Stunt Of The Week: Heritage Foundation Plays A Foolish Game
I’ve grown increasingly concerned about the poor quality of the Heritage Foundation’s scholarship, but this week’s stunt is awful, even by Heritage standards.
The conservative think tank published an item yesterday purporting to show that passage of the Affordable Care Act immediately stalled private-sector job growth. Conditions were quickly improving, Heritage argues, right up until those rascally Democrats felt the need to overhaul the health care system.
This is deeply foolish, both as an exercise and as an attempt to manipulate data. Here, for example, is a chart showing private-sector job growth in the 12 months after implementation of the ACA began.
Note, three of those months reflect the strongest private-sector monthly totals in the last five years. One might also mention that private-sector employment bottomed out shortly before the Affordable Care Act passed, and has been on an upwards trajectory ever since.
To clarify, I’m not saying the successful passage of health care reform necessarily caused private-sector job growth to improve. There are all kinds of other facts that gave the economy a boost, most notably the Recovery Act (which, incidentally, the Heritage Foundation also dislikes).
But to argue that the ACA was somehow responsible for undermining the economy is unbecoming an institution that claims to be a “think” tank. I know the right hates the reform law — despite the fact that it includes several provisions, including the individual mandate, which had been endorsed by the Heritage Foundation — but this just reeks of desperation.
As Matt Yglesias explained, referring to the Heritage piece, “Clearly … no fair-minded person actually interested in the subject is going to be persuaded by this kind of nonsense. I think it’s really too bad that conservative institutions spend a fair amount of time and energy on projects whose only possible effect can be to mislead their own constituency.”
By: Steve Benen, Contributing Writer, Political Animal-Washington Monthly, July 21, 2011
Questions About Michele Bachmann’s Migraines Aren’t Sexist
Questions about whether Michele Bachmann’s headaches should disqualify her for office may be of dubious validity, but are they sexist? I don’t think so.
In case you’ve missed the media storm du jour, the Daily Caller reported Monday night that Bachmann suffers from incapacitating migraines, and engages in “heavy pill use” to combat them. This has spurred, among other things, cries of sexism.
Fox News Channel host Martha MacCallum, for example, said that “it does feel sexist … Has anyone asked this of the male candidates out there? Do you have any medical issues that you think we should know about?” (As a side note, asking candidates such questions about medical issues is, I think, fairly routine and legitimate.)
Monica Crowley, a conservative talk show host appearing with MacCallum, chimed in, “This does smack of that old school ‘Woman As Hysteric’ kind of thing.”
Well not so fast. Here’s what the Caller reported:
The Minnesota Republican frequently suffers from stress-induced medical episodes that she has characterized as severe headaches. These episodes, say witnesses, occur once a week on average and can “incapacitate” her for days at time.’
Here’s a simple sexism test. Replace reference to Bachmann with references to, say, Mitt Romney. Would a story saying that Romney “frequently suffers from stress-induced medical episodes” that “incapacitate” him for “days at a time” get the same attention? I should think so.
Now, does that mean that the Caller story has merit? That’s trickier. It’s legitimate … if it’s legitimate. In other words if she really is “frequently … incapacitated” for days at a time then, yes, that’s a legitimate line of inquiry. But if it’s a case of occasional migraines getting blown out of proportion by anonymous, embittered former staffers, that’s something else entirely.
Then there are the pills. “The migraines are so bad and so intense, she carries and takes all sorts of pills,” a source tells the Caller. “Prevention pills. Pills during the migraine. Pills after the migraine, to keep them under control. She has to take these pills wherever she goes.”
Well. “Pills” could be anything from aspirins to greenies. Lots of people take pills on a regular basis—taking pills is not in and of itself disqualifying or even troubling. If there were any evidence to suggest that these pills could affect her judgment that would be a different question, but the Caller story doesn’t have it.
One final issue here that the Washington Post’s Chris Cillizza notes, that this isn’t the first time former Bachmann aides have badmouthed her to the press:
A cavalcade of disgruntled former aides (are there ever “gruntled” former aides?) willing to go public with questions and criticisms of Bachmann is decidedly problematic for her presidential candidacy.
After all, if those who know (or knew) her best lack faith in her ability to do the job effectively, it will almost certainly force voters to re-examine their first, generally positive impressions of her.
Indeed, with friends like that, who needs migraines?
By: Robert Schlesinger, U. S. News and World Report, July 20, 2011
Getting to Crazy: The Culmination Of A GOP Process
There aren’t many positive aspects to the looming possibility of a U.S. debt default. But there has been, I have to admit, an element of comic relief — of the black-humor variety — in the spectacle of so many people who have been in denial suddenly waking up and smelling the crazy.
A number of commentators seem shocked at how unreasonable Republicans are being. “Has the G.O.P. gone insane?” they ask.
