“Mediscare”
Watching Paul Ryan earlier today talking at the Peterson Fiscal Summit I was amazed by the number of times he said the word “Mediscare,” which is a conservative jargon term for telling the truth about proposals to eliminate Medicare.
Mr. Ryan may claim — and he may even believe — that he’s facing a backlash because his opponents are lying about his proposals. But the reality is that the Ryan plan is turning into a political disaster for Republicans, not because the plan’s critics are lying about it, but because they’re describing it accurately.
Take, for example, the statement that the Ryan plan would end Medicare as we know it. This may have Republicans screaming “Mediscare!” but it’s the absolute truth: The plan would replace our current system, in which the government pays major health costs, with a voucher system, in which seniors would, in effect, be handed a coupon and told to go find private coverage.
The new program might still be called Medicare — hey, we could replace government coverage of major expenses with an allowance of two free aspirins a day, and still call it “Medicare” — but it wouldn’t be the same program. And if the cost estimates of the Congressional Budget Office are at all right, the inadequate size of the vouchers — which by 2030 would cover only about a third of seniors’ health costs — would leave many if not most older Americans unable to afford essential care.
I’m also amused that Karl Rove has decided to advocate the same political strategery as Col. Mustard. Trying to find the “right messaging” for a plan to destroy Medicare to fund massive upper-class tax cuts is like trying to find the right metrics to show that Melky Cabrera is the greatest player in baseball.
I hope with all of my being that the things Republicans are saying in public about why they lost the special election in New York represent their actual beliefs, and will form the basis of their political strategy for the next year and a half.
Please let it be true.
“I never gave anybody hell! I just told the truth and they thought it was hell.”–Harry S. Truman
Rebranding it!
How about ‘In Order to Get Health Care, You Must Arbeit Until Du Ist Todt?’
Or, “Die Schnell!”
No, while being short, they’re unhelpful.
Also, too – ‘Throw Grandma Under the Bus’ didn’t poll too well either.
How about, “When Grandma Kicks, She’s Leaving You Unicorns and Lollipops?”
Nah, too may Grandma’s out there, and the people who love them.
Karl Rove and Frank Luntz are oviously much better at this than I am.
I think they should rebrand his “modest proposal” the Soylent Green Solution for Granny.
Yep, because capping needs based insurance vouchers is akin to pushing granny off a cliff, but tying ourselves to a government plan that is dependent on congress instituting major cuts to medicare payments to keep it sustainable couldn’t possibly have major negative effects.
government plan that is dependent on congress instituting major cuts to medicare payments to keep it sustainable
I certainly hope this wasn’t intended to be a factual statement.
Well, Cthulhu knows we can’t increase taxes on anybody, because socialism!!!
Socialism? If only.
Heh.
ur spellin it rong. its soshulizm.
Brad’s strategy is to ignore the efforts (opposed by Republicans and found nowhere in their plans) to reduce medical inflation, so he can pretend that cuts in outlays can only come reducing services.
No, I believe they will be as ineffectual as Ryan’s plan.
But I will bite. Which one’s do you think will be most effective?
I pay people to answer that question for me.
Yeah. That’s gonna be an effective board.
Ohnoes! Political opposition!
Doomed! DOOMED!
DOOOOOOOOOOOOOOOOOMED!
If you need me, I shall be on my fainting couch, with a perfumed hanky bearing the logo of the Reason Foundation.
Yes. It will come from the AMA, AARP, AHA, the DNC, and the GOP.
What do you think is going to happen when the IPAB recommends payments being indexed at 2-3% below the trend in medicare growth? Do you think that one of the parties is going to muster the votes to make policy that is hazardous to senior care access and provider profits? Or do you think that the congress will come up with the 3-5ths vote required to override it?
Nobody is going to touch medicare. Political solutions are almost completely off the table at this point.
False.
The DNC is 100% behind the death panel.
Link?
Brad, there is a critical problem with your argument and I don’t understand why people are refusing to address it. If it’s politically impossible for medicare to reduce costs by denying care or paying doctors less, how is it more possible to cut costs by giving out inadequate private vouchers? After all, private care delivers fewer health services for the dollar than traditional medicare so that path leads to an even greater cash crunch. And secondly, seniors will be quite aware of the difference between their voucher and the cost of available private plans while they may not be far less aware of doctors’ prescribing slightly fewer extremely expensive and barely effective end of life measures.
