Thursday, June 30, 2011

Medicare Ad Wars Continue, Lieberman-Coburn Bad Idea for Poor People, Trimming Billions While Keeping Services

More Medicare Ads Hit Republicans

"Priorities USA is up with ads in Iowa, North Carolina, Virginia, Florida and Colorado for the next two weeks, arguing the GOP budget will 'essentially end Medicare for future retirees,' 'slash education,' and 'tear down the middle class.'"   Watch the ad.   Priorities USA -- a "fundraising group supporting President Barack Obama's re-election bid -- is airing ads accusing Republicans of blocking progress on the economy."

It would seem that the accusation is true, considering that Conservative Republicans have no political incentive to help improve the economy.  I don't know when I've ever seen such extreme political positions which leave no known room for progress or compromise.  America is in trouble.

Poor Hit Hardest by Lieberman-Coburn Medicare Changes

As noted in yesterday's Medicare Daily Report, the Lieberman-Coburn Medicare proposal is a bad idea because it shifts costs to beneficiaries when they are least unable to afford them.  Another reason why the Lieberman / Coburn Medicare proposal is a bad idea is that it would raise the age for Medicare eligibility from 65 to 67 by 2025.  "Life expectancy is a fairly complicated measurement that varies drastically across geographical and economic lines.  Any proposal that increases the program’s eligibility age would disproportionately affect people in both the poorest states and lowest income brackets." 

Many of the proposed changes to Medicare sound more and more like an assault on the poor.  Clearly, retired people not only have less money to spend but also must spend more on medical care.  Medicaid also is under attack.

Meanwhile, top Democrats are rejecting the Lieberman-Coburn plan to cut Medicare spending.  "Leading congressional Democrats immediately recoiled Tuesday from a new proposal to cut $600 billion in Medicare spending over the next decade -- in part by raising the eligibility age.  ...  The proposal echoes Republican demands that entitlement reform -- especially deep cuts in Medicare spending -- be a part of any agreement to raise the nation’s debt ceiling."

How to Trim Billions from Medicare

Meanwhile, the Center for American Progress is making suggestions for how to trim hundreds of billions from Medicare and Medicaid without reducing services.  "The ballooning cost of health care is a major driving force behind the budget deficit.  While the Affordable Care Act will reduce the deficit by $230 billion over 10 years, we can save hundreds of billions more by reforming the Medicare prescription drug benefit, and by reducing Medicare and Medicaid payment errors."  Their list is really quite short considering how much it might save.  Be sure to check it out.


Wednesday, June 29, 2011

Lieberman-Coburn Would Slash Medicare, Debt Negotiations Still Focus on Medicare

More Proposed Bi-Partisan Cuts to Medicare

The Joe Lieberman and Tom Coburn plan to slash Medicare is getting a cold reception.  "The new effort aimed at bridging the partisan divide over debt reduction aims to cut more than $640 billion from Medicare over the next 10 years, largely by raising deductibles and other costs for beneficiaries.  It would require wealthier Americans to pay the full cost of their Medicare premiums, raise the eligibility age to from 65 to 67, create a minimum out-of-pocket deductible of $550 and raise premiums, among other changes."  Unfortunately, the plan requires seniors to bear the heaviest burden of addressing Medicare's problems.  And, neither Democrats nor Republicans -- who continue to beat the same drum -- are enamored of the ideas.

It hardly seems that a proposal like this would have a chance in today's environment.  "Doomed" might be a fair assessment.  "Lieberman and Coburn's proposal includes several politically risky benefit changes, such as making seniors pay more for their prescription drugs."  Coburn, Lieberman cook up 'bipartisan' Medicare slashing plan.

On a similar note:  "Republicans may be suffering politically for voting to phase out Medicare.  But they moved the needle on the policy debate way to the right, and, as such, cutting Medicare now is basically a fait accompli.  The latest plan comes from Sens. Tom Coburn (R-OK) and Joe Lieberman (I-CT).  This is an interesting political coalition for a few reasons.  Recall that Coburn left the Gang-of-Six Senate debt talks for proposing dramatic cuts to Medicare, and has now found comfort in the arms of liberals' darkest bete noire."  However, Democratic leaders already have rejected the Coburn, Lieberman plan to raise the  Medicare retirement age to 67.

