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.

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?

Jo Ann Emerson Asks For Forgiveness?

In the run-up to the 2010 elections, many Missouri bloggers tried to remind folks about Roy Blunt’s connection to Jack Abramoff and Tom DeLay, both convicted felons, as well as Blunt’s other rather extensive ties to lobbyists. 

He trounced Robin Carnahan by a 54-41 margin.

Many also tried to point out his crucial role in the last-minute passing of the Medicare Part D entitlement—unfunded—which he acted out by helping the House Republican leadership cajole and caress as many reluctant Republicans as they could in order to get their votes, sometimes getting them to switch their votes. (FiredUp!Missouri has a nice summary of the sordid tale here.)

After all, as The Washington Post put it, the House leadership made sure their members knew the prescription drug benefit issue was important “to the party and the president.”

Yeah.  And to the drug companies.

The pharmaceutical industry benefits from the legislation because most of the cost is picked up by taxpayers and the Medicare program is not allowed to negotiate prices with the drug companies. Not allowed by law.  By a law that was pushed by Tom DeLay and Roy Blunt and enacted in 2003 by a majority of Republicans, including by Representative Jo Ann Emerson, a legislative neighbor of Blunt’s here in Missouri at the time.

As former Reagan domestic policy adviser and Bush I treasury official Bruce Bartlett said, “the Medicare drug benefit was a pure giveaway,” and it, “had no dedicated financing, no offsets and no revenue-raisers; 100% of the cost simply added to the federal budget deficit.”  He added:

…anyone who voted for the drug benefit, especially someone who switched his vote to make its enactment possible, has zero credibility. People like Franks ought to have the decency to keep their mouths shut forever when it comes to blaming anyone else for increasing the national debt.

He finished with this:

It astonishes me that a party enacting anything like the drug benefit would have the chutzpah to view itself as fiscally responsible in any sense of the term. As far as I am concerned, any Republican who voted for the Medicare drug benefit has no right to criticize anything the Democrats have done in terms of adding to the national debt.

Well, Jo Ann Emerson, who represents the south central and southeast part of our state, was one of those Republicans who voted for the prescription drug bill to keep it alive in the House.  And she was one of those who changed her vote, at the behest of Roy Blunt.  And then she voted against it on final passage.

Go figure.

In any case, I’m not at this time going to knock Emerson for that vote-and-switch. That’s not the point I want to make.

I want to offer her some praise.

Perhaps out of some kind of legislative penance, she is trying to make amends.  According to Vermont Public Radio Emerson is co-sponsoring a bill with Vermont Democrat Peter Welch that would,

allow the federal government to negotiate prices for prescription drugs that are bought under the Medicare Part D program.

Congressman Welch has essentially called Medicare Part D a “corrupt bargain,” and claims that his and Emerson’s bill would save taxpayers $156 billion over the next ten years by giving the government the power to negotiate a bulk discount for drugs.

The idea has failed before but Welch is optimistic about the bill’s chances this time:

I think we’ve got a pretty good shot at passing it this year because there is such a focus on the budget. The total focus on the new Republican majority is on cutting spending. This is tailor-made to help them achieve that goal. It’s $160 billion in savings. I think it’s a very compelling argument and it will allow those who claim they want to taxpayer money a chance to do so.

I’m not exactly sure how proud Rep. Emerson is of her co-sponsorship of this bill, since I could find nothing about it on her website, but here’s hoping she will enthusiastically work out her penance for her past legislative sins, at least one of them at the urging of Roy Blunt.

And perhaps this proposal will serve as a test for those Republicans in Congress who talk big about the debt and deficit but often shrink in the presence of traditional Republican constituents like the drug companies.

Republicans Planning Another Kidnapping

“If we get to the point where you’ve damaged the full faith and credit of the United States, that would be the first default in history caused purely by insanity.”

Austan Goolsbee, on ABC’s This Week


Watching Austan Goolsbee, chairman of Obama’s Council of Economic Advisers, on television this morning, I finally got the sense that the administration understands just how crazy are the Tea Party Republicans.

It didn’t seem to surprise anyone in the administration that Republicans were willing to hold hostage millions of unemployed Americans in order to save rich folks from 1990s tax rates.  But now that there is another hostage situation developing—some Republicans are saying they won’t vote to raise the debt ceiling unless there are also cuts in entitlement programs—it appears the administration is finally going to get out ahead of this mess and control the debate.

