Medicare hypocrisy

When asked on a Sunday morning show (about a month ago) about his Medicare hypocrisy, I believe Mitch McConnell basically cited the purpose for the cuts, i.e. saving Medicare vs. funding a new program, as the distinction. This reasoning is still hypocritical, but it may reflect a reality about ends, means, and ideology. Politicians may reconcile their ideology-based and party-based decisions by focusing on longer-term ends rather than means. Which makes it impossible to take practical steps that both sides theoretically could agree on.

Cutting Medicare to save money. Republicans yes. Democrats no.

Cutting to fund another entitlement program. Republicans no. Democrats yes.

To be fair, Paul Ryan has not proposed a budget. His recent fiscal plan is a "roadmap" that doesn't address the 2011 budget, but instead covers a long-term strategy.

He went on MSNBC to clarify that the GOP budget proposal is coming out in March:

http://www.youtube.com/watch?v=v9y-JCf5Tyo

Do you think the powers of Obama-Reid-Pelosi would ever consider breaking up this comprehensive reform into small edible pieces that can by themselves offer incremental improvements....

For starters, what if they offered a very simple bill that passed the tax-writeoff for insurance purchases (that employees of healthcare prioviding employers get)---if thyey simply gave that write-off to every one!

One simple bill that suddenly and dramatically de-couples employment from healthcare.....my guess is that that would offer a tremendous release of pressure on the whole joblessness crisis!!!

Are Obama & Pelosi simply too ideolgically rigid to open themselves up to an idea like that?

This isn't the end----merely a first step---a sign of good faith to all Americans that they are more interested in solving a problem than enacting an agenda.

Ezra!!! What do you say? Can you make it happen?

I understand the need to fund the health insurance reform bill, but doing it with medicare cuts is the dumbest thing the Dems have proposed in the whole debate.

Seniors are paranoid about preserving Medicare, and they vote in huge percentages. Why would the Dems voluntarily alienate this group? Do they want the seniors to vote Repub. in 2010 and 2012?

Fiscal responsibility doesn't have to come with political suicide as a side effect.

dumb, dumb, dumb.

The new era "post-partisan" politics has officially ended and we are now in to the "post post-partisan polarization"

Ezra---DO YOUR THING!!!

http://online.wsj.com/article/SB10001424052748703382904575059573079680544.html

I'll get you started....Paul Ryan=Evil!

My personal belief is Paul Ryan=The Next President of the USA in 2012!