Why, yes, it has. But this isn’t something that just happened, it’s the culmination of a process that has been going on for decades. Anyone surprised by the extremism and irresponsibility now on display either hasn’t been paying attention, or has been deliberately turning a blind eye.
And may I say to those suddenly agonizing over the mental health of one of our two major parties: People like you bear some responsibility for that party’s current state.
Let’s talk for a minute about what Republican leaders are rejecting.
President Obama has made it clear that he’s willing to sign on to a deficit-reduction deal that consists overwhelmingly of spending cuts, and includes draconian cuts in key social programs, up to and including a rise in the age of Medicare eligibility. These are extraordinary concessions. As The Times’s Nate Silver points out, the president has offered deals that are far to the right of what the average American voter prefers — in fact, if anything, they’re a bit to the right of what the average Republican voter prefers!
Yet Republicans are saying no. Indeed, they’re threatening to force a U.S. default, and create an economic crisis, unless they get a completely one-sided deal. And this was entirely predictable.
First of all, the modern G.O.P. fundamentally does not accept the legitimacy of a Democratic presidency — any Democratic presidency. We saw that under Bill Clinton, and we saw it again as soon as Mr. Obama took office.
As a result, Republicans are automatically against anything the president wants, even if they have supported similar proposals in the past. Mitt Romney’s health care plan became a tyrannical assault on American freedom when put in place by that man in the White House. And the same logic applies to the proposed debt deals.
Put it this way: If a Republican president had managed to extract the kind of concessions on Medicare and Social Security that Mr. Obama is offering, it would have been considered a conservative triumph. But when those concessions come attached to minor increases in revenue, and more important, when they come from a Democratic president, the proposals become unacceptable plans to tax the life out of the U.S. economy.
Beyond that, voodoo economics has taken over the G.O.P.
Supply-side voodoo — which claims that tax cuts pay for themselves and/or that any rise in taxes would lead to economic collapse — has been a powerful force within the G.O.P. ever since Ronald Reagan embraced the concept of the Laffer curve. But the voodoo used to be contained. Reagan himself enacted significant tax increases, offsetting to a considerable extent his initial cuts.
And even the administration of former President George W. Bush refrained from making extravagant claims about tax-cut magic, at least in part for fear that making such claims would raise questions about the administration’s seriousness.
Recently, however, all restraint has vanished — indeed, it has been driven out of the party. Last year Mitch McConnell, the Senate minority leader, asserted that the Bush tax cuts actually increased revenue — a claim completely at odds with the evidence — and also declared that this was “the view of virtually every Republican on that subject.” And it’s true: even Mr. Romney, widely regarded as the most sensible of the contenders for the 2012 presidential nomination, has endorsed the view that tax cuts can actually reduce the deficit.
Which brings me to the culpability of those who are only now facing up to the G.O.P.’s craziness.
Here’s the point: those within the G.O.P. who had misgivings about the embrace of tax-cut fanaticism might have made a stronger stand if there had been any indication that such fanaticism came with a price, if outsiders had been willing to condemn those who took irresponsible positions.
But there has been no such price. Mr. Bush squandered the surplus of the late Clinton years, yet prominent pundits pretend that the two parties share equal blame for our debt problems. Paul Ryan, the chairman of the House Budget Committee, proposed a supposed deficit-reduction plan that included huge tax cuts for corporations and the wealthy, then received an award for fiscal responsibility.
So there has been no pressure on the G.O.P. to show any kind of responsibility, or even rationality — and sure enough, it has gone off the deep end. If you’re surprised, that means that you were part of the problem.
By: Paul Krugman, Op-Ed Writer, The New York Times, July 14, 2011
Justifying Cuts: A Well-Used But Misleading Medicaid Statistic
“Cash-strapped states are also feeling the burden of the Medicaid
entitlement. The program consumes nearly 22 percent of states’ budgets today, and things are about to get a whole lot worse.”
— Sen. Orrin Hatch (R-Utah), June 23, 2011, at a hearing of the Senate Finance Committee
“Medicaid is the lion’s share of that spending burden as it now consumes about 22 percent of state budgets now and will consume $4.6 trillion of Washington’s budget over the next ten years.”
— Former Kentucky governor Ernest Lee Fletcher (R), June 23, 2011, at the same hearing
“Across the country, governors are concerned about the burgeoning cost of Medicaid, which in fiscal 2010 consumed nearly 22 percent of state budgets, according the National Association of State Budget Officers. That’s larger than what states spent on K-12 public schools.”
— Washington Post front page article, June 14, 2011
When a statistic is universally tossed around as a certified fact, it’s time to get suspicious.
Such is the case with this oft-cited statistic that 22 percent of state budgets is being gobbled up by Medicaid, the state-federal program that provides health coverage for the poor and the disabled. Medicaid supposedly is even dwarfing what is spent on educating children and teenagers.
