From: Chairman [redacted] of the [redacted] Committee
To: Healthcare Reform Drafting Group II
Re: Finessing the Health Plan Deficit
( This is a Class I rice-paper memo. )
The estimated deficit for our health reorganization plan is causing us trouble in the press. President Obama has promised not to raise taxes on the middle class, and not to increase the deficit. Unfortunately, we have to live with this until the plan passes Congress.
After passage, we will spend what it takes, just like the last times.
Please hold off on more complexity. I asked for enough boards, committees, commissions, and regulators to confuse things and distract our opponents. You went overboard, but that is not a big problem. Just don't add more.
(Jim, that advisory commission on do-it-yourself birthing is out. I know it would save money, but it is out for now.)
Here is how we will handle the cost. Pick a big cost to convince people that we are serious. Too small looks like we might be hiding things. (If they only knew.) Keep it under $1 trillion over 10 years. That seems to be the right psychological price point for the public.
Now, this is how we will "pay for it". Assign whatever fees (not taxes!) you want against insurance companies, big businesses, and "private" doctors. Make the fees big enough to cover the entire added cost of the plan. Yes, even if you think we can't raise that much money from those fees.
The Congressional Budget Office will score the plan based on the fees we say we will raise. They will find that the plan is covered, and that is all we care about. We have convinced the public that only deficits matter, not the actual cost.
Our opponents will express doubt that we can collect all of the money we say we will. But, that is just their opinion, and the CBO will go along with us.
So, we will have a plan that does not increase the deficit, and there are no taxes on the middle class, only fees on evil companies and rich doctors.
To Fred: Yes, the fees would be passed through, and effectively would be a tax on employees and patients. I appreciate your insight. Forget about it. We will be rearranging everything in any event, after the bill is in effect for a while.
Good work everyone. Just a few more all-nighters, and we will get this thing passed. Remember that there are enough boards, committees, commissions, and regulators to provide plum assignments for all of you.
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