Excerpt from WSJ:
~~~~~~~~~~~~~~~~~~
As with its campaign last year to smear Republican Whip Eric Cantor, the White House's attack on Mr. Ryan is designed to isolate and discredit one of the GOP's brightest thinkers. So it only aids the White House when "anonymous" Republican members—annoyed that they must have this debate—gripe to the press that Mr. Ryan doesn't "speak" for them.

Mr. Ryan, by contrast, isn't apologizing for offering ideas to the very president who keeps claiming Republicans are the party of "no" and who claims to want entitlement reform. A handful of House reformers are calling the Democrats' ruse—reminding voters that what makes this surreal is that the only choice right now is between bad Democratic ideas and worse ones.

These are the smart GOP members willing to do the hard work of explaining the difference between, say, Democratic legislation that would strip money from today's Medicare beneficiaries and funnel it to a new, unsustainable, middle-class entitlement, and Mr. Ryan's plan, which would preserve today's program for older Americans while plowing money from reform back into long-term solvency. As cheap as the attack on Mr. Ryan is, they understand that this debate was always coming, and that what they say now matters to the GOP's future ability to govern.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The big difference is that the Republican cuts (proposed in 1995 by Gingrich and more recently by Paul Ryan) involve gutting Medicare at its core and slowly winding it down till everyone is basically in the private market with a marginal subsidy/voucher. Their recent defense of Medicare was purely a political stunt, which I will admit they are very very good at (if only they had the same talent at actual governance).

Democrats instead want to cut excess spending in Medicare (specifically the 14% markup on Medicare Advantage plans that cover the SAME benefits as traditional Medicare), keeping the program intact and more efficient (experimenting with bundling payment plans, etc).

I think Medicare fraud should be a HUGE focus and something that should attract bipartisan support - it could save hundreds of billions as far as I know (a recent 60 minutes report detailed how fraud is accomplished).

So Ezra!

Do you acknowledge a HUGE distinction between Republican plans for stripping money away from Medicare in order to help pay for Medicare....

vs.

Democrat plans to strip away money from Medicare in order to pay the creation of a huge federal healthcare entitlement program that will take care of every American from now on.

Costs and benefits. Cutting Medicare because of its own insolvency is a cost and a benefit. Cutting it to help pay for something that promises to be even more insolvent and oppressive is two costs.

Democrats are focused on using federal government power to give away healthcare services to all.

Republicans are focused on reigning in government power in order preserve a sustainable model.

Democrats lie through their teeth when they tell voters that their plans are fiscally sustainable.

Perhaps the Republicans are guilty of a lie of omission in not speaking at length on the consequences of their hard choices.

Lets all try harder to be fair.

Rather important piece here:

http://www.realclearpolitics.com/articles/2010/02/12/paul_ryans_lonely_challenge.html

This captures the huge leadership imbalance between Representative Paul Ryan and President Barack Obama!

Hey Eff You Ezra
for making this false equivalence.

Please stop legitimizing the The Corporate Tools like Ryan and his fluffer FastEddie who've wrecked this economy and are trying to do it again.

"Cutting Medicare to save money. Republicans yes. Democrats no.

Cutting to fund another entitlement program. Republicans no. Democrats yes."

So if another entitlement program is created, then saving money on Medicare is somehow wrong?

Ezra is not pointing out that it is hypocritical for Republicans to oppose health care. It is possible for Republicans to argue that they oppose health care reform DESPITE the savings it would generate in Medicare spending.

Instead, just as Krugman's column points out, Republicans:

"...have been scoring political points by denouncing proposals for modest cost savings — savings that are substantially smaller than the spending cuts buried in their own proposals."

"So if another entitlement program is created, then saving money on Medicare is somehow wrong?"

It means that we'll have two entitlement programs we can't affoed instead of one.

"Ezra is not pointing out that it is hypocritical for Republicans to oppose health care."

No s***, Sherlock. He's claiming that it's hypocritical for Republicans to oppose cutting Medicare to pay for another entitlement program while supporting cutting Medicare so that it can pay for itself.

"It means that we'll have two entitlement programs we can't affoed [sic] instead of one."

Just for the pure futility of it, I will put the question (which this sentence fails to answer) again.

We KNOW that Republicans do not want health care reform to pass, ok? We get that, "Sherlock." Now, here is the question:

If (in the worst case scenario for you ) ~IF~ (God forbid) it does pass, would it then be a bad thing for the HCR package to include spending reductions in Medicare?

"No s***, Sherlock. He's claiming that it's hypocritical for Republicans to oppose cutting Medicare to pay for another entitlement program while supporting cutting Medicare so that it can pay for itself."

No ... Ezra and Krugman are pointing out that it is hypocritical to try and convince seniors that you oppose health care reform BECAUSE it will include Medicare cuts, when in fact you have opposed Medicare spending all along (and do so now more than ever witness the Paul Ryan budget or "roadmap" or whatever it will be called tomorrow).

"No ... Ezra and Krugman are pointing out that it is hypocritical to try and convince seniors that you oppose health care reform BECAUSE it will include Medicare cuts, when in fact you have opposed Medicare spending all along (and do so now more than ever witness the Paul Ryan budget or "roadmap" or whatever it will be called tomorrow)."

