Free Pot For Everyone, And Other Budget Fantasies

Many liberals are criticizing Paul Ryan for essentially ignoring last November’s election results, as he released his third very dark, very Randian, budget resolution.

But it’s not that Ryan is acting as if the last national election didn’t happen. It’s that he is acting like he and Mittens actually won the damned election. In what can only be considered flat-out delusion (or that he intends to win a GOP primary in 2016), he offers the country a budget proposal that wouldn’t even become reality if Romney and Ryan had successfully duped a majority of Americans last November.

This monster would: repeal ObamaCare, slash Medicaid and food stamps, kill traditional Medicare, cut Pell grants, create lower tax rates for the rich—yet again. There is apparently no allowance for emergency spending on disasters, or the recognition that our infrastructure is crumbling and we need more not less money to fix it. Tax reform is part of the proposal, but we don’t know what the reforms are. The economic growth assumptions are also shrouded in mystery worthy of the ongoing papal conclave.

Not to mention the blinding hypocrisy of supposedly balancing the budget in ten years by using the $716 billion in Medicare cuts (used to help fund ObamaCare), cuts that Ryan and his fellow Republicans so famously campaigned against in both 2010 and 2012.

And not to mention the breathtaking dishonesty of using the $600 billion in revenue generated by Obama’s insistence on the restoration of the Clinton-era tax rates on high-income earners, which settled the fiscal-cliff nonsense this year.

This is not a serious proposal and Democrats in the Senate, who have now released details of their own budget, should revise their proposal in response to Ryan and the Republicans by including a series of people-pleasing goodies like: free health care, a free college education, forty acres and a Ford for all, a chicken in every pot, and some pot in every pipe.

Democrats can then start budget negotiations from there.

If You Don’t Learn Anything Else About Social Security “Reform” Learn This

A frequent contributor to this blog (HL Gaskins) sent in a fantastic and informative clip from MSNBC’s The Last Word that aired last November. I am posting it here because the five-minute essay by Ezra Klein needs to be seen by anyone who gives a damn about Social Security and what it means to so many working people. And after you watch it, pass it on to others.

My parents, both gone, are the kinds of folks Klein is referencing in his piece. When I hear knuckleheads on TV and radio, fretting over the national debt or pretending they want to “save” Social Security and Medicare, saying that we ought to raise the retirement age or the Medicare eligibility age or otherwise penalize working folks for the sins of Wall Street gamblers, I think of my parents. And then I get pissed.

Fortunately, Ezra Klein expresses my outrage in a much more civilized manor:

Fiscal Cliff Frustration

Watching cable news during this fiscal cliff flop can be frustrating.

I actually heard a talking head say on MSNBC this morning that he, a man who held political office as a Democrat but who now works for a Wall Street bank, that there is no way he should get Medicare when he is 65. He should have to wait until he is 67, he proudly said.

That is just part of the talk I have heard everywhere on TV about how Democrats need to cave on “entitlements,” finding some way to get Republicans to make a “deal” before The End of the World comes.

But, again, let’s quickly review what is going on here. From January 2001 until January of 2009, Republicans held the White House, and for a substantial part of that time had effective control of Congress. Thanks in part to Democrats responsibly raising taxes in 1993, Republicans inherited budget surpluses in 2001.

Then, Republicans cut taxes, initiated two wars, cut taxes some more, created a new entitlement program that was a sweet deal for their pharmaceutical industry campaign contributors, and then looked the other way while the economy was looted by reckless, greedy bankers who brought on the worst economic crisis since the Great Depression. While all that was going on, the federal debt soared, and, thanks mostly to those past Republican policies, keeps soaring.

As if that wasn’t enough, when the public, sensibly, put Democrats in control of Congress and the White House, Republicans suddenly found Jesus on the issue of government spending, just when we needed the government to keep spending to save the economy and to keep Americans working.

After finding Austerity Jesus, Republicans decided that the best way to save the country from “big-spending” Democrats (!) was to sabotage the economic recovery and hold the country hostage over the debt ceiling (!) until Democrats gave them what they wanted.

Then, because Democrats wouldn’t give them everything they wanted, they decided to create a situation that eventually led to this fiscal cliff fiasco, which amounts to a job-killing sword of Damocles hanging over the economic recovery.

But before we had to face the fiscal cliff, the parties had to face an election. Republicans didn’t do very well. In fact, Democrats gained seats in Congress and the hated Barack Obama was reelected, substantially, it turns out, because he ran on restoring those 1993 tax rates on the wealthy, those to whom Republicans had handed a rather large gift when they were in charge, a gift about to run out at the end of this year.

So, here we are. The fiscal cliff, which we have because Republican hostage takers needed assurance that Democrats would cut our social insurance commitments and not take away that tax gift from wealthy folks, is getting closer. And after that, yet another debt ceiling fight awaits, as Republicans have threatened to hold the country hostage again.

And some chattering schlemiel on television, a former Democratic congressman who now works for a big bank, says Democrats should be willing to raise the eligibility age for old folks, essentially to pay for the profligacy that Republicans inflicted on the country, old folks and all, during their years of governance. The right-wing drowned us in debt via tax cuts and war spending and a new entitlement program, and they want Democrats to tell old people they will have to pay for it.

It is psychotropically frustrating is what it is.

Chuck Todd, host of MSNBC’s The Daily Rundown, said this morning that “the pubic is craving a compromise.” He said that because of a new NBC/Wall Street Journal poll that found the following:

nbc poll

That poll supposedly indicates that people are beginning to blame “both sides” for the current impasse, which, if true, is a reflection of news coverage and not of reality.

But the poll did confirm a reality that journalists, and pundits on television, ought to pay attention to:

positive negative poll

As you can see, Democrats enjoy relatively strong public support. And look at the bottom of that list. Republicans are 15 points—15 points!—underwater. And looking deeper at those numbers, only 9% of respondents said they had a “Very Positive” view of Republicans, compared to 21% who viewed Democrats very positively.

The bottom line is that the public trusts Democrats to do the right thing during these fiscal cliff deliberations and any deal making that might come from them. And the right thing is not giving political cover to Republicans in Congress—who after recklessly running and ruining the economy, now feverishly want to cut social insurance benefits to rectify their malfeasance.

Journalism, Liberalism, And The Deal

There are very few liberal voices heard on television news, particularly cable television news. Very few. Oh, there are a few liberals here and there, but few liberal voices.

To support that assertion, and, more to the point, to demonstrate how mainstream journalists ignore the liberal voice, I give you an example related to the so-called fiscal cliff negotiations. I will excerpt a tiny part of the opening segment from this morning’s “Jansing and Company,” an MSNBC program hosted by award-winning journalist Chris Jansing.

The segment featured two of her regular guests, Dana Milbank, a liberalish columnist for The Washington Post, and Jackie Kucinich, a political reporter for USA Today, and the daughter of uber-liberal Dennis Kucinich. The topic, and title of the segment, was the “Fi$cal Cliffhanger,” and Jansing introduced a clip of Sen. Dick Durbin (D-Ill.), who had appeared on Meet the Press on Sunday:

JANSING: When it comes to cuts, especially on Medicare, you know that whole conversation has to be had. Here’s what Dick Durbin said on Meet the Press:

DURBIN: I do believe there should be means testing. And those of us with higher income in retirement should pay more. That could be part of the solution. But when you talk about raising the Medicare eligibility age, there’s one key question–what happens to that early retiree? What about that gap in coverage between their workplace and Medicare?

JANSING: Jackie, are Democratic getting away with giving away less on this deal?

I’ll stop it right there because neither Jackie Kucinich, to whom this ridiculous question was addressed, nor Dana Milbank, bothered to point out how ridiculous a question it was, mainly because they, as Washington insiders, buy into its premise.

And that premise is that for people like Chris Jansing, it’s all about “this deal.” It’s all about the mechanics and politics of this deal. For her, and for most journalists covering this sorry episode in American history, what matters is who wins and loses the political game, not who wins and loses as part of what the political game is supposed to resolve.

In other words, few journalists are actually focused on what the wheeling and dealing is about, in terms of its potential effects on real people. And because journalists like Chris Jansing are fixated on the political deal-making mechanics (“are Democrats getting away with” ), they don’t see that they are perpetuating a false equivalence: that Republicans protecting wealthy constituents are morally on a par with Democrats protecting an old-age health insurance program that non-wealthy people depend on to live out their lives in relative security.

Go back and look at Jansing’s intro to Durbin’s argument against raising the retirement age for Medicare:

When it comes to cuts, especially on Medicare, you know that whole conversation has to be had.

Who says it has to be had? And, if it has to be had, who says it has to be had right now? You know who says that? Republicans, particularly Tea Party conservatives in Congress. The public isn’t clamoring for it. In fact, the latest poll from National Journal found,

a full 79 percent of those surveyed want the fiscal-cliff negotiators not to cut the program at all.

Do you know how hard it is to get almost 80% of the people to agree on anything? And it’s not just Democrats in that poll. It’s Republicans, too. So, it’s clear that the enthusiasm for cutting Medicare doesn’t come from the American people but from right-wing politicians and pundits.

And television journalists, because they like to cover a good fight (and perhaps because most of them don’t worry too much about what it would be like doing journalism in their old age), push as unquestioningly legitimate the Tea Party thirst for cutting Medicare (extending the eligibility age is most certainly a cut), as if quenching that thirst is the price Democrats have to pay to make any deal over the fiscal cliff a “fair” deal.

And the fact that some Democrats are stepping up to protect Medicare from some intolerable cuts is not morally equivalent to a demonstrated Republican willingness to protect rich constituencies by threatening the country with fiscal peril. That’s what we are talking about here. Republicans forced this fiscal cliff nonsense on Obama last year by holding the country hostage over the debt ceiling.

And even if they were to momentarily concede defeat on the issue of raising tax rates for the wealthy, it is only because they see another opportunity to force Democrats to help them do nasty things to Medicare: the debt ceiling will come up again in a couple of months and they have expressed willingness to hold the country hostage again to get what they want.

And what conservative Republicans actually want is for Democrats to get in bed with them as they do nasty things to Medicare. Republicans can read the polls. They know how unpopular what they want to do to Medicare is. And by playing the game the way they are playing it—which means journalists will cover the game (“this deal“) and not their motives—they hope to achieve a diminution in value of a program they have long hated and long wanted to reign in, if not outright kill. And they hope to achieve it with Democratic cover, as Democrats realize some changes need to be made to keep the program solvent.

Republicans, of course, claim they want to “save” Medicare. Hardly. That’s even laughable. Republicans have already demonstrated that they don’t want it to survive in its present form by voting en masse to voucherize the program (the first Ryan budget plan). And they have demonstrated that they want to dramatically shift Medicare costs to the less affluent (the second Ryan budget plan).

Thus, instead of focusing on the tactics or strategy in the political game, what Jansing and other journalists should be asking is this: What really motivates Republicans, as they appear so willing, so often, to hurt the financial and economic standing of the country?

Word To Democrats: Be Careful On Entitlement Reform

A few Republicans are publicly divorcing themselves from Grover Norquist, which is a good sign. But not enough Republicans are yet ready to absorb fully the meaning of the GOP’s defeat on November 6.

As President Obama has said several times now, if the last election had one clear message, it was that the wealthiest Americans, those who have been doing pretty well despite a sluggish economic recovery, need to “pay a little more” in taxes and thus get things started in terms of fixing our long-term fiscal problems.

