Tuesday, May 31, 2011

Today's Theme: Mediscare; And, Will Democrats Have the Courage to Control Costs?

Republicans cry "Mediscare" and try to back pedal and say it isn't so, but Ryan's Plan Really Would End Medicare and replace it with something entirely different.  "Republicans couldn’t get enough of Paul Ryan and his 'bold' and 'visionary' budget plan when he unveiled it back in April.  But after the applause faded, it began to sink in that Ryan’s plan would essentially abolish Medicare, the government health insurance program for seniors.  This didn’t go over well with voters ...."  The political problems for Republicans continue as Americans see through the smoke and mirrors.

In the New York Times,  op-ed columnist Paul Krugman takes Ryan to task ("Medicare and Mediscares") noting that "Mr. Ryan may claim -- and he may even believe -- that he’s facing a backlash because his opponents are lying about his proposals.  But the reality is that the Ryan plan is turning into a political disaster for Republicans, not because the plan’s critics are lying about it, but because they’re describing it accurately."  Nicely done; the column puts recent events in perspective.

Meanwhile, although there's much talk about whether Democrats can take advantage of the Republican's Medicare blunder, some Democrats now think Medicare Puts the House in Play.  "Democrats say the House of Representatives has become much more competitive because of their success using Medicare as an issue to win the New York special election earlier this week.  'I fundamentally believe the House of Representatives is in play,' Democratic Congressional Campaign Committee Chairman Steve Israel told reporters Thursday, hedging by adding that he’s not yet ready to predict that Democrats will win enough seats to take control."  Hopefully, the Democrats will have some significant Medicare improvement ideas to put on the table.

It's generally understood that Republicans are better able to use (and even create) political advantages; they really know how to play hardball and how to spin.  Will the Democrats have the fire in their belly to really fight for Medicare and stand up for their purported values?  Republicans still are trying to equate budget problems with Medicare; it's a mantra.  The Democrats need to be more clear that unfair tax advantages and foreign interventions are the budget busters.  And, they need a Medicare mantra of their own.

Missed this one a few days ago, but I still can recommend it.  "Will Anybody Make the Case forMedicare Reform?"  "Yes, the Dems have succeeded in beginning to turn the political tide against the GOP by attacking their plan for Medicare, but they've done so by playing offense, not defense: Dems have raised fears about the Ryan proposal but haven't made a full-throated defense of their own Medicare reform plan -- namely the major provisions for bringing down health-care costs through the Affordable Care Act.  And, without strong defenders, some of those key changes have been under increasing threat of being weakened or dismantled."  Again, real solutions to strengthen and improve Medicare are needed.

For comments about the need to address Medicare's real problems, see "Squandering Medicare's Money" which focuses on needless procedures.  "Much has been said about the growing gap between the program’s spending and revenues -- a gap that will widen as baby boomers retire -- but little attention has been focused on a problem staring us in the face: Medicare spends a fortune each year on procedures that have no proven benefit and should not be covered."

In a less politically charged atmosphere, "relatively easy" administrative changes would be possible.  Today somehow, we have to muster the courage to address necessary improvements without yielding to the tremendous hue and cry that regressives will mount.


Sunday, May 29, 2011

Republicans Deny Medicare, Democrats Deny Problems, JFK's Historic Medicare Speech

The GOP continues to minimize the political importance of Medicare, even as they continue their assault:  McConnell Downplays the Politics of Medicare.  "Senator Mitch McConnell knows one of the golden rules of politics: when your friends are down, do some punching on their behalf.  Mr. McConnell, the Senate minority leader, took advantage of a quiet Friday morning before a holiday weekend to make some things clear on behalf of his party:  the defeat of a Republican in a New York special election portends nothing; any compromise to lift the debt ceiling will include a reshaping of the Medicare program but not tax increases; and Bill Clinton agrees with Republicans."

