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“Saving Medicare From The GOP, Again”: Raising Medicare Age Won’t Save Money But Will Cost Lives

Raising taxes on the rich alone won’t close the deficit or erase the national debt, as Republicans superciliously inform us over and over again. But in their negotiations with the White House to avert the so-called fiscal cliff, Congressional Republicans seem obsessed with a change in Medicare eligibility whose budgetary impact (when compared with ending the Bush tax cuts for the wealthy)  is truly negligible — but whose human toll would be immense.

That Republican imperative is to raise the Medicare eligibility age from 65 to 67.

Why do Speaker John Boehner and the Republican majority in the House so badly want to put Medicare out of reach of elders younger than 67? It will be costly to their most loyal voting constituency among older whites. And it won’t save much money, according to the nonpartisan Kaiser Family Foundation’s latest study – which shows that the estimated $148 billion in savings over ten years is largely offset by increased insurance costs, lost premiums, and higher subsidies that will be paid as a consequence. The Center on Budget and Policy Priorities offers an even more stringent analysis, which shows that raising the eligibility age in fact will result in total costs higher than the putative federal savings — which amount to around $50 billion over ten years. Contrast that with the savings achieved by ending the Bush tax cuts for the wealthy, which amounts to well over $1 trillion during the same period — and it becomes clear which party wants to reduce deficits.

Assuming that the savings are mostly mythical, the only sensible assumption is that Republican politicians and financiers simply hate Medicare, a highly successful and popular federal program that the right has been trying to destroy, with one tactic or another, ever since its establishment in 1965. They don’t really care whether their alleged solutions save money or improve efficiency. They want a privately-funded medical system that preserves profits rather than a system that improves and expands health care, as Medicare has done for almost half a century.

What the Republicans evidently desire most in their “reform” crusade is to exacerbate inequality among the elderly – because that is the only assured outcome of their plans.

The impact of raising the Medicare eligibility age by two years will fall most heavily upon older African-American and other minorities, as they are still known.  The projected damage is summarized clearly in a chart posted on Monday by Sarah Kliff at the Washington Post’s Wonkblog. The number of uninsured among the elderly will be increased for all groups, but the greatest increase will be among minorities, who will also become more likely to postpone medical care because they lack coverage. The net effect of those changes, to project from what we already know about people who  lack of insurance and postpone care, will be earlier deaths and much suffering.

Even more broadly, delaying eligibility is a direct assault on the standard of living of working-class Americans, especially those who have earned their way through physical labor.  By age 65, people who have spent decades engaged in hard physical work – as firefighters, nurses, or other first responders, to consider the most obvious examples – are ready to stop working. Medicare is a critical element of their ability to retire, but Washington elites, especially on the right, are obtusely unsympathetic to their conditions.

It is up to the Democrats in Washington, especially President Obama, to protect Americans from such policy proposals, which are economically idiotic and socially inhumane.  For there is one objective that the Republicans would certainly achieve if they induce the President to accept, or worse, propose, any such plan: They will discredit his second term before it has begun.

 

By: Joe Conason, The National Memo, December 11, 2012

December 11, 2012 Posted by | Health Care, Medicare | , , , , , , , | Leave a comment

“Save The Babies Or Save The Budget”: Dear Conservatives, Your Opposition To Family Planning Comes With A Huge Price Tag

Conservatives have long painted themselves as the guardians of fiscal sanity. But they have also fashioned themselves as the guardians of the innocent babies being preyed upon at Planned Parenthood. Even though abortions make up just 3 percent of the services Planned Parenthood provides—and many clinics don’t provide them at all because of restrictions placed on the funding they receive—conservatives have long held a legislative grudge against the organization and have even broadened their contempt to other family planning clinics.

That deep-held distaste for women’s health providers led Texas lawmakers last year to slash $73 million from all of its family planning services and shift the money to other areas of the budget. This blunt instrument hit all of the state’s women’s health providers, but was meant to target Planned Parenthood and deny it taxpayer dollars—even though the clinics that received state subsidies for care never performed abortions.

This may be in line with their staunch opposition to what they see as a baby-killer, but that ideology comes with quite the price tag. News has surfaced that for the two-year period between 2014 and 2015, poor women are expected to deliver nearly 24,000 babies that they wouldn’t otherwise have had if they had access to state-subsidized birth control. Those extra births will cost taxpayers as much as $273 million, with between $103 million to $108 million of that hitting the state’s general revenue budget alone. Much of the cost comes from caring for those infants through Medicaid.