On Sunday, John McCain’s lap dog, Sen. Lindsey Graham, clearly abandoned Grover Norquist and his infernal tax pledge. I have heard replayed numerous times the following excerpt from Graham’s appearance on ABC’s This Week With George Stephanopoulos:

I will violate the pledge, long story short, for the good of the country, only if Democrats will do entitlement reform.

In context, though, Graham was not endorsing an increase in marginal tax rates (“I agree with Grover, we shouldn’t raise rates,” he said), but only an increase in revenues by other means, like capping deductions for wealthy families (“If you cap deductions around the $30,000, $40,000 range, you can raise $1 trillion in revenue,” he claimed). But, so be it. In whatever form, it is clear that some Republicans, feeling the heat of November 6, are starting to warm up to an increase in federal revenues and it seems likely that more, perhaps enough to get a deal done, will follow.

Now comes the “if Democrats will do entitlement reform” part.

Appearing with Lindsey Graham on ABC’s This Week was Sen. Dick Durbin, a Democrat who signed onto the Simpson-Bowles deficit reduction plan.

He said a couple of things that illustrate the problems for President Obama and the Democrats, in terms of getting a deal that Democrats like me can support. First, Durbin suggested that Social Security shouldn’t be part of a larger budget deal since it is funded separately and “does not add one penny to our debt.” It’s pretty clear that most Democrats feel the same way. They believe that the relatively simple fixes for Social Security don’t belong in the discussion going on now. So, leave that program out of it.

Then we have this:

DURBIN: Medicare is another story. Only 12 years of solvency lie ahead if we do nothing. So those who say, “Don’t touch it, don’t change it,” are ignoring the obvious. We want Medicare to be there for today’s seniors and tomorrow’s, as well. We don’t want to go the Paul Ryan route of voucherizing it, privatizing it, but we can make meaningful reforms in Medicare and Medicaid without compromising the integrity of the program, making sure that the beneficiaries are not paying the price for it, except perhaps the high-income beneficiaries. That to me is a reasonable approach…

STEPHANOPOULOS: Does that include raising the age for Medicare eligibility?

DURBIN: Here’s my concern about that, George. What happens to the early retiree who needs health insurance before that person’s eligible for Medicare? I had it happen in my family, and I’ll bet a lot of your viewers did, as well. We’ve got to make sure that there is seamless coverage of affordable health insurance for every American. My concern about raising that Medicare retirement age is there will be gaps in coverage or coverage that’s way too expensive for seniors to purchase.

STEPHANOPOULOS: Is that a fair point, Senator Graham?

GRAHAM: Not really. I don’t think you can look at entitlement reform without adjusting the age for retirement, like Tip O’Neill and Ronald Reagan did. It goes to 66, 67 here pretty soon for Social Security. Let it float up another year or so over the next 30 years, adjust Medicare from 65 to 67 over the next 30 years, means test benefits for people in our income level. I don’t expect the Democrats to go for premium support or a voucher plan, but I do expect them to adjust these entitlement programs before they bankrupt the country and run out of money themselves. So age adjustment and means testing for both Social Security, Medicare I think is eminently reasonable. And all those who’ve looked at this problem have done that over time.

Democrats would, of course, agree to means-testing entitlements. No doubt about that. But raising the eligibility age for retirement and old-age health care? Not so fast.

Paul Krugman, a leftish economist, is definitely opposed to the idea, as he indicates in this short post, his generalized objection based primarily on the differences in life expectancy between economic classes (folks with lower earnings don’t tend to live as long as those with higher earnings, thus raising the eligibility age would have a disproportionately harmful effect on lower wage earners).

There have been more specific objections to raising the age, including these:

  • folks with physically demanding jobs would likely be forced to hang on another few years to keep their insurance;
  • cost-shifting to retirees who won’t have adequate income to absorb the increase;
  • an increase in the number of uninsured Americans (especially among low-income groups, including African-Americans and Hispanics);
  • the obvious increase in the cost to those employers who offer health care benefits to retirees (the employer plan would become the primary payer), which would, among other things, discourage employers from offering such retirement plans.

Now, an astute reader might suggest that some of these objections could be answered by provisions already in place in the Affordable Care Act. In fact, I heard a commentator this weekend suggest that raising the eligibility age for Medicare was no big deal since ObamaCare will provide coverage for those seniors who can’t afford it.

Well, that turns out to be partially true, at least according to a study done by the Kaiser Family Foundation, which looked at raising the age in the context of the Affordable Care Act (it assumed an increase in the Medicare eligibility age to 67 that would go into effect in 2014, just for simplicity). I suggest all those interested in this topic read that study, but its conclusion was as follows (highlights mine):

Previous studies conducted prior to the enactment of the 2010 health reform law concluded that raising the age of Medicare eligibility would produce significant federal savings, but would also increase the number of uninsured older adults and shift risk and additional cost onto retirees who lack health insurance and onto employers that offer retiree health plans. Our analysis, which takes into account the coverage expansions and subsidies in the ACA, finds that net federal savings to the federal government would be considerably lower than previously estimated because the federal government would incur new costs associated with expanded coverage for 65- and 66-year olds under Medicaid and premium tax credits and cost-sharing assistance for lower-income individuals in the new health insurance Exchange.

We estimate that nearly one-third of the 65- and 66-year-old adult population who would be affected by an increase in the age of Medicare eligibility [about 5 million people]—those with low incomes who would qualify for Medicaid or generous premium tax credits and cost-sharing assistance through the Exchange—would face lower out-of-pocket costs than they would have paid under Medicare in 2014 as a result of this policy change –generally those with incomes below 300 percent of the FPL [federal poverty level]. However, two-thirds would face higher out of-pocket costs, on average, due to higher premium contributions for employer-sponsored coverage and for coverage in the Exchange. The shift of adults ages 65 and 66 from Medicare to the Exchange is also projected to increase premiums that would be paid by adults younger than age 65 in the Exchange, as older adults enter the Exchange risk pool. In addition, Part B premiums paid by the elderly (ages 67 and over) and by disabled Medicare beneficiaries would be expected to increase, as the healthiest and lowest-cost segment of the Medicare population is removed from the Part B risk pool and shifted to the Exchange or to employer-sponsored plans. States and employers are also expected to see increased costs.

The study warns:

Given the magnitude of the changes that we estimate would occur by raising the Medicare eligibility age, this analysis underscores the importance of carefully assessing the distributional effects of various Medicare reforms and savings proposals to understand the likely impact on beneficiaries and other stakeholders.

It’s just not as simple as Republicans, like Lindsey Graham above, make it. And Democrats need to be careful about getting giddy over a possible Republican retreat on raising revenues and under the influence of such giddiness make a bad agreement on entitlements.

In short, Democrats need to remember who their constituents are.

Unbelievable, Almost

Democrat Tammy Baldwin has an 84% chance of beating former Governor Tommy Thompson in the race for Wisconsin’s Senate seat, according to the incomparable Nate Silver.  A particularly devastating ad she is now running is this one:

That ad not only hurts the former governor, who was once very popular in Wisconsin, but it shows how Republicans in general can’t be trusted to reform Medicare and Social Security. If only Democrats would make this larger point against Republicans as concisely and forcefully as Baldwin’s campaign has made it against Thompson.

During last week’s vice-presidential debate, there was only a brief mention of the issue of Medicare not being able to use its clout to negotiate with drug companies for lower prices. In the middle of Paul Ryan’s defense of his indefensible scheme to voucherize Medicare, Biden brought it up:

BIDEN: Martha, if we just did one thing, if we just — if they just allowed Medicare to bargain for the cost of drugs like Medicaid can, that would save $156 billion right off the bat.

RYAN: And it would deny seniors choices.

Deny seniors choices? You mean like whether to buy drugs at a lower cost?

It is a fact that there are some 47 million Medicare beneficiaries and almost 28 million enrolled in its prescription drug plan, Part D (most other Medicare beneficiaries also have drug coverage, but receive it through TRICARE, FEHB, and the VA, or are active workers with other insurance).

It is almost unbelievable that Medicare is prohibited by law from negotiating on behalf of its beneficiaries. One study found that*,

For each of the top 20 drugs prescribed to seniors, the lowest price charged by any of the top Part D insurers is higher than the lowest price secured by the VA.

Among those top 20 drugs, the median difference between the lowest Part D plan price and the lowest VA price is 58 percent.

That’s money coming out of the pockets of seniors and taxpayers and going into drug company coffers. I say this situation is “almost” unbelievable because, after all, we are talking here about Republicans. You can go to OpenSecrets.org and look at political contributions by the drug industry for the year 2002, just one year before Republicans passed their pharmaceutical-friendly Part D program. You will see there the following:

That pretty much tells us why it is that Medicare is prohibited by law from using its bargaining power on behalf of its beneficiaries and taxpayers, and it tells us why Tammy Baldwin may just upset the favored former governor who helped make it possible .

_____________________________________

*Also from the study:

The price differential between the lowest VA-negotiated price and the lowest price available from a part D private plan is often substantial (table ). For example:

For Zocor (20 mg), a lipid-lowering agent, the lowest VA price for a year’s treatment is $127.44, while the lowest Part D plan price is $1,485.96—a difference of $1,358.52, or 1,066 percent.

For Protonix (40 mg), a gastrointestinal agent, the lowest VA price for a year’s treatment is $214.52, while the lowest Part D plan price is $1,148.40—a difference of $933.88, or 435 percent.

For Fosamax (70 mg), an osteoporosis treatment, the lowest VA price for a year’s treatment is $250.32, while the lowest Part D plan price is $763.56—a difference of 513.24, or 205 percent.

For Toprol XL (100 mg), a beta blocker, the lowest VA price for a year’s treatment is $250.06, while the lowest Part D plan price is $395.52—a difference of $145.46 or 58 percent.

For Celebrex (200 mg), an anti-inflammatory, the lowest VA price for a year’s treatment is $632.09, while the lowest Part D plan price is $946.44—a difference of $314.35, or 50 percent.

ObamaCare At Work

Buried on page 7B of Monday’s Joplin Globe was more good news from ObamaCare:

As of Monday, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications. The penalties are part of a broader push under President Barack Obama’s health care law to improve quality while also trying to save taxpayers money.

And about the inevitable squawking:

“It’s modest, but it’s a start,” said Dr. John Santa, director of the Consumer Reports Health Ratings Center. “Should we be surprised that industry is objecting? You would expect them to object to anything that changes the status quo.” [...]

If General Motors and Toyota issue warranties for their vehicles, hospitals should have some similar obligation when a patient gets a new knee or a stent to relieve a blocked artery, Santa contends. “People go to the hospital to get their problem solved, not to have to come back,” he said. [...]

Medicare deputy administrator Jonathan Blum said he thinks hospitals have gotten the message.

“Clearly it’s captured their attention,” said Blum. “It’s galvanized the hospital industry on ways to reduce unnecessary readmissions. It’s forced more parts of the health care system to work together to ensure that patients have much smoother transitions.” [...]

Under Obama’s health care overhaul, Medicare is pursuing efforts to try to improve quality and lower costs. They include rewarding hospitals for quality results, and encouraging hospitals, nursing homes and medical practice groups to join in “accountable care organizations.” Dozens of pilot programs are under way. The jury is still out on the results.

Well, maybe the jury’s still out. But at least, thanks to Democrats, there is a jury.

