ObamaCare has been defined by one con after another, from inception to implementation, from political kickbacks to "keep your doctor."  Only a Supreme Court thumb on the scale allowed the law to even see the light of day.

And now we continue to find out "what is in it."  Kimberly A. Strassel, writing in the Wall Street Journal, exposes yet another scheme buried in the bill, this time by Senator John Kerry.

Prior to ObamaCare, Strassel notes, each state was allocated Medicare wage reimbursement funds to "divvy among their hospitals," with Medicare rules requiring that a state's urban hospitals be reimbursed at least at the level of its rural hospitals.

But Strassel reports that Kerry "slipped an opaque provision" into ObamaCare that required the Medicare reimbursements to come from a national pool in place of state allocations:

The Kerry kickback didn't get much notice, since it was was cloaked in technicality and never specifically mentioned Massachusetts. But the senator knew exactly what he was doing.

You see, "rural" hospitals in Massachusetts are a class all their own. The Bay State has only one, a tiny facility on the tony playground of the superrich-Nantucket. Nantucket College [sic] Hospital's relatively high wages set the floor for what all 81 of the state's urban hospitals must also be paid. And since these dramatically inflated Massachusetts wages are now getting sucked out of a national pool, there's little left for the rest of America. Clever Mr. Kerry.

[The actual hospital name is Nantucket Cottage Hospital.]

The Boston Globe's Tracy Jan reported on the "Bay State boondoggle" a few weeks ago, observing that Massachusetts had bilked the system for "more than $250 million in bonus Medicare payments to the state's hospitals."

According to the Globe, New Jersey Democrat Senator Robert Menendez was also behind the Medicare pool provision, although Massachusetts reaped most of the benefit.

Massachusetts Democrat Representative Edward Markey, who is running in a special election this week for Kerry's Senate seat, is defending the Kerry-Menendez handiwork, with the curious defense by the Massachusetts delegation that a bill to end the scheme would "unfairly" target Massachusetts.

The Globe also recounted the observation of one Dr. Donald "ration with our eyes open" Berwick:

... the payment system is so complex that it's highly "susceptible to gaming and manipulation."

"It's a zero-sum game," Berwick said. "What Massachusetts gets comes from everybody else."

Strassel reports that a hospital group says the fleecing could reach $3.5 billion over the next ten years, and that 68 senators, including 23 Democrats, voted for an amendment to "kill the Bay State fleecing" as part of a non-binding budget resolution last March. 

Illinois alone has already lost $60 million to the Medicare pool scheme, and big losses across other states have led to an effort now underway to get a binding vote on the matter.

The upshot of all this, according to Strassel, is that:

... [v]ulnerable Democrats, under pressure from home-state constituencies, want to look willing to "fix" or "improve" parts of a wildly unpopular health law that they supported. This has provided Republicans with the opportunity to recruit them for bipartisan votes to repeal parts of the act.

That template is worth remembering as the law flails ahead into a no man's land of soaring premiums, rickety health exchanges and expensive mandates and taxes... And a lot of members are going to be looking for cover.

Human nature in the halls of state hasn't changed in the 400 years since Shakespeare said "there is something rotten in the state of Denmark."