Surrealism surrounds federal payment discussions

The discussions in Washington, DC, about the future of Medicare and Medicaid have gone totally haywire.  Check out this story in the New York Times.

We'll start with the lede:

As Congress opens a politically charged exploration of ways to pare the deficit, President Obama is expected to seek hundreds of billions of dollars in savings in Medicare and Medicaid, delighting Republicans and dismaying many Democrats who fear that his proposals will become a starting point for bigger cuts in the popular health programs.

Is this some odd way of the President delivering on his promises relative to his health care reform legislation?  Remember, he said he was hoping for three things: (1) a reduction in health care costs; (2) an increase in access for people currently uninsured or under-insured; and (3) maintaining choice for people in their selection of doctors and hospitals. But, as I noted at the time:

On the cost front, the president for now seems to be confusing underlying costs with how much the government chooses to pay. . . .  Reductions in appropriations might reduce costs to the federal government, but they do not reduce the underlying costs of care. 

Well, maybe they intend to just cut the rates to doctors.  After all, each year, just before an automatically scheduled rate reduction occurs, Congress votes to defer it.  But this year for sure.  Right.

Or maybe they will change the eligibility age for Medicare.  From the Times:

In negotiations with Congressional Republicans in July, Mr. Obama went further. He indicated that he was willing to consider a gradual increase in the age of eligibility for Medicare . . .

Gee, we've come a long way from proposals that might have decreased the age of eligibility.

. . .  and cuts in federal payments to states for Medicaid. 

The head of the New York Hospital Association explains:

Further cuts in the growth of Medicare and Medicaid would not only impair access to care, but also lead to job loss in the health care industry, directly contravening the president’s goal of job creation.

I have made this point, too:

With 50% of American hospitals operating at a deficit right now, it is hard to imagine how a reduction in federal payments . . .  deals with the cost problem. 

It isn't often that I hope for gridlock in Washington, DC, but these folks seem so confused about what's up that paralysis might be just what the doctor ordered.