Republican Admits “Do Away With Medicare” Is The Goal

If you have paid close attention to the debate over Medicare vis-à-vis Paul Ryan’s budget plan—a plan endorsed by Mitt Romney as well as nearly every Republican in Congress—you will often hear fact-checkers and Republicans say a version of the following, as expressed in a Fox “News” headline in August of this year:

Fact Check: Obama running against outdated version of Ryan Medicare plan

Here is the argument, as presented in the article:

The Obama campaign would like voters to believe that Paul Ryan’s Medicare plan would “end Medicare as we know it” — privatizing the whole system and costing seniors more than $6,000 extra a year.

But the campaign, even before Ryan was selected as Mitt Romney’s running mate, has effectively been running against the wrong Ryan plan.

The president’s accusations largely refer to Ryan’s 2011 plan, ignoring the fact that the House Budget Committee chairman rolled out a different version in 2012 — taking into account Democratic critiques. Though the 2012 plan is more moderate, Obama and his surrogates have all but ignored the newer version as they amp up their accusations against the Romney-Ryan ticket.

Most glaringly, the campaign has omitted a key point.

While Ryan’s 2011 plan proposes to give seniors a government payment to buy private insurance, his 2012 plan offers seniors a choice.

Under the blueprint, seniors could use the payment to buy private insurance or stay in traditional Medicare.

Forget that phrase, “taking into account Democratic critiques,” which, the biased article alleges, compelled Ryan to change his plan. The point here is that the newest version of Ryan’s extremist plan gives seniors a “choice” between private insurance and Medicare as we know it, and that revised plan, despite what conservatives claim, still endangers traditional Medicare.

Democrats have argued that the choice, even under Ryan’s “more moderate” plan (!), would result in much higher costs for seniors, particularly sicker seniors, and would result in the end of Medicare as we know it because there is no requirement that private insurers “provide a standard set of benefits—allowing them to design benefits that attract healthier beneficiaries,” according to policy analysts at the Center for American Progress Action Fund.

Those analysts say:

Since the mid-1980s, private Medicare plans have attracted the healthiest, lowest-cost enrollees from the Medicare population—a phenomenon known as “adverse selection.” This trend would accelerate under the Romney-Ryan plan. If less healthy, more costly beneficiaries are left behind in traditional Medicare, then premiums for traditional Medicare would rise. In turn, more beneficiaries would leave traditional Medicare, causing premiums to rise further, and so on—creating a so-called “death spiral.”

Now, thanks to Tommy Thompson, former governor of Wisconsin, former Secretary of Health and Human Services under George Bush (“under his watch” the government was prohibited from negotiating drug prices on behalf of seniors), and currently the GOP candidate for U.S. Senate from Wisconsin, we can confirm the Democrats’ argument.

I hadn’t seen it until Monday night, but a video created in May of this year has Thompson saying:

… be able to take away the litigation that the trial lawyers are doing, so that doctors don’t have to keep doing extra things to protect themselves from getting sued, which drives up our costs.

Change Medicare and Medicaid like I did welfare — and who better than me, who’s already finished one of the entitlement programs, to come up with programs to do away with Medicaid and Medicare? 

Let’s block-grant what the state has, and allow the states to determine what’s going to go into Medicaid. And Medicare, let’s wait until everybody that’s right now that’s under 55—that reaches 55 by age [sic] 2020—and give them a choice whether or not they want to purchase health insurance with a subsidy from the federal government, or stay on Medicare. I’m here to tell you, when you look at the situation nobody’s going to accept it, because Medicare’s going broke by the year 2022.

That’s the plan, folks. That’s what even the revised Ryan plan, or a similar one Tommy Thompson has in mind, is designed to accomplish. From the lips of a seasoned, “American conservative legend“:

Do away with…Medicare.”

 

The Ryan Speech

Should not the multitude of words be answered? And should a man full of talk be justified? Should thy lies make men hold their peace? And when thou mockest, shall no man make thee ashamed? For thou has said, “My doctrine is pure, and I am clean in Thine eyes.”

But, oh, that God would speak and open His lips against thee…

—The Book of Job

aul Ryan claims he is a good Catholic boy. And now we know that good Catholic boys make incredibly good liars.

Lying in politics mostly comes in the art form of spinning the facts to one’s advantage. Every politician does that and it is part of the profession. But sometimes there comes along a practitioner of the political arts who goes beyond spin, beyond the normal bounds of the business.

Paul Ryan essentially began his journey toward a new national political career and conservative stardom by denying his philosophical mentor, Ayn Rand, three times before the Romney-cock crowed with the news that he wanted Ryan to be his partner in a new limited liability company, Romney-Ryan.

And once he shamelessly denied his undeniable teacher, once Ryan said, “I reject her philosophy,” it was easy for this good Catholic boy to become part of a campaign that is brazenly attempting to elect Romney-Ryan, LLC, on a platform of secrecy, subterfuge, and slander.

Wednesday night’s convention speech was Ryan’s introduction to low-information voters, those folks who don’t much follow the news or pay attention to politics until it is forced upon them by the networks.

Thus, the temptation to tell the most audacious lies possible to that audience was irresistible, because first impressions are important, especially when a campaign has enough Koch and other billionaire money to keep impressing, to keep the lies going, fact-checkers be damned.

Ryan has lied about a GM plant closing in his hometown of Janesville, saying on August 16 of this year:

I remember President Obama visiting it when he was first running, saying he’ll keep that plant open. One more broken promise.

During his convention speech last night, he lawyered up that claim and put it this way:

A lot of guys I went to high school with worked at that GM plant. Right there at that plant, candidate Obama said: “I believe that if our government is there to support you … this plant will be here for another hundred years.” That’s what he said in 2008.

Well, as it turned out, that plant didn’t last another year. It is locked up and empty to this day.

You see the serpent’s subtlety here? The sophist’s sophistication? In this version of things, Ryan is not now claiming Obama broke his promise to keep the plant open—because he never made such a promise—but he is connecting Obama with the plant’s closing in a way that makes it appear Mr. Obama was responsible for it.

The problem is the plant closed just before Christmas in 2008, a month before the newly-elected president took office.

Ryan also lied during his speech about the National Commission on Fiscal Responsibility and Reform, co-chaired by Democrat Erskine Bowles and Republican Alan Simpson:

He created a bipartisan debt commission. They came back with an urgent report. He thanked them, sent them on their way, and then did exactly nothing.

Notice the “they” in that sentence construction. “They came back with an urgent report.” But Mr. Ryan was part of that debt commission, part of that “they.” And he voted to kill the effectiveness of that “urgent report.” He did that. He voted to kill that report, which fell three votes short of being adopted and sent to Congress for an up or down vote.

And then Ryan claimed that Obama did “exactly nothing.” Hardly. As CNN pointed out:

Obama never fully embraced the Bowles-Simpson recommendations. But he incorporated some of the recommendations the co-chairs made in a plan he sent to Congress the following April, one that called for a mix of spending reductions and tax hikes.

All that and more is bad enough. But the most brazen of lies Ryan told on Wednesday, the one that should have literally brought the building down upon him if God were paying attention, was this one:

…the biggest, coldest power play of all in Obamacare came at the expense of the elderly.

Now, not only is that a lie, it is one of those lies that the liar knows is a lie, as opposed to a simple friendly spin of the facts. Because there are no facts here to spin. This is an utter lie and it has time and again been exposed as one by fact checkers. But Romney-Ryan, LLC, are not in the fact business. That’s not their trade, not their expertise.

What they are good at is taking an admittedly effective lie and simply repeating it, again and again and again, against the wind of truth, as if the wind blows right through them—no, as if there is no wind.

Obamacare came at the expense of the elderly,” he said. He actually said that. He stood there in front of millions of people, his Catholic Christian credentials on his sleeve, and told older Americans that Mr. Obama, using “the biggest, coldest power play of all,” was using them—folks on Medicare, for God’s sake— for his scheme of “government-controlled health care.”

How does such wicked hubris get born?  Where does such dark audacity come from?  From the same place this comes from:

So our opponents can consider themselves on notice. In this election, on this issue, the usual posturing on the Left isn’t going to work. Mitt Romney and I know the difference between protecting a program, and raiding it.

Never mind that Mr. Ryan’s famous budget, which Mitt Romney enthusiastically embraced, included the same smart reductions in spending—not a penny of which “came at the expense of the elderly“; and never mind that Obamacare makes Medicare more solvent and offers older folks free preventive services and closes the prescription drug donut hole; and never mind that when Romney-Ryan, LLC, get finished with Medicare, “raiding it” may be impossible because there may not be an it to raid.

I know some Democrats today are a little nervous. Ryan’s speech, replete as it was with falsehoods, was a powerful one. Lies can be quite seductive. And I know some on the left are worried that successfully combating such a blatant and well-funded disregard for the truth may be impossible.

But of course it is not impossible. There is plenty of time. We will have our turn in the spotlight. We have our message. But part of that message must include a new offensive against the devilish disdain for facts that characterizes the brand of Republican politics that Romney-Ryan, LLC, are trying to sell to that razor-thin slice of the electorate who remain open to persuasion.

Democrats must, they simply must, begin today to call both Mr. Ryan, a former altar boy, and Mr. Romney, a fiercely loyal Mormon, what they are: liars of a rare breed who simply continue to lie despite being shouted down by the facts.

A rare breed of liars with a treasure chest of riches that can buy enough 30-second ads to shout down those shouting facts and smother the fact checkers. A breed so rare that we may never—must never—see their likes again.

And if Democrats fail to push back and win against such brazenness, if the dark partnership of Romney-Ryan is successful with its strategy of deceit, if they walk into the White’s House on a red carpet of fiction and fraud, then that rare breed of liars will no longer be so rare. They will beget a legion of imitators.

And our politics, our democracy, will never be the same.

____________________________

Tough Love Is For The Other Guy

Paul Ryan said Saturday morning to a gathering of pale-faced Republican geezers in Florida,

Our solution to preserve, protect, and save Medicare will not affect your benefits.

Yesterday I posted a piece on how Republicans, in order to sell their plan to radically revamp Medicare, are appealing to the selfishness of current seniors, hoping those seniors won’t begin to wonder how long young folks will keep paying for benefits those young people will never get.

A retired local conservative commenter, who is living on a military pension, responded to my piece with this:

…cutting military retirement benefits is coming, like it or not by anyone. But you would not do it I hope for those that have planned their lives and are living on such benefits today.

Same with Medicare. People have planned their lives for that program and need it to live as planned.

The idea here is that “I’ve got mine” and it is too bad if folks in the future have to take less, but they should keep paying for “mine.” Nothing could better illustrate what I was trying to say in the piece I wrote than that conservative’s comment.

Another commenter on the piece characterized the conservative’s thoughts this way:

Being a silver-haired geezer myself, I can see that they want to do the same thing to Medicare and Social Security that has been done to the educational system. Hey, WE got our valuable college degrees for peanuts and earned the big bucks during our peak years, but now we realize it wasn’t fair, and so YOU are going to have to suck it up, kid. And don’t come begging at grandpa’s door, because I now believe in tough love!

Amen. Tough love, if you will notice, is almost always directed at someone else.  When Paul Ryan, for instance, had the chance to practice some tough love during the Bush administration and demand that the expanded drug benefit or the two wars be paid for, he made the decision to defer the tough love until later, which happened to be when a Democrat was in the White’s House.

And Ryan’s tough love was in full force when he opposed Obama’s stimulus plan to help start the economic recovery, even though he later sent letters requesting some of the money so his constituents wouldn’t have to suffer from his tough love. (And then, taking lessons from Romney, he lied about doing so.)

