(Update: please see this Editor's Note, from me, about the memo and its origins.)

As Democratic momentum continues (Sam Farr is now a yes vote, for example), a bit of a scoop for House Republicans, though it probably won't be enough: they've obtained a memo from senior Democratic spokespeople to other Democratic spokespeople urging them to avoid talking about parts of the health care debate that are a mite inconvenient to the notion that the overall reform will be deficit neutral.

 (Read it here: 20100319100051579.pdf) Specifically, of course, the "doc fix" -- known internally as "SGR," for "sustainable growth rate."  Basically, Medicare's physicial reimbursement system will create liabilities of more than $330 billion over ten years. So the Democratic document warnspress secretaries in boldface type: "The inclusion of a full SGR repeal would undermine reform's budget neutrality."  


Why yes. Yes it would. That's why members should "focus only on the deficit reduction and number of Americans covered."

Elsewhere, the document notes that the preliminary CBO estimate released yesterday doesn't include certain discretionary spending items, so "Do Not Give Them Ground By Debating Details."

Democrats do have responses to all of this: the doc fix will be fixed later in the year -- though in a way that may cut payments to doctors --  and it won't in and of itself contribute to long-term deficits (unless it isn't fixed), and in any event the health care legislation is as honest an attempt to extrapolate costs as there's been.  

Still, it's never good to admit that you've got to fudge a bit to keep a handle on the talking points.


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