A False Equivalency: Don’t Blame ‘Both Sides’ For Debt Impasse
Washington has many lazy habits, and one of the worst is a reflexive tendency to see equivalence where none exists. Hence the nonsense, being peddled by politicians and commentators who should know better, that “both sides” are equally at fault in the deadlocked talks over the debt ceiling.
This is patently false. The truth is that Democrats have made clear they are open to a compromise deal on budget cuts and revenue increases. Republicans have made clear they are not.
Put another way, Democrats reacted to the “grand bargain” proposed by President Obama and House Speaker John Boehner by squawking, complaining and highlighting elements they didn’t like. This is known throughout the world as the way to begin a process of negotiation.
Republicans, by contrast, answered with a definitive “no” and then covered their ears. Given the looming Aug. 2 deadline for default if the debt ceiling is not raised, the proper term for this approach is blackmail.
Yet the “both sides are to blame” narrative somehow gained currency after Boehner announced Saturday that House Republicans would not support any increase in revenue, period. A false equivalence was drawn between the absolute Republican rejection of “revenue-positive” tax reform and the less-than-absolute Democratic opposition to “benefit cuts” in Medicare and Social Security.
The bogus story line is that the radical right-wing base of the GOP and the radical left-wing base of the Democratic Party are equally to blame for sinking the deal.
Leave aside, for the moment, the fact that in the Obama-Boehner proposal, there would be roughly three dollars’ worth of budget cuts for every dollar of new revenue. Don’t pause to ask whether it makes sense to slash government spending when the economy is still sputtering out of the worst recession in decades. Instead, focus narrowly on the politics of the deal.
It is true that House Minority Leader Nancy Pelosi howled like a blindsided politician when she learned that entitlement programs were on the table. But her objections — and those of Democrats in general — are philosophical and tactical, not absolute.
Progressives understand that Medicare and Social Security are not sustainable on their current trajectories; in the long term, both must have their revenue and costs brought into balance. Pelosi’s position is that each program should be addressed with an eye toward sustainability — not as a part of a last-minute deal for a hike in the debt ceiling that covers us for two or three years.
It’s also true that Democrats believe they can win back a passel of House seats next year by highlighting the GOP plan to convert Medicare into a voucher program. They don’t want Republicans to be able to point and say, “See, the Democrats want to cut Medicare, too.”
There’s nothing in these Democratic objections, however, that couldn’t be creatively finessed. You can claim you haven’t actually “cut” a benefit, for example, if what you’ve done is restrained the rate at which its cost will grow. You can offset spending with new revenue, and you can do so in a way that gives low-income taxpayers a break. Democrats left the door open and these options could have been explored.
The story on the Republican side is entirely different. There are ways to finesse a “no new taxes” pledge, too. Instead of raising tax rates, you close loopholes in the name of reform; you add an enhancement here, a “user fee” there, and you can manage to get the revenue you need and still claim you haven’t voted to raise taxes.
But Republicans are taking the position that not a cent of new revenue can be raised, no matter the euphemism. Some Democrats, yes, are being scratchy and cantankerous. But Republicans are refusing to negotiate at all. That’s not the same thing.
I understand why President Obama, in his news conference Monday, chided “each side” for taking a “maximalist position.” For political and practical reasons, it’s advantageous for him to be seen as an honest broker.
Meanwhile, though, the clock ticks toward Aug. 2 and the possibility of a catastrophic default becomes more real. And no one should be confused about what the president confronts: On one side, grousing and grumbling. On the other, a brick wall.
By: Eugene Robinson, Opinion Writer, The Washington Post, July 11, 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
Is Paul Ryan’s Medicare A Voucher System Or Not: Who Is Demagoguing Who?
During the White House meeting this week between President Obama and the Republican leadership, Rep. Paul Ryan took the President to task for demagoguing Ryan’s proposed Medicare changes.
According to the Congressman, the insistence on the part of the President- and his brother and sister Democrats – that the program is a voucher system rather than the ‘premium support’ program Ryan steadfastly claims the idea to be, is grossly misleading Americans, all for the purpose of political gain.
While Ryan’s confrontation with Obama brought cheers from the GOP freshman class who fill the corridors of Congress these days, the question that needs to be asked is, ”Who is demagoguing who?”
In truth, the concepts behind premium support and voucher programs are fairly close, each with a similar objective – the government helping out the beneficiary by paying a portion of a benefit, in this case an insurance premium.
