Should seniors on Medicare and those about to join the program be worried about benefit cuts? That was an issue in the midterm elections, when the GOP positioned itself as champions for the senior set, and painted Democrats as the bad guys. Last week Politico’s Brett Coughlin broke news when he asked House Minority Whip Steny Hoyer whether Democrats could be counted on to protect Medicare benefits and control premium increases. Said Hoyer:
“It is our belief that you can—as was done in 1983 on Social Security—and as we are committed to doing, we can adjust Medicare provisions, and we can adjustment those in the future, and perhaps we can make some adjustments for present recipients.”
Adjustments? How’s that for euphemistic code speak? What adjustments did a top Dem have in mind? Was he signaling benefit cuts for the “present recipients,” or not? If so, then current beneficiaries need to take note and think about how they will pay for their medical care should Congress go along with any cuts. The press has to tell them, though. The MSM apparently hasn’t yet realized that perhaps Medicare isn’t as sacred as the Dems made it out to be on the campaign trail. Hoyer amplified his thinking for Politico:
“We want to make sure that the benefits that are available to recipients, which they need are protected, so within that context, just as we did with Social Security in 1983, we need to address Medicare and Medicaid and Social Security, to ensure their continued availability and sustainability over the long term.”
Do Hoyer’s adjustments signal more means testing? As Campaign Desk has noted several times, wealthier seniors already are paying higher premiums for Part B, which covers physician and hospital outpatient services, and for Part D, the drug benefit. The percentage of “wealthier” recipients paying higher monthly Part B premiums is expected to jump from about five percent to about fourteen percent by the end of the decade, and the percentage of those paying a higher Part D premium will also triple over that period.
Apparently some seniors are beginning to note that they must pay higher premiums, and have been asking why. That prompted Medicare officials to send a memo to insurance companies that provide the privatized drug benefit to help them answer customers’ questions.
Did Hoyer mean that beneficiaries with more income would get fewer benefits? Many experts believe that would turn Medicare into a welfare program like food stamps and Medicaid instead of social insurance, where everyone is entitled to a basic benefit as a matter of right.
Coughlin tried to pin down Hoyer and asked if he supported the recommendations of the president’s now-defunct deficit commission chaired by Alan Simpson and Erskine Bowles. Those recommendations call for cutting Medicare by another $400 billion. The health reform law already cut $500 billion from the program, mostly in the form of cuts to hospitals and sellers of Medicare Advantage plans. The Simpson-Bowles blueprint also would prohibit Medigap plans—which most beneficiaries buy to cover what Medicare doesn’t—from covering some of Medicare’s gaps. That, of course, means beneficiaries must dig deeper into their own pockets to pay their doctors. The new law already requires that insurance regulators come up with a scheme to make seniors cover more of their medical costs if they buy Medigap policies Plans C and F—the two most popular plans.
FYI: Hoyer gave Coughlin the same blah-blah answer to questions about the Simpson-Bowles recommendations. He said that he wasn’t going to “specifically adopt any particular proposal,” adding that “ some will have greater support than others.” No kidding!
There are two kinds of stories we see here. One is the political story. Are Democrats—the traditional champions of benefits for the little people, aka Social Security and Medicare—trading places with Republicans? The second is the good old informational story of super interest to readers, listeners, and viewers.
Seniors on social security shouln't have to be paying anything out of pocket for medicines or doctors,we pay it in for that reason not to take care of illegels and general lazy people and furthermore if you haven't paid it in you shouldn't recieve it, and I am not talking a about ameican born mothers and housewifes drawing off there husbands.
#1 Posted by Dlrollin, CJR on Mon 24 Jan 2011 at 03:54 PM
"Are Democrats—the traditional champions of benefits for the little people, aka Social Security and Medicare—trading places with Republicans?"
Repubmocrats are champions of whatever fills their bank accounts and election boxes.
George Bush: No more nation-building! No more policing the world! Limited govt! Compassionate conservatism!
Barack Obama: The first thing I will do is end the war! Close Guantanamo! No more special privileges for Wall Street! Transparency!
H.L. Mencken: "Government is a broker in pillage, and every election is a sort of advance auction in stolen goods."