But our local conservative commenter, again a man who lives on an inflation-protected military pension that he earned from his years of service, wasn’t finished with his own tough love campaign. He wrote:

The GOP has said economic processes MUST CHANGE today because our national wants far exceed our national resources.

Here is my response to that comment:

What you call our national wants are actually national needs, unless you think we don’t need the social stability that Social Security and Medicare and Medicaid provide, or unless you believe we can stop funding the Defense Department.

But even if you consider those things “wants,” you are still wrong in claiming that those wants exceed our national resources. In fact they don’t. We have plenty of national resources, as we are very wealthy.

What we have is a political party, which you almost always support, that has designated most of our national economic resources as untouchable, except when it comes to the military.

And they have decided that the uneven distribution of income in America is not to be feared but to be embraced, as it will somehow inspire the have-nots to work harder so they too can someday send their excess dough to the Cayman Islands for some much needed rest.

The truth is that conservatives controlling the GOP today do not value the stability that comes from social programs, programs they routinely disparage openly and without apology.

For instance, Mr. Obama has been falsely called “the food stamp president” by Newt Gingrich, as if providing food stamps to folks who need them in bad times is worthy of condemnation. It turns out that George W. Bush was actually the food stamp president and God bless him for it. It was the least he could do for helping screw up the economy, which made food stamps such a necessity for many folks.

And you know what your conservative intellectual hero-columnist Charles Krauthammer recently wrote about Bush? He denigrated him for his,

philosophically undisciplined, idiosyncratically free-spending “compassionate conservatism.”

You see, for ideologues like Krauthammer, compassion has no place in conservatism, a point I am happy to make every day.

People like Gingrich and Krauthammer and Rush Limbaugh and a horde of Republican politicians often refer to an “entitlement society,” as if people—they want you to think it is mostly black people—who receive government help aspire to do nothing more than lie around the house and get fat on food purchased with money stolen from taxing “job creators.” That is what the Romney ads falsely claiming that Obama waived the work requirement for welfare benefits is all about.

You see, these folks have always hated the social safety net because most of them have never needed it or have arrived at a place where they know they never will. In one way or another, they’ve got theirs and to hell with everyone else.

And it is that sentiment that serves as the subtext of the Ryan-Romney campaign and that will be what voters affirm or reject in November.

How Long?

Well, your friends with their fancy persuasions
Don’t admit that it’s part of a scheme,
But I can’t help but have my suspicions
‘Cause I ain’t quite as dumb as I seem.

And you said you were never intendin’
To break up our scene in this way,
But there ain’t any use in pretendin’, 
It could happen to us any day.

—Ace, “How Long

s we now watch dueling presidential campaign whiteboards, which must make Glenn Beck very proud, I want to call your attention to something E. J. Dionne rhetorically asked Ryan-Romney this morning on MSNBC about their “bold” Medicare “improvement” plan:

If this is so good, if it’s such a good idea, why don’t you propose it for today’s senior citizens?

Well, of course the answer to that is because if they did propose it to today’s senior citizens, the geezers would, as fast as their geezerly legs could take them, run toward Obama and down-ballot Democrats in November and deliver the present incarnation of the Republican Party the coup de grâce it most certainly deserves.

So, what Republicans are doing is telling today’s seniors they don’t have to worry about Paul Ryan’s heroic plan to “save” Medicare, since the heroes have come not to save them but to save future geezers.

Current old folks, say the Republicans, can continue to count on authentic Medicare and need not fret over whether Ryan and Romney are offering a counterfeit version. In other words, the GOP, which has totally committed to the voucherized Medicare proposal, is counting on the selfishness of seniors to get them through this election.

Of course, Republicans hope that today’s senior citizens don’t stop to consider what would happen to them and their for-now untouched benefits, if some day millions of young people working and paying Medicare taxes grow tired of paying for current geezers’ full bennies, particularly when those young folks realize that the Ryan-Romney scheme will leave them with an old-age health care plan that will cost them more and provide them less.

How long will young people pay to keep octogenarians and nonagenarians on real Medicare after they figure out that Ryan and Romney have sold them a fake?

That is a question I would ask if I were a silver-haired geezer.

A Fiscal Fantasy

This morning on MSNBC Ezra Klein made a great point about how most of the talk surrounding Ryan’s budget plan has been limited to the Medicare issue. But there is a lot more to it than that:

What people don’t realize about it is the cuts to other health care programs, primarily Medicaid, are almost twice  as large as Medicare…

Medicaid, of course, is a means-tested health program for low-income folks, including children, the elderly, and the disabled.  More than half of the funding for each state is provided by the feds.

According to the Kaiser Commission on Medicaid and the Uninsured, those Ryan—now Romney-Ryan—cuts Klein referenced, along with repeal of the Affordable Care Act which Romney and Ryan promise to accomplish, will in, say, Missouri mean that somewhere between 46% and 53% of folks who would otherwise be enrolled in Medicaid under current law in 2021 would not be so enrolled.

That represents between 650,000 and 750,000 Missourians whose well-being, unless the state came up with more revenue itself (!), would be sacrificed in the name of budget austerity that has as its guiding principle the idea that rich folks need more tax cuts.

But that’s not all. Klein also makes the point that the Ryan plan is designed to shrink other parts of government spending as a share of the economy, to uncivilized levels by 2050. He  presented this graph:

Klein wrote something remarkable that should be shouted from the housetops (emphasis mine):

The truth is that the Ryan budget’s largest long-term savings don’t come from Medicaid or Medicare or Social Security, or even Medicaid and Medicare and Social Security put together. They come from everything else. Ryan says that under his budget, everything the federal government does that is not Medicare, Medicaid or Social Security will be cut to less than 3.75 percent of GDP by 2050. That means defense, infrastructure, education, food safety, energy research, national parks, civil service, the FBI — all of it. Right now, that category of spending is 12.5 percent of GDP.

Think about that. A government that small could not possibly “establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity” in 2050. But it’s all nonsense, as real-time, Nobel Prize-totin’ economist Paul Krugman pointed out:

Look, Ryan hasn’t “crunched the numbers”; he has just scribbled some stuff down, without checking at all to see if it makes sense. He asserts that he can cut taxes without net loss of revenue by closing unspecified loopholes; he asserts that he can cut discretionary spending to levels not seen since Calvin Coolidge, without saying how; he asserts that he can convert Medicare to a voucher system, with much lower spending than now projected, without even a hint of how this is supposed to work. This is just a fantasy, not a serious policy proposal.

Well, what is serious is the philosophy behind the proposal, which philosophy is based on a fantasy, a fantasy that what is wrong with our fiscal house can be fixed by throwing the poor, the elderly, and the sick in the streets to fend for themselves and by shrinking government to a size that could truly be drowned in Grover Norquist’s bathtub.

McCaskill: “I’m Not Willing To Blow Up Medicare”

Saint Rachel Maddow had a dustup on Meet the Press  with right-winger and editor of National Review Rich Lowry. Following the lead of his lying leader, Lowry was pushing a two-year-old lie (which Democrats failed to adequately address in 2010) that Obama’s health care reform law slashed billions out of Medicare:

RICH LOWRY: …Republicans should go on offense on Medicare, because the president, as part of Obamacare, passed $700 billion in cuts in Medicare.  And Romney wants to repeal Obamacare, including those cuts…So at the top of a ticket Romney versus Obama, there’s only one of those guys who wants any cuts affecting current seniors…That’s not Mitt Romney.

Of course that is blatantly false. There were exactly zero cuts in Medicare benefits to “current seniors” or, indeed, to future seniors. The “cuts” were actually reductions in the future payments the program makes to participating hospitals (and other providers but not including doctors) and reductions in Bush-era overpayments to private insurance companies participating in Medicare Advantage.

But don’t take my word for it. Here’s Gail Wilensky, former administrator—under W. Bush—of the Centers for Medicaid and Medicare:

There are no reductions in the Medicare benefits promised in law.

Obviously, that fact hasn’t stopped Romney, Ryan, and other Republicans, including the national Chamber of Commerce, from lying about the issue—going on offense, as Lowry described it—which is made worse by the fact that, as Maddow tried to point out on Sunday, Paul Ryan’s budget contains the same “cuts” to Medicare!

At the end, Maddow asked Lowry a question:

What I want to know is the logic of attacking somebody for something that you yourself are proposing to do?

Logic? Ah, the logic in lying about imaginary Medicare cuts is in the fact that Republicans have so much money this year they can lie, and lie continuously, with impunity. Like here in Missouri, where, as Bloomberg points out, the Rovian smear group, Crossroads GPS, is doing damage to Claire McCaskill:

…an ad sponsored by Crossroads that’s run 858 times says Democratic Senator Claire McCaskill voted for Medicare cuts that could slash benefits for the program’s enrollees.

That ad ran 858 times as of June 28! It has undoubtedly run a gazillion times since, as McCaskill has become, in the words of Andy Kroll at Mother Jones, “Dark Money’s Top Target.”

Well, McCaskill is at least fighting back with charges of her own. This morning on Fox and Friends, the show with the ambitious mission of extirpating IQs everywhere,  she was treated rather rudely by host Steve Doocy, but before he went on an inelegant Romney-Ryan offensive, she managed to get in a shot at Paul Ryan:

I think he’s willing to blow up Medicare to give more tax cuts to folks at the very top…I have worked in a bipartisan way to bring down federal spending, but I’m not willing to blow up Medicare in the process—especially when you consider that Paul Ryan believes that at the same time we blow up Medicare, we need to give another tax cut to people who make more than a million a year.

“Blow up Medicare.” I like that phrase because it perfectly describes what conservatives have wanted to do to the program since it was created. Blow it up, obliterate it, or, as they phrase it these days, “save” it.

Call It “ClaireCare” If You Want, McCaskill Should Say

I will take Claire McCaskill at her word that she is not skipping the Democratic National Convention because she is afraid to cavort with Mr. Obamacare himself and other Democrats who don’t enjoy overwhelming popularity here in Missouri.

She told Morning Joe:

I’ve never gone when I’ve had a contested race. You’ve got to say to people at home, which is more important: Going to a place with a bunch of party honchos and having cocktail parties, or being at home talking to them? So this has never been a hard call for me. Everybody is trying to make this a big deal and narrative. It’s just stupid.

All of the chatter about McCaskill’s reasons for not going to North Carolina later this summer, along with the  expectation that the Supremes will rule on the Affordable Care Act tomorrow, has me wondering just why it is that here in Missouri, as elsewhere, the concept of “ObamaCare” is relatively unpopular, even while its constituent parts are not. My conclusion is that such dissonance is attributable to a failure to properly—and constantly—educate an inattentive public.

Which, of course, made me wonder, for instance, what Ms. McCaskill has said about the ACA and how she has tried to educate Missourians on the virtues of the law.

Well, she did make an effort to do so in March, sort of. Here is how TPM began a story about it:

Grilled about her support for the Affordable Care Act, Sen. Claire McCaskill (D-MO) told a home state radio interviewer that the law’s core structure is “exactly” like the House GOP Medicare privatization plan that conservatives support and liberals detest.

Hmm. That’s not exactly a good way of selling ObamaCare to liberals, now is it? She went on:

“The irony of this situation is that these are private insurance companies people will shop to buy their insurance. It’s not the government,” she told KMOX of St. Louis on Wednesday. “It’s exactly what Paul Ryan wants to do for Medicare.”

