmacy counters? Issuing on-the-spot authorizations for payments? Hardly.

The Washington Post's reporter manages to give us a clue about the kind of thing we should expect to be hearing.

In a call with reporters, [Health and Human Services Secretary Mike] Leavitt said enrollment in the program, called Medicare Part D, exceeded expectations and put the administration "well on track to meet our goal of enrolling 28 to 30 million in the first year." Last year, officials predicted 39 million seniors and disabled people would participate, according to documents published in the Federal Register on Jan. 28, 2005.

In the past month, 2.6 million people have signed up for a drug plan. Seniors have until May 15 to enroll.

Even as federal leaders touted the enrollment figures, state officials and health care experts continued to report widespread difficulties, especially for the poorest and sickest seniors who were forced to switch from state Medicaid programs to the new Medicare plans on Jan. 1. Nearly two dozen states have intervened, saying they will pay for medications for any low-income senior who is mistakenly rejected.

The large majority of people counted in those enrollment numbers were people who already had drug coverage. Of those who were covered by a government plan under Medicaid, tens of thousands have had problems.

For many people, regular medication is the only thing keeping them out of the hospital with life-threatening conditions, at additional expense. When their prescription runs out, the clock starts ticking, and it's hours, not days before they need the ambulance, a hospital bed, doctors and nurses. This isn't a situation where it's morally or economically acceptable to say "Whoops. Well, we were close. We'll get it figured out real soon now." Getting people enrolled shouldn't be the measure, getting people their medications should be the measure. They have failed miserably.

Nothing that has happened is something that hadn't been predicted by observers well in advance, and it could have been avoided with planning and foresight. A GAO report in December gave plenty of reason to doubt the transition would go smoothly. The administration responded to a draft, as cited in the final report(pdf):

In its comments, CMS objected to any implication that it has not taken all steps to keep potential problems to a minimum. Furthermore, the agency asserted that its contingency plans fully address the problems we describe and that they will ensure that dual-eligible beneficiaries will have immediate access to needed drugs. While we credit CMS for taking steps to mitigate potential risk for dual-eligible beneficiaries, we believe that the agency’s complete confidence in contingency plans that have yet to be fully tested, publicized, or implemented may be premature. Our report provides valid reasons why the effectiveness of these plans is uncertain at this time.

Hmm, that sounds familiar, doesn't it? 'Trust us, we've got it under control, we know what we're doing', despite clear evidence that they are wrong, and that they have no basis for such confidence.

This isn't just an honest mistake. This is, yet again, arrogance and incompetence to the point of being criminal.

For all Mr. Bush's protestations about keeping us safe, thousands of poor elderly Americans are at risk, and the greatest threat to their life is the Federal government.