Lawmakers may not care about what this means for the lives of the low-income women who are now bearing and raising children whose births they would have otherwise prevented had they had access to contraception. But conservatives, the fiscally responsible party, are now thinking twice about the budgetary implications. The New York Times reported last week that “a bipartisan coalition is considering ways to restore some or all of those family planning dollars, as a cost-saving initiative if nothing else.” It’s not like the budget hit should come as a surprise, however. When the cuts were initially debated, an estimate was circulated that they would lead to an extra 284,000 births at a cost of $239 million. Yet the cuts passed, “a price that socially conservative legislators were willing to pay in their referendum on Planned Parenthood,” as the Times reports.

And unfortunately, the ideological battle against Planned Parenthood will not be brought to a complete cease-fire, even in the face of these stark numbers. Planned Parenthood will almost certainly be excluded from any reinstated family planning funding because of an existing ban against taxpayer money going to providers who are “affiliated” with clinics that perform abortions, even if they don’t do so themselves. While there are other women’s health providers in the state, RH Reality Check’s Andrea Grimes set out to find out whether the hundreds of listings on Texas’s website actually provide the services women need. She found that “many of them don’t provide any kind of contraceptive care, don’t take Medicaid Women’s Health Program clients, or are simply misleading duplicate listings.”

And the ones that do offer the right services likely won’t be able to meet the huge increase in demand. Grimes cites a study that found that Planned Parenthood accounted for half of the state’s women’s healthcare, serving nearly 52,000 clients. The remaining providers mostly serve ten or fewer patients. That’s just not going to cut it for all of the women who now need to find care.

Continuing to deny funding to Planned Parenthood will keep costing the state, even if other clinics see their funding reinstated. To the tune of an estimated $5.5 million to $6.6 million as a result of paying for the entire women’s health program on its own, rather than receiving the 90 percent federal matching funds, as well as paying for a higher number of births that will have to be covered by Medicaid funds.

Texas is a huge state, so its case sticks out like a sore thumb. But it’s not the only one to go after family planning services and Planned Parenthood. As the Guttmacher Institute reports, last year some states felt compelled by the federal push to ban federal funds from going to Planned Parenthood to look at whether providers in their states that use private funding for abortion should be barred from receiving state funding or, in some cases, federal Medicaid reimbursements. Currently, six states prohibit some providers from receiving family planning funds and in three the restrictions apply to those that provide abortion or are affiliated with agencies that do.

So conservative lawmakers across the country will now be faced with a choice: save the babies or save the budget. Because it’s clear that you can’t do both. Organizations that provide contraception—and, it must be said, abortions—not only do great service to the women who need to control their fertility and their lives. They do great service to taxpayers. By giving women access to contraception, publicly funded family planning organizations save us $3.74 for every dollar we spend in avoided Medicaid costs associated with unplanned births. Their services saved federal and state governments $5.1 billion in 2008.

As Texas has just found out, those aren’t imaginary numbers. They are very real. Whoever says that contraception and abortion aren’t economic issues should take a second look. They have a huge impact on women’s financial situations. But, perhaps higher on conservatives’ checklist, they have an enormous impact on the budget.

 

By: Bryce Covert, The Nation, December 10, 2012

 

 

December 11, 2012 Posted by | Women's Health | , , , , , , , , | Leave a comment

“The Austerity Trap”: What Raising The Medicare Eligibility Age Really Means

After a campaign in which Republicans attempted to pillory Barack Obama for finding $716 billion in savings from Medicare (via cuts in payments to insurance companies and providers but not cuts to benefits), those same Republicans now seem to be demanding that Obama agree to cuts in Medicare benefits as the price of saving the country from the Austerity Trap, a.k.a. fiscal cliff. Oh, the irony! You’d almost think that they weren’t really the stalwart defenders of Medicare they pretended to be.

And there are some hints that the Obama administration is seriously considering agreeing to raise the Medicare eligibility age from 65 to 67 as part of this deal. It’s a dreadful idea, and as we discuss this possibility, there’s one really important thing to keep in mind: Medicare is the least expensive way to insure these people. Or anybody, for that matter. In all this talk of the bloated entitlement system, you’d be forgiven for thinking Medicare was some kind of inefficient, overpriced big government program. But the opposite is true, and that’s why raising the eligibility age is such a dreadful idea.

