Category Archives: Medicare

We Like It, We Really Like It

“Consider these numbers from a Kaiser Foundation poll from last week. Percent who like the ACA’s extension of dependent coverage: 76. Percent supportive of the act’s closing of the Medicare drug “donut hole”: 73. Percent favoring “guaranteed issue” of coverage to people who are already sick: 69. Percent who back the Medicaid expansion: 62.

“Oh, wait. Those are the Republican percentages. The overall percentages, respectively, are 80, 79, 70, and 74.

“It’s the same old disconnect. Just as majorities of even rank-and-file Republicans support things like restricting the gun-show loophole (indeed a majority of NRA members support that), majorities of Republicans back these and other basic common-sense provisions of the ACA. And yet these same Republicans keep reelecting to Congress a horde of dishonest and ideologically driven harlots who’ve voted 50-whatever times to do away with all these positive changes.

“Here are two other numbers from the Kaiser poll. They gave people four options: keep the law as is, keep it and change it where needed, get of it and replace with a GOP alternative, and simply get rid of it and replace it with nothing. The first two and the second two can be reasonably grouped together as “basically support the law” and “basically oppose the law.” The numbers are 59 to 29. Not against—in support of the law.”  Italics in original.

Michael Tomasky, Obamacare Crosses the Finish Line,” The Daily Beast

Hannity and Cruz Flat Out Lie About Obamacare Costs

I thought Forbes was a serious publication, but apparently not.  Check out Chris Conover’s “Obamacare Will Increase Health Spending by $7450 for a Typical Family of Four.”

Here’s a news flash for you — if you provide health insurance to 30 million more people, health care spending will go up!  Conover takes the Medicare actuary’s prediction that health care spending will go up $621 billion over the next ten years, and works that out to $7,450 for a “typical” family of four.

Conover contrasts this increase in spending with Obama’s promise that premiums would go down $2,500 a year for a family of four.  Now, if you read the article carefully, it’s clear that he’s comparing the apples of $7,450 over ten years with the oranges of $2,500 per year.

Guess who either didn’t really the article carefully or who doesn’t give a damn about the truth (and I suspect it’s the latter)?  Sean Hannity and Ted Cruz.  On his show tonight, Sean explicitly said that it would be an increase of $7,450 per year for a family of four.  Ted Cruz chimed in that it was a $10,000 swing compared to Obama’s promise.  Um, only if you purposely confuse a single year with a decade because you’re trying to scare the hell out of people.  I’m guessing that many more people watch Sean than will read the Forbes article, let alone read it carefully.

The other problem with Conover’s article is that he talks about an increase in health care spending as if he were talking about a family’s out–of–pocket costs.  He makes no attempt to distinguish how much will be paid by the government (expanded Medicaid, health insurance subsidies, etc.), how much will be paid by insurance, and how much will actually paid by that “typical” insured family of four.

Because if he did that, if he were honest, it wouldn’t be anywhere near $7,450, and it wouldn’t be so impressively scary.

 

Setting Him Up to Fail

“Republicans have held the administration to about one-third of the money [to implement the Affordable Care Act] that the Bush administration received from a Republican-led Congress for the lesser challenge of starting up the Medicare drug program.”

From “G.O.P Is Readying a New Offensive Over Health Law,” Jackie Calmes, NYT

 

OK, The Deficit Problem Is Solved

Well, that was easy.  From “Health Care Spending Growth May Have Slowed Permanently,” Brian Beutler, Talking Points Memo:

“Health care spending growth has famously slowed over the past five years, significantly enough that the Congressional Budget Office recently revised its projections of Medicare and Medicaid spending over the coming decade downward by hundreds of billions of dollars.

“Now, research papers suggests the recent slowdown doesn’t just reflect temporary economic weakness, but also structural shifts in how health care is delivered and financed — possibly attributable to the Affordable Care Act — and thus might be a harbinger of a longer-term trend.

If they’re right, and the trend continues, it means workers can expect higher wages and the country’s projected medium term deficits are significantly overstated, which in turn suggests lawmakers’ continuing obsession with the current budget deficit, and deficits over the coming decade, are misguided.