Rep. Ryan likes to point out that his proposed Medicare program is the same as that employed by the Federal Employees Benefits Program and the Medicare Part D benefit that helps seniors pay for their prescription drugs. Both these programs operate using government premium support, whereby the government contributes towards the payment of the premiums charged by the private insurance carrier to the beneficiary, but makes the government’s share of the premium payment directly to the insurance company issuing the policy.
This direct payment is what is often considered the point of distinction between a voucher and premium support. In a voucher program the government gives the financial support directly to the beneficiaries who are then on their own to do what they will with the money, so long as they don’t look to the government to do anything else for them.
Using this standard alone, Rep. Ryan would have a point.
Indeed, his plan proposes seniors going to private insurers for their health care coverage with the government contributing a share of the premium charges and making the payment directly to the insurance company. This is just as the federal government does in the cases of federal employee benefits and Medicare Part D.
However, there is a more important distinction between premium support plans and vouchers.
In the plan that provides heath care benefits for federal employees, on which Ryan relies to make his premium support case, if a government employee’s premium costs go up –and they always do – the government increases the premium support in lockstep with the increased premium.
Not so with RyanCare.
Ryan’s proposal, that would turn Medicare into a private insurance program with the government providing assistance to seniors on their premium payments, limits increases in that support to the cost of living index – an amount wholly insufficient to cover the extra costs as we know that rising costs of health care and premium charges always exceed annual cost of living increases. Thus, if premiums increase (and of course they will) the costs of these increases will be shifted to our senior citizens who, in most instances, would not appear to have the ability to take on these increased costs on their fixed retirement budgets.
This, by anyone’s definition, is a voucher program.
In a recent piece by Washington Post blogger Ezra Klein, Ezra interviewed Henry Aaron of the Brookings Institute and Bob Reischauer of the Urban Institute. Messrs. Aaron and Brookings are the two gentlemen who originally came up with the term “premium support” to describe their idea for a Medicare system where the program is opened up to competition by private insurers but has safeguards built in to protect Medicare beneficiaries from the very cost shifting program the Ryan plan proposes.
While Ryan has largely adopted this model – the two originators make clear that he has done so without the key cost shifting safeguards that they believe are so essential to it working.
According to Aaron-
If one does the arithmetic, income grows a few percentage points faster than prices. Health-care spending grows faster than income by a couple of percentage points. So we’re looking at linking to an index that grows less rapidly than health-care costs by three to four percentage points a year. Piled up over 10 years, and that’s a huge erosion of coverage. It’s vouchers, not premium support.
Clearly, Ryan’s plan bears a far greater resemblance to a voucher program than the premium support programs he looks to as back up for what he is selling.
We can have a debate as to whether we would be better off turning Medicare over to the private markets. While I believe it is an idea fraught with dangerous consequences to our future seniors (those who are not yet 55 years of age), an honest debate to discuss these different ideas cannot hurt.
However, when Ryan and friends continue to play the political game of blaming the President for misleading the public when it is, in fact, Ryan who is attempting to mislead, there will be no honest debate.
It is not the President who is demagoguing on this one – it is Paul Ryan.
By: Rick Ungar, The Policy Page, Forbes, June 5, 2011
GOP Has 2012 Trouble: Attacking Medicare And Social Security Could Be Death Of Republicans’ 2012 Hopes
Recent weeks have finally defined the race for the 2012 Republican presidential nomination. The field has finally achieved a greater level of clarity as many candidates have opted out, running the absurd-to-formidable gamut from Donald Trump to Mitch Daniels. A smaller number have opted in, running the has-been to may-never-be gamut from Newt Gingrich to Tim Pawlenty, not to mention former Massachusetts Gov. Mitt Romney, who officially entered the race yesterday.
A former Minnesota governor, Pawlenty officially joined the wannabe ranks last week with a speech aimed at defining himself as a fearless teller of hard truths (previously he had perhaps best been known for lacking any definition at all). This is smart on several levels. He quickly moved to fill the void left by Daniels, the governor of Indiana, whom many in the party had yearned for as a tough-minded fiscal hawk. And in part it is a strong bid for the mantel of not-Romney, the alternative to the former Massachusetts governor and current GOP front-runner. Romney is a laughably transparent flip-flopper, so Pawlenty’s new truth-teller frame could make him an ideal foil.