#2 Posted by Dan A., CJR on Mon 24 Jan 2011 at 05:06 PM
What I think you have to see is that America's fiscal future is dependent on negotiations with very powerful interests and that the environment in which the government must negotiate is very hostile to the government's need for concessions. You can't even get an open, private, industry friendly insurance market running without accusations of socialism and death panels; never mind the accusations of medicare benefit cuts as a result of eliminating inefficient, republican implemented, non cost containing, medicare advantage plans. You have a hard time governing when every attempt to govern is treated as another diabolical move by the antichrist.
So the government is boxed in. It has a revenue problem. Revenues are a percent of GDP (taxes) and greater percentages of that GDP have been concentrated in the upper brackets, in the highest 1%, for 30 long years. These people have the disposable cash the government needs to function, but these people also have the means to protect their disposable cash, especially in the wake of the the Citizens United decision. Therefore, we have an environment in which money is concentrated at the top, but policy is restricted from collecting that money. I mean, while everyone was grousing about borrowing and deficits and all the money it would cost to revive the economy and assist the unemployed, the elites bullied through the deficit busting Bush tax cut extension.
We have a rent problem. There are various economic actors who charge rents upon the essential resources they provide (finance particularly) but there is one that affects government more specifically (though that may change since the government now guarantees the TBTF banks who are powerful enough to thwart any attempt to regulate them in exchange for their government back stop. That's another topic) Health care is a socialized cost, whether that cost is socialized privately by insurance plans or publicly by medicare, and the government is on the hook for the lemons in the health care protection market (the elderly who participate in medicare and require drugs and procedures well beyond the average population). Medicare is in crisis. The fees Medicare collects are no longer sufficient to the task of covering the costs, never mind maintaining the trust fund.
A possible fix is to negotiate down the costs of healthcare provision, but the healthcare provision industry is a powerful interest and if the government tries to contain those costs, the industry will pay to demonize them for doing so.
The government could also try and use its purchaser power to negotiate down costs of drugs for the elderly, like it does for veterans, but the drug provision industry is a powerful interest and if the government tries to contain those costs, the industry will pay to demonize them for doing so.
The government cannot control its provision costs, so therefore it must increase its revenues, by borrowing or by increasing premiums, or it must reduce its services. The elites are trying to constrain government borrowing (now that a democrat is in charge and they have their tax cuts) so the available options are like the ones in 1983, in which FICA was increased, the eligibility age was raised, the percent of taxable retired income was increased and other measures which you can read about here:
http://en.wikipedia.org/wiki/Social_Security_(United_States)#Amendments_of_the_1980s
This is the policy box, from which acceptable policy options can be picked from, and the condition for a policy's inclusion in the box is that powerful people do not get inconvenienced by it. The little people could get squashed for all they care, but rich people do not want higher taxes or reduced rents considered. And therefore, since we live in times of timid governance towards the powerful, they won't be.
As Dean B
#3 Posted by Thimbles, CJR on Tue 25 Jan 2011 at 12:31 AM
A couple of posts about the powerful and how their share of GDP has increased:
http://motherjones.com/kevin-drum/2011/01/power-baby-power
"I suspect there's no feasible path to Will's state of the world. The problem is that a system that generates enormous income inequality also generates enormous power inequality — and if corporations and the rich are allowed to amass huge amounts of economic power, they'll always use that power to keep their own tax rates low. It's nearly impossible to create a high-tax/high-service state if your starting point is a near oligarchy where the rich control the levers of political power.
I am, fundamentally, old fashioned about this stuff: I think of the world as largely a set of competing power centers. Economics matters, but power matters at least as much, and I think that students of political economy these days spend way too much time on the economy and way too little time on the political. This explains, for example, why I regret the demise of private sector labor unions. It's not because I don't recognize their many pathologies, or even the fact that sometimes they stand in the way of economic efficiency. I'm all in favor of trying to regulate the worst aspects of this. But large corporations have their pathologies too, and those pathologies are far worse because there's no longer any effective countervailing power to fight them. Unions used to provide that power. Today nobody does."
and their attitude towards us and government as a result:
http://rortybomb.wordpress.com/2011/01/21/kristol-kalecki-and-a-19th-century-economist-defending-patriarchy-all-on-political-macroeconomics/
"It seems that there is an increasing sense among certain types of neoliberal business elite that Obama hasn’t been favorable enough to the business community, and that he needs to reconcile this fast in order to fix the economy...
Why is Obama once calling members of the financial sector “fat-cat bankers” – while they were rolling the taxpayer, paying huge bonuses out of TARP and the Federal Reserve – important for an article about jobs? Is the idea that business leaders feel sad and offended important for why demand is down and unemployment is high? The government can act, through monetary and fiscal policy, to get jobs going again, but that leaves business elite not in charge of the economy.
