It’s been hard to escape from Medicare in the 11 days since Wisconsin Rep. Paul Ryan burst into the news as vice presidential candidate with big and well known ideas about the health program for nearly 50 million Americans. Medicare zoomed to the top of the issues parade, elbowing the economy.
Romney and Ryan hope it will be a winning issue for them; they are preaching the conversion of Medicare, a social insurance program, into a privatized voucher plan, in order, they say, to save it. The problem is that many experts believe such a plan will heap more medical costs on seniors. And if, as in their latest version, it offers seniors a choice between traditional Medicare insurance and vouchers, a number of experts also fear that the healthiest and youngest citizens would take the vouchers, leaving the traditional plan in what insurers call a “death spiral,” which, as the term suggests, is not good.
Romney and Ryan’s plan of attack, meanwhile, is to blast the president for “cutting” funds from Medicare in order to help fund Obamacare, the nation’s new health reform law. Last week a GOP campaign ad told seniors: “The money you paid for your guaranteed healthcare is going to a massive new government program that’s not for you.”Romney reinforced that line of attack on the stump in Ohio: “He’s raided that trust fund. He’s used it to pay for Obamacare, a risky unproven federal government takeover of healthcare.”
This tack offers new twists on an old argument, which reporters need to understand. This past May, I noted that the GOP successfully had used a similar argument about Medicare cuts—at the time the number for the “cut” was $500 billion—to win Congressional seats in the 2010 elections, and they used it again this primary season. With Ryan’s ascendency to the GOP ticket, and egged on by GOP strategy gurus, the claim is back, this time morphing into a $716 billion “cut.” So it has worked as a strategy. But is it accurate?
The facts
For starters it bears repeating that the Affordable Care Act (ACA), sometimes called Obamacare, is not an “unproven government take-over of healthcare.” The health law was patterned closely on the reform model that Romney championed and fought for in Massachusetts when he was governor. That law, although far from perfect, seems to be working reasonably well there. And under Obamacare, the government takes over nothing. Private insurers will continue to provide the insurance; private doctors will continue to provide the care.
And as for the $716 billion dollar cut, the facts are and continue to be: The health reform law did take $500 billion out of the future spending projections in the Medicare budget to help fund subsidies for the uninsured, and to help shore up Medicare’s finances further into the future. Most of these cuts centered on reduced reimbursements to providers—mostly to hospitals, which agreed to smaller payments over 10 years in return for more patients with insurance, which the ACA promised to deliver. In other words, they didn’t squawk about it.
About $136 billion were cuts to payments made to sellers of Medicare Advantage plans, which provide benefits to seniors who opt for them instead of traditional Medicare. The rationale: Policy experts and the government’s Medicare Payment Advisory Commission (MedPac) found that there was no justification for paying Medicare Advantage insurers fourteen percent more on average than it costs the government to provide the same coverage under the traditional Medicare program. In other words, the government was wasting money. Insurers didn’t make a big fuss either; at the time, they worried more about a “public option” becoming law.
Good piece, Trudy. And Jackie Calmes of NYT got another underreported aspect of this in her article today pointing out that if Romney restored the $716 billion in reduced Medicare spending over 10 years that would raise beneficiaries' premiums significantly and also hasten the insolvency date of the Medicare hospital trust fund. He has no good response to that critique.
http://www.nytimes.com/2012/08/22/us/politics/costs-seen-in-romneys-medicare-savings-plan.html?_r=1&hp
Another underreported issue is whether the Ryan-Romney proposal to have their capped, privatized, voucherized Medicare proposal only apply to people under 55 is politically viable. That would mean a big policy cliff between Americans based on one day's difference in birthdays. People born on one day would be guaranteed (with the death spiral caveat you mention) access to the traditional uncapped Medicare program which would pay for their full benefits. People born one day later would be shoved into the capped, voucherized program where they likely would be exposed to significantly increased out of pocket costs. Would Americans stand for that gross disparity?
