14 July 2004

Fooled twice/The Medicare cost scandal

The Bush administration's penchant for secrecy and disinformation just gets weirder and weirder. This time the topic is not Iraq intelligence or Dick Cheney's energy task force. It is a deliberate effort by administration officials to suppress data that threatened its prized Medicare legislation last year -- an episode that should frighten anyone who believes in government integrity and representative democracy.

Readers will recall that the landmark Medicare prescription-drug bill passed Congress by a slender margin last fall, after fiscal conservatives balked at its price and Republican leaders twisted arms strenuously in its support. They might recall that a few weeks later the White House raised its estimate of the bill's cost from $395 billion to $534 billion -- an error of more than 33 percent that would have scuttled the legislation. They might recall allegations that the Department of Health and Human Services knew of the higher cost estimate before Congress voted and deliberately withheld the figure from lawmakers.

Last week the inspector general of the agency that oversees Medicare issued its own report on the episode. The report confirmed that a career professional, Richard Foster, concluded before Congress voted that the new drug benefit would actually cost between $500 billion and $600 billion. It confirmed that Foster asked permission to share his estimate with Congress. It confirmed that his boss, a Bush appointee named Thomas Scully, warned Foster not once but five times to withhold the estimate and threatened to fire him if he released it. Yet, in a remarkable conclusion that rests on an opinion from the Bush Justice Department, the inspector general concluded that Scully broke no law.

It's hard to say how Congress should react to this sort of deception. It's too late to repeal the costly Medicare plan; it's written into law, and elderly Americans are starting to use it. It's too late to fire Scully; he quit shortly after the Medicare vote and went to work for the pharmaceutical industry. Lawmakers might ask someone from the White House to appear on Capitol Hill and explain why Congress should believe anything the administration says anymore.

Of course there's nothing wrong with a presidential appointee imposing new priorities at a federal agency -- that's one reason the United States holds presidential elections every four years. It is quite another for a political appointee to muzzle a public employee who is doing the taxpayers' work, or to deliberately mislead Congress about a hugely expensive new federal program. If the Republican-controlled Congress and the Bush Justice Department won't do something about this shameful chapter -- well, that's why the United States holds presidential elections every four years.

Minneapolis Star Tribune

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