“It’s subsidized by the government — premium subsidies — which is exactly, this is the irony,” continued McCaskill, who faces a tough reelection battle this fall. “You think what Paul Ryan wants to do for seniors, you think it’s terrific. But when we want to provide private health insurance for people who don’t have insurance with subsidies from the government, you think it’s terrible.”

Her point here is, of course, unassailable. There is a lot of Republican hypocrisy associated with the debate over health care reform, particularly since almost the entire scheme that is now called ObamaCare is made up of ideas that once were dreamed up in the minds of right-wingers.

But that doesn’t let Claire off the hook, in terms of her responsibility to educate folks about the law. I looked on her campaign website and I found the following under “Healthcare“:

Claire has fought for expanded health insurance for all Missourians, from children to seniors. In her first term, Claire helped protect children with pre-existing conditions from being refused insurance and saved seniors from paying too much for prescription drugs by helping to close the Medicare Part D “donut hole.” Claire strongly believes that affordable health care is necessary in a successful economy and will continue to fight to make sure all Missourians have access to it, while also fighting to ensure those who chose not to be insured don’t pass along their medical costs to other Missourians.

This paragraph constitutes a summary of the details that follow on the page, but what we see here is essentially an explanation of the Affordable Care Act, of ObamaCare, but without the name attached. Now, while it is understandable that she would want to stay away from terms that Republicans and their moneyed funders have tainted via their propaganda campaign against “ObamaCare” and the ACA, what McCaskill is doing is essentially furthering the public’s misunderstanding of what is the health care reform law that goes by those names.

I can’t help but wonder what public opinion about the ACA might be today, if folks like McCaskill would not only consistently tout the parts of the law that people like, but aggressively defend the idea behind the one part they don’t like, the dreaded mandate.

Something like the following would be in order, coming from the moderate Missouri Democrat who voted for the ACA and who gets constantly attacked for doing so:

You’re damned right I voted for ObamaCare. And I’m proud of that vote. Hell, I wish they’d call it ClaireCare, so proud I am to have voted for it.

You know why?

Because it helps protect Missourians with pre-existing conditions from getting screwed by insurance companies;

Because it protects Missourians who get sick from getting booted off the insurance they had before they got sick;

Because it provides insurance for Missourians who can’t afford it and who would otherwise go without it and get sick and die or who would end up in an emergency room with a horrible and horribly expensive disease that we’d all end up paying for;

Because it allows about 40,000 Missouri kids to stay on their parents insurance until they are 26;

Because it has already “saved 111,815 Missouri seniors on Medicare an average of $627 per person on their prescription drugs by closing the Medicare Part D ‘donut hole‘” (quote from her website);

And because it has already “provided 431,945 Missouri women with free mammograms, bone density scans, and cervical cancer screenings with no co-pay” (quote from her website);

As I said, you’re damned right I voted for what you derisively try to call “ObamaCare,” and I couldn’t be prouder. Tell me, my critics, which one of the above “becauses” would you like to repeal? Huh?

And I’m even proud of the fact that I voted for the hated mandate because it was at least an attempt to get folks to stop gaming the system and help pay their own way. Aren’t you tired of some people trying to get something for nothing?

Any bleeping questions?

More Falsehoods About Social Security And Medicare

By now everyone has heard the news:

WASHINGTON – The Medicare and Social Security trust funds are both on “unsustainable paths” — as they have been for years — and will be exhausted by 2024 and 2033, respectively, a trustee report released Monday said.

And by now maybe you have heard the misinformation.

Joe Scarborough said this morning that Social Security will be “bankrupt” three years earlier than projected last year and it will just keep ratcheting up until it will be no time until it is gone. “It’s going down,” he said. In fact, here was the graphic on the screen as the panel discussed the issue:

Social Security benefits to be depleted by 2033.” What tommyrot that is. Benefits, far from being depleted, will continue long after 2033, even if nothing is done.

But first, let’s look at Medicare. As the USA Today story noted:

The trustees have predicted the depletion of the Medicare Trust Fund every year since they first began issuing reports in 1970, and they ultimately extend the deadlines out a few more years.

Yes, look at this from the Congressional Research Service:

As you can see, since such reports have been created, the projections of insolvency have been fairly imminent. Consider this from Sarah Kliff at Wonkblog:

…the trust fund doesn’t really decide Medicare’s fate. Instead, it’s an accounting term. When we talk about the Medicare Trust Fund, we’re pretty much referring to where our payroll taxes to finance the insurance program get stored. If the Trust Fund runs out, that means it can no longer cover everything it’s supposed to pay for. But Congress could — and, many think, would — make up the difference by borrowing, cutting spending elsewhere and using the savings to plug the hole, or finding new sources of revenue.

“The fund is a fiscally neutral element in the goods and services of Medicare finances,” Theodore Marmor, Spencer Martin and Jonathan Oberlander wrote in one article on the topic. “Congress can change the taxes that finance Medicare if it has the will. Likewise, it can change the benefits and reimbursements of the program.”

So, you can easily see that Medicare won’t be “bankrupt” in 2024, even though there is a definite problem with its financing that has to be soon addressed (apart from just shifting the cost on to future seniors, as the Romney-Ryan budget plan does*).

Likewise, Social Security is not now bankrupt and won’t be in 2033. Why? It is simple, as John Harvey at Forbes pointed out:

It is a logical impossibility for Social Security to go bankrupt.

Here’s how the Social Security Administration explains it:

The current Social Security system works like this: when you work, you pay taxes into Social Security. The tax money is used to pay benefits to:

  • People who already have retired;
  • People who are disabled;
  • Survivors of workers who have died; and
  • Dependents of beneficiaries.

The money you pay in taxes is not held in a personal account for you to use when you get benefits. Your taxes are being used right now to pay people who now are getting benefits. Any unused money goes to the Social Security trust funds, not a personal account with your name on it.

Because wage growth has been slow, and because the economy hasn’t exactly been great, money going into the trust funds has slowed down, but Social Security is not—not—paying out more in benefits than it is bringing in. Payroll taxes, along with interest from the special issue Treasury bonds the program holds, plus taxes on Social Security benefits paid by high-income taxpayers, all add up to an increase in the Social Security surplus.

Get that? The program’s surplus is still growing.

But even though Joe Scarborough got it wrong about Social Security and bankruptcy, he did get something right. He said the program’s future finances could be fixed in about twenty minutes.

One way of doing that—without cutting benefits—would be to eliminate the Social Security tax cap, which is currently set at $110,100. Eliminating the cap would mean that those who make more than that (about 6% of wage-earners) would then have to pay Social Security taxes on all their wages. Just this simple move would guarantee payment of full benefits for at least 75 years.

So, although we will hear a lot of Republicans talking about the demise of the two most important social stabilizers we have, using trust fund projections as tools to severely weaken, if not destroy, our safety net, the truth is that the future of both programs can be fixed without dramatically altering their nature, if there is the political will to do so.

And it is up to voters to impregnate the Republican Party with that will.

_________________________________

* Sadly, Willie Geist, a fixture on “liberal” MSNBC from 4:30am until 8:00am, defended the GOP budget plan and Paul Ryan, saying,

He doesn’t do this because he likes throwing old people out on the street; he’s trying to make it solvent. He’s trying to save it in the long term…he’s trying to do something big…

Willie, of course, will never have to worry about surviving his old age on reduced Social Security benefits or worry about how he is supposed to come up with the thousands upon thousands of dollars to get health care when he is too old for television.

Throw Medicare From The Train—Part Deux

Here’s the basic outline of House Budget Committee Chairman Paul Ryan’s 2013 budget in one sentence: Ryan’s budget funds trillions of dollars in tax cuts, defense spending and deficit reduction by cutting deeply into health-care programs and income supports for the poor.”

Ezra Klein

The Associated Press story in today’s Joplin Globe (the paper’s version was shortened for publication) summed up the Ryan budget plan nicely:

Mixing deep cuts to safety-net programs for the poor with politically risky cost curbs for Medicare, Republicans controlling the House unveiled an election-year budget blueprint Tuesday that paints clear campaign differences with President Barack Obama.

The AP also reported Mitt Romney’s rather enthusiastic support for the plan:

The House Republican budget rejects the out-of-control spending and higher taxes proposed by President Obama in his budget last month. By proposing prescriptions that will strengthen Medicare for generations to come, it also highlights President Obama’s failed leadership on entitlement reform.

So, now that we know where Romney stands (a rare achievement), let’s look at some of the Ryan plan in broad strokes, as presented by the AP: (follow the link for the details):

The Republican proposal…would wrestle the federal spending deficit to a manageable size in short order, but only by cutting Medicaid, food stamps, Pell Grants and a host of other programs…

The plan calls for steep drops in personal and corporate tax rates in exchange for clearing away hundreds of tax deductions and preferences. It would eliminate oft-criticized corporate tax boondoggles but also tax deductions and credits claimed by the poor and middle class.

To cope with the unsustainable growth of Medicare and the influx of retiring baby boomers, the GOP budget reprises a controversial approach that would switch the program — for those under 55 today — from a traditional “fee for service” framework in which the government pays doctor and hospital bills to a voucherlike “premium support” approach in which the government subsidizes purchases of health insurance.

If that all sounds familiar, that’s because we saw this movie last year. The difference is that this year’s sequel is even gorier (aren’t they always?) than last year’s spine-chilling offering.  And it was meant to be that way, according to Paul Ryan:

We are sharpening the contrast between the path we are proposing and the path of debt and decline that the president has placed us upon.

Sharpening, indeed.

Perhaps most appalling—considering all the cuts in the rest of the budget and the change in Medicare—is this:

The GOP measure also would replace $55 billion in Pentagon spending cuts and $43 billion in cuts to non-defense appropriations set to take effect in January with at least $261 billion in other savings over the coming decade, including curbs to food stamps, federal employee pensions and further cuts to federal health care programs.

As The Hill reported, not only does Ryan’s plan “shield the Pentagon from nearly $500 billion in automatic cuts and roll back some of the $487 billion reduction” already approved, the plan,

also increases national defense spending to $554 billion in 2013, an increase of $8 billion over the $546 billion that was agreed to under the Budget Control Act.

Get that? The GOP budget actually increases defense spending over what was agreed to last year!

All of the above is from neutral journalists. If you want to read progressive takes on the Ryan plan, go to the Washington Post and read Ezra Klein or to the Center for American Progress, which has a series of articles presenting the details of the plan. It ain’t pretty. And there is, as always, the Center on Budget and Policy Priorities here and here.

____________________________________

As for a short, non-partisan analysis of the “premium support” plan for “saving” Medicare, go to Kaiser Health News. Here is part of that analysis:

All plans, including traditional Medicare, would submit bids for how much they would charge to cover a beneficiary’s health care costs. The government would pay the full premium for the private plan with the second lowest bid, or for traditional Medicare, whichever is lower. Beneficiaries would have to pay the difference if they chose a plan that set rates higher. There could be one less expensive plan option, and beneficiaries who chose it would get a rebate for the difference…

But some critics are already arguing that the government-administered option would not be affordable and that it could cause doctors to leave the program. Critics have argued that the government-run plan would attract the sickest people, driving up its costs, while private plans would lure the healthiest.

This plan is the so-called Wyden-Ryan “compromise.” If you have wondered why a Democrat with liberal bona fides—Oregon Senator Ron Wyden—would team up with a right-winger like Paul Ryan to develop a plan to “protect Medicare,” go here and read Senator Wyden’s explanation. (You might be surprised; I was. But it is still unconscionable to give Ryan and the Republicans some political cover at a time like this, when so much is at stake.)

