Undoing Medicare: The Real 'Death Tax'

James Fallows wrote a blistering criticism of the Paul Ryan BUDGET FRAUD. He has come back to the Ryan FRAUD for more.

We can't let up. We have to keep at it, and I'm going to try and do my part.
A FRAUD is a SCAM is a SHAM.

THAT is Paul Ryan and his Budget.

From James Fallows:

Undoing Medicare: The Real 'Death Tax'


From my days as a school kid I remember the original debate over creating Medicare. At the time, my dad -- a small-town doctor and at that stage a conservative -- was, like most doctors and the AMA as a whole, strongly against the plan, as a step toward "socialized medicine." After all, when his patients couldn't pay, he found ways to reduce or forgive their fees. The opposing argument, which in the long run convinced nearly everyone (including the AMA, and my father) was that leaving older people exposed to the threat of open-ended and potentially ruinous medical expenses, or dependent on individual doctors' charity, was harmful all around.

Controlling the open-endedness of medical spending is of course a major public and private challenge. To repeat: "bending the curve" of health-care expenses is absolutely necessary. But until recently it had been taken as settled wisdom, on both policy and political grounds, that insuring people against the risk of complete financial ruin from late-in-life medical expenses left everyone better off. Old people, their families, doctors and the medical system too. Our health care system is out-of-control and unsustainable in countless ways. But very rarely has anyone argued that removing universal coverage for older people would make things better rather than worse.



That's the understanding being challenged by Rep. Paul Ryan's "serious" budget plan. I've been trying to find the way to convey what it would mean to go back to the pre-Medicare era in which each family had to prepare for unknowably large late-in-life expenses. Merrill Goozner, on his GoozNews site, has just now put it in the way I was looking for. He writes (emphasis added):

Here's the real argument young and middle-aged people need to hear, and the real reason why the "more skin in the game" argument can never work for seniors or other vulnerable populations, including them when they reach that age. Seniors and the poor account for over half of health care spending. Within those groups, 5 percent of the population accounts for 50 percent of health care costs; and 20 percent of the population accounts for about 80 percent. These costs come for the most part at times when economic incentives have no influence at all on medical decision-making: in medical crises; in treating chronic conditions; and, for most Medicare patients, in the last six months of life.

That's why a voucher program for Medicare, which will shift an increasing share of those inevitable costs onto the elderly themselves, can fairly be categorized as a 100 percent estate tax or death tax. People under 55 need to know that if the plan crafted by Rep. Paul Ryan were passed, most of them will never have a cent to leave to their children. It will all go to the health care industry to support the American way of dying.

Here's a bit of real world evidence supporting that view: Why is the savings rate so unbelievably high in China -- as much as 50 percent of the GDP? There are many reasons, crucially including exchange-rate policy. But a very powerful individual motivator is each family's knowledge that there is no Medicare-like system for their older members. Health care is on cash-payment basis there, and so every family must save like crazy against the risk that the parents or grandparents will require very expensive late-in-life care. More savings would be good for America, but that's not the right way to induce them. It's hard to believe that the Republicans will seriously embrace a plan to undo Medicare.
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UPDATE: Two points I thought of making, but skipped, earlier today.

1) If one major goal is containing overall health spending, it is flat-out delusional to think that older people, in their role as patients or individual purchasers of insurance policies, can be more effective negotiators than Medicare in its entirety dealing with the health system as a whole.

Doctors gripe about Medicare, but they hardly love the private insurers. And every bit of real-world evidence suggests that private insurers are worse at containing total costs, and of course administrative overhead, than Medicare or especially the VA. I won't give all the details now, but Phillip Longman on the VA is a great place to start. Moreover, the people shopping for insurance will be in a terrible position: older, retired, many or most with preexisting conditions. In short, if you want to "bend the curve" of medical spending, this is exactly the wrong way to do it.

2) If another major goal is reducing the non-purely-economic costs and anxiety of disease and treatment, then this is also a terrible idea. It means that, potentially, every older person, plus his or her family, must factor in a risk they're not now exposed to: the "what if??" of absolutely ruinous medical costs.

In short: the overall economic price tag for medical care is likely to go up under this plan; and the number of people who will have to live with worry about ruinous medical bills will be much greater. This is part of the reason why, until very recently, no "serious" person proposed getting rid of Medicare.

More Voter Suppression Activity From the GOP- this time in KANSAS

hat tip -3CHICSPOLITICO:

Here's the latest bit of Voter Suppression from the GOP...this time in KANSAS:

Voter ID now Kansas law
Posted: April 18, 2011 - 3:49pm
By Tim Carpenter
THE CAPITAL-JOURNAL

Gov. Sam Brownback made a fixture of Kansas politics Monday requirements voters present proof of citizenship and photograph affirmation of their identity as the price of participating in elections.

The measures were long championed by conservatives who expressed apprehension that unauthorized voters were distorting elections through fraudulent means. The rules could spark a legal challenge from voters who feel disenfranchised by the new hurdles to electoral participation.

