As Sen. Mitch McConnell runs victory laps around his fiscal cliff compromise, he's also talking up entitlement reform to "avert a European-style debt crisis" and to "save the country."
Making fewer seniors eligible for full Medicare benefits in the future is one of the reforms McConnell touts as a way to preserve the popular program.
No one disputes the urgent need to rein in health care spending — by both government and the private sector. How to do it and who will bear the costs are the tricky questions.
In this debate it helps to have a legion of lobbyists and millions of dollars to shower on politicians, as a fiscal cliff subplot reveals.
The New York Times recently reported that, tucked away in the legislation that averted broad tax increases and spending cuts, is a favor for Amgen, the worlds's largest biotechnology company.
This favor will cost Medicare $500 million over two years by allowing the company to continue selling a lucrative dialysis pill without government price controls.
The surprise paragraph, which did not mention Amgen by name, reversed a policy that Congress enacted in 2008 to discourage overprescribing of drugs to dialysis patients, the Times reports.
The favor came two weeks after Amgen agreed to pay $762 million after pleading guilty to fraudulently marketing an anti-anemia drug.
One of Amgen's 74 lobbyists in Washington is Hunter Bates, McConnell's former chief of staff. Amgen's employees and political-action committee gave McConnell $73,000 in the last five years.
But Amgen is an equal opportunity giver, showering $5 million on campaigns and committees since 2007, including more than $141,000 to President Barack Obama and $67,750 to Sen. Max Baucus and $59,000 to Sen. Orrin Hatch, respectively chairman and ranking minority member of the Senate Finance Committee. (Amgen's lobbyists also include a former chief of staff to Baucus.)
Notably, no one is claiming ownership of the pro-Amgen provision.
A spokesman for McConnell said the Senate Republican leader did not push for the provision in the negotiations and that it was a bipartisan decision of the Finance Committee.
But Baucus and Hatch emphasize that the White House and Senate leadership, including McConnell, had final say on the bill.
So, what tidbits of enlightenment might be gleaned from this murk?
For one, if we sincerely want more economical health care based on best medical practices, policy decisions can no longer flow from mostly political motives, as this one appears to.
Also, before raising the Medicare eligibility age from 65 to 67, Congress should make sure that all the science-based savings have been wrung from Medicare, especially since there's so much evidence from places like the Mayo Clinic that smarter spending produces better outcomes for patients.
Raising the Medicare eligibility age would save the federal government money, but it would drive up health care costs overall by forcing seniors to buy more expensive private insurance or go without preventive care.
The provisions in Obama's health care reforms aimed at containing costs and improving outcomes have been demonized as "death panels" and bureaucratic interference in doctor-patient decisions.
But, as this episode illustrates, Americans would be better off — physically and fiscally — with policies based on clinical research and accountability than by surrendering such decisions to corporate lobbyists and the politicians who owe them.