You who? If you are talking about me personally, I think Medicare is going bankrupt and we ought to do something about that. And that something does not include reducing Medicare spending in order to spend the money on another entitlement program that will likewise be broke in the not too distant future.

But, given a choice between blowing money on Medicare and blowing money on Obamacare, I'd choose to blow it on Medicare. At least Medicare recipients have been paying into the system for like, forty years or more.

"It means that we'll have two entitlement programs we can't affoed [sic] instead of one."

I love it when pedants attack my typos.

"But, given a choice between blowing money on Medicare and blowing money on Obamacare..."

Like I said, your preference that HCR fail is completely understood, but the question that you continue to avoid is:

If (in the worst case scenario for you ) ~IF~ (God forbid) HCR does pass, would it then be a bad thing for the HCR package to include spending reductions in Medicare?

"If (in the worst case scenario for you ) ~IF~ (God forbid) it does pass, would it then be a bad thing for the HCR package to include spending reductions in Medicare?"

That depends. Would the discussion honestly admit that Medicare recipients will receive less care, and that even if they do like the plan they currently have they won't necessarily get to keep it?

I'm opposed to entitlements, but I dislike the entitlements we have a lot less than I dislike the ones you're proposing. So, yes, I'm willing to leverage the FACT that your entitlements cut care to one of the most active voting blocs in order to prevent you from expanding it.

And an opposition to entitlements, BTW, is not an opposition to healthcare reform. I guess we're just a little smarter in that we haven't run out of ideas for fixing the problem without gutting it altogether in favor of a MASSIVE entitlement expansion.

There's nothing hypocritical or even obstructive about it -- we're simply holding your side to its words, and using your own words and positions against you. Patrick_M, meet Saul Alinksky.

"That depends."

The answer to my simple yes or no question is "that depends," followed with a question, followed with three additional paragraphs further discussing opposition to entitlement programs.

I rest my case.

The answer to my simple yes or no question is "that depends"

Because your "simple yes or no question" is ambiguous. You say the plan reduces spending, but the *issue* is whether the plan reduces *care*. In case you didn't notice, much of the public debate was about whether care would be reduced. Your side would offer silly "sense of the Senate" gestures suggesting that its intent was to preserve care, but at every turn it would reject amendments to actually *guarantee* the preservation of care.

It's perfectly clear what was going on, and Republicans successfully made that case to the public.

The real IQ test here, though, is whether you understand the real cuts and are simply in on the scam, or if you actually believe no cuts in care would occur. I'd like to see all you libs answer that question, so see which are the cheats and which are the fools.

I'm happy to discuss even your plan if framed accurately, but we seem to get held up on the premises long before we get to discussing the disastrous plan. I refuse to allow you to create new language for the sole purpose of making your new entitlement idea politically correct. It's a redistribution of care, and it will introduce new rationing.

When you are prepared to discuss it as such, the simple yes and no questions will not have false premises or vague meanings.

"The real IQ test here, though, is whether you understand the real cuts and are simply in on the scam, or if you actually believe no cuts in care would occur. I'd like to see all you libs answer that question, so see which are the cheats and which are the fools."

Ok then. If it helps you to answer the question, please assume that I am 100% ignorant of what the real cuts are, and also that I am a complete fool. You may also assume that you are all-knowing. Assume that we have zero disageement about your beliefs about redstribution and rationing.

Now the yes or no question (still) is: would you support the reductions in future Medicare spending that are part of the HCR package, if they were not tied to creating any new entitlement?

I much prefer Keith Hennessey's response to Krugman: http://keithhennessey.com/2010/02/12/krugman-gingrich-ryan/

"If (in the worst case scenario for you ) ~IF~ (God forbid) HCR does pass, would it then be a bad thing for the HCR package to include spending reductions in Medicare?"

Since I told you in an earlier thread that my preference is for the funding for any HCR to come entirely from reducing the exclusion, you would be correct in assuming that I don't think any funding for HCR should come from spending reductions in Medicare.

Spending reductions in Medicare, along with increasing the age for eligibility, means testing premiums, etc. should be directed at creating a sustainable health care system for the aged.

"would you support the reductions in future Medicare spending that are part of the HCR package"

Probably not those exact reductions. Those cuts were proposed in order to milk the greatest amount of money from Medicare for some other entitlement that can't pay for itself.

Unlike you, my conscience does not permit me to cut someone's Medicare Advantage while insisting that "if you like the plan you have you can keep it." So you can be pretty sure that my cuts wouldn't sound like yours.

Test

"Unlike you, my conscience does not permit me to cut someone's Medicare Advantage..."

Since 2006, the taxpayers have been paying an average of 14 percent more for people in the private Advantage insurance than for those enrolled in the traditional Medicare program.

Somehow the "rationing" out of taxpayer money to Medicare beneficiaries now favors the profits of private insurance companies, which often engage in agressive (and occasionally deceptive and abusive), marketing practices to the elderly. That strikes me as some really lousy rationing.

"...you can be pretty sure that my cuts wouldn't sound like yours."

On that we are in full agreement.