#1 Posted by Harris Meyer, CJR on Wed 22 Aug 2012 at 12:53 PM
A teacher would be fired if her lectures were as unpredictable as the events the news media must investigate. And her license would be taken away if she repeatedly interrupted her lectures with advertisiements that featured sexually attractive actresses. Which makes it easy for Republicans to lie about Obamacare. But is the news media going to improve their profession by communicating like a teacher instead of a reporter?
#2 Posted by Stanley Krauter, CJR on Wed 22 Aug 2012 at 04:33 PM
Yes it is accurate only, I strongly agree with Ryan's plan. There is a possibility to cut medicare costs...
http://www.medicarehawaii.com/
#3 Posted by Nikki, CJR on Thu 23 Aug 2012 at 05:27 AM
Trudy...
If you are honestly trying to make the claim that cutting nearly a TRILLION dollars in Medicare funding won't effect Medicare benefits...
You need to sell that load of baloney somewhere else.
You can spin all you want with your standard one-sided dependence on purported "expert" analysis from leftist advocacy groups... And you can play the semantic "savings" versus "cuts" game all day long.
But chopping nearly a TRILLION dollars from Medicare is what it is.
We all know what really happened. Obama robbed Medicare to fund Obamacare. He took money destined to care for old people to give instead to the people he deems to be "poor".
That's just the REALITY here.
#4 Posted by padikiller, CJR on Thu 23 Aug 2012 at 12:04 PM
Val, that isn't the REALITY so just stop it.
The hospitals agreed to medicare price cuts in exchange for the mandate, which would eliminate much of their unisured visits to the emergency room overhead, and by scrapping the stupid medicare advantage program which did not bring any private sector cost containment magic to Medicare provision.
And it's kind of rich of the republicans to complain about this when they voted not for cost containment, but for a complete scraping of the entire Medicare system for Paul Ryan's (who's only the vice presidential candidate these days) Medicare coupons for private coverage which we know, from medicare advantage, will not contain costs and we know, from Paul Ryan's proposal, that the design is not to insure seniors health care costs - but to offload them onto seniors personal pocketbooks. We've seen how this works when it came to pharmacology, seniors go in to penury and/or take desperate trips up to Canada to attempt to get a better deal.
So yeah, republicans should stfu on Medicare since they've hated the program since the beginning, have done nothing but hurt the program's solvency while in charge, and rely on the same medicare cuts to make their projections as democrats under their coupon program.
And since when did fiscal responsibility entail complaining about cost cutting?
#5 Posted by Thimbles, CJR on Thu 23 Aug 2012 at 01:30 PM
Linked to from here:
http://m.washingtonpost.com/blogs/plum-line/post/the-morning-plum-no-romney-and-ryan-dont-really-want-a-great-debate/2012/08/21/821297d0-eb7a-11e1-9ddc-340d5efb1e9c_blog.html
Is this:
http://www.thedailybeast.com/articles/2012/08/21/the-only-big-idea-coming-out-of-the-romney-ryan-camp-is-the-big-lie.html
"I think they wanted exactly that. But that sure isn’t what they’re getting. Romney and Ryan are both turning somersaults to say that they are this big government program’s true protectors. Ryan even dragged his mother into it over the weekend! And as for Romney, it is just astonishing to hear him stand up as he did last week and whack Obama for cutting $716 billion from Medicare while lavishing praise on Ryan, whose Medicare plan from last year cuts exactly the same $716 billion (and then some), and say that he and Ryan are going to save Medicare, unlike that nasty Obama.
The truth, of course, is that Ryan’s premium support plan would devastate Medicare because it would slow the increased spending to a rate well below the rate at which health-care costs have been rising in recent years. In polls like one the Kaiser Family Foundation commissioned earlier this year, even majorities of Republicans don’t want Medicare restructured along Ryanesque lines. These guys may not be able to count, but they can read polls, and so they know very well that if they gave the county the honest debate we were told we were going to have about Medicare, and for that matter about taxation, they’d wake up Nov. 7 with about 120 electoral votes in their pockets and conservatism in tatters.