On This Week, Goolsbee said the following:

Well, look, it pains me that we would even be talking about this. This is not a game. You know, the debt ceiling is not something to toy with. If we hit the debt ceiling, that’s essentially defaulting on our obligations, which is totally unprecedented in American history. The impact on the economy would be catastrophic. That would be a worst financial economic crisis than anything we saw in 2008.

As I say that’s not a game. I don’t see why anybody’s talking about playing chicken with the debt ceiling. If we get to the point where you’ve damaged the full faith and credit of the United States, that would be the first default in history caused purely by insanity. There would be no reason for us to default other than that would be some kind of game. We shouldn’t even be discussing that. People will get the wrong idea. The United States is not in danger of default. We do not have problems with that. This would be lumping us in with a series of countries throughout history that I don’t think we would want to be lumped in with.

On Meet The Press today, Republican Senator Lindsey Graham had no problem with publicly announcing his intention to execute yet another game of chicken:

To not raise the debt ceiling could be a default of the United States in treasury obligations. That would be very bad for the position of the United States and the world at large. This is an opportunity to make sure the government is changing its spending ways. I will not vote for the debt ceiling increase until I see a plan in place that will deal with our long-term debt obligations, starting with Social Security, a real bipartisan effort to make sure that Social Security stays solvent, adjusting the age, looking at means test for benefits. On the spending side, I’m not going to vote for a debt ceiling increase unless we go back to 2008 spending levels, cutting discretionary spending.

To be fair, Graham did suggest some ideas that might help solve the long-term debt problem, including means-testing the Republican-created entitlement program Medicare Part D.  But he also said, “Obama health care needs to be repealed and replaced,” so how seriously can we take anything else he says, when he knows that’s not going to happen?

Finally, if Obama and the White House deal with this hostage crisis the way they dealt with the last one, there’s no telling what damage Tea Party Republicans and their fellow travelers will do to the country, in terms of our commitment to those who aren’t wealthy Republican constituents.

Goolsbee’s words today offer some hope that they will handle this Republican threat much better.  And while we will have to come up with solutions to the deficit and debt problems ahead, the administration simply can’t allow Republicans to execute another political kidnapping with impunity.

Threatening a default on our debt obligations—thus risking an unprecedented economic crisis—should be characterized in precisely the terms Goolsbee used this morning: It’s insane.

Pledging Republicans Can’t Escape Responsibility

I can’t let the day continue without a comment on the Republican Party’s latest “Pledge to America,” apparently necessary because numerous previous pledges the party made to the American people fell, shall we say, somewhat short of expectations.

Most of the people who will be waving around the newest pledge today—which, of course, is missing important specifics—we must not forget, were:

RESPONSIBLE for a decade-long decline in middle class well-being;

RESPONSIBLE for presiding over a record-breaking lack of job creation during the Bush years;

RESPONSIBLE for the wealthier getting wealthier during their governing tenure, even as the rest of the country lost ground and in some cases lost hope;

RESPONSIBLE for handing President Obama a $1.3 trillion annual budget deficit and a fast-sinking economy, as the Bush administration slinked out of Washington;

RESPONSIBLE for handing President Obama two protracted wars, funded on credit;

RESPONSIBLE for a deficit-funded Medicare Part D program that helped enrich pharmaceutical companies;

RESPONSIBLE for doing nothing about the rising costs of health insurance and the nasty practices of private insurers related to pre-existing conditions, rescission, and other unconscionable acts;

RESPONSIBLE for standing in the way of Democrats as they have tried to repair the damage done to the economy under Republican leadership;

RESPONSIBLE for giving aid and comfort to this year’s crop of radical Republicans, some of whom have made pledges of their own to get rid of Social Security and Medicare and the Department of Education, among other things;

I urge everyone to read at least the preamble to the Pledge to America, full of half-truths, quarter-truths, and lies, while keeping in mind the above list of gifts Republicans have recently given to the American people.

Dear Tea Partiers: Here’s How Much Debt George W. Bush And Roy Blunt Foisted On Your Children And Grandchildren

Since some Tea Party folks just refuse to get it, and since conservatives don’t want to hear that the candidates they supported are largely responsible for the economic morass we are currently trudging through, here again is an interesting graph, found on the  Center on Budget and Policy Priorities website. 

It shows what the “legacy costs” of the Bush policies are projected to be, costs that the Obama administration has to account for as it tries to rescue the economy.  These Bush policy legacy costs have now magically become Obama’s “out-of-control spending,” according to the apostles of animosity on the right.

