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
Medicare Saves Money: Ensuring Health Care At A Cost The Nation Can Afford
Every once in a while a politician comes up with an idea that’s so bad, so wrongheaded, that you’re almost grateful. For really bad ideas can help illustrate the extent to which policy discourse has gone off the rails.
And so it was with Senator Joseph Lieberman’s proposal, released last week, to raise the age for Medicare eligibility from 65 to 67.
Like Republicans who want to end Medicare as we know it and replace it with (grossly inadequate) insurance vouchers, Mr. Lieberman describes his proposal as a way to save Medicare. It wouldn’t actually do that. But more to the point, our goal shouldn’t be to “save Medicare,” whatever that means. It should be to ensure that Americans get the health care they need, at a cost the nation can afford.
And here’s what you need to know: Medicare actually saves money — a lot of money — compared with relying on private insurance companies. And this in turn means that pushing people out of Medicare, in addition to depriving many Americans of needed care, would almost surely end up increasing total health care costs.
The idea of Medicare as a money-saving program may seem hard to grasp. After all, hasn’t Medicare spending risen dramatically over time? Yes, it has: adjusting for overall inflation, Medicare spending per beneficiary rose more than 400 percent from 1969 to 2009.
But inflation-adjusted premiums on private health insurance rose more than 700 percent over the same period. So while it’s true that Medicare has done an inadequate job of controlling costs, the private sector has done much worse. And if we deny Medicare to 65- and 66-year-olds, we’ll be forcing them to get private insurance — if they can — that will cost much more than it would have cost to provide the same coverage through Medicare.
By the way, we have direct evidence about the higher costs of private insurance via the Medicare Advantage program, which allows Medicare beneficiaries to get their coverage through the private sector. This was supposed to save money; in fact, the program costs taxpayers substantially more per beneficiary than traditional Medicare.
And then there’s the international evidence. The United States has the most privatized health care system in the advanced world; it also has, by far, the most expensive care, without gaining any clear advantage in quality for all that spending. Health is one area in which the public sector consistently does a better job than the private sector at controlling costs.
Indeed, as the economist (and former Reagan adviser) Bruce Bartlett points out, high U.S. private spending on health care, compared with spending in other advanced countries, just about wipes out any benefit we might receive from our relatively low tax burden. So where’s the gain from pushing seniors out of an admittedly expensive system, Medicare, into even more expensive private health insurance?
Wait, it gets worse. Not every 65- or 66-year-old denied Medicare would be able to get private coverage — in fact, many would find themselves uninsured. So what would these seniors do?
Well, as the health economists Austin Frakt and Aaron Carroll document, right now Americans in their early 60s without health insurance routinely delay needed care, only to become very expensive Medicare recipients once they reach 65. This pattern would be even stronger and more destructive if Medicare eligibility were delayed. As a result, Mr. Frakt and Mr. Carroll suggest, Medicare spending might actually go up, not down, under Mr. Lieberman’s proposal.
O.K., the obvious question: If Medicare is so much better than private insurance, why didn’t the Affordable Care Act simply extend Medicare to cover everyone? The answer, of course, was interest-group politics: realistically, given the insurance industry’s power, Medicare for all wasn’t going to pass, so advocates of universal coverage, myself included, were willing to settle for half a loaf. But the fact that it seemed politically necessary to accept a second-best solution for younger Americans is no reason to start dismantling the superior system we already have for those 65 and over.
Now, none of what I have said should be taken as a reason to be complacent about rising health care costs. Both Medicare and private insurance will be unsustainable unless there are major cost-control efforts — the kind of efforts that are actually in the Affordable Care Act, and which Republicans demagogued with cries of “death panels.”
The point, however, is that privatizing health insurance for seniors, which is what Mr. Lieberman is in effect proposing — and which is the essence of the G.O.P. plan — hurts rather than helps the cause of cost control. If we really want to hold down costs, we should be seeking to offer Medicare-type programs to as many Americans as possible.