"Unlike you, my conscience does not permit me to cut someone's Medicare Advantage while insisting that "if you like the plan you have you can keep it.""

Address it in the full context please, asterisk. Address what I actually said, not what you think you can refute.

"Address it in the full context please, asterisk. Address what I actually said, not what you think you can refute."

Really? The "full context" is the blogger's entry and all of the commentary that follows.

What each of use has said is all there to be read. I trust that any intelligent reader is able to digest the full context of a posting which appears immediately (or nearly immediately) above my reply.

"Spending reductions in Medicare, along with increasing the age for eligibility, means testing premiums, etc. should be directed at creating a sustainable health care system for the aged."

Your cuts don't sound like the RNC's "Health Care Bill Of Rights for Seniors" rolled out by Chairman Steele last August. Going rogue here, bgmma50?

Sorry to be such a "pedant," but what's up with your plan for "means testing premiums?" By "premiums" for Medicare, I assume you mean the FICA taxes?

You really want to make these taxes means-tested -- in other words, you want to extract higher percentage contributions from the wealthy and to reduce or exempt "premiums" paid by lower and middle class Americans?

Plus your plan to finance health care is to eliminate existing tax credits to the largest employers ("my preference is for the funding for any HCR to come entirely from reducing the exclusion")?

Your schemes are well to the left of Speaker Pelosi.

Patrick, if you say you're going to cut a benefit because of fraud, then the benefit is cut. You're not saying, "We're going to reduce fraud." You're saying, "Providing this benefit is not worth the cost."

If you like your current plan, and your plan includes Medicare advantage, then you can't keep it. Because it's being cut.

Why you're cutting it may be important to someone who's opening up a new entitlement, but the bottom line is that for people on the old entitlement it's still a cut.

I'd be happy to see you cut out the fraud, but that would only save so much. And that's why you're cutting out the *benefit* -- because it saves *more*. You're rationing care from Medicare Advantage to your "universal healthcare" entitlement.

It's really neat to see you liberals squirming like worms rather than admit to the rationing at the heart of your proposal. By the way, have you heard the Robert Reich speech where he lays it on the line, about what politicians would say if they were *honest* about their healthcare reform plans?

It's refreshingly candid -- but admittedly not as entertaining as your squirming is. Don't worry -- we will continue to tell the public the truth, so you can continue to lie to them. In fact, right now I'd rather have them see you lying than see you admit to the ugly truth. The polls show that the public is learning a lot from it.

"Your cuts don't sound like the RNC's "Health Care Bill Of Rights for Seniors" rolled out by Chairman Steele last August. Going rogue here, bgmma50?"

Just because virtually all Republicans hate Obamacare, it doesn't mean we all hate it for the same reasons.

"Sorry to be such a "pedant," but what's up with your plan for "means testing premiums?" By "premiums" for Medicare, I assume you mean the FICA taxes?"

No. I mean premiums. Most people already pay Part B premiums, but they pay nothing for Part A premiums. People are living longer and demanding much more costly medical care than they did 40 or 50 years ago. Many seniors can afford to contribute to the cost and should be expected to do so. They probably won't like it, but I suspect they'll hate it less than they hate the idea of having their benefits taken away.

"Plus your plan to finance health care is to eliminate existing tax credits to the largest employers ("my preference is for the funding for any HCR to come entirely from reducing the exclusion")?"

Not just the largest employers, all employers. The exclusion is not only grossly unfair, it's the main driver of the out of control costs we have in this country, and the Democrat's abject failure to adequately address this issue is one of the main reasons I object to their bills. And I didn't advocated eliminating the exclusion, I advocated limiting it. I would restrict the amount of subsidies to the amount that can be raised by reducing the exclusion. Rather an exquisite dilemma, don't you think?

"Not just the largest employers, all employers."

I made reference to "largest" because larger business are more likely to provide health benefits (and thus qualify for the exclusion) than small businesses.

Of course, if you impose new limitations on exempting premiums paid by employers from payroll and income taxes, you will create new disincentives for employers to offer the benefit at all, leading to fewer Americans having employer-provided coverage.

And since you simultaneously propose limiting all health care subsidies to the uninsured to the amount of increased revenue you will be making from the tax hike on employers, your plan puts all of them in a shrinking pool as well.

So your plan results in steadily decreasing the number of people with employer-provided insurance, and thereby also steadily decreasing the number of people with government-subsidized private insurance. Got it.

Your means-testing of Medicare premiums is an interesting notion, but I am curious why you would means test the premiums collected rather than the benefit claims paid out. We could always tell Warren Buffett that since he can afford his own private plan, it is better that he not present his health claims to the Medicare system. That's not my proposal, I am just asking why that idea is any less logical than providing care to Mr. Buffett with a higher out-of-pocket contribution.

"It's really neat to see you liberals squirming like worms rather than admit to the rationing at the heart of your proposal.... It's refreshingly candid -- but admittedly not as entertaining as your squirming is. Don't worry -- we will continue to tell the public the truth, so you can continue to lie to them."

And a "really neat" Valentine's Day to you too.