"I think these are reasonable steps to protect the rights of our citizens," Brownback said at the Statehouse.

Brownback long ago endorsed the voter ID and citizenship provisions incorporated into House Bill 2067.

Secretary of State Kris Kobach is credited with raising profile of the issue during his successful campaign in 2010. He said the Kansas legislation uniquely combined picture IDs for in-person voting, photo and signature security protections for advance balloting and proof of citizenship.

"No other state in the union does as much to secure the integrity of the voting process," Kobach said. "If you want the Cadillac of voter security, the Kansas model is the way to go."

The photo ID requirement will take effect Jan. 1.

Starting in 2013, anyone registering to vote for the first time in Kansas will have to provide proof of their U.S. citizenship, such as a birth certificate or passport, though a Kansas driver's license could suffice for many.

This is all about VOTER SUPPRESSION - PLAIN AND SIMPLE. Right in time for the 2012 election.






Rachel Maddow tells it like it is about this, pointing out that Kansas doesn't have the infrastructure to even do the checks on the people, electronically the way the other state that has proposed this does. It's ass backwards, and knows damn well, that they don't have the capability of checking all these folks, so, of course, if they can't be checked, they can't be approved to vote.

Visit msnbc.com for breaking news, world news, and news about the economy

Heads Up To All the Senior Citizens Who Fell for the GOP Lies about ObamacareS - get ready, because they're coming after MEDICARE

And, only because I know that there are plenty of Senior Citizens who weren't stupid enough to believe the GOP Lies About OBAMACARES, well, here's the payback for your idiocy:

The Republicans want to PRIVATIZE MEDICARE.

Let me repeat that to you.

THE REPUBLICANS WANT TO PRIVATIZE MEDICARE.

From the Wall Street Journal:

GOP Aim: Cut $4 Trillion
Budget Plan Would Transform Medicare, Reset Budget Debate; Democrats Balk.

By NAFTALI BENDAVID
Republicans will present this week a 2012 budget proposal that would cut more than $4 trillion from federal spending projected over the next decade and transform the Medicare health program for the elderly, a move that will dramatically reshape the budget debate in Washington.

The plan would essentially end Medicare, which now pays most of the health-care bills for 48 million elderly and disabled Americans, as a program that directly pays those bills. Mr. Ryan and other conservatives say this is necessary because of the program's soaring costs. Medicare cost $396.5 billion in 2010 and is projected to rise to $502.8 billion in 2016. At that pace, spending on the program would have doubled between 2002 and 2016.

Mr. Ryan's proposal would apply to those currently under the age of 55, and for those Americans would convert Medicare into a "premium support" system. Participants from that group would choose from an array of private insurance plans when they reach 65 and become eligible, and the government would pay about the first $15,000 in premiums. Those who are poorer or less healthy would receive bigger payments than others.

The proposal would also convert Medicaid, the health program for the poor, into a series of block grants to give states more flexibility. And it is expected to suggest significant cuts in Social Security, while proposing fewer details on how to achieve them.

The federal government expects to spend about $275 billion in 2011 on Medicaid, the program that provides medical care to the poor and disabled, up from $117.9 billion in 2000. The Congressional Budget Office projects Medicaid spending will roughly double by 2021.

Now, these mofos want to continue with their UNPAID TAX CUTS FOR THE RICH, but somehow, I'm supposed to just ' trust' them on GIVING VOUCHERS FOR MEDICARE?



Anyone who has any relationship with an elderly person knows that it's a series of medical mishaps, one after the other. When one medical problem is solved, here is another. And, what about our elderly who have CHRONIC DISEASES, such as diabetes, hypertension, etc. There are multiple doctors involved in the care of said Senior Citizen.

My mother had diabetes. On top of having a Primary Care doctor, she also had an Endocrinologist, you can't go to a regular podiatrist, you have to go to one that specializes in diabetic patients; because she has diabetes, that brought on the possibility of glaucoma, and had to go to an optomotrist who deals with diabetic patients. As she aged, further ' complications' from diabetes revealed themselves, and thus, new doctors.

WHEN, and in WHAT WORLD, do the Elderly see FEWER doctors as they AGE?

Don't be suckered in by the 10 year plan.

Unless your behind believes you're going to DIE within the next 10 years, that means, in 10 years, your 10 year older self, will be thrown out to the wolves.

What happens when your voucher runs out?

Who has more power, millions upon millions of Seniors in one pool, or you, going from doctor to doctor, worrying about squeezing the most bang for your buck, when all you should be worrying about is if your elder is getting the right treatment for their PRESENT medical issue....because, you know another one will be coming down the block.

I found this excellent comment on another board:

What private medical insurance market for seniors? It never existed, and never will. They have the worst pre-existing condition of all... they are seniors. There is no profit in insuring the health of people who are guaranteed to have medical issues. What Medicare really is as much as anything is a medical Sam's club. It using purchasing power to reduce the costs of the people it covers. Without that, there is no cost containment.