House Minority Leader Nancy Pelosi said, "It is unfair to ask seniors to get less in benefits and wait longer to get onto Medicare -- all while Republicans back tax breaks for Big Oil and corporations that ship American jobs overseas.  Just like the Republican plan to end Medicare, this proposal is unacceptable, especially for struggling middle-class Americans."

Debt Update: Medicare Under the Gun

And so, the Conservative Republicans have really dug in their heels and said, give us huge Medicare cuts, or raise the debt limit yourself.  "Senate Republicans are threatening openly to throw up their hands and let Democrats vote to raise the debt limit on their own if President Obama doesn't cave and agree to trillions of dollars in entitlement cuts and zero tax increases."  All of this puts House Speaker John Boehner (R-OH) in an incredibly awkward position.  "Boehner is stuck between the absolute imperative that Congress raise the debt limit, and the highly partisan demands of his caucus, which won't vote to allow the country to borrow more money without simultaneously cutting a big hole into the social safety net."

Video update on the budget talks and possible Medicare cuts:  Health On The Hill: Obama Confers With Senate Leaders On Budget (from Kaiser Health News).


Tuesday, June 28, 2011

Debt Gridlock, Conservative Medicare Defectors, "Wean Them Off Medicare," More Ad Wars, Home Care for Seniors, FYI

Debt Limit Faces Impasse

"With just over one month left until the government begins to default obligations to creditors, vendors, and entitlement beneficiaries, leaders of both parties in Washington made clear Monday that the underlying gridlock isn't going anywhere.  That means a half-trillion dollar impasse will have to be bridged, quickly, if the country's to avoid a domino effect of economic consequences.  And with the White House and Congressional Republicans staking out incompatible positions, it's unclear how that will happen."

"In the hours before an evening meeting with President Obama, and in a number of different venues, Senate Minority Leader Mitch McConnell renewed his insistence that Republicans will not accept any tax increases as part of a trillion-dollar deficit reduction package the GOP is demanding before agreeing to let the country pay all its bills on time."  Statesmanship, please.

Conservative Republicans Abandon Medicare Repeal

Yes, it does appear that even Conservative Republicans are retreating from the Ryan budget plan.  For example, Jim Sensenbrenner Backs Off Medicare Plan.  "One of the most conservative veteran Republicans in the House, Rep. Jim Sensenbrenner, backed away from the GOP's controversial Medicare plan at a town hall in his Wisconsin district."

"Sensenbrenner declined to back Ryan's plan on Sunday, backtracking from his earlier support of the proposal.  'I'm not here to say he's right or he's wrong, but at least he's got a plan,' he told the town hall.  But when the same Medicare-altering proposal came before the house in April, Sensenbrenner voted to support it."  Even the most Conservative Republicans are having trouble sticking with the Ryan plan.  (See many of our previous Medicare Daily Reports for more about that.)  Will Paul Ryan himself be left abandoned by his former allies?

Bachman:  "Wean Everyone Off Medicare"

"This past weekend, Rep. Michele Bachmann (R-MN) addressed the right-wing Constitutional Coalition’s annual conference in St. Louis.  She had dropped out of the Tea Party Convention occurring on the same day in Nashville to make the appearance."  She has a plan to deal with the debt; put simply, We Must ‘Wean Everybody’ Off Social Security, Medicare.

Here's what she said:  "So, what you have to do, is keep faith with the people that are already in the system, that don’t have any other options, we have to keep faith with them.  But basically what we have to do is wean everybody else off."  This appears to be part of the slightly altered direction recently taken by Right Wing Republicans and Tea Partiers.  Clearly, they are feeling the political heat from people on Medicare and their defenders.  So, now they are emphasizing "keeping faith," but not with future generations --  our children and younger workers.

By the way, this is the same Michele Bachman who confused John Wayne (the actor-governor) with John Wayne Gacy (the notorious serial killer).  Sometimes it's like a contest between Bachman and Palin to see who can make the most outrageous and ignorant mistakes.  But, watch out; they both have followings (or followers).

