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.

23 Comments

  1. You tell ’em, Duane. Eugene Robinson did so this morning. See http://www.truthdig.com/report/item/facts_get_in_the_way_20120817/?ln

    Like

    • Another good link on HC, Herb. In fact, it is so good that I’m moved to repeat the core of it here for those who may be counter-motivated to click on the link. Truth deserves repetition.

      Everyone agrees that something has to be done about skyrocketing costs for Medicare and also Medicaid, the health care program for the poor. Obama took the first step toward “bending the curve” of cost increases with the Affordable Care Act. Leave aside, for the moment, the fact that Romney now pledges to undo the progress Obama has made. The question is what do we want Medicare to be?

      There is no reason why Medicare cannot be reformed as a social insurance program. Other industrialized countries provide universal health coverage for their entire populations for a fraction of what we spend in the United States, and those other countries achieve equal or better health outcomes. Surely we can continue to do so for those of retirement age—if we still want to.

      The question to ask Romney is whether he believes in social insurance—whether his objections to the way Obama has begun to reform Medicare are fiscal or ideological. Ask him and Ryan whether they agree that markets are often efficient but seldom compassionate. Ask him whether he sees the free market as our servant or our master.

      Like

      • Jim,

        Herb’s link is a good one.

        The reality is the Republican Party has been replaced by reactionary ideologues. The party is not conservative, nor is it Christian by any authentic standard — unless ovary-obsessed homophobes have discovered ancient texts proving Jesus was a money-hungry bigot, eager to placate Judean casino owners when not selling over-priced bread and fish to gullible customers.

        It is beyond understanding how “fiscal conservative” deficit hawks can champion Ryan’s proposed budget. Ethan Pollack of the Economic Policy Institution has crushed Ryan’s number salad into dire prognosis:

        “Against a current policy baseline, the [Ryan] budget cuts discretionary programs by about $120 billion over the next two years and mandatory programs by $284 billion, sucking demand out of the economy when it most needs it and leading to job losses. Using a standard macroeconomic model that is consistent with that used by the private-and public-sector forecasters, the shock to aggregate demand from near-term spending cuts would result in roughly 1.3 million jobs lost in 2013 and 2.8 million jobs lost in 2014, or 4.1 million jobs through 2014.”

        Aside from exacerbating job losses, the Romney endorsed Ryan fiasco would add an additional $5 trillion to the deficit and cut GDP 3.5 percent.

        The silver lining to this unnecessary train wreck is slashed corporate/upper income tax rates, and the end of Medicare/Medicaid as they currently exist.

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        • John,

          You wrote,

          Aside from exacerbating job losses, the Romney endorsed Ryan fiasco would add an additional $5 trillion to the deficit and cut GDP 3.5 percent.

          That point doesn’t get made often enough and gets lost in the confusion, much of it allowed to fester because of a lazy or defensive mainstream press, afraid of being called out as “biased” by conservatives.

          Duane

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    • Herb,

      O’Brien has been one of the few straight journalists willing to take on this lie face to face with either the candidates or their surrogates. The fact that Gene Washington could write about it the way he did makes that point. She has been the exception because a lot of on-air non-partisan journalists simply don’t want the label Sununu tried to put on her:

      When O’Brien reminded Sununu of these facts, he barked that she should “put an Obama bumper sticker on your forehead.” But the claim that Obama had “gutted Medicare” remained false, and O’Brien told Sununu: “You can’t just repeat it and make it true, sir.”

      Thanks for linking to Gene Robinson because he is among the finest columnists out there and pointing to the proper way to conduct journalism is priceless.

      Duane

      Like

  2. ansonburlingame

     /  August 17, 2012

    Well Duane, 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.

    BUT future military personnel, given the notice that their retirement will be different and less than before will at least have the time to plan for that future. Will they complain? Sure they will. Will they vote in favor of such a change? Probably not as well.

    But is it a required change to government fiscal policy? You bet it is in my view.

    Anson

    Like

  3. writer89

     /  August 17, 2012

    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!

    On a more serious note, the reason medical care, college degrees and a shitload of other things have become so expensive in our society is because we are paying a bunch of predatory middlemen (insurance companies, for-profit colleges, etc.) for completely unnecessary services. Cut them out of the picture, put in a few reasonable cost controls, and we’ll be able to afford universal medical care and higher education and food and energy for everybody who needs those things, just like the rest of the civilized world. A few banksters, oil company execs and insurance CEOs will probably go broke. Boo-fucking-hoo.