But note the phrase “state-federal.” There’s billions of dollars in federal money involved, and the “22-percent” statistic obscures that fact. Let’s dig a little deeper into the numbers.
The Facts
Medicaid was a central part of President Lyndon Johnson’s “Great Society” initiative in the mid-1960s. Each state administers its own Medicaid program, but with federal oversight, federal requirements—and plenty of federal dollars. On average, the federal government provides 57 percent of Medicaid funds.
Initially, Medicaid was focused low-income Americans, but elderly nursing home care has also become a big part of it. The new health care law would also greatly expand eligibility to people up to 133 percent of the official poverty line.
There’s no question that the recession has put pressure on Medicaid spending, as more people lost jobs or income and so became eligible for coverage. The new requirements of the health care law also will boost Medicaid spending.
The assertion that Medicaid is 22 percent of state spending, and thus now exceeds education spending, comes from an annual survey of the National Association of State Budget Officers (NASBO). But if you dig into the report — if you just go to page
one — you will see that this number includes the federal contribution, in what
is known as “total funds.”
If you want to see what states themselves are spending on Medicaid —“general funds” — you have to use another set of statistics.
As NASBO says on page one, “For estimated fiscal 2010, components of general fund spending are elementary and secondary education, 35.7 percent; Medicaid, 15.4 percent; higher education, 12.1 percent; corrections, 7.2 percent; public assistance, 1.9 percent; transportation, 0.8 percent; and all other expenditures, 27.0 percent.”
In other words, without the federal dollars included, Medicaid falls to second place, far behind education. It turns out that on average, states spend 15.4 percent of their funds on Medicaid — not 22 percent.
Brian Sigritz, NASBO’s director of state fiscal studies, said, “You are correct that there are several different ways of looking at Medicaid spending that you can use. If you consider just general funds, K-12 easily remains the largest component of general fund spending, as it historically has been.”
Indeed, when you look at NASBO’s historical data (table three of this report), it becomes clear that Medicaid spending, as a proportion of general funds, has remained relatively consistent since 1995 — about 15 percent — in contrast to the popular image of being a drain on state budgets.
Sigritz said that the two figures provide a different picture of state spending. “General funds gives you a sense of spending deriving from state revenue, while total funds gives you a sense of total state expenditures,” he said. “Typically when you discuss overall state budgets you examine the various funding sources that go into them including general funds, other state funds, bonds, and federal funds.”
The Office of the Actuary for Medicare and Medicaid makes this distinction. The 2010 Actuarial Report for Medicaid notes the broad figure, but then takes pains to add: “This amount, however, includes all Federal contributions to State Medicaid spending, as well as spending from State general revenue funds and other State funds (which for Medicaid consists of provider taxes, fees, donations, assessments, and local funds).” The report concludes: “When only State general revenues are considered, however, Medicaid spending constitutes an estimated 16.2 percent of expenditures in 2009, placing it well behind education.”
Antonia Ferrier, a spokeswoman for Hatch, defended the 22-percent figure, noting its wide use. “It is part of their budgets, and there are many different streams of funding that fund those state budgets (including federal funding, taxes, etc.) that fund their many programs,” she said.
But Colleen Chapman, a spokeswoman for the Georgetown University Center for
Children and Families, a policy and research center, said, “In the current budget debate, the data are being misused to argue that the Medicaid program in states is out of control and needs to be cut dramatically, when in fact, Medicaid is still much less of state spending than education and has not grown, as a portion of state budgets, in any way close to the mammoth way that others argue it has.”
The Pinocchio Test
We will label this with one of our rarely used categories: TRUE BUT FALSE.
(We still need to get an appropriate icon for this one — suggestions are welcome.)
Yes, the 22-percent figure is a valid number. But it is being used in an inappropriate way, and therefore is misleading. Hatch and Fletcher are only the latest in a long line of public figures — and news outlets — who have seized onto this number without apparently realizing that it is the wrong statistic to use. If people want to understand the impact the Medicaid is having on state budgets, politicians should begin to use the 15-percent figure — or at the least offer a caveat to the 22-percent number. Otherwise, there might be some Pinocchios in their future.
By: Glenn Kessler, The Fact Checker, The Washington Post, July 5, 2011
GOP Returns To ‘Death Panels’ Narrative In Desperate Effort To Change The Medicare Story
Republican Member of Congress, Phil Gingrey (GA), has decided that the moment has arrived to get back on offense in the debate for the future of Medicare.
At a press conference earlier this week, Gingrey returned to one of the GOP’s favorite ‘boogeymen’ in an effort to make us forget just how much we hate the Republican approach to reforming Medicare. He went after the fifteen-member panel of medical experts established by the Affordable Care Act who go by the name the Independent Payment Advisory Board (IPAB).