The total refusal on the part of erstwhile Ryan plan defenders to engage with this obvious comparison is just another reason not to take them very seriously.
If you look down thread you will see that I stated that I don’t think vouchers will work either. My point is that it will be completely impossible to make medicare unsustainable without difficult cuts, and the political climate right now is steering the public into extremely unreasonable expectations concerning future spending and future entitlements.
Joe,
The more distant medicare payments steer away from payments made by private insurers, the larger the gap in access will be.
Everytime that board cuts payments down to inflation +1%, more providers will withdraw from seeing medicare patients.
This is true. Controlling medicare costs under the ACA is accomplished by significant cuts to Medicare Advantage and indexing medicare payments GDP growth+1.
Those are dramatic cuts from the growth and levels of current medicare funding.
Medicare Advantage is a boondoggle to begin with.
Please. Brad can’t even tell Medicare and Medicaid apart. You think he can tell the difference between Medicare and Medicare Advantage?
Regardless, 25% of medicare recipients are on Medicare Advantage, and they will have a real loss in benefits.
Boondoggle or not, the cost savings result from a drop in benefits for those individuals.
Do you have any evidence for this assertion that people who switch from Medicare Advantage to Medicare will see actual benefit reductions, as opposed to just costing less money by being in a demonstrably-more-efficient program?
Because, as a matter of fact, replacing a boondoggle effort with an effective effort doesn’t actually reduce the efficacy of that effort.
You seem to be arguing as if spending the money is the point.
http://www.allhealth.org/briefingmaterials/927_biles_medicarebeneoopcosts_ma_ib-840.pdf
Medicare Advantage beneficiaries typically have much lower out-of-pocket costs.
They also often include far more benefits and coverage than the standard Medicare plan
There’s a difference between cutting benefits in social insurance (which actual socialists have done and will always need to do sometimes) and having an ideological hostitily to social insurance as such.
If you want to run on turning Medicare into a cash grant, then take your case to the people! I’m sure it will be really popular and lead to solid Republican majorities forever!
On the merits, changes have to be made to benefits. The ACA was a start. But the basic idea of the public insuring old people (better yet, everybody) is a good one.
Yes, when the vouchers prove inadequate to purchase insurance, the medical care will be provided by unicorns! Why do Democrats hate unicorns?
They will increase the amount of the vouchers, just as they will when they realize that the “GDP+1″ limit the ACA applies to medicare payments is completely insufficient.
Both of the plans are indexed to GDP+1, the only difference is that Ryan wants an executive secretary to make the decision to avoid cuts that amount to rationing, and the ACA appoints the IPAB.
http://theincidentaleconomist.com/wordpress/the-aca-the-gdp-and-the-ipab/
I don’t believe a voucher program is going to do anything to stop the cost growth and don’t support the Ryan plan, but the plan the democrats have in place are scheduled to drop medicare type expenditures just as much as the Ryan plan is.
Yes, when the vouchers prove inadequate to purchase insurance…
You have no evidence of that. Anyway, the reimburesement rates government insurance pays now is already running off the doctors.
Anything you subsidize you get more of. Anything you tax you get less of.
Figure it out, Einstein.
“Anything you subsidize you get more of. Anything you tax you get less of.”
And the R’s are against the “Death Tax”
Why do they want more Americans to Die?
Bankrupting families for Granny’s nursing home care is being a realist; keeping private companies from skimming off the tax payers is a calamity to the medical system!
Bankrupting families for Granny’s nursing home care is being a realist;
Yes, but that is part of the Medicaid cuts. This is about Medicare cuts. What do you know, Republicans have multiple proposals to screw over Granny and her kids.
(lest I be misunderstood, snark is directed against Republicans, not you)
Because “markets” are always so much more efficient and cost effective in providing all services and goods needed by human beings and doing so in the most equitable way possible, am I right?
No, because we have a Lemons Problem with medicare. Right now we know we need to make fundamental changes to the structure of medicare, but it is impossible to propose one without making significant cuts to medicare expenditures.
Any major cut to medicare expenditures, and the ACA is also full of them, is going to lead to lead to access and pricing problems.
