A new ad from a dark money group, One Nation, associated with the one-time master of political duplicity, Karl Rove, paints Roy Blunt as a stalwart defender of Medicare. The same group tried to scam Missourians last fall with a message about how Blunt, who usually comes off as a slick Washington operator, really cares about the folks at home, veterans in that case. The motivation for both ads is probably the fact that Blunt seems to have a real competitor this election year. And it follows that this new ad is as bogus as the earlier one.

The new Medicare ad reflects widespread concern about a proposed trial of a new Medicare reimbursement formula – and, on the part of Republicans, no doubt, opposition to anything put forward by the Obama administration. Democrats are also concerned, but willing to critique and, if necessary, improve the proposed experiment.

As Politico describes it, “the Obama administration’s Medicare experiment would test whether the program’s payment system encourages doctors to prescribe more expensive drugs, since they’re paid a set percentage of a drug’s price — therefore getting more for a higher-cost drug.” It’s potentially a big deal since, according to Politico, “Medicare’s Part B program spends nearly $20 billion on drugs every year, and advocacy organizations are pouring millions of dollars into campaigns for and against the experiment.” Pouring money, did they say … enter Roy Blunt.

The issue is not black or white. The experiment has its advocates as well as its detractors within the affected communities:

Peter Bach, a Memorial Sloan Kettering researcher and drug pricing critic, told POLITICO’s podcast that Medicare’s planned pilot is a necessary reform. He argued that lobbyists have dramatically distorted the administration’s goal of reducing doctors’ incentives to prescribe high-cost drugs.

“This has been a highly coordinated effort to misinform the electorate, to frighten patients and to misinform policymakers about even the basic math,” Bach said.

Ted Okon, the executive director of the Community Oncology Alliance, countered that Medicare’s pilot is a dramatic overreach that would short-change doctors. He also warns the overly broad scope of the Medicare experiment could set a precedent for a future president — say, Trump — to circumvent Congress to make changes to Obamacare.

“If this is not changed appreciably, the only recourse will … be to pursue legal action,” Okon said. “There’s too much riding [on it]. It’s not just a reimbursement cut.”

Bach argued that Medicare’s current reimbursement system is set up to reward doctors, like oncologists, when they prescribe more expensive medicines. And whether that’s a good idea depends on how you view the doctor’s role, Bach said.

“Do you view them as a real estate broker,” he asked, “where if the real estate broker sells an expensive house, they make more money than a cheap house? Or do you view them more like the UPS delivery guy — it doesn’t matter what’s inside the box, whether it’s a stuffed bunny or a bunch of diamonds, they get paid the same amount to bring the box.”

Bach thinks it’s time physicians move toward the latter model, arguing that reducing doctors’ incentive to prescribe high-cost drugs would help tamp down drug spending, the fastest-rising sector of health care.

Okon cautioned that changing how doctors get paid could backfire and potentially keep patients from receiving drugs they need.

I’m a cancer patient so I’ve got, to use one of the GOP’s favorite terms, skin in the game. I trust my doctor and I’m not too concerned about the new proposal. I’m sure, based on my own research, that the drugs used in my chemotherapy are bedrock for my diagnosis, and, when they no longer work – a likely development with my type of cancer – I can’t see that this provision will prevent me from getting the drugs I need to combat my disease. I should also add that my experience with Medicare during my treatment has been excellent.

Roy Blunt’s advocacy for the status quo – and, incidentally, the folks lobbying to preserve a generous revenue stream – makes me even more skeptical about whether or not the revised rule’s impact will be negative. Why? Just consider Blunt’s past record on Medicare. After all, he’s the guy who said Medicare never made anyone healthier and that establishing the program was a mistake. Most recently, he cut money from the Medicaid program that helps vulnerable seniors navigate the program:

The State Health Insurance Assistance Program (SHIP) that provides seniors with a better understanding of Medicare and saves them millions, would be eliminated by a budget bill approved by the Senate Appropriations Committee, reported Kaiser Health News. In a statement by Sen. Roy Blunt (R-MO), chairman of the appropriations committee’s health and labor committee, said that ending SHIP could save $52 million and would help pay for a $2 billion increase for the National Institutes of Health, increase resources for opioid abuse prevention, and restore year-round Pell Grants. “Medicare is very complicated,” said Howard Bedlin, vice president for public policy and advocacy at the National Council on Aging. “Last year SHIPs helped 7 million people navigate this program and without those services, people will not be able to make well-informed choices. That’s going to cost them money.”

I’d say that when it comes to this newfound zeal for Medicare, Blunt ought to put his mouth where his money is except that he seems to be doing just that when you consider that health care industries that stand to loose money by these new rules are also big Blunt campaign donors; health industry PACs have gifted him with $174,000 this cycle alone. Absent that incentive, as his stinginess in regard to the SHIP program indicates, he isn’t that interested in helping folks on Medicare. As this new ad campaign underlines, Roy Blunt may be putting his mouth where his money is, but he’s also trying to confuse seniors about there that “is” is.