According to Gingrey-
“Democrats like to picture us as pushing grandmother over the cliff or throwing someone under the bus. In either one of those scenarios, at least the senior has a chance to survive.
But under this IPAB we described that the Democrats put in Obamacare, where a bunch of bureaucrats decide whether you get care, such as continuing on dialysis or cancer chemotherapy, I guarantee you when you withdraw that the patient is going to die. It’s rationing.” (Via Politico)
Wow…that does sound scary! In fact, it sounds an awful lot like a …..Death Panel.
Thank goodness that absolutely nothing Gingrey said at his press conference beyond “My name is Phil Gingrey” has even the slightest connection to the truth.
Like it or not, here are the facts –
In order to keep Medicare spending under control, the Affordable Care Act, aka “Obamacare”, established specific target growth rates for the government program that cares for our seniors.
To ensure that these targets are met, the reform law created the IPAB for the purpose of monitoring the growth of Medicare spending and to make recommendations to cut the same in those years where it looks like we are going to blow past the targets – and only in those years.
So, if the growth in Medicare costs is staying within the boundaries set by law, the IPAB has no authority to propose any changes whatsoever.
Why was it necessary to create this panel of experts?
Prior to creation of the IPAB, it was left to Congress to make decisions about who and what should be covered by Medicare.
While Congress has long had their own board of experts to rely on (“Medipac”), the profound influence of special interests combined with a general lack of understanding of the world of medicine – and the economics that rule that world – made it fairly obvious that Congress was not the best place to get the job done.
If you doubt this, simply look at how poorly Congress has managed the growth in Medicare costs to date. And before you blame this on whichever president you would like to put in the crosshairs, you should be very clear that it is, indeed, the job of Congress to make these decisions and manage this policy.
The IPAB was created to solve this problem.
As noted earlier, the board has no statutory impact whatsoever on Medicare payment rates and policy during the years when the spending targets are being met. Their powers only come into play in those years where Medicare actuarial reports suggest we are spending too much money per the restrictions established by Obamacare.
During those years when the board is required to come up with proposals to get spending under control, they will provide these proposals to the DHHS who must then implement them – unless Congress takes it upon itself to come up with their own proposals and pass them into law.
Thus, Congress retains the absolute ability and opportunity to effectuate its own program to bring Medicare costs back in line with the targets any time they wish. Maybe it was me, but I don’t recall Gingrey pointing out this little detail. And there is something else that Representative Gingrey forgot to mention during his tirade. There is an entire list of policy items contained in the ACA that are specifically prohibited to the IPAB.
And what would you imagine is at the top of that list?
The Board is legally barred from proposing anything that will ration health care, restrict benefits or modify the eligibility criteria for beneficiaries.
What’s more, until 2020, the IPAB may not come up with proposals that place the rates being charged by primary hospitals and hospice programs in their sights. This prohibition was the result of the ACA already putting the moves on these organizations when it comes to what the government pays them. Thus, it seemed fair to give them some breathing room for the next eight years or so.
As a result of these inconvenient truths, it is rather difficult to concoct the scenario where Gingrey and friends see this insidious opportunity for the board to ration our health care.
The only argument I can imagine is to suggest that the board could recommend reducing the sums paid to physicians who provide Medicare services to patients. Were this to occur, more physicians might decide to drop out of Medicare, creating a longer waiting period for patients needing to see a doctor.
Of course, even this is not rationing.
Further, the SGR issue is about to become a thing of the past as Congress moves toward reaching a permanent solution to the problem created by an outdated formula that puts physicians in a position of taking major pay cuts from Medicare each year.
Once the physician payment issue is resolved, it becomes hard to see where the IPAB is going to exercise this health rationing Gingrey so fervently fears.
What should disturb each and every American is not only that Gingrey is willing to flat out lie in order to feather his political nest, he is using that lie to pull our attention away from the true health care rationers in our system – the private insurance companies.
Think this is a liberal red herring designed to distract you from the evil government plan to kill grandma?
Ask your physician about the hoops he or she must jump through to gain insurance company approval to do the job you hire them to do. Ask them how much of their time and money is wasted arguing with health insurance company representatives whose sole job is to turn down a requested procedure so that they will not have to pay for the same. Take a look at some of your statements from your insurer and see where they’ve denied payment on any number of technicalities resulting from a contract you signed that you could not possibly understand.
This is the true rationing problem in the United States today.
Still, polls continue to show that many Americans are deeply displeased with Obamacare.
I continue to believe that this is the direct result of so many of us not understanding what the legislation does – and does not – do.
But there is one thing we should all be able to understand.
If the opponents of health care reform and the current approach to Medicare are continuously left to base their arguments solely on lies, should it not occur to us all that maybe the law is better than what we’ve been led believe?
If not, why the lies instead of criticism based on the truth?
By: Rick Ungar, The Policy Page, Forbes, June 24, 2011
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