All the earmarks of a fool
By A TIMES EDITORIAL
Published August 15, 2007
"The trouble with this country is that there are too many politicians who believe, with a conviction based on experience, that you can fool all of the people all of the time." Franklin Pierce Adams
Congressional Democrats promised they would end the practice of secret earmarks, in which individual members add something to a bill that helps an influential constituent back home. They even passed an ethics rule that says pet projects hidden in legislation will be disclosed before a vote. As legendary newspaper columnist Franklin Pierce Adams warned, however, if you believe that you're being played for a fool.
A major bill to expand health care for uninsured children and boost Medicare benefits was loaded with earmarks in disguise, nearly all for Democratic members who revealed nothing before the bill passed. A New York Times analysis of the bill found that giveaways to individual hospitals worth hundreds of millions of dollars were written in code that was not all that difficult to crack.
To divert more Medicare money to one hospital, the bill contains this language: "Any hospital that is co-located in Marinette, Wis., and Menominee, Mich., is deemed to be located in Chicago." Only one hospital matches that description - Bay Area Medical Center, which serves the two bordering cities more than 200 miles from Chicago.
By magically moving the hospital to Chicago, at least on paper, the author of that language, Rep. Bart Stupak, D-Menominee, would boost the hospital's Medicare income by millions of dollars. That's because 70 percent of the amount Medicare pays a hospital is based on labor costs in the community, which are usually higher in large urban areas such as Chicago.
In the same way the bill would up the reimbursement rates for any New York hospitals that share a "single unified governance structure" and are less than 3/4 of a mile apart in a city with no more than 30,000 and no fewer than 20,000 people. Could that be Kingston and Benedictine hospitals in Kingston, N.Y., population 22,828 and represented by Rep. Maurice Hinchey, D-Hurly, N.Y. (just down the road from Kingston)? Yes, those are the only hospitals that fit the description, and they are now considered to be in New York City, more than 100 miles away, for Medicare billing purposes.
No hospital is named in the bill, yet it moves several to sometimes distant urban areas by adding a description that fits only one hospital, such as hospital number 360112, which is the Medicare provider number for St. Vincent Mercy Medical Center in Toledo, Ohio. Democratic Rep. Marcy Kaptur (guess where she's from) justified making her city part of the Ann Arbor, Mich., labor market 40 miles away because St. Vincent "is a source of good jobs."
Job creation isn't one of the legitimate reasons for raising a hospital's Medicare reimbursement rate. Neither is being an influential legislator or a member of the ruling party. (Republicans did the same thing when they were in charge.)
The harm done by such chicanery is that this is a very important piece of legislation, particularly the part that would expand medical coverage for uninsured children. As for Medicare, certainly the reimbursement rate for doctors and hospitals is a legitimate issue, particularly at a time when hospital revenues are being squeezed. Yet these not-so-hidden earmarks appear to be nothing more than "hospital pork," as critics call them.
What House Democrats have done is cast themselves as hypocrites and given President Bush another excuse to veto the bill if these projects survive in negotiations with the Senate. Looks as though Democrats are the fools this time.