“Zombies Against Medicare”: The Right Has Never Abandoned Its Dream Of Killing The Program
Medicare turns 50 this week, and it has been a very good half-century. Before the program went into effect, Ronald Reagan warned that it would destroy American freedom; it didn’t, as far as anyone can tell. What it did do was provide a huge improvement in financial security for seniors and their families, and in many cases it has literally been a lifesaver as well.
But the right has never abandoned its dream of killing the program. So it’s really no surprise that Jeb Bush recently declared that while he wants to let those already on Medicare keep their benefits, “We need to figure out a way to phase out this program for others.”
What is somewhat surprising, however, is the argument he chose to use, which might have sounded plausible five years ago, but now looks completely out of touch. In this, as in other spheres, Mr. Bush often seems like a Rip Van Winkle who slept through everything that has happened since he left the governor’s office — after all, he’s still boasting about Florida’s housing-bubble boom.
Actually, before I get to Mr. Bush’s argument, I guess I need to acknowledge that a Bush spokesman claims that the candidate wasn’t actually calling for an end to Medicare, he was just talking about things like raising the age of eligibility. There are two things to say about this claim. First, it’s clearly false: in context, Mr. Bush was obviously talking about converting Medicare into a voucher system, along the lines proposed by Paul Ryan.
And second, while raising the Medicare age has long been a favorite idea of Washington’s Very Serious People, a couple of years ago the Congressional Budget Office did a careful study and discovered that it would hardly save any money. That is, at this point raising the Medicare age is a zombie idea, which should have been killed by analysis and evidence, but is still out there eating some people’s brains.
But then, Mr. Bush’s real argument, as opposed to his campaign’s lame attempt at a rewrite, is just a bigger zombie.
The real reason conservatives want to do away with Medicare has always been political: It’s the very idea of the government providing a universal safety net that they hate, and they hate it even more when such programs are successful. But when they make their case to the public they usually shy away from making their real case, and have even, incredibly, sometimes posed as the program’s defenders against liberals and their death panels.
What Medicare’s would-be killers usually argue, instead, is that the program as we know it is unaffordable — that we must destroy the system in order to save it, that, as Mr. Bush put it, we must “move to a new system that allows [seniors] to have something — because they’re not going to have anything.” And the new system they usually advocate is, as I said, vouchers that can be applied to the purchase of private insurance.
The underlying premise here is that Medicare as we know it is incapable of controlling costs, that only the only way to keep health care affordable going forward is to rely on the magic of privatization.
Now, this was always a dubious claim. It’s true that for most of Medicare’s history its spending has grown faster than the economy as a whole — but this is true of health spending in general. In fact, Medicare costs per beneficiary have consistently grown more slowly than private insurance premiums, suggesting that Medicare is, if anything, better than private insurers at cost control. Furthermore, other wealthy countries with government-provided health insurance spend much less than we do, again suggesting that Medicare-type programs can indeed control costs.
Still, conservatives scoffed at the cost-control measures included in the Affordable Care Act, insisting that nothing short of privatization would work.
And then a funny thing happened: the act’s passage was immediately followed by an unprecedented pause in Medicare cost growth. Indeed, Medicare spending keeps coming in ever further below expectations, to an extent that has revolutionized our views about the sustainability of the program and of government spending as a whole.
Right now is, in other words, a very odd time to be going on about the impossibility of preserving Medicare, a program whose finances will be strained by an aging population but no longer look disastrous. One can only guess that Mr. Bush is unaware of all this, that he’s living inside the conservative information bubble, whose impervious shield blocks all positive news about health reform.
Meanwhile, what the rest of us need to know is that Medicare at 50 still looks very good. It needs to keep working on costs, it will need some additional resources, but it looks eminently sustainable. The only real threat it faces is that of attack by right-wing zombies.
By: Paul Waldman, Op-Ed Columnist, The New York Times, July 27, 2015
“Privatization Of Medicare”: Jeb Bush Now Says He Wouldn’t ‘Phase Out’ Medicare. What He Would Do Is Just As Wrong
It had to happen sooner or later: a Republican presidential candidate says something suggesting he’d destroy Medicare, the Democrats jump all over him, and he backtracks, saying that’s not what he meant and in fact he only wants to strengthen it. This time it’s Jeb Bush, who said the other day that though we can keep Medicare around for the people who are currently on it, “we need to figure out a way to phase out this program for others and move to a new system that allows them to have something – because they’re not going to have anything.”
This is an old argument from Republicans, one they also use to justify attacks on Social Security: the program is doomed anyway, so we should go ahead and privatize it. The argument is completely wrong with regard to Social Security, and the truth about Medicare is that the program’s future is looking brighter and brighter — in no small part because of the Affordable Care Act. The argument Bush is making is ten years out of date.