Although the infamous Bush tax cuts for the wealthy and the two deficit-financed wars are counted as part of the legacy costs in the graph below, of significant note is the fact that the cost of Bush’s Medicare Part D prescription drug program is not counted. The authors point out that the “the new program has also added significantly to deficits through 2019, but data limitations leave us unable to quantify its net budgetary effects.”

So, the truth is that the following graph, which attempts to quantify the painful and enduring costs of electing George Bush president in 2000—as well as keeping in office people like Roy Blunt, who enabled him—actually underestimates the damage:

Never, Never, Never Forget GOP Malfeasance

Today’s Globe carried an AP story—way back on page 6B—titled, “Dems see GOP hypocrisy in health debate.”

The story began:

Republican senators attacking the cost of a Democratic health care bill showed far different concerns six years ago, when they approved a major Medicare expansion that has added tens of billions of dollars to federal deficits.

The inconsistency — or hypocrisy, as some call it — has irked Democrats, who claim that their plan will pay for itself with higher taxes and spending cuts and cite the nonpartisan Con­gressional Budget Office for sup­port.

By contrast, when Republi­cans controlled the House, Sen­ate and White House in 2003, they overcame Democratic opposition to add a deficit­financed prescription drug ben­efit to Medicare. The program will cost a half-trillion dollars over 10 years, or more by some estimates.

The story points out that 24 Republican senators who voted against health care reform voted for the 2003 Medicare expansion, quoting some of them including Orrin Hatch:

Six years ago, “it was standard practice not to pay for things,” said Sen. Orrin Hatch, R-Utah. “We were concerned about it, because it certainly added to the deficit, no question.” His 2003 vote has been vindicated, Hatch said, because the prescription drug benefit “has done a lot of good.”

So, it was okay to fund expansion of Medicare six years ago because “it was standard practice”?  What a defense.

But particularly galling were the comments of Olympia Snowe, who Obama and Senate Democrats courted to the point of nausea in order to gain her “bipartisan” vote:

Sen. Olympia Snowe, R-Maine, said simply: “Dredging up histo­ry is not the way to move for­ward.” She noted that she fought unsuccessfully to offset some of President George W. Bush’s deep tax cuts at the time.

But for now, she said, “it’s a question of what’s in this pack­age,” which the Senate passed Thursday in a party-line vote. The Senate bill still must be rec­onciled with a House version.

The political situation is dif­ferent now, Snowe said, because “we’re in a tough climate and people are angry and frustrat­ed.”

Sounding like Anson Burlingame, her “let’s forget about the past and move forward” dodge doesn’t do justice to the harm Republicans have done to the economy, and just because we are in a “tough climate”—created by Republican malfeasance—I suppose we are all supposed to forget about the fact that most congressional Republicans truly are monumental hypocrites.

Thankfully some honest conservatives still exist:

“As far as I am concerned, any Republican who voted for the Medicare drug benefit has no right to criticize anything the Democrats have done in terms of adding to the national debt,” said Bruce Bartlett, an official in the administrations of Ronald Reagan and George H.W. Bush. He made his comments in a Forbes article titled “Republi­can Deficit Hypocrisy.”

Bartlett said the 2003 Medicare expansion was “a pure give­away” that cost more than this year’s Senate or House health bills will cost. More important, he said, “the drug benefit had no dedicated financing, no offsets and no revenue-raisers. One hundred percent of the cost sim­ply added to the federal budget deficit.”

The pending health care bills in Congress, he noted, are pro­jected to add nothing to the deficit over 10 years.

The AP story also points out that the 2003 Medicare expansion vote was quite divisive in the House:

It resulted in a nearly three-hour roll call in which GOP leaders put extraor­dinary pressure on colleagues to back the prescription drug addi­tion to Medicare. In the end, 204 Republicans and 16 Democrats voted for the bill.

Part of that “extraordinary pressure” was exerted by none other than our own Roy Blunt, who was part of the Republican leadership in the House at the time* and who is now seeking to bring his hypocrisy with him to the Senate, should he convince a majority of Missourians next year he is worthy of Kit Bond’s seat. Bond, by the way, also hypocritically voted for Medicare expansion and against health care reform.

*Jo Ann Emerson from the 8th congressional district in Missouri changed her “no” vote to “aye,” after pressure from Republican leaders in the House. The bill initially passed the House 216 to 215.
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