Continuing Ad Wars

"Eight members of Congress are the targets of ads, released Monday by the Democratic House Majority PAC, that criticize their votes on the House GOP budget proposal."  See Dem group keeps up budget attacks.  "According to the group, minute-long radio spots will run in the home districts of Arkansas Reps. Rick Crawford and Tim Griffin,  Colorado Rep. Scott Tipton,  Iowa Rep. Steve King,  Illinois Rep. Bobby Schilling,  New Hampshire Rep. Charlie Bass and Nevada Rep. Joe Heck.  The ad against Minnesota Rep. Chip Cravaack will run on cable television."

Home and Community-Based Care

Kenneth Thorpe, Chair of the Department of Health Policy & Management at Emory University's School of Public Health says, "Based on my experience, common ground on Medicare is possible and, in the short term, policymakers have an immediate and time-sensitive opportunity to prevent and manage costly chronic illnesses such as cancer, diabetes and hypertension through a coordinated approach to treating patients led by home health care.  By strengthening options that let people get much-needed care at home, policymakers can save money, give older Americans what they want and address the chronic disease epidemic facing our nation."  Read more about Why America Needs Seniors to Remain Healthy and in Their Homes.

For Your Information

FYI . . . .  "At a critical juncture in the deficit reduction talks, the leaders of prominent national religious, civil rights, charitable, economic research, and low-income advocacy organizations are calling on Executive and Congressional leadership to honor the precedent set by previous deficit reduction negotiations that have reduced the deficit without increasing poverty."  We agree.  See Leading National Groups Urge Importance of Reducing Deficits Without Increasing Poverty.


Monday, June 27, 2011

Democrats: Medicare Cuts on Table, Bi-Partisan Move on Medicare Fraud, Small Cuts to Medicare, House Republicans Still Under Medicare Siege, GOP War on Women

Democrats:  Medicare Cuts Open for Negotiation

The Democrat strategy that we've seen unfolding over the past week or so is becoming evident in the debt negotiations.  "Democrats laid out additional details on Friday of their plans to cut the deficit, signaling they would be willing to negotiate some Medicare cuts on the provider side as part of a deal to raise the debt ceiling this summer.  Sen. Chuck Schumer (D-N.Y.) and Rep. Chris Van Hollen (D-Md.) told reporters they would be willing to look at 'delivery system reform' of Medicare, which would change the way providers on the senior health care system are paid."  Of course, providers won't be happy about this.

"'There are three approaches: One is the Republican approach to end Medicare as we know it, transfer it all to insurance companies, which will not reduce costs, it will simply shift costs to beneficiaries,' Schumer said on a call with reporters.  'Second is to do nothing.  We reject both of those.'  Instead, Schumer said the Democrats will push for changes to the 'delivery side' of Medicare, such as implementing more information technology and putting more emphasis on prevention."  This clearly will test the Conservative Republican contention that the cost of Medicare is their key concern.  Unfortunately, a debt agreement looks unlikely until rhetoric is replaced with statesmanship.

Bi-Partisan Proposal on Medicare Fraud Prevention

Meanwhile, two Senators have specific ideas about halting unnecessary costs in Medicare and Medicaid:  New Bill Aims to Curb Medicare and Medicaid Fraud - Better Databases Could Stop Billions in Improper Payments.  "Sens. Tom Carper (D-DE) and Tom Coburn (R-OK) are expected to introduce a bill today that will prevent a slew of health care scams, including stopping 'dead' doctors from placing Medicare orders.  If approved, the measure is expected to save taxpayers billions of dollars by reducing waste, fraud, and abuse in our health care system."  Few would disagree that such reform simply makes sense.

Small Steps to Lower Medicare Costs

"With the 2012 election fast coming into focus, Congress is unlikely to alter seniors' beloved Medicare in any fundamental way.  But Congress can, and should, take small but important steps now to lower the cost of the program, says Robert Berenson, a physician, health policy researcher and former Medicare official."  Read the KHN Interview: Take Small Steps Now To Lower Medicare Costs.  Among Dr. Berenson's comments, "There's plenty to do in Medicare that is not about rationing.  It's about identifying areas where the program is being abused and going after them."  Also see the brief video -- Controlling Medicare Costs.