It makes sense that the harmful changes in Medicare sought by Republicans also will create problems for the ability of Social Security to provide income security for older and disabled Americans.  Here's a new analysis demonstrating just that:  Republican Medicare Proposal Erodes Social Security. "Forty Republican Senators and 235 Republican House members have voted not just to eliminate Medicare, eviscerate Medicaid, and give the wealthy and corporations even bigger tax breaks.  They've also gone on record in support of eroding Social Security benefits.  That's analysis from Social Security Works and the Strengthen Social Security Campaign.  Even though the Republican plan doesn't directly cut Social Security, the increased costs to seniors for Medicare would continuously erode the value of Social Security benefits, and by 2014 [sic -- they mean 2041], '19 years after the Medicare voucher begins—an average worker’s Social Security benefit is estimated to be worth less than their Medicare costs.'"  Here's the analysis -- Republican Medicare Plan’s Increased Costs to Seniors Will Consume Social Security Benefits Needed to Live.

What’s really scary? Acting like nothing’s wrong with Medicare.  And we agree.  Democrats and Liberals deserve a spanking for not taking a serious look at how to fix Medicare's real problems, and this is it.  "If Medicare reform is on life support, it’s not because of a special election in upstate New York or the Senate’s rejection of the House GOP budget plan.  It’s because one side wants to air TV commercials of a dark-suited Republican pushing grandma off a cliff, while pursuing a path of neglect that would let her die bed-ridden and alone.  There can be no 'hands off Medicare' policy.  Either your hands are busy trying to fix the indisputably broken program, or your hands are holding it down, helping it collapse under its own unbearable weight."  We need more hands on deck fixing Medicare.

A Little History:  At a Medical Care for the Aged rally at Madison Square Garden on May 20, 1962 -- almost exactly 49 years ago, President John F. Kennedy spoke about the need for medical care for the aged:  "Now why are we here?  What is the issue which divides and arouses so much concern?  I will take a case which may be typical, a family which may be found in any part of the United States.

"The husband has worked hard all his life and he is retired.  He might have been a clerk or a salesman or on the road or worked in a factory, stores, or whatever.  He's always wanted to pay his own way.  He does not ask anyone to care for him; he wants to care for himself.  He has raised his own family, he has educated them -- his children are now on their own.  He and his wife are drawing social security, it may run seventy-five dollars, a hundred, hundred and twenty-five in the higher brackets let's say it's a hundred.  He has a pension from where he worked, the results of years of effort.

"Now, therefore, his basic needs are taken care of.  He owns his house.  He has twenty-five hundred or three thousand dollars in the bank.  And then his wife gets sick -- and we're all going to be in a hospital, 9 out of 10 of us, before we finally pass away, and particularly when we're over 65 -- now she is sick, not just for a week but for a long time.  First goes the twenty-five hundred dollars -- that's gone.  Next he mortgages his house, even though he may have some difficulty making the payments out of his social security.  Then he goes to his children, who themselves are heavily burdened because they're paying for their houses and they are paying for their sicknesses, and they want to educate their children.  Then their savings begin to go."

"So therefore now, what is he going to do?  His savings are gone -- his children's savings, they're contributing though they have responsibilities of their own -- and he finally goes in and signs a petition saying he's broke and needs assistance."


Saturday, May 28, 2011

Republicans Continue Decades-Long Hostility to Medicare, GOP Ups the Pressure, The Constitutionality of Medicare

The Republican hostility to Medicare has never been more evident than it has been of late.  I think the Tea Partiers have emboldened (or simply energized) the Republicans, and now their intentions are more evident than ever before.  (Does anyone remember when you could be a Republican and NOT a be Conservative?  I do.)  They may pretend otherwise, but Republicans have been trying to weaken Medicare for years.  If the public really does support Medicare, how can the Republicans be taking such a political risk?  Or isn't it a risk at all?

Here's the full story:  House Republicans Have Voted To Cut Over $1 TRILLION From Medicare Since 1991.  "While Republicans in both chambers of Congress continue to spread the falsehood that Democratic health care reform cuts Medicare (it doesn't) [note their related strategy below], House Republicans have in fact voted to cut $1.02 trillion from Medicare since 1991 - on top of their refusals to increase payments to Medicare physicians."

How do the Republicans discount the public support for Medicare?  Well, regarding their stunning loss in the NY-26 special election, after making all manner of excuses for their loss (but never fully acknowledging the importance of Medicare), they now say their own candidate -- in a heavily favored Republican district -- was inferior.