The initial policy is very inconsequential, as the AARP and the health industry are going to get their way when it comes to medicare spending, whether its through vouchers, premium support, the ACA’s exchanges and IPAB.
And premium support is not an entirely unreasonable way to handle medicare if they are handled correctly (it appears that Ryan’s plan doesn’t handle the vouchers correctly). Furthermore, while the IPAB doesn’t seem like a particularly effective idea to me, it wouldn’t hurt, and it would be far more successful if the public had any reasonable expectations about the future of medicare.
But just as republicans won saying democrats were trying to “kill granny”, and just as democrats are going to run with republican’s geriatricidal tendencies as far as they can, I can’t imagine the IPAB getting anyone appointed, let alone getting their proposals approved.
Meant to link to this excellent Greg Ip post:
http://www.economist.com/blogs/freeexchange/2011/05/politics_medicare
A “lemons” problem is an adverse selection problem. A solution is single-payer. The insurance pool just is the population as a whole. No more adverse selection problem.
I disagree a bit about the IPAB thing, because in the end an unsustainable trend won’t actually be sustained. Politicians need someone to blame, but the rate of growth in health care spending literally cannot continue indefinitely.
I know what a lemons problem is.
From the Ip post:
And if the the solution isn’t a reasonable political one that is looking increasingly unlikely, it will be a sudden catastrophic one.
Ip is being very creative, but this isn’t a “lemons” problem they way I’ve ever heard the term used. There’s no information issue here; it’s not like the Democrats don’t KNOW that Ryan’s plan is a flawed piece of garbage. The voters don’t know any more or less about medicare issues than any other.
This simply isn’t a “lemons” problem. If you’re going to characterize this as an economic problem, it’s a lack of demand for medicare solutions at a market-clearing price. Most of the electorate either doesn’t want one, or doesn’t want to pay the price (in lost benefits, lost profits to their economics sector, or higher taxes) it would cost.
Enough time wasted on this.
That’s because it isn’t a lemons problem. Which means Brad apparently doesn’t know what one is after all.
Ip doesn’t know the difference between adverse selection and a prisoner’s dilemma.
Shorter Brad (though he will not admit it): The market sucks and does a lousy job of providing access to health care.
“Right now we know we need to make fundamental changes to the structure of medicare…”
Actually…no. Not so much. Like, at all.
Fear not, Joe Biden is negotiating a Serious Compromise on cutting Medicare where we will go off the cliff at 55 mph instead of 100. All Serious and Reasonable liberals will support it as it impliments the bulk of the Catfood Commission recommendations.
As I said to Brad P., there’s a difference between benefit cuts (which are indeed inevitable) and abandoning a social insurance model (whihc is not inevitable and is just driven by the fanatical wing of the Republican party).
Also, too:
Not just a lie, but a damn lie:
Shorter Republican asshole: I’ve got mine, Jack.
I thought it wasn’t free. I thought that was the whole Republican complaint about social programs.
The benefits are indeed free to the recipient. Much as I disagree with Woodall, he’s right about this.
To turn the tables: I’m a garden-variety liberal, and I support more taxes and more redistribution. So a Republican could accuse me of hypocrisy — “if you think more taxes are good, why don’t you just pay more?” The answer, obviously, is that my paying more, by myself, doesn’t accomplish much. If lots of people like me paid more taxes, though, that would put a lot of money into the system, which could be used toward good purposes.
Similarly, for one citizen to receive a benefit is not a great cost to the state. It’s perfectly reasonable to believe benefits should be reduced for everybody, while availing oneself individually of all the benefits that are out there.
An abundance of team spirit is all that is required in each instance.
So they just let the seniors die off in droves, and then the Social Security deficit goes away, too. If only they can sell half their base on the idea that the best way to balance the budget is on their graves…
So they just let the seniors die off in droves…
Errr….the Republican Plan is not to change anything for anyone 55 or older. Not exactly the scary stuff you say.
Right, because we’re sending the 54-and-under crowd to Never Never land, where they’ll never grow old!
The Ryan plan changes Medicare Advantage just like the ACA only uses the savings for tax cuts. And they cut Medicaid which many of those over 55 rely on.