Raising the eligibility age saves very little money, on the order of a few billion dollars a year. That’s because the 65 and 66-year-olds will have to get insurance somewhere, and many of them are going to get it with the help of the federal government, either through Medicaid or through the insurance exchanges, where they’ll be eligible for subsidies. However, since many Republican-run states are refusing to expand Medicaid in accordance with the Affordable Care Act, lots of seniors who live in those states will just end up uninsured, which will end up leading to plenty of financial misery and more than a few premature deaths. Put this all together, and the Center on Budget and Policy Priorities estimates that while the federal government would save $5.7 billion a year from raising the eligibility age, costs would increase by more than twice in other parts of the system—for the seniors themselves, employers, other enrollees in exchanges who would pay higher premiums, and state governments.

What we’d be doing is taking people off Medicare, the most efficient and inexpensive option for them to have insurance, and putting them into the individual market, which works less well and costs more. When we start talking about this in more detail, that’s what Republicans should really be forced to address.

If you want more details on the implications of raising the eligibility age, you should be reading Jonathan Cohn and Sarah Kliff. But it’s important that we keep the big picture in view as the Austerity Trap deal takes shape. If anything, we should be putting more people on Medicare—that would save money and improve health in the system overall (you may recall that when the ACA was being debated one of the proposals was to allow people over 50 to buy in to Medicare, an idea we should bring back). There’s an argument being made that raising the eligibility age may not be a good idea, but the administration has to give Republicans something, and it’s not that big a deal. If that’s the case that wins the day, we should be clear about exactly what it means: a more expensive health care system, exactly the opposite of what everybody says they want.

 

By: Paul Waldman, Contributing Editor, The American Prospect, December 10, 2012

December 11, 2012 Posted by | Health Care | , , , , , , , , | 1 Comment

“Republicans Need To Wise Up”: It’s Not Their Uninspiring Candidates Or Unsound Tactics, It’s Their Unpopular Ideas

The biggest problem the Republican Party faces is not uninspiring candidates or unsound tactics. It is unpopular ideas.

This reality was brought home in last month’s election. It’s playing out in the struggle over how to avoid the “fiscal cliff.” And we’ll see it again in coming fights over immigration, entitlements, inequality and a host of other issues. Here’s the sad thing: Republicans get this stuff so wrong that Democrats aren’t even forced to go to the trouble of getting it right.

There will be those who doubt the sincerity of my advice to the GOP, since my standing as a conservative is — justifiably — less than zero. But I’ve always believed in competition, if only to prevent liberals from becoming lazy and unimaginative. One could argue that this is already happening.

Take the question of what to do about undocumented immigrants. The Republican Party takes an uncompromising line against anything that could be construed as amnesty — any solution that provides “illegal” immigrants with a path to citizenship. Much has been made of the impact the immigration issue had in the election, as Latinos voted for President Obama over Mitt Romney by nearly 3-1.

It is obvious to sentient Republicans why the party cannot afford to so thoroughly alienate the nation’s largest minority group. What the GOP seems not to grasp is that the party’s “send ’em all home” stance is way out of line with much of the rest of the electorate as well.

A Politico-George Washington University poll released Monday asked voters whether they favored “an immigration reform proposal that allows illegal or undocumented immigrants to earn citizenship over a period of several years.” That would be amnesty, pure and simple — and a whopping 62 percent said they were in favor, compared to 35 percent who said they were opposed.

You might expect Democrats, then, to be pushing hard for a straightforward amnesty bill. But they don’t have to. Because Republicans are so far out in right field on the issue, Democrats haven’t actually had to do anything to reap substantial political benefits. They’ve just had to sound more reasonable, and less hostile, than Republicans, which has not required breaking a sweat.

On the central fiscal-cliff question, the GOP is similarly out of step. The Politico poll found that 60 percent of respondents favor raising income taxes on households that earn more than $250,000 a year. The Republican Party says no — and thus allows itself to be portrayed as willing to sink the economic recovery, if necessary, to ensure that tycoons can keep their pantries stocked with caviar.

Where is the incentive for Democrats to get serious about fiscal matters? As long as the GOP remains adamant on what many Americans see as a no-brainer question of basic fairness, those who believe in progressive solutions get a pass.

The truth is that raising top marginal rates for the wealthy is probably as far as we should go on the tax front right now, given the fragility of the recovery. The best thing we could do for the country’s long-term fiscal health is spur the economy into faster growth, which will shrink deficits and the debt as a percentage of gross domestic product.

That said, it’s hard to imagine long-term solutions that don’t eventually require more tax revenue from the middle class as well as the rich. But why should Democrats mention this inconvenient fact when Republicans, out of ideological stubbornness, are keeping the focus on the upper crust?