Politicians love to position themselves as tellers of hard truths, brave enough to boldly level with the voters. And the current tempestuous political climate, with its roiling discontent with politics as usual, especially lends itself to such a pose. Pawlenty is merely the latest candidate to seize this meme.
But his candidacy runs squarely afoul of Robert’s 13th rule of politics: People like the idea of hard truths and hard-truth tellers much more than they like the reality of them. You can ask straight shooters like Walter Mondale (“Mr. Reagan will raise taxes, and so will I. He won’t tell you. I just did.”), Paul “I’m not Santa Claus” Tsongas, and John “Straight Talk” McCain. Winning the presidency requires an aspirational element at odds with the doom-and-gloom that comes with those self-consciously trying to speak hard truths.
So kudos to Pawlenty for standing up to big ethanol in little Iowa. But while some may take off their hats to him for traveling to Florida in order to call for overhauls (read: cuts) of Social Security and Medicare, it might be merely to scratch one’s head. As Hot Air blogger Allahpundit quipped after Pawlenty’s Florida performance, “Alternate headline: ‘Pawlenty now unelectable in not one but two early primary states.’ ”
Maybe this is actually deep strategy. Many conservatives and Tea Partyers in particular seem intent these days on—as Ronald Reagan used to complain of some of his more gung-ho supporters—going “off the cliff with all flags flying.” Perhaps this is a clever way for Pawlenty to appeal to that “I’d rather lose being right” instinct.
An additional problem for would-be hard-truth tellers is that in the telling, these so-called truths often become vehicles for an even harder ideology. The attempt to conflate serious problems with ideologically inflexible and partisan solutions can create political tensions and open deadly political rifts. See the political abyss House Budget Committee Chairman Paul Ryan has marched his colleagues into over his plan to repeal and replace Medicare.
With the future insolubility of Medicare as a starting point, Ryan and the GOP have embarked on an emphatically ideological course. They hailed themselves as seriously facing a tough issue, and they spin the plan as an attempt to save the program, but all it would save would be the name “Medicare.” A guarantee of healthcare would be replaced with a voucher of diminishing value. If it fails to cover seniors’ costs . . . tough luck. The view was perhaps best summed up by Georgia GOP Rep. Rob Woodall, who chastised a constituent at a town hall meeting last month when she asked how, after Ryan’s reforms eliminated the guarantee of Medicare, she could expect to get medical coverage since she worked for a company that doesn’t offer it in their retirement package. “Hear yourself, ma’am,” he said. “You want the government to take care of you, because your employer decided not to take care of you. My question is, ‘When do I decide I’m going to take care of me?’ ”
Woodall, like many conservatives, fails to grasp why programs like Medicare were created. They were a response to a market failure—specifically an inability of senior citizens to get or pay for healthcare. But in Woodall’s world there are apparently no market failures; if seniors can’t get healthcare it’s because they simply won’t take responsibility for themselves. Of course in 1964, 44 percent of senior citizens had no health coverage, and the cost of medical bills had driven more than one third of them below the poverty line. If only they had had the moral fiber to take care of themselves!
Safe in a heavily conservative district, Woodall can spout such nonsense. But roughly 60 House Republicans represent districts Barack Obama won in 2008 and virtually all voted for the Ryancare overhaul. In this case, the gap between hard truths and hard ideology may be big enough to swallow a House majority.
Just ask the pollsters employed by the House GOP, who warned that the bill was a ticking time bomb, Politico reported last week. Or ask Jane Corwin, that bomb’s first casualty. She is the Republican who lost May’s special election in a GOP-leaning New York district in which the Ryan plan was the defining issue. Or ask Sens. Olympia Snowe, Susan Collins, Lisa Murkowski, and Scott Brown, four of the five Senate Republicans who fled the plan last week (the fifth, Rand Paul, opposed it as not being conservative enough).
Or ask Gingrich, the former House speaker who drew party-wide opprobrium when he dismissed the Ryan plan as being so much “right-wing social engineering.” Pity poor Newt: He was just trying to tell a hard truth.
By: Robert Schlesinger, U. S. News and World Report, June 3, 2011
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GOP And Media Alert: Vouchercare Is Not Medicare
What’s in a name? A lot, the National Republican Congressional Committee obviously believes. Last week, the committee sent a letter demanding that a TV station stop running an ad declaring that the House Republican budget plan would “end Medicare.” This, the letter insisted, was a false claim: the plan would simply install a “new, sustainable version of Medicare.”