For a readable critical analysis of that Wyden-Ryan plan go here and here and here to get educated. It is essential to know what may happen to a vital social program.

Finally, in case any of us might think the White House will get wobbly-kneed on the Medicare proposal in the Ryan budget, remember this initial statement from Obama’s Communication’s Director Dan Pfeiffer:

We are concerned that Wyden-Ryan, like Congressman Ryan’s earlier proposal, would undermine, rather than strengthen, Medicare. The Wyden-Ryan scheme could, over time, cause the traditional Medicare program to “wither on the vine” because it would raise premiums, forcing many seniors to leave traditional Medicare and join private plans. And it would shift costs from the government to seniors. At the end of the day, this plan would end Medicare as we know it for millions of seniors. Wyden-Ryan is the wrong way to reform Medicare

Debt Hysteria Housecall

A conservative Globe blogger is in serious need of some timely counsel, and, being a conscientious public servant, I am here to provide it. He commented on my recent post, Let’s Agree:

We, all of us, in America, today are facing a $65 Trillion HOLE (Ok, plus or minus a “little bit”). Said another way…each and every American is “in hock” for about $550,000 due and payable some day.

And the crazy thing is NO ONE talks about that number nor does ANYONE propose how to fix it, “on bite at a time”.

And:

Well it is possible for a man to eat an elephant. But he must do so one bite at a time. But while we all argue, the NUMBER just keeps on going up and up. THERE, Duane, is the curve that MUST be bent, NOW. Just how deep is a $65 Trillion “cliff” I wonder?

Richest nation in the world my hind foot. Not with that kind of balance sheet!!!

Anson 

Dear Anson,

Because I hate to see you in such a state, as your Doctor of Tranquility, I am offering my limited help (I’m not a Doctor of Finance, remember) in treating the unfortunate hysteria you are suffering over the issue of the alleged “65 trillion” dollar financial “HOLE” you claim the country is about to disappear into. (Or are we going off a cliff? Or eating elephants? I forget.)

You should know that people who make that frantic $65 trillion charge (or any of the other various amounts) in the way they do are using what I consider to be the accounting equivalent of junk science:

First of all, the term “unfunded liabilities” has normally been used in right-wing, fear-generating blogs and articles and Fox “reports” on this very long-term wild speculation you mention, but that term has been lately discredited (because a “liability” is more of a legal term and promises made by the government are not actually legally binding on it). I notice now many folks are using the proper term, “unfunded obligations,” which is more accurate, but still junk, when used in the kind of analysis you referenced.

To put it as simply as possible, what you are referring to with your scary high number is the difference between projected federal financial commitments under current law and the projected revenues available to cover those commitments—over a completely arbitrary time horizon of 75 years.

These obligations are not technically “debt,” since Congress is free to pass legislation that would eliminate them altogether (don’t try doing that with your debt, by the way). And it is beyond silly to say “each and every American is ‘in hock’ for about $550,000 due and payable some day.”

Second, that time horizon (did you even know what it was?) could just as well have been 750 years and that big and fat and scary number would have been even bigger and fatter and scarier. (Let me see, what comes after “trillion”?)

The truth is that no one—or almost no one—actually believes these numbers are accurate for a lot of reasons, most notably that policies and situations change quite frequently over even short periods of time (just look at budget surpluses under Clinton and deficits under Little Bush), and 75 bleeping years is sort of a long time, don’t you think?  Go back 75 years (1936?) and imagine a bureaucrat in the government, perhaps Newt Nostradamus, estimating “unfunded obligations” in 2011. It is absurd on its face.

And while we’re at it, the Social Security and Medicare Boards of Trustees have said that

Projected Medicare costs over 75 years are about 25 percent lower because of provisions in the Patient Protection and Affordable Care Act…

Do you believe that? Of course you don’t.

The reason some conservatives promote hysterical talk about such things as unfunded liabilities and use such frightening language is because they seek to dismantle or sharply reduce our social commitments and scaring the public is one way, they believe, they can do it. 

While it is true that Medicare funding is a big problem in the out years, it is not, as I demonstrated recently, an insurmountable one, if policies to control health care costs are implemented and other things are done, like, say, raising revenues.  And they will get implemented and revenues will get raised, in some way at some time. So, get some sleep and stop worrying about it, for God’s sake. (Or, if you can’t sleep, use the up time to write your favorite Republicans and urge them to get real about taxes.)

Third, there is a comparative fallacy involved in these numbers. The gap, instead of being put in the form of aggregate unfunded dollar commitments, should be put in the form of percentage of projected GDP, which would attempt to account for economic growth over the time period. That way future gaps could be more fairly compared with today’s gap.  But then those numbers wouldn’t look or sound so damn scary, would they?

Fourth, let’s look at those “unfunded obligations” in a way that conservatives won’t like.  Let’s discuss Pentagon spending in those terms.  Is defense spending an obligation? Yeah, sort of (see the Constitution). And, like Social Security and Medicare, is there a Pentagon tax dedicated to our national defense? Huh? Nope, there’s not.  So, using the analysis you are advancing, every single dollar of necessary future military spending is an unfunded obligation, right?  That means, projected over 75 years, the gap between revenues specifically dedicated to the Defense Department and the projected military spending is, well, it is more money than God, or even Mitt Romney, has!

This stuff the right-wind peddles is analytical junk, Anson.  There really are no such things as “unfunded” obligations because the government has the power to tax to meet them. And using such language in the context you and others use it unnecessarily scares people who don’t know any better, and it doesn’t help arrive at rational solutions to our very real problems with long-term debt. 

The fact is you don’t need those misleading large numbers to make the point—which nearly everyone understands by now—that some important changes in Medicare (and a tweak or two in Social Security) are necessary to keep us fiscally sound.  Indeed, distorting the picture so grossly tends to lead away from careful, reasonable solutions in favor of distinctly reactionary and irrational ones. (Of course, as I said, some folks on the right wouldn’t mind that one bit, as long as the New Deal fell victim to such panic.)

But I am under no illusion that you, in your zeal to save the country, will stop worrying and stop trying to scare the bejesus out of people because you are fixated on our debt problem and therefore welcome uncritically any analysis that generates fear over it.  And I am certain you will not now listen to,

Your  Doctor of Tranquility,

Duane

How To Fix Medicare And Beyond

I have written quite a bit about health care reform over the past few years, including my last post of 2011, which received this comment from the always thoughtful and thought-provoking Jim Wheeler:

My conclusion: the present system, including the ACA, is unaffordable and the Paul Ryan plan is even worse. Extending Medicare to all ages, sorry Duane, would have the same problem, unless that is, if the government were given pricing power in the medical market, but it seems to me that such would be equivalent to the Public Option, the only solution that makes sense to me. The bottom line is a tough one in that any viable solution will have to slash industry profits by half, which is why industry lobbyists sank the Public Option in the first place.

My response is necessarily lengthy because the issues are obviously difficult.  But let the following stand as my current, if somewhat tentative, endorsement of what to do to fix what is wrong with our health care system, despite the passage of the Affordable Care Act:

Jim,

As you know, I was a proponent of the public option. But the kind of public option I would favor was found in H.R. 4789, which had 82 co-sponsors. It amended the Social Security Act “to authorize an option for any citizen or permanent resident of the United States to buy into Medicare.”

I choose Medicare-for-all not because it would be the best possible system, but because it seems to me to be the only politically possible system that would also be a considerable improvement over what we have now. I say that because most people already have a high opinion of Medicare and would, with gentle persuasion over time, be open to applying it to all people.

My own personal choice—I want to make clear—would be a complete government health care system, similar to the VA system, or even expanding the current VA system to include all people.  It turns out that since the late 1990s—contrary to what most people believe—the VA system—socialized medicine—is the model of efficiency and effectiveness. (And, of course, the “moderate” Mitt Romney wants to privatize it.) It also has the power to negotiate discounts for prescription drugs, which is essential to control costs.  This kind of truly socialized medicine would be my “public option.”

But I recognize the near-impossibility of such a move, given our politics and our historical national aversion to such things, even though it appears to me that conservatives would have a hard time labeling the VA system as dangerous European socialism and the military veterans who use it as scary socialists. But I digress.

Let’s talk first about the possibility of fixing or improving the current Medicare system, before extending it to all people. Without the fix, I agree that it would be a problematic option for all people.

To begin, let me get this out of the way: As a rule, I believe choice and competition are good things and serve us well as Americans. But let us keep in mind that they ought to be our servants and not our masters.

I also believe the profit-motive is indispensable for a society that seeks a general prosperity that benefits everyone, even if there are some inequities necessarily arising out of a system that values the concept of making gobs of money. (Severe inequities, though, should be addressed via a progressive tax system, but that’s for another day.)

But those who believe that increased choice and competition and profit-opportunities in the health care system overall will lead to greater efficiency and reduced costs don’t understand how the American health care system works or how it has worked in the past. (Phillip Longman does; read here and here for the details.) What this choice and competition leads to most often is inefficiency and wasted resources, often at the insistence of the health care consumer, who doesn’t mind all that much in times of dire need if, for instance, the specialist orders extra—and profitable—but unnecessary treatment.

Look at this graph, which I know you are familiar with:

The idea here, of course, is that as Americans (the top blue line) we are spending a lot of money on our private, profit-based health care system, compared with most of the rest of the industrialized world, and we are not necessarily getting our money’s worth. Many unnecessary expenses are built into the kind of system we have, including unnecessary treatment in the form of operations and other costly procedures.  

And, look, I don’t necessarily chalk up everything wrong with this picture to “greedy bastards” in the health care and health insurance business. There are plenty of entrepreneurial reasons why over-treating patients makes $en$e (see, for instance, this New York Times article by Dr. Peter Bach, who criticizes fee-for-service plans because they encourage doctors to quickly move patients through their practices and to order expensive and profitable testing).

And there are plenty of profit-minded reasons, given our capitalist system and what some call “actuarial logic,” why it is that insurance companies charge older folks more for insurance or discriminate against the sick, even though such behavior causes gratuitous harm to society.  They are in business to make money, not to promote the general welfare.

So, it only makes another kind of sense—common sense—to take, or begin to take, the profit-motive out of our health care system. As I said, I would be in favor of a complete government-run, VA-like system, but the second-best in my opinion would be to improve the Medicare system and extend it to all folks who want it.

Based on all that, I suggest considering the recommendations of the above-mentioned Phillip Longman, who says that to improve and make Medicare financially sustainable, we ought to set a date certain for the conversion of that system from an inefficient fee-for-service plan to one that utilizes Medicare-certified nonprofit HMOs.  He addresses the historical problems with Health Maintenance Organizations (there are many) and offers valuable examples of ones that have worked well, including, but not limited to, the VA system. (Among other non-government players, he mentions the Cleveland Clinic and the Mayo Clinic.)  

Longman says:

Approximately a third of all Medicare spending goes for unnecessary surgeries, redundant testing, and other forms of overtreatment, according to well-accepted estimates. The largest single reason for this extraordinary volume of wasteful and often dangerous overtreatment is Medicare’s use of the “fee-for-service” method of compensating health care providers that dominates U.S. medicine, under which doctors and hospitals are rewarded according to how many procedures and tests they perform. To fix this, the federal government should do the following: announce a day certain and near when Medicare will be out of the business of subsidizing profit-driven, fee-for-service medicine.

Republicans, famously, have voted en masse to voucherize Medicare, which would, as Longman says, “lead to seniors paying for nearly 70 percent of the cost of their health care, which is hardly insurance at all.” And certainly not “Medicare” at all.