They know this. They know that the truth would crush them electorally. And so it follows that they know they must lie. They must lie about their Medicare plans. They must lie about the effects of their tax plans on average people and rich people. And they must tell a number of lies about Obama, all the better if they involve race, as the welfare lie does.
So this will be the entire point of the Romney-Ryan campaign. Lie lie lie. Muddy the waters. Turn day to night, fire to water, champagne to piss. Peddle themselves as the precise opposite of what they actually are. That is clearly the m.o.
This is the case for two reasons. First, it is forced on them historically. Ronald Reagan could get away with sunny generalizations about supply-side economics because in 1980, it was just a theory. Now, after George Dubya, it’s been utterly discredited in practice. Conservatives still must believe these absurd things—that lower tax rates will produce more revenue—but now we know they’re not true, so they have to lie about them. And second, it is simply in Romney’s weasely nature never to say anything forthright about any topic."
#6 Posted by Thimbles, CJR on Thu 23 Aug 2012 at 02:45 PM
And there's this:
http://tpmdc.talkingpointsmemo.com/2012/08/surrogates-admit-romney-will-cut-medicare-benefits-for-current-seniors.php
As Greg Sargent said in the link above:
"The guiding idea for Romney and Ryan is to “get government out of the way” by repealing Obama’s signature initiatives and gutting regulation. The GOP candidates vaguely promise to replace those things, without saying with what — because admitting they’d replace them with nothing would be politically unthinkable."
So they got nothing to run on.
#7 Posted by Thimbles, CJR on Thu 23 Aug 2012 at 02:49 PM
Oh neat.
http://www.balloon-juice.com/2012/08/23/igmfy-young-people/
"One of the pure joys of campaign reporting is the “headlines” e-mail. When a candidate has a particularly good day—a killer debate, a speech that goes off with no falling lights or flags—journalists get a missive from the campaign that runs through the bedazzled takes of your peers. The subtext is this: Why haven’t you written your story about how fantastic we’re doing?
On Saturday, shortly after Rep. Paul Ryan spoke at The Villages in Florida, the Romney campaign sent out no fewer than 14 incredible headlines. “Nothing but Cheers for Paul Ryan’s Medicare Plan at The Villages,” reported the Tampa Bay Times. (The planned community, where souped-up golf carts dominate the roads, is a Republican stronghold.) “Ryan Campaigns With Mother, Vows To Protect Medicare for Seniors,” reported the Hill."
The Villages? What in the hell are those. (protip: if you sleep there, the pod people will get you)
http://www.balloon-juice.com/2012/08/23/master-of-the-villages-of-the-damned/
"Via Dave Weigel, Tampa Bay Times reporters Michale Van Sickler and John Martin on the The Villages, its developer, and how it’s been set up to “provide a foundation for Republican candidates“..
Read the whole thing. Property control, local taxation authority, and socially-sanctioned authoritarianism enforced via media domination: The only difference between H. Gary Morse and your average feudal baron is better medical technology and worse public architecture."
It's all about stagecraft with these people.
#8 Posted by Thimbles, CJR on Thu 23 Aug 2012 at 07:55 PM
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#9 Posted by PETERSENSummer20, CJR on Fri 24 Aug 2012 at 03:32 PM
Kevin Drum did a post on this:
http://www.motherjones.com/kevin-drum/2012/08/itsy-bitsy-716-billion-medicare-qa
"There's no way to cut a bunch of money out of anything and guarantee that it will have no effect whatsoever.
However, the basic shape of the river here is pretty simple: Obamacare does indeed reduce Medicare spending by $716 billion (over ten years), but it doesn't reduce Medicare benefits by a single dime. It's unlikely that Medicare beneficiaries will see any noticeable effects at all."
#10 Posted by Thimbles, CJR on Fri 24 Aug 2012 at 10:54 PM
I agree with you! I agree with Ryan's plan. There is a possibility to cut medicare costs!
www.medicarearkansas.com
#11 Posted by julieanderson, CJR on Tue 20 Nov 2012 at 05:05 AM