Tag: framing

Medicare and the Overton Window

This Pelosi post got me thinking about just what a Democratic response to a Ryan-style plan on Medicare should even be. After all, if you work from Ryan’s far right starting point and counter with “well, let’s just privatize x% of Medicare for this set of individuals” or some other “sensible middle” type compromise, then you’ve already lost. You’ve advanced the GOP’s idea of the program (which is a bad one) significantly and at the expense of the better solution: Medicare as it stands or Medicare plus substantial improvements.

It is a fact that the real driver of deficits in this country are healthcare expenses. Don’t take it from me, here’s the CBO’s report (PDF link):

Medicare and Medicaid are responsible for 80 percent of the growth in spending on the three largest entitlements over the next 25 years and for 90 percent of that growth by 2080.

But if we could achieve the per patient healthcare cost of most of the other developed nations in the world, we’d be facing yawning surpluses in this country, not deficits, and we’d very likely have better individual health outcomes to boot.

Therefore: the Democratic response to Ryan’s “privatize Medicare” should in fact be: Medicare For All. Period. We don’t want to reduce this program. Like 87% of all Americans, we think it should at the bare minimum stay just as it is. Preferably, we’d like to massively expand it. This has the dual benefit of covering medical expenses for everyone in the country and relieving the number one deficit driver in the economy: everyone’s medical expenses. Plus this means we eliminate the dread ACA and its totalitarian horrors. Everyone wins!

Now, of course, I don’t really think Medicare For All has any particular chance of becoming law; what using this sort of proposal does do is set the limits of the debate more appropriately and in ways that tend to favor outcomes preferable to the Democrats.
On the right: Eliminate Medicare and let the wealthy fend for themselves.
On the left: not only keep Medicare, but make it the healthcare provider for all, with tremendous humanitarian benefit but also knock-on budget benefits.
Then you’d be down to arguing about whose plan actually saves more money long term and how that impacts health outcomes in America. Which is precisely where the debate needs to be.

It’s Courageous To Go Die in the Streets

David Brooks:

Today, Paul Ryan, the Republican chairman of the House Budget Committee, is scheduled to release the most comprehensive and most courageous budget reform proposal any of us have seen in our lifetimes….His proposal will set the standard of seriousness for anybody who wants to play in this discussion….This budget tackles just about every politically risky issue with brio and guts….Paul Ryan has grasped reality with both hands. He’s forcing everybody else to do the same.

Kevin Drum responds:

Courageous. Serious. Gutsy. I imagine that within a few days this will be the consensus view of the entire Beltway punditocracy. A plan dedicated almost entirely to slashing social spending in a country that’s already the stingiest spender in the developed world, while simultaneously cutting taxes on the rich in a country with the lowest tax rates in the developed world — well, what could be more serious than that?

I think I’m going to be sick.

He’s right, but it didn’t take a few days and it’s not just Our Punditocracy; here’s the generic Democrat legislator last night on Hardball (sorry, no transcript yet):

[it was] “courageous” [for Paul Ryan to put up a plan to abolish Medicare and other federal social programs]

This is deadly serious. It’s easy to say we drugged bloggers out here are simply another example of the smelly hippies flying off the handle on something. Rest assured: We are not. You are going to be fighting 100% of the GOP caucus, some non-zero percent of the Democratic caucus (exactly 100% of the Democrat caucus), the entire Beltway elite media, and the do-nothing defensive crouch of the President and his administration heading into 2012. Keep in mind where that “sensible compromise” is going to land when the Overton Window has been set far, far to the right. Every possible outcome other than status quo within the current frame of the debate is going to be a major GOP win, far beyond anything that’s happened in recent political history. And that’s with a Democratic Senate and a Democratic President faced with a politically daunting 87% public approval of either continuing or increasing Medicare coverage relative to today’s levels. This is why they fail.

Shortly after the Democrats’ “shellacking” last November, I phoned a friend in the White House who had served in the Clinton administration. “It’s 1994 all over again,” he said. “Now we move to the center.”

Robert Reich: Why Obama Isn’t Fighting the Budget Battle.
This is, to say the least, deeply troubling. The administration (and the Beltway media as well) have been all-too-willing to lap up the standard FOXnews and talk-radio line about Obama governing from the “far left” and being a “radical socialist” and so forth. Has not and is not.
In fact, he’s been governing from the center, or even center right all along. That’s simply how it is. Look at the record. Lowered taxes, passed a previously GOP-pushed version of health care reform, pushes previously GOP position on environment, GOP position on torture, GOP position on Guantanamo, GOP position on everything. It’s just that the GOP (wisely, from their viewpoint) promptly disavows these positions and moves the Overton Window ever further to the right. Thus, Obama’s “move to the center” described here will conceivably locate him somewhere to the right of Reagan. Which is what the GOP would certainly enjoy (and but simultaneously of course still criticize his supposedly socialistic positions), but it’s not what the voters who elected Democrats in three straight elections culminating with Obama’s own election want.
The sad fact is that Democratic “strategists” took exactly the wrong message from the “shellacking,” as usual, and are telling all Democrats to forget their ideas, get as far into a defensive crouch as possible, and “weather the storm.” When they lose again in 2012, it’ll me more of the same: this isn’t an example of voter fury with no clear outlet or focus or unifying leader to channel it one way or another (beyond “throw the bums out!”), this isn’t the fault of our lack of strong positions, of not fighting for the will of the people, of not presenting a compelling and alternate vision for America, it’s because we weren’t far enough to the right.
The problem is that it’s not true, hasn’t been true, won’t be true. Ever. This is why they fail.

