Tag: medicare

The hard truth about health care

Everyone knows — or should know — that the United States spends much more than any other country on health care. But the Kaiser Family Foundation broke that spending down into two parts: the government’s share and the private sector’s share (both measured as a percentage of total gross domestic product), then compared the results to figures from 12 other countries that are members of the Organisation for Economic Co-operation and Development. And here’s the shocker: Our government spends more on health care than the governments of Japan, Australia, Norway, the United Kingdom, Spain, Italy, Canada or Switzerland.

Think about that for a minute. Canada has a single-payer health-care system. The government is the only insurer of any note. The United Kingdom has a socialized system, in which the government is not only the sole insurer of note but also employs most of the doctors and nurses and runs most of the hospitals. And yet, measured as a share of the economy, our government health-care system is the largest of the bunch.

And it’s worse than that: Atop our giant government health-care sector, we have an even more giant private health-care sector. Altogether, we’re spending about 16 percent of the GDP on health care. No other country even tops 12 percent. Which means we’ve got the worst of both worlds: huge government and high costs.

It’s also important to note that, even with this high spending, we’re getting worse outcomes than all the Western countries spending 5-7x less than we do. And, of course, if we had the costs of any of these countries we’d be facing surpluses today instead of deficits. But we’re told the only road forward for our country is to slash Medicare, Medicaid, and the rest of the social safety net and give the money to the richest 1%. Saying anything else isn’t Serious.

The hard truth about health care

Almost 60,000 average Americans had the courage to go out and charge those beaches on Normandy, to drop out of airplanes who knows where, and take on the battle for freedom. Average Americans. The very Americans that our government now, and this president, does not trust to make a decision on your health care plan. Those Americans risked everything so they could make that decision on their health care plan.

Rick Santorum, mulling the true evil of Hitler: an under-appreciated penchant for wanting to provide affordable health care.
Source: tpmdc.talkingpointsmemo.com

…these are the basic points liberals should be arguing:

• These vouchers would be grossly inadequate.
• For that reason, most seniors wouldn’t be able to afford adequate coverage.
• Medicare as it exists today is indeed sustainable.

If you find yourself arguing about something else, you may already have lost.

Bob Somerby, speaking the truth. Keep it simple and to the point. Pizza, the Marine Corps, and their relative similarities or interchange rates need not enter into it and our arguments tend to be weakened or just diffused by the presence of these things.
The Democrats have a uniquely potent message to offer here, one that polls almost uniformly in their favor; as a result, constantly going off to fight ultimately pointless side-battles is precisely what the GOP would love to have happen. It muddies an otherwise crystal clear dichotomy. The GOP wants to end Medicare as we know it. The Democrats do not. This is because Medicare, even as currently figured, is sustainable. Long term fixes and cost (and rate of cost-growth) containment through mechanisms installed in the ACA? Of course. Wholesale gutting that leaves only the name in place: not necessary. Period.

In a Decent World

jeffmiller:

There’s a lot I simply don’t understand here, but let’s talk for a second about the thing in bold.  Forget all of the problems with the chart and sustained unemployment and people dropping out of the job market and people accepting lower pay or benefits and everything else that your red and blue chart doesn’t address.  That “steepest climb” you’re talking about … that climb doesn’t show job growth.  Every one of those months shows continued job losses.   And the time when the stimulus end?—that’s the time where there is actual job growth.  The chart, in other words, can tell a story that’s exactly the opposite of what you’re saying in bold.  

Now, you can argue that the stimulus resulted in smaller job losses than there would have otherwise have been, or that the job growth at the tail end of the chart was sparked by the stimulus that preceded it—you can argue these things, but the chart doesn’t prove these things.  The chart is just data, with its flaws and limitations.

