$8.3 billion buys you a lot of research.
It's almost half NASA's annual budget, and more than the National Science Foundation spends each year.
It's more than the cost to build the Large Hadron Collider (LHC), with money left over for the particle accelerator's operating costs. It's enough to build and launch the Hubble Space Telescope (HST). It's more than the cost of the Human Genome Project (HGP), and enough to fund 8,300 research grants of a million dollars each.
When you spend $8.3 billion on research, you expect to find out something good.
And $8.3 billion is what's been spent by the Obama administration on the "Medicare Advantage Quality Bonus Payment Demonstration." So what have we learned from it?
Some background: Medicare Advantage - AKA "Medicare Part C" - is a managed care alternative to regular Medicare in which the government pays private insurers for the health coverage of seniors. While popular, many people (including President Barack Obama) have called for cuts to Medicare Advantage, because it costs more per senior citizen than traditional Medicare. And, under the 2010 Affordable Care Act (ACA) - AKA "Obamacare" - that's precisely what was set to happen: Medicare Advantage would continue, but at per-senior funding levels more in line with traditional fee-for-service Medicare.
However, about a quarter of the seniors on Medicare - 12 million or more people - opt for Medicare Advantage. It has more benefits, more choice, and better preventive care. The cuts to Medicare Advantage were going to be unpopular.
However, a few months before the 2012 elections, the Obama administration decided to spend $8.3 billion to partially offset those cuts. Congress didn't authorize this infusion of funds; rather, the Health and Human Services Department (under Secretary Kathleen Sebelius) said they were funding a three-year "demonstration project" to investigate how certain payment methods affect the efficiency and quality of Medicare services.
Weird, right? The administration decides to spend billions "studying" the efficiency of payments that are being phased out. And they do it just in time to keep seniors from being upset by those cuts. (Think of it as another Obamacare waiver, which - if you like your Medicare Advantage plan - let's you keep it just a little longer.)
To make matters worse, the Government Accounting Office (GAO) - which audits the federal government - questioned not just the legality of the shift in funds, but also whether the "study" met basic research requirements. For one thing, the "demonstration project" has no control group. In other words, this research program is so poorly constructed that it's not clear if anything can be learned from it.
Although, maybe something has been learned from this demonstration project, because earlier this year the Centers for Medicare & Medicaid Services (CMS) announced that the cuts to Medicare Advantage would continue to be put off, and that funding for 2015 would actually increase. (Down the road, though, the funding picture is less clear.)
So, what on earth is going on here?
Medicare Advantage both costs and provides more than regular Medicare, so there's a legitimate cost-benefit debate about whether it should be cut. But Obama and the ACA had already decided that it should be cut, so why spend billions to study the efficacy of payments they've decided to end?
In the name of being charitable, I won't just assume that this was an attempt to keep senior citizens from voting against Obama and other Democrats in the 2012 election. But, when you spend $8.3 billion dollars in research, you need to pony up some scientific-sounding results.
The LHC has increased our understanding of quantum mechanics, just as the HST has done for the stars and the HGP has done for human genes. And they will continue to do so.
Perhaps President Obama - who promised to "restore science to its rightful place" and invest in science and technology, especially in vital areas where private enterprise dreads to go - could tell us what important scientific discoveries have been unveiled by the billions he spent researching Medicare Advantage.
Is that too much to ask?