Democratic fixes, says Longman, are less onerous for seniors, but “don’t necessarily save money” because “profit-maximizing providers remain free to game the system.” And some of the fixes built into the Affordable Care Act, like the Independent Payment Advisory Board, are subject to political demagoguery (“death panels”) and thus reversal, and at best, even if they survive, their ability to do good is “gradual.”

Longman again:

Unless a more immediate and certain reform is applied, most of the Medicare population will continued to be treated—for years if not decades to come—by the status quo of a pattern of deeply fragmented, wasteful, and dangerous fee-for-service care, the cost of which everyone now agrees is unsustainable. If we’re going to avoid financial Armageddon, we have to do better than that.

Phillip Longman’s idea of setting a date “when the Medicare system will stop covering fee-for-service medicine” and instead give seniors a choice “among competing managed care organizations” that do not operate under the profit motive sounds like a good place to start to me, in terms of fixing the Medicare system we have today.

After that, or as part of that fix, we could, if we generated the political will, extend the program as an option to all—even though Longman does not go that far in his proposal.

And speaking of political will, over all this talk of reform hangs the politics. By adopting his proposal, Longman argues, both Democrats and Republicans can declare some kind of victory:

It allows Democrats to say that they will not cut benefits to Medicare recipients. And Democrats should also like that these nongovernmental organizations serving the Medicare population will have the freedom to do things liberals have long wanted Medicare itself to do, like bargain with drug companies for lower prices. Meanwhile, Republicans who support this proposal will be able to boast that it takes vast decision- making power out of the hands of “unelected bureaucrats in the federal government” and puts that power in the hands of private organizations that compete with each other for customers.

Longman closes with this, which will serve as my close:

America is still a rich and productive country. Compared to Europe or Japan, it has a youthful population and no real long-term debt crisis except that caused by huge volumes of wasteful and dangerous fee-for-service medicine. So once again in our long history, Americans can have their cake and eat it too. We can improve our health care while lowering its cost, and in the process eliminate our long-term deficits and resume building for future.

So why don’t we feel more optimistic? Because there is this feeling of despair, especially among policy makers and the chattering classes, that we don’t know how, politically, to bring health care costs in line. We know that all other developed countries get better health care for less money, and that it is no real mystery how they do it. But all their approaches seem—or can be spun as— socialistic, paternalistic, and fundamentally un-American, and therefore impossible to consider.

Yet we have within our reach a solution that is not imported from abroad, and that has been proved on our own shores by all-American institutions, from our best nonprofit HMOs to the VA health system. We may not currently have the political will to use these institutions as the model and means to fix the health care crisis, and hence eliminate our long-term fiscal problems. But we shouldn’t fool ourselves into thinking it can’t be done.

If you want to hear Phillip Longman discuss at length his findings about the VA health system—he started out as a skeptic—here is a video of the talk. His interest in the health care delivery system was related to the unfortunate experience of his late wife, who died of breast cancer:

 

Let’s Agree

Let’s stop subsidizing the wealthy. Stop crony capitalism. Stop corporate welfare. Means-test our entitlement programs.”

The above quote was not said by some wild- or starry-eyed liberal. It was said by the Buddha of budgetary knowledge on the right, Paul Ryan, on ABC’s This Week last Sunday. 

In the spirit of the New Year and New Beginnings, let us end this year with a note of agreement. I agree with Mr. Ryan that we should stop crony capitalism—the only kind there will ever be without adequate public attention—and stop corporate welfare—corporations are doing just fine, thank you—and we should means-test our entitlement programs—especially Medicare, which is, as Paul Ryan knows very well, the biggest driver of our long-term debt problem. 

And Paul Ryan also knows very well that the plan he advanced earlier this year—which nearly every Republican this side of the Asteroid Belt voted for—would end the system created in 1965, even if the name would live on. (No matter what Politifact says.) Let’s all at least agree on that. 

And let us agree that the current Medicare system, which took more than 50 years to bring into reality, should be preserved. After all, it was signed into law by a Texan, Lyndon Johnson, and was supported by almost half of the Republicans in Congress at the time. 

So sensitive are Americans to perceived government interference, that even the sainted FDR dared not force the issue of public health insurance—which he supported—before the enactment of his social security bill was assured in 1935. And despite Missourian Harry Truman’s efforts to get the job done—President Johnson would eventually credit “the man from Independence” for those efforts and make the 81-year-old fighter the program’s first enrollee— it took another generation before folks without means could rest a little easier knowing they had at least basic health insurance they could afford, when they were on the unprofitable side of life. 

And among those who could rest a little easier were my parents. My dad, who was 56 years old when Medicare was passed, worked all of his pre-heart attack life. My mom worked full-time at home and part-time at what she called the “dime store.” Were it not for Medicare, well, the alternative for them would have been and, for me, remains, unthinkable.  Let’s agree that, for them and millions of  people like them, access to affordable government health insurance made—and for now, still makes—America a better place in which to live.

Truman, in a special message to Congress in November of 1945—1945!—said there were “certain rights which ought to be assured to every American citizen.” One of them, he said, was “the right to adequate medical care and the opportunity to achieve and enjoy good health.” What a shame, more than 65 years later, we are fighting over The Affordable Care Act, which guarantees Americans, sick or well, rich or poor, the right to health insurance, or rather the right to purchase health insurance from profit-minded private insurers. It is, by no means, a fulfillment of the vision of liberals, old or new. But it ain’t nothing. 

And yet we fight. Let’s agree to stop fighting about something so necessary. 

Truman said: 

In the past, the benefits of modern medical science have not been enjoyed by our citizens with any degree of equality. Nor are they today. Nor will they be in the future—unless government is bold enough to do something about it. 

People with low or moderate incomes do not get the same medical attention as those with high incomes. The poor have more sickness, but they get less medical care. 

He didn’t must make that statement in 1945 without evidence to back it up. And he had plenty: 

The people of the United States received a shock when the medical examinations conducted by the Selective Service System revealed the widespread physical and mental incapacity among the young people of our nation… 

As of April of 1945, nearly 5,000,000 male registrants between the ages of 18 and 37 had been examined and classified as unfit for military service. The number of those rejected for military service was about 30 percent of all those examined. The percentage of rejection was lower in the younger age groups, and higher in the higher age groups, reaching as high as 49 percent for registrants between the ages of 34 and 37. 

Think about that. And think about the health of those back then who were in their forties and fifties and sixties and beyond. Truman, understanding that the child is father of the adult, said that it is “important to resolve now that no American child shall come to adult life with diseases or defects which can be prevented or corrected at an early age.” 

Let’s agree that health care involves inter-generational agreements. Old folks, let’s make sure the young are cared for, even if their parents are not rich. Young folks, let’s make sure the old are cared for, even if they lack wealth. All of us are either young or getting old. The Affordable Care Act is simply a part of these inter-generational agreements—without which any modern and civilized society cannot continue to be modern and civilized. It ought to be without controversy, or at least without animus. 

But it’s not. We have folks around the country, and folks in Congress, who are fighting for the repeal of the Affordable Care Act with a kind of religious zeal, as if to lose the battle would mean the end of a God-blessed America. There are even some radicals who would move us back to not only 1964, before Medicare, but to 1934, before Social Security. They would leave the non-rich at the mercy of charities or family and friends, of whatever means. 

But if we can’t finally agree, as Paul Ryan seemed to suggest last Sunday, that entitlements—Social Security, Medicare and Medicaid—are a permanent part of our social fabric and that in order to afford them we may need to, among other things, means-test them, then I’m not sure there is anything we can agree on as a civilized nation.

As Harry Truman said so long ago, our government needs to be “bold enough” to do something about inadequate health care in our country.  All he was really saying was we-the-people need to be bold enough.

Bold enough to agree.

Silence Of The Fact Checkers

The left is rightfully outraged over Politifact’s designation as “Lie of the Year” Democratic claims that Republicans, when voting on Paul Ryan’s budget plan, voted to end Medicare.

Politifact was wrong and Democrats are right.

Even if Politifact and FactCheck.org are technically correct that the program “would not end” under the Republican proposal, that is a distinction without a difference. Voucherizing the program for all people under 55 would completely change it from its original conception by inventing a new system to take its place. Republicans weren’t so dumb that they would actually change the name of the program, but they would completely change its nature and its name would mean something totally different from what it means today.

What Republicans would actually do—we know this because almost all of them in the House and Senate voted to do it—is kill Medicare for those under 55, skin its corpse like Buffalo Bill did his victims in “Silence of the Lambs,” and dress up their new program in Medicare’s pelt. 

Now, if Politifact and other fact-checking organizations still think it is fair to call what’s underneath that layer of skin “Medicare,” then they are doing their readers a great disservice and it is up to Democrats to educate people before it is too late and the program is in the morgue—where many conservatives have wanted to put it since it was born.

“We Don’t Have Enough Revenue To Pay For Decency”

Jeffrey Sachs, among other things, is an economist at Columbia University, and he is a fairly frequent critic of President Obama, essentially from the left (as he was this morning on Morning Joe). The following very short clips (both around two minutes, counting the commercial) feature a concise yet profound explanation as to just what is going on in America.

The first (which has a technical problem at the end) is an overview of non-security discretionary spending, and the second is a short talk on Medicare and the health care system:


It’s Only Called Class War If We Fight Back

More than a week ago, economist and former Secretary of Labor Robert Reich gave a speech at the “Summit for a Fair Economy” in Minneapolis and addressed several “downright bald-faced lies” told by conservatives and Republicans about the economy.  He ended his speech with this:

The greatest enemy we have is mass cynicism. When people really get to the point where they think nothing can be done, then the other side wins. That’s what they want by the way. That’s what they want…[The other side] wants government at all levels to function so badly that people say government can’t work…they also want politics to be so bad and so paralyzed that most Americans say nothing can be done…

It’s easy, when they are scared and disorganized, for people to be subject and vulnerable to demagogues who come along and say to them, “You know…the reason you’re in trouble is because of government, or it’s because of immigrants or it’s because of the poor or it’s because of blacks,” or it’s because of a number of scapegoats that are always offered up, the same scapegoats.

But in reality, we are all struggling over a smaller and smaller share of a bigger and bigger pie. And they are deflecting and diverting attention from the story which is that more and more of the income and wealth is going to big corporations and to the very, very super rich in this country and that is what has to be reversed and that is why we have to take back America.

Class warfare?  Yes, that’s what it is called if someone on our side fights back.  Pay attention today to the criticism of President Obama today as he announces his debt-cutting plan that includes taxes on the rich.  His plan has already been called class warfare by Republicans this past weekend.  Ask yourself why it is called class warfare if a champion of the middle class and poor decides to fight back?

Finally, as ammunition in the effort to fight back, here are some of Reich’s compact responses to the “downright bald-faced lies” told by the Right:

“DOWNRIGHT BALD-FACED LIE” #1: Giving tax cuts to the rich and corporations will trickle down to everyone else

A lie! it has not happened; it has never happened. They don’t need more tax cuts. Big corporations are now sitting on more than 2 trillion dollars of cash. There are higher corporate profits now than we have seen in 35 years. ‘s not happened and The ratio of corporate profits to wages is now higher than it’s been since before the Great Depression of the 1930s.

“DOWNRIGHT BALD-FACED LIE” #2: Shrinking government creates more jobs

I debate a lot of…conservative economists and others on television who keep on saying this and I keep on saying, “Tell me your theory. How is it that if you lay off teachers and social workers and firefighters and police officers, that you have fewer people building the roads, building the highways, building the infrastructure, fewer people rebuilding our schools, fewer people doing all of the public’s work, how can that create more jobs?”