Bush did try to walk back his statement a bit, saying the “phase out” part was taken out of context and he’s only talking about how we “reform our entitlement system.” Here’s his follow-up, which doesn’t change the essence of what he was arguing:
“It’s an actuarially unsound health care system,” said Bush, who said something must be done before the system burdens future generations with $50 billion of debt. “Social Security is an underfunded retirement system; people have put money into it, for sure.
“The people that are receiving these benefits, I don’t think that we should touch that; but your children and grandchildren are not going to get the benefit of this that they believe they’re going to get, or that you think they’re going to get, because the amount of money put in compared to the amount of money the system costs is wrong.”
Bush hasn’t yet released his plan to phase out/reform Medicare, but given these comments it seems likely he’ll embrace something like what Paul Ryan has been advocating for years. It involves changing Medicare from a guaranteed single-payer government insurance plan into a voucher plan, in which the government gives senior citizens a set amount of money with which they can go out and get private health insurance. It saves money by limiting the value of that voucher, so if it’s less than what coverage actually costs, well, tough luck. In that way, it eliminates the central promise of Medicare, which is that every American senior citizen will have health coverage.
We’ll await Jeb’s particulars, but I promise you that most of the GOP candidates will embrace some version of this plan, because that’s what the Republican consensus on Medicare is these days. And it’s always justified with the argument Jeb gives: because of skyrocketing costs the program is doomed, so privatization is the only way to make sure it’s there for your kids. But don’t worry, current seniors, we won’t touch your Medicare! Which is one of the ironies of their argument: the free market is supposed to make everything wonderful, but they fall all over themselves to promise senior citizens that they won’t disturb the big-government, socialist program that seniors love.
Now on to the cost question. As it happens, the Medicare Trustees just released their annual report on the future of the program. And as Kevin Drum noted, things are looking a lot sunnier than they were a few years ago:
Ten years ago, Medicare was a runaway freight train. Spending was projected to increase indefinitely, rising to 13 percent of GDP by 2080. This year, spending is projected to slow down around 2040, and reaches only 6 percent of GDP by 2090. Six percent! That’s half what we thought a mere decade ago. If that isn’t spectacular, I don’t know what is.
Those are projections for what’s going to happen decades from now, so things are doubtless going to change. But the presumption of the Republican argument is that Medicare is eventually going to eat the entire federal budget, and so we have no choice but to fundamentally alter it. And that’s just not true.
The other assumption they make is that the way to alter Medicare is simple: privatize it. But they’re wrong about this, too. Medicare is expensive, but that’s not because it’s an inefficient big-government program. In fact, Medicare is remarkably efficient, more so than private insurance. That’s because it benefits from economies of scale, and because it doesn’t have to spend money on things like marketing, underwriting, and big salaries for executives. The reason Medicare is expensive is that American health care is expensive, and it serves a lot of people. The retirement of the large Baby Boom generation is what’s producing its current funding challenges.
Let’s not forget that at the same time Republicans cry that Medicare is unaffordable and so must be dismantled, they fight any effort to actually lower costs in a rational way. For instance, they’re adamantly opposed to comparative effectiveness research, which involves looking at competing treatments and seeing which ones actually work better. That this isn’t something Medicare already takes into account sounds ridiculous, but it’s true. If there are two medications for a particular ailment that are equally effective, but one costs $100 a year and one costs $100,000 a year, wouldn’t it make sense for Medicare to 1) find that out, and 2) make coverage decisions accordingly? But Republicans have said no — Medicare should just pay for both, no matter what it costs.
Republicans also oppose the most significant effort to reduce Medicare costs in decades, something called the Affordable Care Act, which included all kinds of provisions meant to achieve this goal. Perhaps most critically, the law starts a move away from the fee-for-service model, in which doctors and hospitals make more money the more procedures they do, to a model where they get paid a single rate for treating a patient. Under the fee-for-service model, if your hospital screws up, you get an infection, and you have to get re-admitted, they make more money; the ACA actually punishes them for that, giving them a greater incentive to provide better and less expensive care.
But Republicans not only want to repeal the ACA, which means repealing all those kinds of payment provisions, they have nothing much to say about how, specifically, we might save money in Medicare. Their only answer is that if we privatize it, the magic of the market will produce savings. Of course, if that were true America would have the cheapest health care system in the advanced world, since ours is already more private than in any other similar country. And yet we don’t — ours is far and away the most expensive, and that’s precisely because the market has failed.
