Smart bombs: Look beyond earmarks

It seems the smaller a budget item is, the more outrage it provokes. We need a name for this. Backward Budget Bloviation, or something like that. It used to be money for foreign aid or the National Endowment for the Arts that triggered this syndrome. Now, the trendy sliver of the federal budget is earmarks.

As you’ll recall, earmarks took center stage in the presidential campaign, as U.S. Sen. John McCain routinely rapped them, while his running mate slinked away from Alaska’s inordinately smelly pile. After President Obama signed the $410 billion omnibus spending bill last week (with all of the correct noises against earmarks), the bold protectors of taxpayer money took the microphones to denounce 1.7 percent of the package.

I’m all for earmark reform, but the idea that it’s going to solve any big budget issues is baloney. But apparently it makes for good TV, because news networks loaded up on stories, complete with cute little drawings of pigs and ears. Meanwhile, Obama’s plan to rein in Medicare costs flat-lined with producers. Guess the numbers were just too big to be interesting.

According to the Congressional Budget Office, bringing Medicare Advantage payments in line with regular Medicare “would save $54 billion over the 2009-2012 period and $149 billion over the 2009-2017 period.”

Now that’s a bridge to somewhere.

Medicare Advantage was introduced as a way to bring private enterprise and competition to the government health care program for the elderly in the hopes that it would lower costs. It didn’t work out that way. Instead, Medicare Advantage spends $1.30 for every dollar spent on regular Medicare. Insurance companies love this subsidy, but there is no correlation between this increased spending and positive outcomes for patients.

You’d think self-described budget hawks could get interested.

U.S. Sen. Charles Grassley, R-Iowa, used to be chairman of the Appropriations Committee, so he knows a lot about government spending. He suggested Obama veto the spending bill because of the $7 billion in earmarks, but he defends the much larger Medicare Advantage subsidy. He’s also a fierce proponent of wasteful corn ethanol subsidies, which just happen to benefit his home state.

The Dartmouth Institute for Health Policy estimates that about 30 percent of U.S. health care spending could be zapped without hurting quality. That works out to about $700 billion.

Cut it to $7 billion and maybe somebody would get angry.