Yet here we are, with the confidence of the business sector being the main anxiety of our recovery, reading article after article arguing that Obama needs to appoint more business leaders to key positions to make the business community feel included. We’ll discuss it more in 3 months when unemployment is still high and elites argue that President Obama should immediately replace Biden with a Xerox CEO...
So if you are a type who believes the government can only do bad, who believes that prosperity flows from how appreciated the business community feels, and who believes strongly in the Natural Order, then you are not going to be in favor of activist monetary and fiscal policy to fix the economy. You also won’t have any actual coherent view of what is wrong with the economy."
This is the story that needs telling. The problems we face have no solutions unless the important people, ones who are often causing the problems, are protected from any and all parts of the solution.
In this situation, the only solution is suffering, pain, and sacrifice for the bottom 99%.
The people who can least afford it pay for the ones who have all the money to begin with. All the little fish fall through this new, low thread, wide gap, social net. Government protection is for big fish only.
This is sick.
#4 Posted by Thimbles, CJR on Tue 25 Jan 2011 at 01:01 AM
Perhaps Steny Hoyer's blah, blah, blah is due to the fact that he has no idea what's in the so-called health care law and other relevant issues although it could also be the usual polticial obsfucation they all put forth b/c the truth would be a) off the talking points a/k/a smoke and mirrors and b) not a pretty picture so best that the public doesn't know the ugly details wherein lies the devil.
An example of a politician not knowing what they are talking about was Neil Cavuto's interview with Sheila Jackson-Lee during the second day of the debate re repealing Obamacare. She couldn't hold her own. She said that the mandate to purchase health insurance is no different than the mandate states have to purchase auto insurance - if you don't do the latter, you are fined.
That is not true. If you don't own a car or don't drive, and, therefore, don't have auto insurance, you are not fined. Mitt Romney and other Massachusetts politicians tried this silliness when the MA plan, model for Obamacare, was implemented in the Bay State four years ago, and national Democrats as well as Obama took over this mantra during the "health care reform" debacle. So did the talking heads on the faux TV news shows.
Then Jackson-Lee said, as she stood in front of a blown-up photo of an elderly woman lying in bed wearing an oxygen mask, that if it weren't for the national health insurance law, this woman would have died. Huh?
Obamacare hasn't kicked in yet, and furthermore, this elderly woman is most likely on Medicare, so not dying has nothing to do with the national so-called health care reform law. Cavuto tried to tell Jackson-Lee these two important facts but could barely get a word in edgewise b/c Jackson -Lee then said that what she meant was, Medicare is gov't run health care. I was falling over with laughter to keep from crying.
Sheila Jackson-Lee probably knew nothing more than the talking points she has been given about Obamacare by fellow Dems or her caucus or Sibelius. The same holds true for John Olver (D-MA) who can only cite the Sibelius talking points such as 50 million will now have coverage. But he couldn't hold a town hall for his constituents b/c he was either afraid or didn't know what to say, and most certainly, would not have been able to answer questions. If a representative of the American people can't or refuses to talk with his/her constituents, then he/she should not be allowed to vote on their behalf. (Not that any of them listen to their constituents, but you get my drift.)
Markey from Massachusetts said during the recent debate regarding repeal of this law that kids with pre-existing are now covered. Wrong. This doesn't begin until 2014 due to an "error" when the bill was written and rammed through. He also said that if it weren't for the national health plan "granny wouldn't be able to get her medication." What planet does this guy live on? Granny still can't afford her medication under the national plan. A $250 check when a senior reaches the donut hole against the thousands of dollars a senior must pay while in the donut hole is a joke, and the 50 percent discount on brand-name meds is a hoax b/c the pharmacy plans push generics. If you want the brand, your doctor has to appeal the denial. Maybe Markey thinks this is a good deal? Personally, I think seniors in Massachusetts should donate their $250 to MA U.S. Sen. John Kerry so he can pay those pesky yacht taxes he tried to get out of by docking his new boat in neighboring Rhode Island.
This country is run by crooks - red and blue. There's really no difference between the parties except for the framing. Democrats would have us believe that they work for us while Republicans, at least, are up front about the fact that they don't give a damn. Both parties dine at the same trough, and it's really a game of good cop, bad cop.