Share the Sacrifice

Digby nails it…and gets the result into The Hill, where the intended audience might actually have to face the facts:

Even worse […] is the common assertion by these millionaire pundits that “we all” must sacrifice for the greater good and allow Social Security to be slashed. This is usually spoken with such a tone of lugubrious forbearance that one imagines they would like us to believe that while they might be forced to become Wal-Mart greeters in their elder years, patriotic duty demands we all pitch in. They seem to have no idea that the median wage in this country in 2009 was $26,261 — sadly, lower than it was in the year 2000. (Even when you average in the billionaires, it was only $39,269.) Clearly, the average political TV host takes home many times that wage, so this idea that “we” are all “sharing” in the proposed sacrifices is a bit much, particularly in light of the recent extension of the Bush tax cuts, hailed in the media as the greatest piece of legislation since the founding of the republic.

Read the whole thing.

Share the Sacrifice

Social Security Pays for Itself

OMB director Jacob Lew, from the turnstile:

Social Security benefits are entirely self-financing. They are paid for with payroll taxes collected from workers and their employers throughout their careers. These taxes are placed in a trust fund dedicated to paying benefits owed to current and future beneficiaries.

[…]

For years, the surpluses in the Social Security trust fund have helped to mask our deficits elsewhere. Now that we are paying Social Security back, the problem is not with Social Security, but with the rest of the budget. In 2001 and 2003, Washington cut taxes for the wealthiest Americans and later expanded Medicare without paying for it. Blaming Social Security for our fiscal woes is like blaming you for not saving enough in your checking account because the bank lost all depositors’ money.

Replace “Washington” in the second-to-last sentence with “Republicans and the Bush Administration rammed through” and we are in full agreement. Now if we can just get serious people talking in these terms on the serious Sunday morning shows (and etc…) every week for the next 20 or so years, the logical argument can finally begin on equal footing.

Social Security Pays for Itself

Next up: American Mexceptionalism

Only one sitting president in the last 82 years has publicly uttered the magical phrase “American exceptionalism” – care to guess who it is? Ronald Reagan, he of the “shining city on a hill?” George W. Bush, who closed his speeches by asking that “God continue to bless” America? Nope. The only president to publicly discuss (and for that matter embrace) “American exceptionalism” is Barack Obama.

I would have been surprised were it otherwise. It’s just how FOXmemes work.

Next up: American Mexceptionalism

Beyond Medicare, the major drivers of the deficits are not talked about so much by the fat cats and demagogues because they were either responsible for them, or are reaping gargantuan benefits from them, or both. The country is drowning in a sea of debt because of the obscene Bush tax cuts for the rich, the wars in Afghanistan and Iraq that have never been paid for and the Great Recession.

Bob Herbert, saying what so many others seemingly find so very hard to face or admit. This is who we are, and it’s critical that we face it.
Yapping about Social Security and the necessity of cuts to same is just that: yapping. The money is in Medicare (as in: controlling the costs of) and the Bush tax cuts (as in: all of them, even those marginally aimed at the middle class). Solve those two and get employment rolling and everything else that today seems utterly intractable will simply melt away. Even better: the Bush tax cuts will solve themselves if we can just muster the will to let them.

Those Liberals at the AP

The far-left journalists over at the AP make the hard calls and reports that there is trouble at the mill, everyone:

LONDON — Prime Minister David Cameron yesterday waded into waters in which past British governments have foundered, promising fundamental changes to the country’s expensive and over-stressed public health care system.

I see. Crazy expensive socialist medical care. Only Lord Jesus can Know how much that stuff costs. Or, you can throw your lot in with pointy-headed statisticians and find out that it costs about $2317 per capita for the UK to provide universal, essentially free care to everyone (free as in beer, it is obviously paid for through various taxes and etc…). The US? We pay $5711 per capita. More than twice as much.
Now, of course, that would all change if we look at percent GDP, right? The US is such a giant economy and all. Actually, no. The US spends ~15% of GDP on healthcare, UK: ~8%. So it’s roughly half as expensive, whether considered as a function of the overall economy or strictly in terms of what’s spent per individual. And but so they all get access to healthcare. In the US, well, the GOP assures us that the market will take care of that any minute now.

Now we come to “over-stressed,” which must mean that outcomes are terrible in Britain when compared to the US, which (as we’re told repeatedly) has the finest care anywhere. They must be choking the streets with bodies over there if they spend half as much and then funnel that through some socialistic nightmare of a healthcare bureaucracy. Not so much: turns out they live longer, have lower infant mortality, and, of course, have universal access to free-as-in-beer healthcare 24/7, all without having to use the ER as their primary care physician or being told to just go die in the streets already. In fact, we typically rank in the low end of developed nations, not even within spitting distance of dread France, and always well behind the UK.

So, AP wrong on “expensive,” wrong on “over-stressed.” But they did get the current PM’s name right (though notably not his party affiliation; can’t go around limning the word “conservative” with “fundamental changes” and “foundered,” now can we?). So there’s that.