Now McConnell’s saying there will be no debt ceiling increase without major cuts in Medicare. A competent political party would call his bluff and take him to the woodshed (hell, a competent political party would have tied extending the debt ceiling to extending the Bush tax cuts), but, sadly, McConnell knows exactly who he’s dealing with and will more than likely get a deal that would have been unaginable a year ago.
A competent political party would run circles around the Republicans in negotiations, get them to agree to cuts 1/3 of what they wanted, and then meet their number with phantom cuts that add up to peanuts, like last time?
Well, we can hope that the voters have given Democrats a wake-up call and the party is in a different place from where it was a year ago.
One of the heartening things about the public reaction to the Ryan plan is that his naked efforts to pander to the self-interest of the elderly currently receiving Medicare (by assuring them that their benefits would be untouched and only younger people would be lucky enough to have “choice”) seem to have failed spectacularly.
Can’t Wall Street put the leadership of the Republican party into receivership or something. There must be some clause in there somewhere.
BTW, the Democrats are a more *heterogenous* party than the Republicans. That’s a different thing than a less competent party. The Ryan plan does not seem like the move of a competent political party.
I think one can make a case that heterogeneity accounts for some of the reasons why Democrats continually find themselves negotiating on Republican terms with respect to the budget and taxes, but certainly not all of the reasons.
Excellent point.
If the Republican Party was more heterogeneous, they wouldn’t have all marched off the cliff together by voting for the Ryan Plan.
Leave Melky alooooooooone!!!! And screw Paul Ryan; he’s a known liar, and continues to lie about his lying. The Republican party has finally sunk to the point of satire, in my humble opinion. There is extensive groupthink and I do believe they have finally overreached in their long campaign to destroy our democratic republic. I know those are harsh words, but quite frankly, I do believe that is the end game for the GOP, in the long run. Turn this country into a plutocracy, government for and by the (rich) people. I hate them so much….
Get it straight – it’s FREEDOM AND EQUALITY, not democracy, they’re against. And having to pay their fair share.
After all, they’re at the top of the heap, democracy wise.
Mr Ryan and others repeatedly scream “Mediscare!” because they will be quoted by the media without any refudiation.
Let’s see if tonight on the News Hour old Jeem will ask Bobo about Krugman addressing Bobo’s Broderite column claiming equal demagoguery from both parties.
“Mediscare” seems like an own goal to me. If everyone says Paul Ryan’s plan is gonna destroy Medicare and he says “MEDISCARE MEDISCARE MEDISCARE” that would make me scared if I was, you know, one of his base.
I was just thinking this, too. It is relying on a lot of nuance from voters that pride themselves on a lack of nuance, a trait often encouraged by repubs. “MediScare” just has a certain zing to it.
Anything would’ve been better, even MediGate. Potential slogan: “Medicate, not MediGate.”
Here’s the MEDISCARE Paul Ryan is talking about.
And it’s all a bald-faced LIE because the plan doesn’t change anything for those over 55.
those over 55 NOW
The “but it won’t change anything for those over 55 right now” is the most blatant tell that what they’re doing is a shitty deal — if it were a great deal, why not impose it on everyone right away? Oh, right, because it sucks, and because the Republicans are hoping that they can run this game and still get the elderly whites who vote for them to turn out.
Well, fuck Gen X, anyway, yet again. They worked their entire life paying extra to fill up the SSRI surplus for the boomers, will have paid into Medicare their entire working lives for the boomers, and will get fuck-all when it’s their turn to retire.
The problem is that those who ‘designed’ this program were socialists that had no clue when it came to economics and set it up as a Ponzi scheme instead of a funded retirement program.
Then, each subsequent liberal administration and/or congress expanded the program to cover more and more and more in an effort to buy votes.
Let’s face it, it’s a financial monstrosity. If it weren’t, it wouldn’t be the issue it is.
So, you can try to change it without disrupting the lives of the most vulnerable who are near retirement and have planned their lives around it, or you can just make this a socialist nation and pony up from the general coffers.
I think the latter is what you have in mind, anyway.
The problem is that those who ‘designed’ this program were socialists
That word does not mean what you think it does. Nor is Medicare a “Ponzi Scheme”. The problem is skyrocketing healthcare inflation, which nobody, especially not conservatives, anticipated.
Normy has his Social Security cue cards and Medicare cue cards mixed up again.