“The study by Harvard researchers, featured in the latest edition of Health Affairs, finds, like all studies of this nature, that the recession and weak economy contributed significantly to the spending growth slowdown. Less generous benefits, resulting in higher out-of-pocket costs, accounted for 20 percent of it. Faced with less generous coverage and less disposable income, people consumed fewer health services.

“But the good news is that spending growth also slowed among those whose health benefits haven’t changed, including Medicare patients. And that suggests a more enduring trend.

“’Our findings suggest cautious optimism that the slowdown in the growth of health spending may persist — a change that, if borne out, could have a major impact on US health spending projections and fiscal challenges facing the country,’ the authors write.

“In a related article, health care economist David Cutler attributes the majority of the slowdown to fundamental changes — including perhaps slowing technological and pharmaceutical innovation, and increased efficiency among providers. If current trends continue, he concludes, then over the next 10 years ‘public-sector health care spending will be as much as $770 billion less than predicted. Such lower levels of spending would have an enormous impact on the US economy and on government and household finances.'”

Stick that in your pipe and smoke it, Paul Ryan!

Of course, that money will probably be spent on more war(s).

 

 

The GOP — All Politics, No Policy

“[W]hat you’re seeing clearly demonstrated here is a kind of policy nihilism on the part of the GOP that helps explain why addressing the country’s problems has become all but impossible. It isn’t enough for Boehner to disagree with [NRCC Chair Greg] Walden over Chained CPI. Boehner effectively controls the NRCC. The notion that this is a private matter between him and Walden is just hogwash. If Boehner doesn’t think the NRCC should attack Dems over a policy that GOP leaders themselves say they want Dems to join them in supporting, he could, you know, just say so. After all, if Republicans won’t say they’ll refrain from attacking Dems over Chained CPI — after embracing the Ryan plan to cut Medicare while attacking Dem candidates over Obamacare’s Medicare cuts for two straight cycles — why would they ever embrace entitlement reform, as GOP leaders themselves are asking them to do?”

Greg Sargent, The Plum Line, WaPo

Hypocrisy and politics are like peanut butter and jelly, but I really believe today’s GOP has taken things to a whole new — and low — level.  They are, in effect, refusing to govern.

The GOP — Garbage In, Garbage Out

From “Paul Ryan’s budget:  Social engineering with a side of deficit reduction,” Ezra Klein, Washington Post:

“Here is Paul Ryan’s path to a balanced budget in three sentences: He cuts deep into spending on health care for the poor and some combination of education, infrastructure, research, public-safety, and low-income programs. The Affordable Care Act’s Medicare cuts remain, but the military is spared, as is Social Security. There’s a vague individual tax reform plan that leaves only two tax brackets — 10 percent and 25 percent — and will require either huge, deficit-busting tax cuts or increasing taxes on poor and middle-class households, as well as a vague corporate tax reform plan that lowers the rate from 35 percent to 25 percent.

“But the real point of Ryan’s budget is its ambitious reforms, not its savings. It turns Medicare into a voucher program, turns Medicaid, food stamps, and a host of other programs for the poor into block grants managed by the states, shrinks the federal role on priorities like infrastructure and education to a tiny fraction of its current level, and envisions an entirely new tax code that will do much less to encourage home buying and health insurance.

“Ryan’s budget is intended to do nothing less than fundamentally transform the relationship between Americans and their government. That, and not deficit reduction, is its real point, as it has been Ryan’s real point throughout his career.”

“The problem is that these ideas are not, on their own, popular.  In fact, they’re deeply unpopular, and considered quite radical.  That’s why Newt Gingrich rejected Ryan’s initial budget as ‘right-wing social engineering’….  But presented on their own, Ryan’s plans scare people.

What Ryan has found is that the way they’ll get a hearing is if they’re presented as necessary, prudent measures to forestall an even more dramatic debt crisis.

“But whether these are good or bad ideas, they are not, under any reasonable definition of the term, necessary ideas.”

We’ve got Paul Ryan using phony scare tactics on the budget, and Rand Paul doing the same on the drones.  When I think of the GOP today, I think, “Garbage in, garbage out.”  We have neither a debt nor a drone crisis.  How can we solve  our real problems when one party is so focused on imaginary ones?