Medicare Attacks Continue on Republicans

Democrats still are capitalizing on the unpopularity of the Ryan plan to repeal Medicare.  "Democratic House Majority PAC will take a crack at GOP Minnesota Rep. Chip Cravaack Friday with the release of a new ad criticizing the congressman for endorsing a Republican House proposal to dramatically alter Medicare.  The independent expenditure group's main beef with Cravaack is his support of House Budget Chair Paul Ryan's proposal that would require changes to Medicare as a method of battling the budget deficit."

For further examples of Republican trouble: "Strategists always contend that the best stance for candidates to take on a controversial issue is none at all.  That seems like particularly good advice for Republicans when it comes to the 2012 budget plan proposed by Rep. Paul Ryan (R-Wis.).  But that counsel is also rapidly becoming unrealistic as the Ryan plan, passed by the House in April, is evolving into the litmus test for Republican candidates fighting key 2012 Senate primaries in places like Florida, Missouri and New Mexico."

For a rundown of the various states, see Republican candidates squeezed on both sides over Medicare.  "The outcome of those races could help determine the shape of Congress in 2013.  On the campaign trail, conservatives are already pushing Republicans to embrace Ryan’s plan in the primaries, and so are Democrats, who hope to use the Medicare overhaul against the GOP in the general election."

Is There a GOP War on Women?

ThinkProgress says the GOP is waging a continuing war on women.  "In Congress and state legislatures across the country, Republicans have targeted public health programs for drastic spending cuts or full elimination, focusing especially on programs that benefit women the most.  ThinkProgress compiled a list of the most drastic cuts the GOP has attempted to make to women’s health programs:"  "Medicare/Medicaid: The House GOP budget authored by Rep. Paul Ryan (R-WI) would end Medicare as we know it and turn Medicaid into a block-grant system, disproportionately hurting women.  Both programs aid more women than men, and women in general retire at lower incomes than men.  The average retired woman earns $14,000 in income each year -- $12,000 of which comes from Social Security.  Under Ryan’s plan, the average female senior would pay all of that $12,000 for Medicare coverage."


Friday, June 24, 2011

Franken on Medicare & Progressive Values, More Good News for Medicare - Bad News For Ryan, Budget Talks Continue

Al Franken on Medicare and Progressive Values

Senator Al Franken (D-MN) is Fighting For America's Middle Class.  Here's an excerpt from his speech on Saturday at Netroots Nation 2011, the annual convention of progressive grassroots leaders and activists.  "Progressives, in a way, are the new conservatives.  We want to conserve what we fought to build.  And the right-wingers who call themselves conservatives are the ones who want radical change in the way our government works, and the way our country works.

"Newt Gingrich went on 'Meet the Press' last month and said that the Ryan plan that would end Medicare was 'right-wing social engineering,' that it was 'too big a jump.'  He has spent the month since apologizing -- but for once in his life, Newt was right.

"Actually, that's not fair.  He was calling for electronic medical records years before the rest of the country got on board with the idea.  So he was right the one other time.  Gotta give a guy credit.  But ending Medicare, like privatizing Social Security, is astonishingly radical.

"Part of the middle class promise is that, after a lifetime of hard work, you'll be able to retire and enjoy the fruits of that labor.  Medicare was established to secure that promise.  There was no private insurance market for people over 65 back in 1964.  [See my blog of May 29 for a link to JFK's "Medicare" speech.]  And if Republicans destroy Medicare, there won't be one now.  The average Social Security benefit is $15,000.  The average out of pocket health care cost for seniors under the Ryan plan would be over $12,000.

"So if Republicans eliminate Medicare, America will become a country in which you can never retire -- and once you physically can no longer work, you are desperately poor until you die.  That is a radical change to our society."

Be sure to read his full column; it's well worth the time.

Poll:  Good News for Medicare - Bad News For Paul Ryan

A new poll finds that Americans oppose the Ryan plan to repeal Medicare and don't care very much for Paul Ryan either.  "Democrats are winning the messaging war on Rep. Paul Ryan’s bid to overhaul Medicare, with a new Bloomberg poll finding 57 percent of Americans believe they would be worse off under his plan.  Only 34 percent said they would be better off if Congress replaced 'traditional Medicare' with a program to purchase private insurance with government subsidies, as Ryan has proposed.  The poll also found Ryan is now the nation’s third most disliked Republican, with net unfavorable ratings that trail only former House Speaker Newt Gingrich and former Alaska Gov. Sarah Palin."  (Note my blog of May 27 where I report that Mr. Ryan is viewed unfavorably by a plurality of voters in his home state.) 