    Like

    • Ah Writer, if only it were that easy. The sad truth is that we are puppets of Big Ed, Big Oil, Wall Street and the medical industrial complex. The choice is clear to me, and probably to you too, but will the young un’s pay attention this election season?

      Got your voter photo ID yet?

      Like

    • Absogalooly correct and well and colorfully put.

      Like

  4. ansonburlingame

     /  August 18, 2012

    Writer,

    Both of us are now old geezers. But once we were young and when we were that age we, I suppose, played by the rules in place. WE did not establish the cost of a college education or the size of (in my case) military retirement benefits. All of that was done for or to us and we simply sucked it up and followed the rules in place at the time.

    Would I for example, have remained in the military for a career as defined by law, not some bureaucratic whim, had those benefits been different? I have NO IDEA now. The variables in such a decision then and now are VERY complex and personal.

    My two sons are in their mid-40s today, working their asses off just like I did at the time. I, back then, and they today have a flexible and reasonable PLAN for their future. THEY can do many things socially and financially NOW if laws change.

    It won’t happen, but say Medicare was suddenly cancelled today for anyone below 50 years of age. Would my two sons adapt and move on? You bet they would. Yes, they might have to work longer in their older age, work harder today to set more aside, but they would NOT just give up and whine about “fairness”.

    I would LOVE nothing better than to see Medicare for all with everyone getting absolutely the best HC possible, for “free” all over America. But guess what, that is impossible to achieve.

    Scarcity, the imbalance between wants and resources to meet those wants is the very foundation of economics. Without scarcity there would be NO economic laws or processes. Economics is the science (and art) of deciding how wants come into balance with resources (land, labor, capital and leadership). That by the way is right out of an economics textbook, not something off the top of my head.

    The GOP has said economic processes MUST CHANGE today because our national wants far exceed our national resources. Thus they come up with a proposal to adapt and you (or progressives) don’t like that plan on the part of the GOP.

    FINE. Now give us YOUR plan, in detail to meet the obvious imbalance between national wants and resources, just for HC alone if you like. Forget all the “other stuff”.

    The only detailed plan put forth by progressives that I am aware of, beyond speeches, is now four Presidential budgets (maybe only three) and EACH ONE was dead on arrival from Dems as well as the GOP.

    I can, as a voter make a value judgement about the “Ryan Plan” because it is very clear exactly what he proposes.

    But how can I make a reasonable and analytical value judgement of the Dem alternative? Forget politcal speeches (Your HC insurance won’t change if you don’t want it to change!!!!). Give us a real plan, like the Ryan Plan in terms of detail and risk.

    Now go back a year and read all written about HC reform in this progressive blog and look for a “plan” to meet progressive “wants”. Then match those wants to resources and see what you get.

    Ryan AND the Presidential Commission from a couple of years ago matched wants to resources and look what happened. Dead on arrival, just like past Presidential Budget submissions.

    And IF you guys win this election AND regain majority control of the Congress look what will happen based on past performance. Wants will NOT balance resources and thus national economic policy returns to a wish list, not reality, at least in the long run.

    And we the nation have been doing exactly that for over 50 years now!!!

    Changed needed (but not wanted)? You bet there is in my view.

    Anson

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    • @ Anson,

      Your criticism of the ACA is valid in that it does not offer a clear path out of red ink for national healthcare and the Ryan plan does, or at least in about three decades (as if anyone could predict such). But the choice you offer is between balancing the healthcare budget on the backs of the poor, the sick, and the elderly or choosing a path that bends toward reform, fewer medical errors, more efficiency and preventive care.

      The clear solution you request from progressives was in fact proposed by Democrats during the debate leading up to the passage of the ACA. It was called the “public option”, and it was shot down by conservatives (and even a few Democrats I believe) who considered it too radical a change. But, I submit, it was less radical than what Rep. Ryan proposes. His path in my opinion is draconian and I find it unacceptable, particularly when it is accompanied, outrageously, by further tax cuts for the rich.

      This is where America finds itself, then. The choice offered the voter is a Hobson’s choice, unfair and unequal austerity or continuing deficit-funded reform. I for one find the former unacceptable.