By: Paul Krugman, Op-Ed Columnist, The New York Times, June 12, 2011
Mitt Romney’s Flawed View Of Freedom
The bales of hay were stacked strategically in the hope that they’d make it into the television screen. The sturdy white barn nearby provided an image worthy of a Christmas card, the symbol of a solid, calm, industrious and confident country. The slogan behind the candidate, “Believe in America,” did not invite debate.
Whatever the punditocracy may have made of Mitt Romney’s formal announcement of his presidential candidacy last week, we could all give the guy credit for trying to reassure us that not everything in politics has changed.
In an age of media flying circuses where you never know who is running for president and who is just trying to boost book sales and speaking fees, Romney did it the old-fashioned way. He really, really wants to be president, and he offered pretty pictures to encourage us to watch him saying so. It was the venerable liturgy of our civil religion.
Unfortunately for Romney, he barely got his moment in the sun because dark clouds rolled in. Sarah Palin and Rudy Giuliani showed up in New Hampshire on the former Massachusetts governor’s magical day, underscoring why Romney is plagued by the word “putative,” which almost always appears before “front-runner.”
But Romney’s travails are about more than the man himself. They speak to the
condition of a party that won’t let him embrace his actual record and constantly
requires him — and all other Republicans — to say outlandish things.
Romney’s greatest political achievement, the Massachusetts health-care law, was a genuinely masterful piece of politics and policy. The New Yorker’s Ryan Lizza recently wrote a superb article about how Romney got the plan passed. The campaign should be
reproducing the article in bulk. Instead, Romney’s lieutenants will pray that Republican primary voters never read the story. Working with those horrid Democrats to pass any sort of forward-looking government program is now forbidden.
When Romney spoke at Doug and Stella Scamman’s Bittersweet Farm, he was guarded in talking about his health plan, saying he “hammered out a solution that took a bad situation and made it better. Not perfect, but it was a state solution to our state’s
problem.” The crowd gave him modest cheers when he got to the part about health
care being a state problem.
But he received what was, by my reckoning, his loudest response when he pledged “a complete repeal of Obamacare.” That’s where the GOP heart is, and Palin and Giuliani both got into most of the Romney announcement stories by bashing him on health care. When you’re forced to tiptoe around your accomplishments, it’s no wonder you get accused of shifting your shape.
Yet it was Romney himself who exposed contemporary conservatism’s core flaw.
“Did you know,” he asked, “that government — federal, state and local — under
President Obama, has grown to consume almost 40 percent of our economy? We’re
only inches away from ceasing to be a free economy.”
Actually, the federal government of which Obama is in charge “consumes” about a quarter of the economy — and this after a severe recession, when government’s share
naturally goes up.
But even granting Romney his addition of spending by all levels of government, the notion that we are “inches away from ceasing to be a free economy” is worse than absurd. It suggests that the only way we measure whether an economy and a country are “free” is by toting up how much government spends.
Are we less “free” because we spend money on public schools and student loans, Medicare and Medicaid, police and firefighters, roads and transit, national defense and environmental protection? Would we be “freer” if government spent zero percent of the economy and just stopped doing things?
Romney, presumably, doesn’t think this, but the logic of what he said points
in exactly that direction. We thus confront in 2012 nothing short of a fundamental argument over what the word “freedom” means. If freedom, as the conservatives seem to insist, comes down primarily to the quantity of government spending, then a country such as Sweden, where government spends quite a lot, would be less “free” than a right-wing dictatorship that had no welfare state and no public schools — but also didn’t allow its people to speak, pray, write or organize as they wish.
Many of us “believe in America” because we believe its history shows that our
sacred liberties are compatible with a rather substantial government that invests in efforts to expand the freedom from want, the freedom from fear, the freedom from unfair treatment and the freedom to improve ourselves. That, as the politicians like to say, is what this campaign is all about.
By: E. J. Dionne, Opinion Writer, The Washington Post, June 6, 2011
Slow Learners: Social Security Privatization Still A GOP Goal
Congressional Republicans have faced all kinds of heat recently for their misguided campaign to end Medicare and replace it with a privatized voucher system. It’s tempting to think the GOP would not only back away from this crusade, but would also learn a valuable lesson about Americans’ appreciation for bedrock domestic social programs.