Seriously? Leaving aside the bit about your troubles with pesky “data”, your expectation is that one month: catastrophic job loss. Next month: spectacular, robust return to full employment of the go-go days of old. In the history of the world, I challenge you to show me a recession that ended abruptly. The one you might point out is the one you also wouldn’t want to mention, as it ended as a direct result of massive and sustained government spending (see: World War II, in which basically everyone in the country had a fake “government” job. How’d that work out for us?). They all end more or less like what we’re seeing now, a gradual improvement in “bad” numbers, then progressive and building improvement on “good” numbers. Businesses don’t simply rehire x-million workers overnight; in fact, they only hire when they absolutely have to, and are thus not typically leading indicators of a recovery. You’ll recall that this recession was declared “over” in September of 2010.

Likewise, you can see the same trending in the diminishing output gap. I know, I know, more dread data. The Democrat and his empirical reality crap again. But it’s a fact: the economy is improving, if slowly. It improved more quickly during the time of the stimulus. Were said stimulus still unspooling, we’d be seeing faster improvement now. The sooner we close said output gap, the sooner revenues improve and the sooner the deficit “crisis” is at an end.

The GOP, of course, knows this too. That’s why they’re riding this particular hobby horse so hard right now. It’s the opportunity to jam their view of society down our throats while the public is scared and feeling serious economic pain. Once things noticeably improve there will be even less stomach for “shared sacrifice” at the hands of eviscerating the social safety net coupled to deep tax cuts for the rich. So, from their perspective it’s now or never. That fact, as much as anything, is why they all voted for the Ryan plan. They see this moment as their last, best chance to end Medicare this decade.

2.96

Emphasis added:

…if even 1/50 of the austerity-induced decline in current output flows through to reduce the economy’s productive potential, that austerity today worsens the debt burden.

This is an unusual result: it applies only to a country with a substantial fiscal multiplier that can fund its debt at very low interest rates. But we are a country with a substantial fiscal multiplier that can fund it’s debt at very low interest rates…

Indeed we are. But no one seems interested in noticing. We can borrow against a 10-year Treasury at a 2.96% yield. The money behind that rate is clearly not concerned with either deficits or the capability of the United States to meet the debt incurred by their purchase yesterday or all the days before that. As Jared Bernstein notes, the current “budget math” still strongly favors a jobs target and not a deficit target.

This is very simple stuff. How many ways do you have to prove that cuts today worsen our long-term fiscal situation before somebody with a D after their name starts talking about this in a compelling, no-nonsense fashion? We can borrow, cheaply, and those dollars (when pumped into the economy) would hasten the closing of our current output gap. This would simultaneously a) obviate the need for further borrowing, b) close the revenue shortfalls of Great Recession, and c) coupled with a do-nothing legislative approach relative to the Bush tax cuts would almost entirely close the existing budget deficits within a few years.

But, by all means, let’s go on pretending that deep, punitive cuts to the social safety net and eliminating access to abortions are the only Serious Person positions possible given the current situation.

2.96

Suck it, Granny

Brian Buetler, TPM: If the Biden group comes up with big cuts, trillions of dollars worth of cuts, but without substantially [cutting] Medicare, it won’t get your vote?
Mitch McConnell (R, KY), Senate minority leader: Correct
Lemkin: I mean, what’s the point of governing if you can’t tell a few old people who’ve finally run out of money to kindly go die in the streets? They should have thought of this before they agreed to take part in Medicare and/or get sick. It’s all about personal choices. Also: Death panels. Real ones. Run by Mitch McConnell and his cronies. Trillions in cuts aren’t the point of any “deficit reduction” talk by the GOP. All they want, all they have ever wanted is an excuse to foist the same old laundry list of punitive attacks on the social safety net coupled to lavish giveaways to their chosen few at the very top. That is all this is, was, or ever will be about. Time for the Democrats to start messaging accordingly. Well past time, in fact. After all, Mitch McConnell stands a pretty good chance of being Senate majority leader in 2013.

[The Republicans are being advised to spend] 2012 accusing the Democrats of sponsoring death panels. The Democrats will spend 2012 accusing Republicans of ending Medicare. Whichever party demagogues best wins.

