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“Why Republicans Are Hell-Bent On Destroying Medicare”: Belief’s That Spring From Ideological Faith, Not Facts

One way you can identify politicians’ sincere convictions is by looking at the things they do even when they know they’re unpopular. There are few better examples than the half-century-long quest by Republicans to destroy Medicare.

As we move towards the 2016 presidential election, it’s something we’re hearing about yet again. Conservatives know the Democrats will attack them for it mercilessly, and they know those attacks are probably going to work — yet Republicans keeps trying. Which is why it’s clear that they just can’t stand this program.

When Medicare was being debated in the early 1960s, one of its most prominent opponents was a certain future president, who recorded a spoken word album called Ronald Reagan Speaks Out Against Socialized Medicine. In it, he said that if the bill were to pass, “We are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.” He failed in that crusade, and ever since, conservatives have watched in pain as the program became more entrenched and more popular.

That popularity didn’t happen by accident. Medicare is popular because it gives seniors something they crave: security. Every American over 65 knows that they can get Medicare, it will be accepted by almost every health care provider, their premiums will be modest, and it won’t be taken away. On the policy level, the program is expensive, but that’s because providing health care for the elderly is expensive. It’s not because the program is inefficient; in fact, Medicare does an excellent job of keeping costs down. Its expenses for overhead (basically everything except health care) are extremely low, somewhere between 1 percent and 5 percent of what it takes in, compared to private insurance costs that can run from 10 percent to 20 percent and, in some cases, even higher. (See here for a good explanation of these figures.)

That’s not to say there’s nothing about the program that could be improved, because there certainly is. The Affordable Care Act tried to institute some Medicare reforms, including moving away from the fee-for-service model (which encourages doctors and hospitals to do as many procedures as possible) and toward a model that creates incentives for keeping patients healthy. It’s still too early to say how great an impact those changes will have. But Medicare is still in most ways the most successful part of the American health insurance system. And if you care about empirical truth, it’s impossible to argue that it’s a failure because it involves too much government.

But Republicans do argue that, and it’s a belief that springs from ideological faith, not facts. In Wednesday’s debate, Rand Paul was asked whether Reagan was right about Medicare, and he responded, “The question always is, what works better, the private marketplace or government? And what distributes goods better? It always seems to be the private marketplace does a better job. Is there an area for a safety net? Can you have Medicare or Social Security? Yes. But you ought to acknowledge the government doesn’t do a very good job at it.” Paul’s ambivalence is obvious — he grudgingly acknowledges that you can have a “safety net,” including Medicare, even as he says it’s terrible. But if that’s so, why not get rid of it entirely?

The presidential candidates who have said anything specific about Medicare all want to move in the direction of privatization, which isn’t too surprising. After all, they believe that it’s impossible for government to do anything better than the private sector, and if you can take a government program and privatize it, that’s what you should do. That’s also what new Speaker of the House Paul Ryan believes: For years he’s been touting a plan to privatize Medicare by essentially turning it into a voucher program. Instead of being an insurer for seniors as it is now, the government would give you a voucher that you could spend to buy yourself private insurance. And if the voucher didn’t cover the cost of the insurance you could find? Tough luck.

When you ask Paul Ryan about this, the first thing he’ll say is that he wants a slow transition to privatizing Medicare, one that won’t affect today’s seniors at all, so they don’t need to worry. In Wednesday’s debate, Marco Rubio made the same argument. “Everyone up here tonight that’s talking about reforms, I think and I know for myself I speak to this, we’re all talking about reforms for future generations,” he said. “Nothing has to change for current beneficiaries. My mother is on Medicare and Social Security. I’m against anything that’s bad for my mother.”

In other words: Medicare is a disaster, but we would never change it for the people who are on it and love it so much. They don’t have to fear the horror of being subject to our plan for Medicare’s future. Which is going to be great.

That contradiction is the essence of the Republicans’ Medicare problem. It’s one of the most successful and beloved social programs America has ever created, and to mess with it is to court political disaster, particularly among seniors who vote at such high rates. And its success is particularly galling, standing as it does as a living rebuke to their fervent belief that there can never be any area in which government might outperform the private sector.

But grant Republicans this: A less ideologically committed group might say, “We don’t like this program, but it’s too politically dangerous to try to undo it. So we’ll just learn to live with it.”