The problem is that those who ‘designed’ this program were socialists that had no clue when it came to economics and set it up as a Ponzi scheme instead of a funded retirement program.
Then, each subsequent liberal administration and/or congress expanded the program to cover more and more and more in an effort to buy votes.
I got Bingo!
It really shouldn’t, but it always amuses me when cock-sure conservatives flaunt their total ignorance of how basic insurance systems work.
Normy, even you may eventually make it to 55 and then, under Ryan’s Soylent Green Health Savings Plan, you are totally fucked.
Normy is not counting on the government and is preparing for himself.
1) independent business
2) 1 yr of running money in metals
3) buys own insurance including long term disability
4) Trying to get off the grid
All of this security is expensive and it would be much more fun to spend the money in more fun ways like vacations and new cars but Normy is the ant and and not the grasshopper.
Having been raised in a poor household, it’s tough to do well and then feel sorry for those who simply will not try.
We applaud your efforts to get off the grid. You do realize that “the grid” includes the internet, don’t you?
I can live without the internet. And if it goes down….well, I’m more ready than most.
The issue is personal responsibility. Attempting to take care of myself so others don’t have to.
Don’t mind helping those who can’t. Have a big BIG problem helping those who won’t try.
Again with the false equivalency. Medicare is simply a health insurance plan for the elderly that we have all been paying into all our lives. This is no more having others take care of you than getting private health insurance, except that the benefits are better because there is no profit involved.
And if it goes down….well, I’m more ready than most.
Normy thought ahead, and has an inflatable friend, and plenty of patch kits.
All of which will last about as long as a grasshopper in a hurricane if Normy has one, count’em, one serious illness in his family, or even a car accident where someone is badly hurt, or (and this is the good bit) he ages to over 60 and tries to buy health insurance in the holiest of holies, the independent market.
I don’t so much object to Normy’s willful ignorance and vicious bigotry as I object to the extent that it’s not just self-destructive — he wants to take everyone else down with him
I have insurance.
Now this may shock some of you, but I ACTUALLY PAY FOR THE INSURANCE instead of asking someone else to.
And we (including you if you are not evading your taxes) have all ACTUALLY PAID FOR OUR MEDICARE INSURANCE. Dumbshit.
Who didn’t see this own goal coming?
Sad, really.
Ok, dumbass troll that just put that in all caps… if you are claiming that no one receiving medicare paid for anything…
What the f*ck did you mean by a Ponzi scheme?
Hmmm?
Wait, what?
Um…
Ya see….
Ah…
Glenn Beck!
If the average republican voter in NY-26 had no trouble penetrating this smokescreen, why would you think it would present a challenge to well-informed progressive commenters.
…well-informed progressive commenters.
They’re not so ‘well-informed’ if they are voting on misinformation. The video of grandma going over the cliff is not good information. It’s propaganda and it’s largely untrue.
Ahhh, but that’s politics.
I have a nephew that told me Glenn Beck was a liar. I asked him what he thought was a lie and he said Glenn stated that Van Jones went to prison. He didn’t, he went to jail.
So, after I demonstrated all of the promises Obama made when campaigning that Obama has not completely forgotten, he now thinks Glenn Beck is the more truthful one.
That’s a great story, Grandpa.
Yeah….this is the bedtime story.
Great Stuff
It’s not about you.
I’m going to have to rethink Buck v. Bell. I don’t want to contemplate the third generation of imbeciles.
Not funny. Absolutely 100% not funny. Go straight to hell.
Unless your nephew is a resident of NY-26 or a well-informed progressive commenter, you have moved the goalpost so far I can no longer see it.
Remind me where it is again?
The video of grandma going over the cliff is not good information. It’s propaganda and it’s largely untrue.
Unwitting admission emphasized.
With some exceptions, the “Pushing granny over the cliff” image is an untrue depiction of how the Ryan plan will work.
This is not trying to convince us that Melky Cabrera is the greatest player in the game, it is trying to convince us that Derek Jeter deserves Gold Gloves. Very serious people in the business of paying attention to these things can see that Jeter is a bold, serious player with the courage to win a Gold Glove. The actual numbers behind his fielding are not worth looking at and are probably untrustworthy anyway. Only a demagogue would look at the numbers.
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