So to sum up, this is the Republican argument on Medicare: We absolutely can’t do anything in particular that would bring down the cost of Medicare, but the cost of Medicare is so outrageous that we have no choice but to privatize it.
When Jeb Bush and the other candidates talk about this subject, pay close attention to what they say. They’ll use the word “strengthen” a lot — we want to strengthen Medicare! They’ll tell seniors, who vote in great numbers, that they aren’t going to touch their precious Medicare. And they’ll ignore what we’ve learned in the last few years, talking as though things look just as bad as they did before the Affordable Care Act was passed and health care spending slowed. But the truth is that their solution is no solution at all.
By: Paul Waldman, Senior Writer, The American Prospect; Contributor, The Plum Line Blog, The Washington Post, July 24, 2015
“I’m Down With The Trends”: Jeb Bush Wants To Be The Uber Candidate. Here’s The Problem With That
Jeb Bush is desperate for you to know that he is the Uber candidate. The old, 20th century ways are not for him and his bold campaign for the future. He’s sharing a ride to the glorious tech-driven tomorrow.
But what does that actually mean? So far he hasn’t said, but he’s certainly getting the coverage he wants.
The front page of today’s New York Times features a photo of Bush in an Uber car, over a story about Republican candidates embracing the company. It summed up the purpose fairly well:
Republican candidates are embracing Uber not just as a paragon of their free-market ethos and distaste for entrenched, government-protected industries, but also as an electoral strategy for building bridges to traditionally Democratic cities, where the company has thrived. During his visit to the left-leaning city of San Francisco on Thursday, Mr. Bush was ferried around, fittingly, by an Uber driver, who deposited him at a campaign event in a black Toyota Camry. “Thanks for the ride!” Mr. Bush hollered as cameras snapped away.
So what exactly is Jeb trying to communicate about the kind of president he’d be? On the surface, it’s entirely substance-free. It’s just about attitude: I’m hip to what the kids are into, I’m down with the trends, I’m forward-thinking. In that spirit, Jeb took to LinkedIn and mobilized a phalanx of Silicon Valley clichés to proclaim that his economic ideas are super-futuristic.
In a post entitled “Disrupting Washington to Unleash Innovators,” he went on and on about how liberals just want to crush innovation with their dastardly regulations, while he…well, he actually didn’t say anything about what sorts of policies he would pursue as president, other than to proclaim, “I’ve got a different view on things, and a different approach. I don’t mind disrupting the established order.” Ooo, did he say “disrupting”? How disruptive!
The truth, though, is that the president of the United States has no power to influence municipal disputes over taxi regulations, so there is approximately nothing Jeb will do as president to affect the regulations that govern Uber and other ride-sharing companies. And if you don’t feel at least somewhat ambivalent about Uber in particular, you haven’t been paying attention.
On one hand, the company provides a service that people find invaluable, and the local taxi regulations it fights against are often ridiculous (side note: despite the conservative assumption that the government “closest to the people” is the best government, it’s often local governments that are most corrupt and have the most onerous and illogical regulation). On the other hand, Uber’s leadership is apparently a bunch of arrogant jerks whose business model is built around moving into a new market, blatantly breaking the laws that restrain their ability to operate, and then trying to build pressure to get the laws changed. (Catherine Rampell lays out some of these issues well in today’s paper.)
In any case, one thing the federal government does have power over — and thus something Jeb Bush would have the ability to affect if he becomes president — is labor standards, and that’s a genuine policy dispute worth exploring. If Jeb’s right and more and more people will be earning income from companies like Uber, how should they be treated? What standards will apply to them? How are these workers going to obtain the things we ordinarily associate with a job, like health insurance, retirement savings, or paid leave?
Bush hasn’t spoken to these issues yet, but I’m pretty sure I know what his position is: the market will work everything out, and government just has to get out of the way. But we already have evidence that in some ways this approach is screwing more and more people over. It may or may not be appropriate to consider someone driving for Uber part-time to be an employee of the company, but what about a case like FedEx, which for years classified thousands of its full-time drivers as “independent contractors,” meaning the company didn’t have to pay payroll taxes or overtime, and could evade all sorts of other labor regulations? The company suffered a series of losses in court over the issue, and just settled a lawsuit by drivers in California for $228 million. Does Bush think they were in the right, and other companies should be able to just reclassify workers whenever they want?
