The Congressional Republicans have once again shown they are the party of redistributing wealth--
from their enemies to their friends:
For decades, Medicare has used formulas that pay more than average per patient to hospitals in large urban areas and to those with high labor costs, and less to those in rural areas and in places with lower labor costs. The bill passed by Congress narrows or eliminates those distinctions by raising rates for lower-paid hospitals, a change that accounts for nearly all of the $13.5 billion. Those and other formula changes will send no money to New York City, and very little to its suburbs.
Members of Congress from rural states portray the change as a matter of fairness, redressing a longstanding inequity. Their urban colleagues, and some from the suburbs, say it ignores real regional differences in the costs of health care.
It's funny how we never hear talk about using a per capita basis for spending on, for example, farm subsidies. To be fair, though, there are problems with rural health care in the United States. But that's not what this bill is about--to quote Tom DeLay from an earlier discussion about redistributing federal wealth from Democratic-leaning areas to Republican-leaning areas for no reason other than partisanship, "To the victors go the spoils."
In all, by the Finance Committee's analysis, hospitals in New York State, the most financially troubled in the nation, will receive $479 million in additional Medicare payments. More than $400 million of that will go upstate. Hospitals in New Jersey will get $102 million, and those in Connecticut, $28 million, and there again, less densely populated areas, in eastern Connecticut and southern New Jersey, will fare best.
By comparison, Texas, with a population similar to New York's, will receive the largest sum, more than $1.1 billion. And some smaller states will receive more than Texas, relative to their sizes: $738 million for Alabama, $551 million for Louisiana and $518 million for Kentucky, to name a few.
This redistribution of federal tax dollars from Democratic to Republican areas has been going on for years. Some disparity in pork spending between the parties is to be expected; in 1994, when the Democrats last controlled both chambers of Congress, districts represented by Democrats received an average of $35 million more federal expenditures than districts represented by Republicans. But the Republicans have turned the typical distribution of pork from the trough into a grotesquery; Republican districts now receive an average of $612 million more than Democratic districts, even after adjusting for inflation.
There are several reasons that more money goes to Republican than to Democratic states and districts, such as where we base our military units. But a simple fact is that Gore states receive an average of $0.87 in federal spending for every dollar of federal taxes they contributed to the treasury, while Bush states receive $1.12 for every federal tax dollar they contribute--and it's getting worse. Between 1992 and 2002 34 states saw an increase in federal expenditures in relation to taxes contributed. (Much of this burden was born by two states--California's ratio went from $0.93 per dollar of taxes in 1992 to $0.76 per dollar in 2002, and Massachusetts went from $1.01 to $0.75.) How did the "donor states" and "recipient states" vote in the last Presidential election? Of the 34 states that receive more federal expenditures than they collect in revenue, 24 voted for Bush. Among the ten won by Gore were the states (except Florida) that he won by his narrowest margins--OR (.0048), IA (.0032), WI (.0022) and NM (.0006, just 363 votes).
No doubt the Bush and DeLay political teams knows these figures, and that's surely one of the reasons why Medicare spending is now going to start tilting to regions based on which party represents its citizens in Congress and how likely they are to vote for George W. Bush next November.