Meanwhile, the pressure mounts and the stakes get higher as Senate Minority Leader Mitch McConnell (R-KY) says he won’t agree to raise the debt limit without Medicare cuts.  He is completely against "entitlements," and says Medicare cuts must be part of the debt limit deal to get his support, and it doesn't matter if negotiators find trillions of dollars in savings elsewhere.  Medicare must be cut.  This appears to be the GOP strategy for getting themselves out of their Medicare mess; get the Democrats to let them off the hook by voting against Medicare. McConnell even invoked President Bill Clinton's name.

When will it end?  Apparently, not as long as there's a Republican / Conservative/ Libertarian / Tea Partier in Congress -- or at least not as long as regressives favor the privileged and ignore the common good.  Give them credit for their persistence.  They don't like Medicare; they don't want Medicare; they are serious; and they won't give up.

Lately, I have been wondering about the false claims that Medicare is unconstitutional.  I know the world has changed and that our country and the American people are different than when the United Sates was founded.  But what about the idea that Medicare is unconstitutional?  Check out this out:  Conservatives Calling to End Social Security and Medicare Are Misinterpreting Constitution. "Numerous lawmakers embrace a discredited theory of the Constitution that would not only end Medicare outright but also cause countless other cherished programs to be declared unconstitutional."

For more, see The Fake James Madison.  "Under the Constitution, national leaders are free to spend money in any way they choose so long as they do so to 'provide for the common defense and general welfare of the United States.'  For this reason, laws such as Medicare and Social Security are obviously constitutional because they both raise and spend money to the benefit of all Americans upon their retirement.  Many members of Congress, however, do not believe the Constitution’s words mean what they say they mean."  Interesting and informative.


Friday, May 27, 2011

The Special Medicare Election, A New Medicare Popularity Poll, and More

In the face of evidence to the contrary, House Speaker John Boehner (R) attributed only a small part of the Republican loss in theNY-26 special election to the electorate's rejection of the GOP's actions to eliminate Medicare.  Yet, for once, everyone who followed the story even remotely knows otherwise.  Medicare was the driving and deciding issue. It's heartening that Americans are beginning to understand the value of Medicare and the crucial consequences of some of the Republican budgetary proposals.

More about the election:

               > VICTORY FOR MEDICARE: Democrat Wins Huge Upset

Meanwhile, as we well know, the Public Is StronglyAgainst Cutting Medicare.  This excellent article offers new polling information. "The conservative assault on government marches on.  Their latest trick is passage of the House Republican budget bill.  This bill takes direct aim at Medicare by proposing to cut funding for the program and turn it into a fixed amount voucher that seniors would have to use to purchase private health insurance.  To say this approach is unpopular is to considerably understate the case."  Excellent charts.

Predictably, Sen. John Cornyn (R-TX) disagrees with the media's coverage of Wednesday's Senate vote on the GOP's Medicare-privatizing budget.  He says they're not really ending Medicare.  However, according to the plan, after 10 years, Medicare hospital insurance would be phased out and replaced with a subsidy to buy "regulated" insurance on an exchange.  Looks like welfare for the insurance industry and less free choice for older health insurance consumers.

Let's face it;  Republicans are in trouble, because they do not understand the importance of Medicare.  Rep. Paul Ryan (R-WI), whose proposal to privatize Medicare has become the center of national controversy, now is viewed unfavorably by a plurality of voters back home in his perennial swing state. He's not the only one in trouble, as elected Republicans and potential candidates alter or spin their messages.

Yet, former Minnesota Gov. Tim Pawlenty said Thursday -- for the first time -- that he supports the House Republicans' budget outline that calls for cuts to the federal deficit as well as federal programs such as Medicare and Medicaid. We'll have to see if he changes his position.

In the meantime, the Architect Of GOP’s Constitution Reading On House Floor Says Social Security And Medicare Are Unconstitutional.  In response to a constituent, Rep. Bob Goodlatte (R-VA) agreed that Medicare isn't in the Constitution and said that the courts have stretched the document to say that it's allowed.  We're not sure if he would agree that the Constitution was created to "promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity."

But enough of the republican nonsense.  For much more thoughtful comments about some of Medicare's real problems, check out Medicare Fix Rose by any Other Name Still Has Thorns by Sheri and Allan Rivlin.  They point out some of the mistakes Democrats make when thinking about solving Medicare's problems.  It begins, "Republicans love the idea of a small government that gives people freedom to pursue their dreams without interference, believing that the free market can, almost magically, solve any problem.  At the same time, Republicans tend to overlook the problems that markets create.  It was from this dream that Republicans passed the budget written by Rep. Paul Ryan (R-WI) through the House of Representatives."