Budget Talks Continue

Meanwhile, deficit talks are in danger as House Majority Leader Eric Cantor (R-VA) withdrew from the negotiations in a calculated attempt to turn the talks in favor of the Conservatives.  "Republicans moved in concert Thursday to disrupt deficit reduction talks with the White House, refusing to participate in some cases until President Barack Obama become more personally involved and resolves the divisive issue of taxes.  It is a high-stakes gamble designed to change the dynamic of the talks and push back hard on the revenue question -- a central tenet for the party.  But it also betrays a growing defensiveness inside the GOP, as the debt ceiling gets closer with no deal in sight and pressure for negotiators to consider defense cuts and eliminating some tax subsidies."

Senator Max Baucus (D-MT) is looking for tax increases in the budget talks: Revenues In Debt Limit Deal Should Match Medicare Cuts.  " 'I'm disappointed that Leader Cantor's withdrawn,' said Senate Finance Committee Chairman Max Baucus during a hearing on health care spending.  'I think we should stay at the table.  I think we should keep working, difficult as it is, and try to balance between Medicare cuts -- additional Medicare cuts -- so long as there is commensurate additional revenue.  We need balance here.'  Baucus made clear that the talks frayed over Democrats' insistence that tax increases of some sort be part of the final deal."


Thursday, June 23, 2011

Much More About The IPAB

I am devoting today's blog to the Independent Payment Advisory Board (IPAB) which is receiving more  and more attention.  In yesterday' blog, we covered Dick Gephardt's interest in eliminating the Board, and he is not the only one.  Mr. Gephardt's comments, however, are rational and largely non-political.  He believes it's Congress's responsibility to handle Medicare cost control.

Now, at a press conference, "in which more than a dozen Republican health care providers blasted the Independent Payment Advisory Board, a panel of 15 experts created by the reform law to slow the growth of Medicare," Rep. Phil Gingrey (R-Ga.) said that the IPAB will cause seniors to die.  "The much-maligned independent Medicare board created by the Democrats’ health reform law ... might actually be worse than 'pushing grandmother over the cliff,' the co-chairman of the GOP House Doctors Caucus charged Wednesday afternoon."  Once again, Republicans are using scare tactics and exaggerations.

Elimination of the IPAB has been on the Conservative Republican agenda for some time.  "Republicans, led by Rep. Phil Roe (R-Tenn.), have targeted IPAB for elimination, claiming the unelected IPAB members will ration care for seniors.  Roe wants House Speaker John Boehner to attach the IPAB repeal bill to legislation raising the debt ceiling."

It turns out that Republicans have a few Democrats on their side when it comes to eliminating the IPAB.  " ... this January, Tennessee Tea Partier Phil Roe introduced a bill to repeal it in the newly Republican House.  Now, by emphasizing its importance, Obama had put IPAB back at the front of the conservative firing line."  Then, "a little-known Democratic congresswoman named Allyson Schwartz signed on as a cosponsor of Roe’s bill."  At first glance, this appears to be a possible step toward bi-partisanship.  Alas, it's only the politics of special interests -- those of the health care industry.

"What Schwartz’s defection really represented, however, was ... a serious moment of escalation in a war that the medical industry is waging against the lynchpin of President Obama’s health care reforms.  To understand why, it helps to know a little bit about Schwartz and who she represents.  A former health care executive from a suburban district outside Philadelphia, she is the health policy brains of the New Democrat Coalition ..."

Read why "If an IPAB repeal bill passes the House with a couple dozen or more Democratic votes, it will set in motion a cascade of events that could end very badly for Barack Obama and his administration’s efforts to rein in long-term federal spending.  What would once have seemed a partisan -- and hence dismissible -- Republican attack on a core pillar of the president’s health care reform will instead have a bipartisan glow."  Friends Like These is from the July / August 2001 issue of "The Washington Monthly," and I strongly recommend it to you.