Republicans won’t give up. They want to undermine Medicare, to privatize it, to try in whatever way they can come up with to hasten the day when it disappears. And no matter how often they fail, they keep trying.

 

By: Paul Waldman, Senior Writer, The American Prospect; Contributor, The Week, October 30, 2015

October 31, 2015 Posted by | Medicare, Republicans, Seniors | , , , , , , , | 2 Comments

“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

July 30, 2015 Posted by | Conservatives, Jeb Bush, Medicare | , , , , , , | 1 Comment

“Republicans Can Kiss Medicare Privatization Goodbye”: GOP Has A Vice Grip On The House, A Much More Tenuous Grasp Of The Senate

For the last four years Republicans have used their small power perch in the House of Representatives to prime members for the day when they’d control the whole government. During each of those years, House Republicans passed a budget calling for vast, contentious reforms to Medicare, Medicaid, and other support programs. Republicans proposed crushing domestic spending to pay for regressive tax cuts and higher military spending, and then went further by laying out specific structural reforms to popular government spending programs.

Today they control the Senate as well, which represents significant progress toward their goal of complete control over the government. But as Republicans inch toward that goal they’re also growing less committed to their ideas.

Senate Republicans will not include detailed plans to overhaul entitlement programs when they unveil their first budget in nearly a decade this week, according to GOP sources… The GOP budget would balance in 10 years, according to GOP lawmakers familiar with the document, but it will only propose savings to be achieved in Medicare and Medicaid, without spelling out specific reforms as Ryan and House Republicans did in recent budgets.

House Republicans can proceed as they have in years past and pass a controversial budget of their own, but based on this report, it looks like the Senate isn’t inclined to reciprocate. The simplest explanation for the commitment gap is that the GOP has a vice grip on the House, but a much more tenuous grasp of the Senate. Leaving Medicare privatization out of the budget is a simple way to make life easier for embattled GOP incumbents in Wisconsin, Pennsylvania, New Hampshire, and elsewhere.

But that basic political calculation speaks to a much bigger structural impediment facing the kinds of policies conservative activists want to see. The farther and farther you zoom out from the gerrymandered districts most House Republicans represent, the more difficult it becomes to build political support for the House Republican budget. At the swing state level it’s very hard. At a national level it’s probably impossible.

Back in 2012, Republicans hoped to skip directly from controlling the House alone to controlling everything. If Mitt Romney and Paul Ryan had won, the party would’ve been well prepared to implement the kinds of policies Ryan had trained his foot soldiers in Congress to vote for. Instead, the slower process of expanding majorities has exposed basic weaknesses in their position.

In 2012, Grover Norquist could, with some authority, declare: “We are not auditioning for fearless leader. We don’t need a president to tell us in what direction to go. We know what direction to go. We want the Ryan budget…. We just need a president to sign this stuff.”

That line of thinking doesn’t hold up anymore. Can Republican presidential candidates run on privatizing Medicare if Senate candidates down the ballot can’t be seen supporting those kinds of reforms? Could they successfully spring a big entitlement devolution on the public in 2017 if they don’t campaign on it aggressively in 2016? George W. Bush tried that in 2005 and it blew up in his face. There’s no reason to think it wouldn’t play out the same way again.

 

By; Brian Beutler, The New Republic, March 16, 2015

March 18, 2015 Posted by | Federal Budget, House Republicans, Senate | , , , , , , , | Leave a comment

“The Obamacare Referendum”: Paul Ryan Is Using Shorthand Again In Selling Changes To Medicare

Did you know that on November 6, 2012, in conjunction with the national election, the United States also had a referendum on Obamacare that Republicans won? No, I didn’t, either, until Paul Ryan informed me of this, via this Think Progress report:

On Sunday morning, Rep. Paul Ryan (R-WI) stopped by Fox News Sunday to preview his new budget, which will be released in full on Tuesday. As it had the past two years, this year’s version will call for massive cuts to social service programs, including food stamps, job training, Medicaid, and Medicare. Host Chris Wallace challenged Ryan on the viability of his plan, pointing out that he wants to repeal and replace Obamacare, and, “that’s not going to happen.”

Still, Ryan insisted that he and then-running mate Mitt Romney won the election on this issue because they “won the senior vote.”