Low and modest income seniors will be hurt by cuts to Medicare which may come
#5 Posted by dianne, CJR on Tue 25 Jan 2011 at 02:56 AM
Thimbles, I'm fascinated by your portrayal of the most powerful monopoly in the world as victim. It would be a hoot if it wasn't such a morbid inversion of reality.
"One hundred senators, 435 congressmen, one president, and nine Supreme Court justices — 545 human beings out of the 300 million — are directly, legally, morally, and individually responsible for the domestic problems that plague this country.
"I excluded the members of the Federal Reserve Board because that problem was created by the Congress. In 1913, Congress delegated its Constitutional duty to provide a sound currency to a federally chartered, but private, central bank.
"I excluded all the special interests and lobbyists for a sound reason. They have no legal authority. They have no ability to coerce a senator, a congressman, or a president to do one cotton-picking thing. I don't care if they offer a politician $1 million dollars in cash.
"The politician has the power to accept or reject it. No matter what the lobbyist promises, it is the legislator's responsibility to determine how he votes.
"Those 545 human beings spend much of their energy convincing you that what they did is not their fault. They cooperate in this common con regardless of party." -Charley Reese
"The highwayman takes solely upon himself the responsibility, danger, and crime of his own act. He does not pretend that he has any rightful claim to your money, or that he intends to use it for your own benefit ... Furthermore, having taken your money, he leaves you, as you wish him to do. ... He does not keep 'protecting' you, by commanding you to bow down and serve him; by requiring you to do this, and forbidding you to do that." -Lysander Spooner
"The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience." -C.S. Lewis
#6 Posted by Dan A., CJR on Tue 25 Jan 2011 at 10:27 AM
I guess Thimbles takes that attitude because the 545 human beings are controlled by the people with the money.
#7 Posted by Ron Rosenthal, CJR on Tue 25 Jan 2011 at 03:35 PM
Moneyed interests influence and bribe, but lack the legal authority to coerce.
#8 Posted by Dan A., CJR on Tue 25 Jan 2011 at 07:17 PM
"I guess Thimbles takes that attitude because the 545 human beings are controlled by the people with the money."
Got it in one. What we have seen in the last 30 years is a failure of representational structure.
"You mean representative government is evil?"
No, representational structure is not the sole domain of government. Corporate executives are intended to represent the interests of shareholders, unions are intended to represent the interests of workers, elected officials are intended to represent the interests of their electorates, and what we have seen in all these cases is that the representatives are working within systems in which the representatives are most rewarded when they represent interests other than those they are intended to. It's in the representative's interest to align with interests of powerful constituencies other than those who got him in his position.
That pull of individual interest corrodes the duty of office, and those who perform the duty of office in spite of the systemic pressure are punished and purged
http://www.leadershipreview.org/2002fall/article1_fall_2002.asp
This happens in corporations, unions, and government. In such cases, the victims are the interests of represented (the electorate, the shareholder, the worker) and those who best attempt to serve that interest.
In perilously unequal societies, in which a minority considers themselves a people apart and controls a dominant amount of resources and influence, representational structures fail. They fail because the system the minority has influence over warps the representatives to serve them and not the people who elected them.
A review of systemic compromise (you've seen this Dan) presented by Dr. Zimbardo here:
http://www.youtube.com/watch?v=cMoZ3ThW6x0
So the question is, what do we do within a society which is based on representative structures that do not represent us? Do we attack the structures? Do we attack those who are compromising the structures? Do we build competing structures that will remain pure for a time?
Remember, we build representative structures to manage complexity on our behalf. For example, we cannot run the computer corporation we own shares in. We need to rely on expertise. When the system of expertise is compromised, what are our options as citizens, shareholders, and laborers? You tell me.
#9 Posted by Thimbles, CJR on Tue 25 Jan 2011 at 07:49 PM
Oh, and I should mention one of the biggest failures of representational structure is Journalism.
Journalism is supposed to represent the interests of the subscribers. Subscribers expect journalism to perform an information service that meets the needs of an informed electorate.
The country requires this, the citizens require this, the shareholders...the advertisers...the government who may or may not cooperate with media demands to deregulate (or give the media access to it)... the business interests (who might trade your outlet like a baseball card and are even more fickle to give access) their interests are not aligned with the duty journalism is supposed to perform. There are too many constituencies.
What's the solution there?
#10 Posted by Thimbles, CJR on Tue 25 Jan 2011 at 08:03 PM