David Brooks, outdoing even his own unusually high standard for making exceedingly stupid statements. One of these is simply not like the other. “Death panels” have been fully, categorically, absolutely, and completely made up from whole cloth. Lies. The biggest lie of 2009, in fact.
The Ryan plan, on the other hand, demonstrably ends Medicare. It transforms the program over the course of ten years from a government-run, single payer system into a voucher-based private insurance steeplechase for Granny and Gramps. If they can’t make the difference between the voucher payment and the cost of coverage, then they can go die in the streets.
Yes, David, a program called Medicare will still exist, and I know it’s terribly hard for you to square that circle inside that mind of yours, but it’s clear to a four year old that that Medicare, the one described in the preceding paragraph, will be nothing like the Medicare we have today.
Furthermore, that David Brooks feels confident pitching this sort of brazen false equivalency from his airy perch at the nation’s finest newspaper is a big indication of just how punishingly stupid our discourse is. Is there an editor in the house? George Will routinely spouting horseshit at the Washington Post is one thing; you’d think the Times still has a standard or two.

Robert Reich: The Republican Death Wish

Oh hell yes:

robertreich:

Can we be clear about that budget problem? It’s driven not by Medicare. It’s driven by the same relentlessly soaring health-care costs that are pushing premiums through the roof and causing middle-class families to shell out more and more money for deductibles and co-payments.

Some features of Obama’s new healthcare law will slow the rise — insurance exchanges, for example, could give consumers clearer comparative information about what they’re getting for their insurance payments — but the law doesn’t go nearly far enough.

That’s why Democrats should be saying this: We need to allow anyone to sign up for Medicare. Medicare is cheaper than private insurance because its administrative costs are so much lower, and it has vast economies of scale.

If Medicare were allowed to use its potential bargaining leverage over America’s hospitals, doctors, drug companies, and medical providers, it could drive down costs even further.

And it could force the nation’s broken health-care system to do something it must do but has resisted with a vengeance: Focus on healthy outcomes rather on costly inputs. If Medicare paid for results — not tests, procedures, drugs, and hospital stays, but results — it could give Americans better health at lower cost.

Emphasis added to point out that this is exactly what Democrats need to be saying. The steadily rising cost of Medicare is only indicative of the problem, it is not the problem. Never was, never will be. Paul Ryan wants to “solve” the issue by simply setting an amount that the government will pay and then telling anyone who can’t meet the difference to kindly go die in the streets.

Democrats, on the other hand, want to solve the problem by solving the problem. And how does the GOP respond? By trying to undo the ACA and any other cost-containment measure. By trying to end Medicare. And, of course, by redirecting the money harvested from the end of Medicare to the richest of the rich. Who so desperately need it.

Robert Reich: The Republican Death Wish

Mediscare

The Medicare Trustees put the projected shortfall at 0.79 percent of payroll, which is approximately 0.27 percent of GDP over the program’s 75-year planning horizon. By comparison, the increase in annual spending on the military between 2000 and 2011 was more than 1.6 percentage points of GDP. This increase in spending did not cause serious harm to the economy, therefore increased spending of one-fifth this size will presumably not be a major problem.

Mediscare

I think every one of these Republican candidates running for the House is going to have a Democratic opponent who’s going to run an ad you can write today. It’s going to start [with] “even conservative Newt Gingrich, the former leader of the Republicans in the House, says ‘It’s radical, it’s social engineering.’”

[…]

Reagan had the 11th commandment, ‘Thou shalt not attack fellow Republicans.’ This is a capital offense against the 11th commandment. He won’t recover.

Charles Krauthammer, making some sense on disgraced former Speaker Newt Gingrich. Broken clock, blind pig, and etc…
Disgraced former Speaker Gingrich never had much of a chance to begin with, but taking at least four positions on the individual mandate and the Ryan plan, many of those positions within one day and all easily available on the television would seem to cap it.
However, I don’t believe for one second that The Democrat would actually use disgraced former Speaker Gingrich in this way for messaging purposes. Shrill. Better to assume that voters know all about the GOP plan to destroy Medicare and but also leave a program in existence called Medicare. Talking about that sort of thing is just rank demagoguery. Any Serious Person will tell you so.