The so-called savings are a bit of a shell game. Two-thirds of the Medicare doc fix is paid for with $4.2 billion trimmed from Medicare payments to hospitals—in other words, taking from one pocket and putting it into another. Are the hospitals going to play along? Or are they going to demand a “hospital fix?”

With the $245 billion “doc fix” added in, the deficit for federal healthcare spending over the next ten years will run to $472 billion.