Alas, that’s not the case. A few days ago, Rep. Pete Sessions of Texas, a member of the House Republican leadership, unveiled the “Savings Account For Every American Act,” which would allow Americans to withdraw from the Social Security system and opt into a privatized system.
Of course, with Social Security functioning as a pay-as-you-go program, if workers “opt out” of the system, Social Security would either (a) crumble with insufficient funds; or (b) need Congress to spend more money to make up the difference. How would Sessions address this? By all appearances, he hasn’t thought that far ahead.
Democrats, not surprisingly, were only too pleased yesterday to go on the offensive.
Democratic Congressional Campaign Committee Chairman Steve Israel (D-N.Y.) on Tuesday predicted that House Republican plans to let workers opt out of Social Security would fail as voters realize how it will threaten their retirement.
“Seniors who have paid into Social Security through a lifetime of hard work shouldn’t end up in a risky privatization scheme to gamble their retirement on Wall Street,” Israel said. “The public has rejected this kind of Social Security privatization in the past and will again.”
Israel accused Republicans of looking to resolve the government’s fiscal crisis by scaling back Medicare and Social Security, while ignoring higher corporate taxes.
In fairness, I should note that “Savings Account For Every American Act” (or, “SAFE Act”) isn’t exactly on a fast track to the House floor. After being introduced late last week the bill, H.R.2109, has an underwhelming six co-sponsors. That’ll likely increase, but Social Security’s supporters probably don’t need to leap into action to defeat the bill just yet.
Still, there’s something truly amazing about the fact that any Republican officials would pursue this at all. The American mainstream has shown, over and over again, that Social Security privatization is a non-starter. The very idea pushed Bush’s presidency into a downward trajectory in 2005, and it never recovered. Even Paul Ryan, when shaping the radical House GOP budget plan, left Social Security out of the equation.
For that matter, after the economy crashed in 2008, I assumed it’d be a long while until Republicans started talking up Social Security privatization again.
Perhaps Pete Sessions and his cohorts are slow learners?
I suppose the real fun would be putting the Republican presidential field on the spot. “Mr. Romney, a member of the House Republican leadership is pushing legislation to privatize Social Security. If such a bill reached your desk as president, would you sign it?”
Inquiring minds want to know.
Update: One of the six co-sponsors is Republican Caucus Chairman Jeb Hensarling of Texas. This is relevant because it means two members of the GOP leadership are on board with this proposal.
By: Steve Benen, Contributing Writer, Washington Monthly-Political Animal, June 8, 2011
Conservative Newspeak?: Grover Norquist Compares GOPers Who Support Lifesaving Health Care Programs To Cancer cells
In the annals of Orwellian Newspeak, Grover Norquist, president of the libertarian group Americans for Tax Reform, may have established a new precedent for what kind of logic-defying propaganda is accepted in our political discourse — and for what journalists will uncritically reprint sans context or question.
In Monday’s Washington Post story on how deep the anti-tax fervor runs inside the Republican Party, Norquist is quoted criticizing three Republicans, including Sen. Tom Coburn (Okla.), for considering anything other than cutting government programs like Medicare and Medicaid as a solution to the national debt. As the Post reports it (emphasis mine):
The work of reducing the national debt must be done entirely by shrinking government, he said. Any compromise that includes taxes would hinder that goal and taint the Republican brand.
Norquist compared Coburn, the most outspoken of the Senate trio, to a “malignant” cell in the body politic. “So,” Norquist said, “we use chemo and radiation to protect all the healthy cells around it, so it doesn’t grow and metastasize.”
That’s right, Norquist is unequivocally saying that efforts to preserve health care programs like Medicare and Medicaid that often use chemo and radiation to cure cancer — these efforts are, in fact, the real malignant cancer that require chemo and radiation to kill.
Orwell long ago warned of a political system that would insist with a straight face that “war is peace, freedom is slavery and ignorance is strength.” But my guess is that he never envisioned one of the leaders of a major political party claiming that curing cancer is actually cancer — and my guess is that he certainly never envisioned one of the world’s leading newspapers printing that allegation without at least questioning it’s logic.
By: David Sirota, Contributing Writer, Salon, June 6, 2011
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