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      • Jim,

        I want to ad to your excellent comment that the way Ryan’s plan supposedly reduces health care expenditures is not only by putting a larger share of the cost on future seniors, but by assuming that the voucherization of Medicare would cause competition among private health insurers that would push costs down.

        However, a likely result of that increased competition would be that insurers will create profitable low-cost policies for the youngest seniors who are still healthy, leaving the older ones with health problems to use the present Medicare system, thus actually making Medicare more expensive, not less.

        Duane

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        • Thanks for clarifying that, Duane. It makes it not only more expensive but less just as well. It’s an important point, one that goes right to the heart of what should properly motivate the HC industry. On the one hand you have the ACA which proscribes charging more for preexisting conditions and on the other the Ryan plan which places profit above the long-term interest of the patient.

          Profit is a terrific motive when the commodities are widgets or SUV’s but for an unpredictable and universally necessary product like insurance for one’s health, it stinks. Nobody knows what malady, condition or accident may change their lives in an instant – we read about it happening every day in the paper.

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    • Anson,

      For the last few years I’ve been piddling around with the idea of a variable rate income tax. Under this concept, there would be a large exemption, say, 30k, with the tax on the balance, after deducting other federal revenues like excise taxes and FICA taxes, at a rate that would fund the annual budget of the U.S. Based on the latest info I have from the IRS, the rate for individual and corporate taxes under this scenario would be 19.0%. There are some other conditions on this such as defining income and treating all taxpayers as “single.”

      Of course, this would require an amendment to the Constitution, and we all know how easy that is. But the amendment notwithstanding, the prime benefit I see here is that with Congress being unable to tinker with the tax code, we the people would be able to see how they are managing the country. If they want to give a break to, say, the too-big-to-fail banks, they can just write them a check. It won’t be buried in a tax code. And we the people will be watching.

      Without going into further details on the variable rate income tax, I believe the same idea could apply equally to Medicare. Currently, those who have earnings from work, such as wages and salaries and business income, pay 2.9%, with 1.45% paid each by the employee and employer. Although computing a variable rate that would cover all annual medicare costs is a little complicated, it would no doubt be over 2.9%. And it would change every year based on how Congress addresses the Medicare law.

      They could start by eliminating Part D and going to a competitive system like the VA has, and allowing the elderly to buy their medications made by the same company from Canada or elsewhere where drug prices are up to 90% less than here in the U.S.

      Anyway, point being that are solutions to our federal deficit problems and the shortfall in funding for Medicare. All it takes is for the Congress to man-up, grow a pair, and do the right thing, both fiscally and morally. Either that or give us all seat belts before we go over the cliff.

      Herb

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  5. for an unpredictable and universally necessary product like insurance for one’s health, it stinks.


    I realize I’m being nit-picky and I do agree with the sentiments you’ve expressed, but I’d say that what we need is not health insurance, but health care.
    Kick the middle-men (insurance companies) out of the look and go straight for health care.

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    • Me too Helen, if I had my druthers and if pigs could fly. 😀

      Like

    • Helen,

      I couldn’t agree more. We must decide as a people that health care is not a privilege but a right, for citizens of the richest country on earth. We went half way in 1986 with the passage of EMTALA, now we have to finish the job with a single-payer system.

      Duane

      Like

      • King Beauregard

         /  August 20, 2012

        Personally I don’t support Single Payer, my preference is a good Public Option. This country is simply too full of idiots who buy into the notion that government is their enemy, and in the interests of respecting their idiot wishes, I’d still want them to be able to opt out of a public plan in favor of a private plan.

        What we will end up with is something pretty close to single payer that covers everyone except the worst this country has to offer … so all the benefits of single payer with the added benefit of an Abominable Fancy of watching idiots bankrupt themselves.

        Like

        • King,

          Never thought of it that way. That is certainly the only argument against single-payer that has any merit, as far as I’m concerned.

          Duane

          Like

  6. ansonburlingame

     /  August 19, 2012

    All valid comments above to my last comment. Thus the political differences, reasonably presented it seems to me.

    Now I also agree that part of the debate over HC reform before arriving at ACA was the public option and I agree that it was “shot down”. The question that should be addressed and answered is WHY it was shot down. Even you, Jim admitted that there was not enought Dem support for the public option to achieve its passage. Well WHY?

