THE BURNED OVER DISTRICT

The way it works is absolutely amazing. Sort of makes the Mind of Mencia seem the equal of Plato.

What he says is that a big increase would be the "beginning of the salvo of the encroachment of the federal government on the health care system."

Huh?

This is the president whose proudest domestic achievement was extending Medicare to cover prescription drugs, one of the biggest "encroachments of the federal government on the health care system" in American history. Honestly, it is mind-boggling that the president could say this.

And I might add that this is the president who engineered the largest federal invasion of public education in history.

But it gets worse. It also gets a little complicated, so stick with me for a second.

House Democrats want to fund an increase for SCHIP by reducing the federal subsidy for a program called Medicare Advantage that pays tax dollars to HMOs to give health insurance to seniors. It's an alternative to Medicare. The idea behind Medicare Advantage was that since large private bureaucracies are so much smarter than large public bureaucracies, it would be cheaper to pay HMOs to cover some seniors than doing it through Medicare.

Wrong.

The government now pays HMOs between 112 and 119 percent of what it costs to cover a person on Medicare. So if it costs the government $100 to cover Sadie Sickly of Illness, Ohio, the government will pay Selfless HMO Inc. $119 to take Mrs. Sickly off their hands. Selfless HMO Inc. – and lots of real life HMOs – make a boatload of money off Medicare Advantage because of this government subsidy.

The Congressional Budget Office thinks that 119 percent subsidy could be cut, and HMOs would still make money and patients would still get good services. So House Democrats want to reduce the government subsidy for HMOs to help pay for an increase in SCHIP funding. Pretty straightforward.

HMOs – surprise, surprise – do not want that Medicare Advantage subsidy to be cut. Neither does President Bush. He thinks the free market is so cool that it should be subsidized by the government.

You see, he doesn't want the government encroaching on the health care system, so he's going take your tax dollars and give them to HMOs so they can encroach on the health care system.

And if he could speak a complete sentence, who could doubt that his reasoning would be as convoluted as a plate of spaghetti, but the tomato sauce would give the spaghetti a higher IQ.