That’s an example of what the Obama administration is trying to address with a new guidance the Labor Department just released to employers. It says in effect that you can’t just take an ordinary employee who works only for you and has all the conditions of their work controlled by you, and say, “You’re now an independent contractor” and thereby evade all your responsibilities as an employer. This kind of mis-classification has spread to all sorts of industries, with millions of employees finding themselves with fewer benefits, lower incomes, and less protection than the law says they ought to have. Hillary Clinton has endorsed the administration’s effort to crack down on mis-classification, but as of yet the Republican candidates haven’t addressed it. It’s no mystery what they’ll say, though: this is just more government meddling in the market.
There’s a lot more we should hear from Clinton on this topic and how it relates to companies like Uber, particularly since she’s the one more inclined to have government respond to the ways our economy is changing. In her economic speech Monday, she mentioned it briefly, saying: “This on-demand, or so-called gig economy is creating exciting economies and unleashing innovation. But it is also raising hard questions about workplace protections and what a good job will look like in the future.” Which is perfectly true, but it doesn’t tell us what in particular she thinks government ought to do to protect workers as the economy transforms.
I’m sure she’ll have more to say on the subject, and perhaps in response Jeb Bush can explain why government has gone too far out of its way to ensure that workers get a fair shake. Or he might even surprise us and offer a program of smart, nimble regulations that would allow innovative new models of work to flourish while still protecting people from exploitation. But until he says otherwise, we have to assume that Bush’s answer to the question of what government should do to respond to economic changes that can make workers more vulnerable is: “Nothing.”
By: Paul Waldman, Senior Writer, The American Prospect; Contributor, The Plum Line Blog, The Washington Post, July 17, 2015
“Bush ‘Woefully Misinformed’ On Overtime Policy”: The Economy, In Other Words, Is Not Bush’s Strong Suit
With Congress unwilling to pass meaningful economic measures, President Obama’s recently unveiled overtime policy is one of the year’s biggest stories on the domestic economy. Jeb Bush, not surprisingly, doesn’t like it, but he may not fully understand it, either.
To briefly recap, under the status quo, there’s an annual income threshold for mandatory overtime: $23,660. Those making more than that can be classified by employers as “managers” who are exempt from overtime rules. The Obama administration’s Labor Department has spent the last several months working on the new plan, which raises the threshold to $50,440 – more than double the current level.
The policy doesn’t just nibble around the edges; its scope includes roughly 5 million American workers. NBC’s Kristin Donnelly reported the administration’s move constitutes “the most ambitious intervention in the wage economy in at least a decade.”
Campaigning in Iowa this week, Jeb Bush said the policy would result in “less overtime pay” and “less wages earned.” The Guardian did some fact-checking.
Numerous economists attacked Bush’s statement, calling him woefully misinformed. And several studies on the rule contradict Bush’s assertion that the overtime rules would “lessen the number of people working”.
Daniel Hamermesh, a University of Texas labor economist, said: “He’s just 100% wrong,” adding that “there will be more overtime pay and more total earnings” and “there’s a huge amount of evidence employers will use more workers”.
Indeed, a Goldman Sachs study estimated that employers would hire 120,000 more workers in response to Obama’s overtime changes. And a similar study commissioned by the National Retail Federation – a fierce opponent of the proposed overtime rules – estimated that as a result of the new salary threshold, employers in the restaurant and retail industries would hire 117,500 new part-time workers.
The Economic Policy Institute’s Ross Eisenbrey added that Bush “should be embarrassed about how misinformed he was.” Noting that the Republican presidential candidate also said Obama’s policy would also prohibit many bonuses, Eisenbrey added, “All of that is exactly wrong – and pretty much nonsense.”
On a surface level, it’s problematic that Bush would flub the issue so poorly, but it’s even more significant in the context of related confusion about economic policy.
Remember, the Florida Republican remains deeply committed to 4% GDP growth – a target no president has reached in the post-WWII era – despite the fact that the number was basically pulled out of thin air.
Bush picked the growth goal because, as he sees it, four is a “round number.” The fact remains, however, that this is “backed by zero substantive analysis of any kind.”
The former governor still sees himself as some kind of economic expert, thanks to Florida’s growth in the 1990s, but as we’ve discussed before, whether Bush is prepared to admit it or not, Florida’s economic growth during his two terms was the result of a housing bubble. In fact, Paul Krugman accurately described it as “the mother of all housing bubbles – and when the bubble burst (luckily for Jeb! just after he left office) it promptly wiped out 900,000” of the 1.3 million jobs created when Bush was in the governor’s office.
The economy, in other words, is not Bush’s strong suit.
By: Steve Benen, The Maddow Blog, July 17, 2015
“Jeb Is Headed For Little Bighorn”: If You Know Neither Yourself Nor Your Enemy, You Will Always Endanger Yourself
In the Art of War, Sun Tzu provided the following wisdom:
So, it is said that if you know your enemies and know yourself, you can win a hundred battles without a single loss.