The same basic dynamic plays out in the question of reforming entitlements. Republicans proposed turning Medicare into a voucher program; polls show that voters disagree. The GOP seems to be falling back to the position that the eligibility age for the program should be raised. Trust me, voters aren’t going to like that, either.

Nor, for that matter, do voters like the GOP’s solution for the millions of Americans who lack health insurance, which Romney summarized as, essentially, go to the emergency room. A smart Republican Party would stop focusing exclusively on how government can pay less for health care and, instead, begin to seriously explore ways to reduce health-care costs. A smart GOP would acknowledge the fact that Americans simply don’t want to privatize everything, which means we need new ideas about how to pay for what we want.

Faced with an opposition that verges on self-parody, progressive thinkers are mostly just phoning it in. This won’t change until somebody defibrillates the GOP, and we detect a pulse.

 

By: Eugene Robinson, Opinion Writer, The Washington Post, December 10, 2012

December 11, 2012 Posted by | Politics | , , , , , , , , | 1 Comment

“Never Ever, Ever, Ever…”: Grover Norquist’s Pledge Used To Be Politically Expedient, Now It’s Not

A few words to ponder as we sail toward the fiscal cliff. Those words would be: “That was then, this is now.”

Strip away the false piety and legalistic hair-splitting offered by Republican lawmakers rationalizing their decision to abandon a pledge that they will never ever, ever, ever vote to raise taxes, and that’s pretty much what the explanation boils down to.

Rep. Peter King says he understood the pledge, propounded by the almighty Grover Norquist and his group Americans for Tax Reform, to obligate him for only one term. Apparently, he thought it had to be renewed, like a driver’s license.

Sen. Lindsey Graham says that if Democrats agree to entitlement reform, “I will violate the pledge … for the good of the country” — a stirring statement of patriotism and sacrifice that warms your heart like a midnight snack of jalapeño chili fries.

In other words: bull twinkies. If you want the truth of why a trickle of GOP lawmakers is suddenly willing to blaspheme the holy scripture of their faith, it’s simple. The pledge used to be politically expedient. Now it is not.

This is not, by the way, a column in defense of the Norquist pledge. The only thing dumber than his offering such a pledge was scores of politicians signing it, an opinion that has nothing to do with the wisdom or lack thereof of raising taxes and everything to do with the fact that one ought not, as a matter of simple common sense, make hard, inflexible promises on changeable matters of national import. It is all well and good to stand on whatever one’s principles are, but as a politician — a job that, by definition, requires the ability to compromise — you don’t needlessly box yourself in. Never say never.

Much less never ever, ever, ever.

So this revolution against “he who must be obeyed,” however modest, is nonetheless welcome. It suggests reason seeping like sunlight into places too long cloistered in the damp and dark of ideological rigidity.

But it leaves an observer in the oddly weightless position of applauding a thing and being, simultaneously, disgusted by it. Has politics ever seemed more ignoble than in these clumsy, self-serving attempts to justify a deviation from orthodoxy? They have to do this, of course, because the truth — “I signed the pledge because I knew it would help me get elected, but with economic ruin looming and Obama re-elected on a promise to raise taxes on the rich and most voters supporting him on that, it’s not doing me as much good as it once did” — is unpretty and unflattering.

In this awkward about-face, these lawmakers leave us wondering once again whether the vast majority of them — right and left, red and blue, Republican and Democrat — really believe in anything, beyond being re-elected.

There is a reason Congress’ approval ratings flirted with single digits this year. There is a reason a new Gallup poll finds only 10 percent of Americans ranking Congress “high or very high” in honesty and ethics.

Lawyers rank higher. Advertisers rank higher. Even journalists rank higher.

This is the sad pass to which years of congressional grandstanding, fact spinning, cookie-jar pilfering and assorted harumphing and pontificating have brought us. And while a certain cynicism toward its leaders functions as a healthy antigen in the body politic, it cannot be good for either the nation or its leaders that so many of them are held in plain contempt.

The moral malleability exemplified by the likes of King and Graham will not help. Perhaps we should ask them to sign a new pledge: “I will always tell you what I think and what I plan to do in plain English, regardless of whether you like it or it benefits me politically.”

But no lawmaker would make that pledge. And who would believe them if they did?

 

By: Leonard Pitts, Jr., The National Memo, December 10, 2012

December 11, 2012 Posted by | Politics | , , , , , , , , | Leave a comment

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