Health Care? Fuhgeddaboudit.

So Paul Ryan would balance the budget in ten years.

You probably won’t be surprised to learn that 70% of the cuts he makes to accomplish that goal are from health care.  Because, you know, we’ve got to keep producing all those weapon systems that the military says it doesn’t need.  We have to be prepared to fight World War II, the Cold War, and the War on Terror.

Besides repealing Obamacare, Ryan would slash Medicaid, shifting much more of the burden to the states, and hand out Medicare vouchers to seniors to go find health insurance, while raising the eligibility age two years.

Isn’t this what we all voted against in November?  Isn’t he what we all voted against in November?

Take two aspirin and don’t call him in the morning, America.

Maybe We All Just Agree

The sequester was set up in 2011 because it was supposedly so awful that the Dems and the GOP would definitely do a budget deal rather than let it take effect.

But now that it’s here, it seems to everybody involved to be a better option than the available alternatives.  The GOP would rather live with the defense cuts that were supposedly anathema to them than raise taxes even on very rich people and corporations.  Sen. John Cornyn of Texas is no Neville Chamberlain, and he’s saying the Pentagon cuts won’t hurt our national security.  The GOP senators who are claiming they will, like John McCain and Lindsey “Butters” Graham, are really outliers even in their own party — after all, they both want to stay in Afghanistan forever, and that’s not where either party is.

The Dems would rather live with the cuts to non-defense spending than accept a deal without more revenue.  The cuts won’t affect things like Medicaid or food stamps.  You’re not going to see sick or hungry children sobbing in the streets.

Americans believe the sequester isn’t big enough or relevant enough to their lives to get upset about.  Yes, people agree with the President that we shouldn’t do big cuts or reform entitlements without raising taxes, but people aren’t rising up against the GOP because the sequester isn’t that significant, either in dollars or affected programs.  Nobody’s Social Security check gets cut, nobody’s Medicare benefits get reduced.

People just aren’t feeling the outrage the President is trying to inspire, and if he keeps it up, he might well lose his good will.

It really feels as if we have a bizarre moment of consensus here — Democrats and Republicans and Independents, in and out of government, seem pretty calm about and comfortable with the sequester, especially if it’s tweaked to give department heads flexibility on where to cut.

The GOP has been cast as having the political disadvantage here.  But if these cuts take effect, and people don’t feel pain from them, voters might say, “Hey, let’s cut a little more.”

GOP’s Attack on Obama Speech Continues Demonization of Romney

The GOP has been attacking Obama’s inauguration speech as partisan.  I actually didn’t think it was particularly partisan, and neither did Newtie, so he and I agree on something, which is kind of creepy.

But what do they think a Romney speech would have been like?  With Obama sitting there, Mittens would have declared that the country repudiated Obamacare and wanted less government spending, especially on social programs and entitlements, and less regulation and lower taxes.  He would have said the country wanted the Ryan budget and privatization of Social Security and Medicare.   He would have said his victory was a repudiation of everything from gay marriage to abortion rights to climate change.  Given the failure to re-elect a sitting president, Mitt’s speech would inevitably have been highly, harshly partisan.

In attacking Obama’s speech, the GOP continues to blame their messenger, not their message, when the country soundly rejected both.  Yes, Mitt was a terrible candidate who personified every negative stereotype and caricature of his party.  But they still don’t get that they surrounded him with embarrassing nut jobs like Todd Akin and Richard Mourdock, and that they forced him to sell a fringe platform.  They still don’t get that if Mississippi rejected a Personhood Amendment, such an amendment is not mainstream.  On this 40th anniversary of Roe v. Wade, new polls show that less than a quarter of Americans want it repealed.  It’s the same on immigration and gay rights and the Ryan budget and the environment.

The GOP somehow is still convinced that while we didn’t like their guy, we like their policies.  In attacking Obama’s speech, they fail to accept that we like both him and the sentiments he expressed on Monday.

The GOP didn’t just lose the election, they lost their compass.   They can’t find their way to the middle, the golden mean where the majority of votes will always be found.