And the answer I get is, “Government always gets in the way.”  I say, “But tell me exactly how is it that if you shrink government you’re going to get more jobs, particularly when consumers are holding back because they can’t do it?”

And the answer I get is, “Government always gets in the way.”  In other words, there is no intellectual basis for the ideology…If you shrink government you get fewer jobs…

“DOWNRIGHT BALD-FACED LIE” #3: Taxing the rich hurts the economy

Under Dwight David Eisenhower—who nobody would call a socialist, I don’t believe—["Some would now," said someone in the audience]—some would now? Yes—the top marginal income tax rate on the top earners was 91%.  And even with deductions and tax credits, that still meant that they were paying an effective tax rate of hugely higher than they are today.  And yet the economy grew faster.

That lie about trickle down, the lie that we must not tax the rich because that would deter them from working hard and investing and creating jobs is nothing but a bald-faced lie, based on ideology rather than facts.

“DOWNRIGHT BALD-FACED LIE” #4: Medicare and Social Security and other spending is the cause of the long-term debt problem

It’s not! The long term debt out there is because of rising health care costs. Medicare is the most efficient system we have…the administrative costs of Medicare are so tiny relative to private insurance, that what we really need, if we want to get Medicare and medical costs down in the future, is Medicare for all.  And then we can move from a fee-for-service system to a fee-for-healthy-outcome system…

“DOWNRIGHT BALD-FACED LIE” #5: Social Security is a Ponzi scheme

Can you imagine the irresponsibility—putting partisanship to one side—I’ve never heard a public official running for national office who lies through his teeth by saying that the Social Security system is a Ponzi [scheme]—I was a trustee of the Social Security trust fund, I know exactly what the actuaries project.  For the next 26 years Social Security is purely solvent, completely solvent; there’s no problem. 

Beyond 26 years the only reason there is a problem with potentially being to pay out everything Social Security owes beyond 26 years… is because of rising inequality, because so much money has gone to the top that the portion of income subjected to Social Security taxes is not going to be enough.  And that’s why the easiest most direct response to the post-26 years from now is to raise the cap on incomes subject to Social Security.

“DOWNRIGHT BALD-FACED LIE” #6: Tax reform should include raising taxes on even the poor

Real tax reform is that we’ve got to expand the earned income tax credit…we’ve got to reduce taxes on the middle and lower middle, and we’ve got to increase taxes on the top—and more tax brackets…go back to where we were before.

Admittedly, this was Reich’s weakest response, as I don’t believe tax rates on the middle income need to come down any further, but otherwise his speech was flawless.

Here is the video:

A Tale Of Two Styles

Over the past couple of days, two people I highly respect, Barack Obama and Paul Krugman,  have succinctly and accurately laid out some rather simple solutions to our long-term debt problems. 

First the President:

When it comes to getting a sustainable debt level, if we went back to the rates that existed when Bill Clinton was President and we made some modest adjustments to Medicare that preserved the integrity of the system, our long-term debt and deficit problems would go away. And most people here wouldn’t notice those changes.

Here’s Krugman:

The truth is that as far as the straight economics goes, America’s long-run fiscal problems shouldn’t be all that hard to fix. It’s true that an aging population and rising health care costs will, under current policies, push spending up faster than tax receipts. But the United States has far higher health costs than any other advanced country, and very low taxes by international standards. If we could move even part way toward international norms on both these fronts, our budget problems would be solved.

Very similar, no?

But let’s look at how both men explain why those solutions won’t immediately be forthcoming.  First the President:

But we’ve become so dug in when it comes to sort of ideological purity that we’re not willing to make modest adjustments like that.

Get it? “We’ve become so dug in…” We. We. The implication is that both sides are dug in and thus equally to blame. And keep in mind that Mr. Obama’s remarks came at a DNC event!  If he can’t clearly name names there, where can he?

Now, Krugman’s view:

So why can’t we do that? Because we have a powerful political movement in this country that screamed “death panels” in the face of modest efforts to use Medicare funds more effectively, and preferred to risk financial catastrophe rather than agree to even a penny in additional revenues.

The real question facing America, even in purely fiscal terms, isn’t whether we’ll trim a trillion here or a trillion there from deficits. It is whether the extremists now blocking any kind of responsible policy can be defeated and marginalized.

There is no doubt who Mr. Krugman believes is responsible for the failure to solve the long-term problem.  There isn’t any “we” to blame.

As I said, I respect both men a great deal.  But until Mr. Obama starts talking like Paul Krugman—no matter what the pundits may say—a majority of the American people may take the “we” seriously in Mr. Obama’s analysis and conclude he is part of the problem.

Obama, Lincolnesque

It’s hard to know what it happening behind the scenes regarding negotiations over the debt ceiling, but we know that folks on the outside looking in—liberal Democrats and conservative Republicans—are worried about negotiators on their side giving up basic principles in order to make a deal.

Now, don’t get me wrong.  There is no moral equivalency here.  Liberal Democrats are worried that “the big three,” Social Security, Medicare, and Medicare, are under attack, and they don’t much appreciate that President Obama seems willing to at least consider unpleasant cuts to those social programs. 

But that can’t be compared morally with Republicans worrying about keeping taxes low on the wealthy, whether individuals or corporations, or their willingness to risk incapacitating the economy in order to get their tried-and-failed way.  They are a disgusting group, this hard-headed, ideologically-centric band of know-nothings.

How this debt-ceiling thing turns out in the end is unpredictable at this time.  And I know liberals are starting to squirm, and some are starting to squawk, about President Obama’s deal-making skills, and his commitment to hard-bargaining with non-compromising negotiators in the House. 

I feel their pain.

But President Obama’s nature is not to gamble irresponsibly with such things as the full faith and credit of the United States, even if his political opponents are.  His nature is not to risk an economic calamity, that would harm most the very people that liberals want to protect, even if Tea Party Republicans don’t give a flying puck about that economic calamity.  In short, he is seeking the best compromise possible in order to save our economic system from the reckless, ideology-crazed conservatives in Congress.

His discussion this morning at a Town Hall event in Maryland included talk of Lincoln and the Emancipation Proclamation.  He has used Lincoln’s willingness to compromise on the issue of slavery before, so it’s a good bet he has Lincoln’s example at the top of his head, as he seeks to avert economic catastrophe.   He pointed out that Lincoln was willing to settle for only outlawing slavery in rebel states as a means of preserving the union and finishing the fight,  a fight which eventually ended with not only the preservation of the Union, but slavery completely abolished.

I think Obama sees this fight much the same way:  Advance things by compromising, even to the point of making some supporters—like me—angry, in order to keep fighting—fighting that will continue through the 2012 campaign—because he believes he can ultimately win the fight for the Democratic vision of the country.

We shall see about that. Much of it will depend on how far he goes to appease unappeasable opponents.

Some things we are not willing to sacrifice,” Obama said today, but “In the mean time, we have a responsibility to do our job.”  Like Lincoln who gave the South every chance to avoid the Civil War, Mr. Obama is giving Republicans every chance to avoid the catastrophe that what would follow a loss of confidence in America’s fiscal sanity.

It’s easy, and understandable, for liberals in the Democratic Party to voice their concerns over what is happening.  After all, most of this fight is taking place on conservative ground.  But what would they—we—have Obama do?  A majority of the American people—including those who didn’t vote—put radical conservatives in charge of the House and gave them filibuster power in the Senate.  The American people.

This is a delicate situation, both economically and politically.  If Obama sent the signal that he was completely dug in on his side, the markets would react negatively and the economy would already start sinking.  He has to be the grownup. He has to be the pea-eater.

In the end, though, there has to be a line he won’t cross.  Lincoln had his, and the South called what turned out to be not his bluff.  Let’s hope that, as Obama said two weeks ago, Republicans won’t call his bluff.

All liberals can do is hope he is not bluffing, and that he will not surrender.

Is This Crisis Going To Waste?

Jim Wheeler, Globe blogger and frequent commenter here, wrote a piece (Into The Abyss) in which he severely criticized Republicans and mildly rebuked Democrats for their failure to use “a threatened national default” as motivation to tackle entitlement reform.

In other words, Mr. Wheeler doesn’t want this crisis to go to waste.

Here is my reply:

Jim,

I’m glad you singled out the President as the only “adult” in this mess.

Mr. Obama said on Monday,

Now is the time to do it.  If not now, when? 

He also made to liberals what I consider to be a powerful argument in favor of entitlement reform:

…if you’re a progressive who cares about the integrity of Social Security and Medicare and Medicaid, and believes that it is part of what makes our country great that we look after our seniors and we look after the most vulnerable, then we have an obligation to make sure that we make those changes that are required to make it sustainable over the long term.

So the argument I’m making to my party is…if you care about those things, then you’ve got to be interested in figuring out how do we pay for that in a responsible way.

The problem with all that is that those on our side who respect Obama and Obama’s argument, don’t believe he is dealing with honest brokers on the other side.

Mitch McConnell has expressed several times his real priority, which is to oust Obama from office. John Boehner is too weak to make a deal, and Eric Cantor is after Boehner’s job and thus is motivated to thwart any genuine efforts on Boehner’s part to do the right thing.

That is why Obama’s position is a hard sell to liberals. We can’t fathom getting a “balanced” deal from the other side. We think Obama will have to cut way too deep and otherwise give away too much of what we value just to get Republicans to raise the debt limit. It’s last year’s hostage situation all over again, with more at stake this time.

And that is why I resent the use of defaulting on our debts as leverage to make a deal of this magnitude.  It’s not honest, as McConnell’s recent move revealed. Obama has made an unbelievably large offer that would cause him great difficulty among those who trust and support him, if Republicans chose to accept it.  But because Obama made the offer, because it came from his tainted lips, it is unacceptable. Republicans essentially want the cuts without giving anything in return.

Finally, if we believe in democracy, then we ought to let the people decide such large matters through elections. As I have argued before, both parties should cast the 2012 elections as a referendum on what kind of country voters want to live in.

Here are the choices on the domestic spending side:

Smaller government and lower taxes: Which means reduced Social Security and Medicare benefits and a rather severe reduction in Medicaid, reduced funding for education and infrastructure, etc.  Paul Ryan’s dissolution of the Medicare program for those under 55 is just one example of what the country would look like, if people choose this option.

Larger government with higher taxes: Which means making investments in education and infrastructure, etc., and tweaking Medicaid and Social Security to ensure their solvency. That leaves the real driver of long-term deficits and debt: Medicare. How do we fix it under this choice?  Well, more on that later, but suffice it for now to say this: Cost shifting of the kind Paul Ryan outlined is unacceptable; so, too, is perpetual tax increases, which could not keep up with the escalating costs.  Democrats will have to propose a fix along the lines of what Kevin Drum outlined:

We need something…that genuinely has an effect on healthcare costs. Something that reduces the amount we pay doctors, hospitals, and insurance companies. Something that provides incentives for difficult end-of-life decisions. Something that makes credible tradeoffs between the cost of new treatments and the likely benefits. And something that gives taxpayers and patients alike a reason to care about all this. 

I’m in tune with your desire to do something about entitlements, Jim, but I’m skeptical of using the threat to ruin our credit (which would increase our debt problems through the increased cost of borrowing) and reversing our barely-discernible economic recovery as the way a democratic nation solves its problems.

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