That's EXACTLY what Medicare is, and why it's been so successful. Also, because it's a FEDERAL Program, the states are not able to mess with the Seniors the way that they are the poor on Medicaid. That purchasing power, or the Government's unwilingness to use it with MEDICARE PART - D, is what it's worst critics have against the program.

If you are 50 years or older - THIS CONCERNS YOU. It should be at the front of your mind.

EVERY MEMBER of Congress, should be FORCED to find healthcare coverage in the PRIVATE HEALTH INSURANCE MARKET.

Every last one of them.

Let's see how they make it being thrown out into the wolves at the mercy of the health insurance industry.

from Talking Points Memo:

Bring on the Bamboozlement
Josh Marshall | April 4, 2011, 11:51AM
As House Republicans cue up their Medicare Phase-out legislation, we're about to be treated, once again, to an example of how political actors use press cowardice to deceive the public. Rep. Paul Ryan's plan, which is now the official Republican plan, phases out Medicare over 10 years. Yet you'll be treated to numerous articles that call this a 'reform' or 'overhaul' or even 'saving' Medicare. But each are no better than straight outright deceptions, whether by design or ignorance.

The Medicare system has been in place in the United States for a bit more than 40 years. The premise is simple: once you hit retirement age you move into a single payer health care insurance system in which Medicare takes responsibility for your care, regardless of the state of your health or income level. There are copays. No one's crazy about exactly how much is covered. Some doctors opt out. You've probably heard all of this at one point or another. But the key is that you're in the program. And for the rest of your life you're out of the private health insurance system. You're covered. Permanently and on the same terms as everyone else.

Now, this isn't just a good thing if you're a senior or have parents who are seniors or have anyone in your life who's a senior, which presumably means virtually everyone. It's also just necessary for pretty obvious reasons.

We all know about pre-existing conditions. You're a cancer survivor so no insurer will cover you. Or you have one of the myriad possible conditions that make you a bad risk. And no insurer wants to issue a policy for someone who odds say is likely to cost a lot of money. Well, guess what, people over 65 all have a preexisting condition: they're old!

..............................
Now, you might say, how is it that the President's health care reform has managed to ban insurers from denying coverage to people with pre-existing conditions? Well, good question. But there's a straightforward answer. Most younger and working age people don't have chronic health problems. So if you can make sure that everybody is in the health care system -- that's what the mandate is about -- you have enough revenues from premiums to offset the very high costs of the relatively small number with chronic conditions. But the same approach won't work with seniors. Because, again, as a group old people just aren't healthy enough. There are complicated health care economics ways of explaining it. But do the math. It's obvious.

The Ryan plan is to get rid of Medicare and in place of it give seniors a voucher to buy health care insurance from private insurers. Now, what if you can't buy as much as insurance or as much care as you need? Well, start saving now or just too bad.

Now, by any reasonable standard, that's getting rid of Medicare. Abolishing Medicare. Phasing it out. Whatever you want to call it. Medicare is this single payer program that guarantees seniors health care, as noted above. Ryan's plan pushes seniors into the private markets and give them a voucher. That's called getting rid of the program. There's simply no ifs or caveats about. That's not cuts or slowing of the growth. That's abolishing the whole program. Saying anything else is a lie.

Absolutely. This no damn ' REFORM'. Call it for what it is.

THEY ARE TRYING TO DESTROY MEDICARE.

You want DEATH PANELS?

How long do you think Senior Citizens will last against the Private Insurance Industry?

COME ON.

If you know a Senior Citizen, if you love one, this is a stand you must take. Call these mofos out for what they are attempting to do.

There are those with a Lord of the Flies mentality, who see nothing wrong with what Ryan is proposing to do.

I happen to not share that mentality, and I think it's fine that the government helps our elders not be mired in poverty (Social Security), and will give them access to healthcare. I think every citizen should have access to healthcare.

They'd crawl over open glass to defend tax cuts for the top 2% in this country, but they'd throw my Mama and yours into the street and tell them - tough shyt- trying to get the medical help that they need.

From Ezra Klein:

What Paul Ryan’s budget actually does
By Ezra Klein
Paul Ryan’s plan for Medicare and Paul Ryan’s plan for Medicaid rely on the same bait-and-switch: They use a reform to disguise a cut.
In Medicare’s case, the reform is privatization. The current Medicare program would be dissolved and the next generation of seniors would choose from Medicare-certified private plans on an exchange. But that wouldn’t save money. In fact, it would cost money. As the Congressional Budget Office has said (pdf), since Medicare is cheaper than private insurance, beneficiaries will see “higher premiums in the private market for a package of benefits similar to that currently provided by Medicare.”
………………..

In both cases, what saves money is not the reform. It’s the cut. For Medicare, the cut is that the government wouldn’t cover the full cost of the private Medicare plans, and the portion they would cover is set to shrink as time goes on

Other articles you should read:

ARROGANT, OUT-OF-TOUCH ELITIST

How The GOP Plan To Kill Medicare And Medicaid Would Work

GOP Wants to Kill Me (and You)

The 2022 Medicare Crisis

The Courageous, Serious, Gutsy Paul Ryan[snark]

Phase Out Credibility