"The Ryan Budget relies on spending cuts exclusively to achieve deficit reduction -- and in its most controversial and ultimately unpopular provision, it replaces the 'Medicare as we know it' guarantee of health insurance for life with a voucher which future seniors can test for value in the free market."


Thursday, May 26, 2011

The Medicare Daily Report

The MEDICARE DAILY REPORT is a compilation of news items about the politics of Medicare, along with commentary about current political developments related to Medicare.

Medicare is one of the greatest American success stories.  Before Medicare was enacted in 1965, aged and disabled people had limited access to physician and hospital insurance.  People over 65 found it almost impossible to get private health insurance coverage once they left their job, and one national survey found that nearly half of the elderly did not have any health insurance.  Given the high cost of health care, the financial consequences both to older Americans and to health care providers was significant and growing worse.

Medicare gave America's working men and women a chance to contribute to their own health insurance in preparation for retirement.  Thus, they could better rely on their own savings and Medicare coverage, instead of looking for public welfare or charity care.

With its passage, Medicare was considered the prudent, feasible, and dignified way to free the aged from the fear of financial hardship in the event of illness and to support the health care system.  Thus, Medicare made access to health care a universal right for Americans once they reached age 65.

Among the strongest and most admirable of American values is working together to solve the largest problems that prevent us from becoming the greatest country and people we can -- creating solutions that make us stronger as a country and as a people.  Medicare is such an achievement.  Medicare matters.  We would be diminished as a country and as a people without it.

Improving and maintaining the common good, as Medicare does, is not only a noble American cause but also a noble American achievement.

We must not ever forget that it has been together, unselfishly, that we have made the greatest strides as a country and as a people.  We banned together in the Revolutionary War in an effort for the common good.  We created our government to address common problems and ensure the common good.  Specifically:

               "We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America."

While America does, and should, honor the rugged individualist, we must never forget that this is an exceptional person.  The great majority of us cannot reach that stature, and even those few who do still need the rest of us.  Our glorious history is full of examples of how individual selfishness was put aside in favor of the common good.

Unfortunately, there also are examples of self-interested individuals and groups who advocate only for themselves -- even with lies and trickery.  We easily can say that for the past 25 years or so, people with vested self interests have dominated politics and business to such an extent that the common good has been compromised.  (For example, government taxes wages harder than it taxes capital gains; thus, a worker pays more on a dollar earned than does an investor.  Another example, some businesses are legally considered people and, although they cannot vote, they can spend millions of dollars to influence elections and our elected representatives, while we simply cannot afford to do so.)  Clearly, things are out of balance between those who actively advocate for further advantages for themselves and those who favor the common good.

I have created this blog to talk about Medicare (and thus also about the common good), because I believe strongly that there is too much selfishness and too little common sense, too much anger and  too little discourse, too much vitriol and too little rational thought, too much ideology and too little statesmanship.

Following America's best examples of success, we need to address the real problems of Medicare.  It may be that it has been so successful in assuring access to affordable care that we take those benefits for granted.  Without Medicare, these problems will re-appear.  We need to keep the basic promises of Medicare by strengthening its commitment to the aged and disabled and solving the problems that get in the way of keeping its promise.

Many Republicans, Conservatives, Libertarians, (and now Tea-Partiers) -- after 45+ years of Medicare success -- want to regress, to turn back to darker days for the elderly, the disabled, and their families.  Instead, we need to make progress by fixing Medicare's problems.  In addition, we need not continue the similarly out-of-date thinking of Democrats and Liberals as to the range of solutions.  Instead, we need to create progress via practical solutions to the real problems which have to do with financing, eligibility, and effectiveness.  On these, there is much room for analysis, debate, reconciliation, and improvement.

The real problem is NOT the very existence of Medicare as if it were some kind of un-democratic institution.  Medicare is not a threat to democracy.  Truly, Medicare has made us a better country and a better people.

With this blog, I hope to appeal to the best in us to work together to solve our problems.  We must reject the paths of ideology without compromise, values without tolerance, individuals without democracy.  Those paths lead to utter failure -- and a serious weakening of America and the American People.