The Health Reform Cookie Monster and You

May 13, 2011 - The following essay of mine appeared in the May issue of Connecticut Medicine. I reprint it here because it addresses the major issue of the budget debate, Medicare reform. The debate kicks off this week. Its outcome may determine the outcome of the 2012 Presidential election.

The Cookie Monster

Me want cookies? Me eat cookies! Me eat anything and everything!

The Cookie Monster, Sesame Street

The new health reform law's cookie monster will always be eating. Its appetite is insatiable. It will eat in broad daylight. It will eat at night. It will eat behind closed doors. It will eat your lunch. It will eat your dinner. It will eat your assets. It will eat the national budget. It will eat 24 hours a day, 365 days a year. It will always be raiding your cookie jar. It will eat things you are not even aware of. It will even eat your money.

• Starting in 2013, if you earn more than $200,000 as an individual or $250,000 as a couple.

. It will eat 1.45% to 2.35% of Medicare Part A.

• That same year in that same group, it will start eating 3.8% of your “unearned income” – investment proceeds from partnerships, royalties, and rents.

• Between now and 2018, if you are an insurance plan bogeyman, it will eat $47.5 billion. After that it will eat $14.3 billion a year. Along the way, you will be emptying your cookie jar to pay more for premiums.

• Through 2019, it will eat $16.7 billion out of drug company proceeds, and $2.8 billion a year thereafter, causing you to take more out of your cookie jar to pay for drugs.

• It will eat $2 billion a year out of the profits of sales of medical devices- pacemakers, prosthetic limbs, and insulin pumps - more out of your cookie jar if you need these things.

• On July 1, 2010, it began eating 10% out of the profits of tanning salons.

• In 2018, it will tax and eat 40% of the costs of Cadillac health plans.

• It says it will even eat its own entitlement, though it has never eaten an entitlement before. Federal cannibalism is unknown. Yet,from 2010 to 2020, it says it plans to eat $549 billion out of Medicare by eating away at Medicare Advantage plans and payments to doctors and hospitals.

• From 2014 to 2024, it will eat $2.5 trillion out of the federal budget.

What a cookie monster is health reform! It is like a big baby- an alimentary canal with a huge and growing appetite at one end and no end in sight at the other. It keeps saying,”Me want cookies!” The trouble is: its cookies are your cookies too.