If you only know yourself, but not your opponent, you may win or may lose.
If you know neither yourself nor your enemy, you will always endanger yourself.
When it comes to Jeb Bush’s understanding of Donald Trump, let’s just say that he really doesn’t have a clue.
Now, those close to his campaign say, Bush, who has taken on the mantle of frontrunner, is bracing for the possibility of a presidential debate pile-on — with Trump leading the charge.
Gaming out how Trump — a bombastic figure who refuses to abide by the usual rules of political decorum — will present himself has become a growing subject of speculation in Bush’s world.
During one recent phone call with a political ally, Bush pointedly asked about the surging real estate mogul. What, the friend recalled the former governor wondering out loud, was behind Trump’s antics, and what was he trying to accomplish?
I don’t think Jeb is alone in being perplexed about Donald Trump’s motives for running for president, but if he doesn’t know what’s driving Trump he’s going to have a hell of a time dodging his hand grenades.
“Trump presents a challenge for Bush because he’s a hand grenade,” said Nelson Warfield, a longtime Republican strategist who has prepared a number of candidates for debates. “His people understand that and will be prepared for anything that comes their way.”
As the Aug. 6 debate grows closer, some Republicans are relishing the prospect of Trump tearing the bark off the former governor — or, at the very least, trying to trip him up. “Trump has one target and one target only,” said an adviser to a rival GOP candidate. “He’s going to bring a lawn mower for Bush.”
Maybe Trump really is best understood as a hand grenade, in which case the damage he does will be somewhat equally dispersed but will also (by random chance) injure some more than others. On the other hand, maybe Trump is better understood as a heat-seeking missile who is locked in on Jeb, and really only on Jeb. If that’s the case, he should be a little more predictable and easier to parry.
In this Politico piece, we can see that advisers to rival GOP candidates are hoping that Trump is in this latter category, and it could be that they are correct.
Now, I know that politicians will say anything and we’re fools to take many of their utterances at face value. But if Jeb believes any part of the following, he doesn’t know his party and may not even know himself:
If Trump is a danger for Bush, some close to the former governor say, he also presents opportunity. The debate will give Bush a national platform to take on Trump in strong terms, presenting himself as a mature, substantive leader who rises above toxic discourse. Bush may have hinted at that approach during a campaign stop in Iowa on Tuesday. “Whether it’s Donald Trump or Barack Obama, their rhetoric of divisiveness is wrong,” the former governor said. “A Republican will never win by striking fear in people’s hearts.”
Jeb should take a look around and even listen to himself as one Republican after another tells the public that we’re all going to die because the president has reached an agreement with Iran on their nuclear program. We’re all going to die if even one prisoner at Gitmo is brought here to stand trial or serve time. We’re all going to die if we don’t invade Iraq and take away their WMD. We’re all going to die if we don’t reinvade Iraq and now Syria to deal with ISIS. We’re all going to die if we give one inch to the commies in Korea or Vietnam or Angola or Cuba or Nicaragua.
And if we’re not going to die, then our culture and our religion are going to die. Our freedom is going to die. Our guns will be confiscated. Our children will be indoctrinated.
Striking fear into the hearts of Americans is pretty much all Fox News does, all day long, every day. There are almost two dozen Republican candidates for the presidency, and every single one of them is out there saying that our whole way of life is going to be destroyed.
Go ahead and try to find me the positive, Reaganesque messaging from these folks. I know Jeb aspires to be that guy, but he’s just not. And he’s going to get his ass kicked in the primaries if he doesn’t begin to understand why the crap Trump is pulling has launched him into a lead in the polls among Republicans.
Dubya once cracked this nut with a “compassionate conservative” gambit that was about as fraudulent as daddy’s thousand points of light. But the current mood of the Republican base is the farthest thing there is away from “compassionate.”
Does Jeb understand what made his father successful (exploiting amnestied black rapists) and his brother successful (buy duct tape, plastic sheeting, and bottled water!)?
Does he know himself and his political clan well enough to understand what needs to be done to capture the hearts of the Republican right?
Because, if he doesn’t, he will always endanger himself when he goes into these debates. And it isn’t only Trump that he needs to worry about.
He’s going to be on a stage with nine other Republicans, none of whom are under the misimpression that the base seeks “a mature, substantive leader who rises above toxic discourse” or whom believe that “the rhetoric of divisiveness is wrong.”
If Sun Tzu was right, Jeb could be headed for Little Bighorn.
By: Martin Longman, Web Editor, The Washington Monthly; Ten Miles Square, July 16, 2015
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