But Comcast, the station’s owner, rejected the demand — and rightly so. For Republicans are indeed seeking to dismantle Medicare as we know it, replacing it with a much worse program.
I’m seeing many attempts to shout down anyone making this obvious point, and not just from Republican politicians. For some reason, many commentators seem to believe that accurately describing what the G.O.P. is actually proposing amounts to demagoguery. But there’s nothing demagogic about telling the truth.
Start with the claim that the G.O.P. plan simply reforms Medicare rather than ending it. I’ll just quote the blogger Duncan Black, who summarizes this as saying that “when we replace the Marines with a pizza, we’ll call the pizza the Marines.” The point is that you can name the new program Medicare, but it’s an entirely different program — call it Vouchercare — that would offer nothing like the coverage that the elderly now receive. (Republicans get huffy when you call their plan a voucher scheme, but that’s exactly what it is.)
Medicare is a government-run insurance system that directly pays health-care providers. Vouchercare would cut checks to insurance companies instead. Specifically, the program would pay a fixed amount toward private health insurance — higher for the poor, lower for the rich, but not varying at all with the actual level of premiums. If you couldn’t afford a policy adequate for your needs, even with the voucher, that would be your problem.
And most seniors wouldn’t be able to afford adequate coverage. A Congressional Budget Office analysis found that to get coverage equivalent to what they have now, older Americans would have to pay vastly more out of pocket under the Paul Ryan plan than they would if Medicare as we know it was preserved. Based on the budget office estimates, the typical senior would end up paying around $6,000 more out of pocket in the plan’s first year of operation.
By the way, defenders of the G.O.P. plan often assert that it resembles other, less unpopular programs. For a while they claimed, falsely, that Vouchercare would be just like the coverage federal employees get. More recently, I’ve been seeing claims that Vouchercare would be just like the system created for Americans under 65 by last year’s health care reform — a fairly remarkable defense from a party that has denounced that reform as evil incarnate.
So let me make two points. First, Obamacare was very much a second-best plan, conditioned by perceived political realities. Most of the health reformers I know would have greatly preferred simply expanding Medicare to cover all Americans. Second, the Affordable Care Act is all about making health care, well, affordable, offering subsidies whose size is determined by the need to limit the share of their income that families spend on medical costs. Vouchercare, by contrast, would simply hand out vouchers of a fixed size, regardless of the actual cost of insurance. And these vouchers would be grossly inadequate.
But what about the claim that none of this matters, because Medicare as we know it is unsustainable? Nonsense.
Yes, Medicare has to get serious about cost control; it has to start saying no to expensive procedures with little or no medical benefits, it has to change the way it pays doctors and hospitals, and so on. And a number of reforms of that kind are, in fact, included in the Affordable Care Act. But with these changes it should be entirely possible to maintain a system that provides all older Americans with guaranteed essential health care.
Consider Canada, which has a national health insurance program, actually called Medicare, that is similar to the program we have for the elderly, but less open-ended and more cost-conscious. In 1970, Canada and the United States both spent about 7 percent of their G.D.P. on health care. Since then, as United States health spending has soared to 16 percent of G.D.P., Canadian spending has risen much more modestly, to only 10.5 percent of G.D.P. And while Canadian health care isn’t perfect, it’s not bad.
Canadian Medicare, then, looks sustainable; why can’t we do the same thing here? Well, you know the answer in the case of the Republicans: They don’t want to make Medicare sustainable, they want to destroy it under the guise of saving it.
So in voting for the House budget plan, Republicans voted to end Medicare. Saying that isn’t demagoguery, it’s just pointing out the truth.
By: Paul Krugman, Op-Ed Columnist, The New York Times, June 5, 2011
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June 6, 2011 Posted by raemd95 | Affordable Care Act, Budget, Conservatives, Consumers, Elections, GOP, Government, Health Care Costs, Health Reform, Ideologues, Ideology, Journalists, Lawmakers, Media, Medicare, Politics, Pundits, Republicans, Right Wing, Seniors, Under Insured, Uninsured, Voters | Canada, Canadian Health Care, Canadian Medicare, CBO, Comcast, Commentators, Demagoguery, Elderly, Government Health Insurance, House Republicans, Insurance Companies, Low Income, Medicare Vouchers, Out of Pocket xpenses, Politicians, Poor, Private Health Insurance, VoucherCare | Leave a comment