Now I think we all understand that Ryan is using some shorthand here: many Democrats hoped, and Republicans feared, that Ryan’s budget, by proposing to change Medicare from an entitlement to publicly-provided health insurance into a premium-support system, would make his party vulnerable to losses it could not manage in its old-white-folks electoral base. Instead, by a variety of means (including over two years of insanely mendacious “death-panel” demagoguery about the impact of Obamacare on Medicare, and the systematic “grandfathering” of seniors from Ryan’s proposed Medicare changes), the GOP ticket managed to promote a health care message that nicely meshed with its overall pitch to old white folks that those people along with their atheist hippie allies were threatening to take away everything good virtuous retirees had worked so hard to secure for themselves, including Medicare (which they tend to regard as an earned benefit as opposed to Obamacare’s “welfare”).

I suppose it’s understandable that Ryan would view any success in selling big changes in Medicare to old folks would represent a political ten-strike, even if he’s now having to incorporate into his budget the same Medicare savings he implicitly attacked during the campaign as a token of Obamacare’s ultimate goal of sending seniors off to euthanasia camps. But it’s still bizarre that he’s touting an incumbent president’s re-election victory as a repudiation of his most important legislative accomplishment. It’s enough to give Dick Morris hope he can come back from ridicule and disgrace and claim he was right all along in predicting a big Romney-Ryan win.

 

By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, March 11, 2013

March 11, 2013 Posted by | Medicare | , , , , , , , | Leave a comment

“Sowing Confusion”: Is There Any Limit To Mitt Romney’s Dishonesty?

The other day, David Bernstein argued that there’s been an “important tipping point” where many national media figures have come to understand that “in the Romney campaign, they are dealing with something unlike the normal spin and hyperbole.” Bernstein suggested they are realizing Romney has crossed into groundbreaking levels of dishonesty.

I wish I were as optimistic. I’d argue that much of the national media is still treating Romney’s nonstop distortions, dissembling, and outright lying as par for the course, as business as usual.

Here’s a test case: The debate over Medicare — and Romney’s embrace of the Paul Ryan plan — is about to dominate the conversation. Romney is moving to get ahead of the story by accusing Obama of being the one who would “end Medicare as we know it.” Here’s the Romney campaign’s statement this morning:

“There are two proposals on the table for addressing the nation’s entitlement crisis. Mitt Romney — along with a bipartisan group of leaders — has offered a solution that would introduce competition and choice into Medicare, control costs, and strengthen the program for future generations. President Obama has cut $500 billion from Medicare to fund Obamacare and created an unaccountable board with rationing power — all while America’s debt is spiraling out of control and we continue to run trillion-dollar deficits.

“If President Obama’s plan is to end Medicare as we know it, he should say so. If he has another plan, he should have the courage to put it forward.”

The claim that Romney supports a solution favored by a “bipartisan group of leaders” is a reference to the plan authored by Ryan and Dem Senator Ron Wyden. The idea that this represents “bipartisan” suppport is laughable. But this type of claim is made on both sides, so put it aside.

More interesting is the assertion that Obama has “cut $500 billion from Medicare” and created an “unaccountable board with rationing power” even as the deficit is “spiraling out of control.” That’s a reference to Obamacare’s efforts to curb spending with $500 billion in savings that are actually wrung from health care providers, not Medicare beneficiaries. That “unaccountable board,” meanwhile, is a reference to the Independent Payment Advisory Board, which is designed to make recommendations for reducing Medicare costs, and explicitly cannot recommend rationing.

Get the trick here? The Romney campaign is accusing Obama of slashing Medicare, and hence “ending Medicare as we know it,” while simultaneously accusing him of failing to curb entitlement spending in ways that pose grave danger to the nation’s finances. This, even as Romney has endorsed a plan that would quasi-voucherize Medicare and end the program as we know it.

This is all about muddying the waters in advance of a debate that could cut badly against Romney. The GOP primary forced him to embrace Ryancare; Dems are going to hammer him over it. So the Romney camp is trying to get out front by blurring lines and sowing confusion over who actually is defending traditional Medicare and who would end the program’s fundamental mission as we know it. The question is whether this, too, will be treated as just part of the game.

By: Greg Sargent, The Washington Post, The Plum Line, March 12, 2012

March 13, 2012 Posted by | Affordable Care Act, Medicare | , , , , , , , | Leave a comment

   

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