    My view is simply. NO ONE could figure out how to pay for it, the public option. Sure the public option meets all the fairness and “social” demands from progressives. But the real problem is that it was and remains financially unachievable, short or long term.

    We cannot “afford” Medicare today, politically, meaning we cannot pay for it as it currently stands, now or “ever”. Well if you guys can figure out a way to PAY for just Medicare as it currently stands, pass the laws to achieve that worthy goal, well THEN tell me how to incease Medicare of something like it to all and still PAY FOR THAT proposal as well.

    Frankly, for you “guys”, I don’t really care HOW you pay for Medicare, just come up with a detailed plan to achieve that goal. Go ahead and tax the rich at 90%, raise Medicare wage deductions but only for the rich, raise income taxes but only for the rich, or whatever. Then add all that money, new money coming in and “prove” that all that money in fact balances Medicare expenses.

    THERE would be a REAL Plan, paying for Medicare. THEN and only then do we have an apples to apples comparison to make with the Ryan Plan or whatever else the GOP came up with. But such a debate, an analytical debate comparing apples to apples is impossible to hold unless all the “apples” are brought to the same table.

    Techncially some guys like Ryan, real thinkers and “understanders” of the details, financial details could have all those apples on the same table in about a week or so.

    the only reason that has not happened is the apples, taken together are far to explosive for politics in America!!!

    Thus we are back to the fundamental reason for economics, balancing wants and resources realistically and completely.

    Anson

    Like

    • Here is what I will say in response to your comment here:

      1. You don’t understand the public option. Jim and I have often tried to explain its salutary effects, but you won’t listen. Enough is enough.

      2. Ryan’s plan regarding Medicare isn’t serious because it “pays” for it by moving a substantial part of the costs to folks who themselves can’t pay for it. Who couldn’t devise a plan that would do that?

      3. Ryan is not one of your “real thinkers and ‘understanders’ of the details,” as his phony “plan” makes clear. Anyone can say they can balance the budget by 2040, Anson, since only God knows what the future entails that far out. And besides that, Ryan admitted that they had not yet “run the numbers” on Romney’s plan, which he is now campaigning on, whatever the hell that plan is. He won’t tell us the details, so how can Ryan understand the details if there aren’t any details? Huh?

      4. You have exactly no understanding of economics, if you think “the fundamental reason for economics” is “balancing wants and resources realistically and completely.” Economics is a study of human interaction within markets, particularly how folks choose to use the limited resources available to them. It attempts to educate us about human behavior, both individually and collectively, in terms of those interactions. Politics, resulting in public policy, is what determines how those resources are allocated, in terms of wants and needs.

      Duane

      Like

  7. ansonburlingame

     /  August 20, 2012

    I am the first one to admit that my fundamental understanding of economics is less than what I would hope to have. It has been about 50 years since I last studied that subject, the SCIENCE of economics.

    However I am now enrolled to audit a course in “Macro” economics at MSSU to improve my level of knowledge, my technical level of knowledge of ECONOMICs, NOT political science however.

    I have read the first assignment for my class. The definition provided above is directly from the textbook. Without scarcity there would be no need for the science of economics according to the text book.

    There is NEVER a “ninth inning” in politics. But there usually is a “final arguement” that is “right” in science, like what is 2 + 2. So I suspect when I continue to request that you progressives “show me the math” I am asking for some “science” not politics in your discussion or rebutals.

    No I will not come close to grasping the full range of economic challenges at the end of semester course. But hopefully I will be able to state better premises and challenges from taking such a course.

    As for “thinkers” on such a subject, Paul Ryan is and will remain FAR beyond my reach in such discussions as well.

    Wants must ultimately be articulated in “apples” to compare them to resources in terms of “apples” as well and in my view. Put the “apples” on the table and add them all up is a good start as far as I am concerned.

    Based on my online reviews the “apples” for Medicare as we know it is about $550 Billion per year. Now show me the resource “apples” to meet that want, Medicare as we know it, just for starters.

    Do that and THEN we can debate the “apples” related to Obamacare or public option or whatever. But remember if we so engage trying to compare “apples” to “oranges” will NEVER be a science, it will just be politics.

    Also I would note that when I took a “political science” course 50 years ago I thought it was an oxymoron then and still feel that way. Adding up poll responses may be “scientific” but the “data” is skewed however one chooses to spin the questions in the polls, or ballot amendment questions as well!!

    Anson

    Like

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