The Senate was forced to concede ground on health care reform yesterday, as the “doc fix” legislation was defeated. The Baucus Bill, which was scored by the CBO at $891 billion, made use of some fiscal sleight-of-hand, building in an unrealistic assumption that doctors’ reimbursement rates under Medicare will be slashed by 25% beginning in 2011. Unfortunately, this “sustainable growth rate” provision has been overridden by Congress every year since 2003, a trend that is likely to continue (so physicians who accept Medicare, already paid at low rates, don’t drop out of the program altogether.)

The “doc fix” was intended to appease the American Medical Association by repealing the sustainable growth rate – but in keeping it as separate legislation, on paper the fix would not drive up the cost of the original Baucus Bill. Fortunately, a slim majority of Senators saw through this shell game and vetoed the legislation.

It shouldn’t be too much to ask Congress to tell the truth on its cost estimates – but then again, it’s not like the government has a great track record on accurate forecasting, as this Joint Economic Committee study from July 2009 points out