Tag: medicare

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.

Put it this way: suppose that from here on out we average 4.5 percent growth, which is way above any forecast I’ve seen. Even at that rate, unemployment would be close to 8 percent at the end of 2012, and wouldn’t get below 6 percent until midway through Sarah Palin’s first term.

Paul Krugman brings the optimism while not-so-gently chiding his fellow media travelers’ insistence that all focus be upon what are essentially made up problems of deficit and government spending. Employment is the problem. Fix that and you can work on wage growth and lessening income inequality across the spectrum, lard on some tax reform, and all these so-called existential spending issues and all the hooha over the “right” size of government will evaporate.
Even less clear is why the media forever focuses on the self-funded, no deficit impact at all for at least 40 years Social Security program when they do a story on the horrors of deficits. It’s a story for another post, but maybe (just maybe!) it’s because they don’t plan on needing it. Medicare, on the other hand, they know they need, know is a deficit ballooner, but just don’t care so long as they get theirs. Very Patriotic.

I happen to think that liberals should be open to Social Security cuts as part of a balanced package of deficit reduction.

Jonathan Chait, spewing the purest form of horseshit possible.
Social Security is not in crisis. All our problems should be like Social Security. Social Security is a rounding error in comparison to the demands of Medicare and Medicaid going forward.
Rest assured, though, The Democrat will engage this issue on the inevitable “savagely cut programs, don’t touch the tax tables or military spending” terms that the GOP demands (and will get) and will thereby set the Overton Window such that the leftmost possible position is that of merely not eliminating the social safety net completely. And wonder why all of us on drugs out here abandon them come 2012.

Competiton

The Jane Hamshers of the world really need to sit down and consider this kind of thing in light of their own unyielding demands for some theoretical, perfect-out-of-the-gate plan that they feel could pass if given the chance and, at least, 55 newly minted progressive Senators:

Congressman Alan Grayson, (D-Orlando), today introduced a bill (H.R. 4789) which would give the option to buy into Medicare to every citizen of the United States. The “Public Option Act,” also known as the “Medicare You Can Buy Into Act,” would open up the Medicare network to anyone who can pay for it.

You see, the current iteration of health insurance reform isn’t it. It’s a starting point. To which popular things, like the public option, or a (vastly superior) Medicare buy-in program can be added. And it’s a hell of a lot harder to argue against a buy-in program when it can be presented as legitimate competition to commercial plans as opposed to some cog in a giant death panels machine. That’s also the moment that all the poisonous rhetoric the GOP employed in the run-up to reform bites them squarely in the ass.

Medicare began as a quite limited program you wouldn’t recognize today. Wasn’t even called Medicare; it was the catchily named Kerr-Mills Act that created Medical Assistance for the Aged (MAA). Can’t imagine why they changed that. But I’m sure everyone blogging about it was quite disappointed with it. Just sayin’.

Pass. The. Damned. Bill.

Opting Out

Paul Starr argues that, because of the potential for real public backlash, the individual mandate should contain an opt-out provision. In a nutshell, you could choose to opt out of coverage…on the condition that you couldn’t easily opt back in for a five year period afterwords.

I agree with Starr that the mandate is the thing that will really burn people up come, oh, 2075 when the last provisions of this damned bill actually go into effect. And that, if the compromises continue, what you’ll have is a mandate to buy today’s overpriced, under-provisioned insurance…now: with a guarantee of coverage! And but so I tend to think a different kind of solution is necessary when talking about the mandate.

Instead of a fine, you automatically enroll mandated but uninsured individuals into Medicare at whatever the premium cost is for a person of their age (and, yes, I’m therefore proposing here that Medicare-based coverage would/should then be open to anybody of any age that fails to procure private insurance; this doesn’t change the fact that it’s a terrible idea that the smelly hippies will hate, hate, hate). That’s the fine: that you have paid for coverage the hard way…through your tax return; but you’ve ultimately just paid for coverage. The end. No further fines, certainly no jail time, just coverage. Whether you like it or not. If you choose not to decide: you still have made a choice.

Ultimately the opt-out only allows for that most dangerous of impulses: the free rider. I won’t pay until I’m really sick or hit by that bus. It just can’t be allowed if we’re to have any chance at all of containing costs. In many ways, it’s precisely this sort of non-covered coverage that is already driving costs today.