The Untold Medicare Improvement
My Fiscal Times column today looks at the latest Medicare trustees report. It shows an enormous improvement in Medicare’s finances due to passage of the Affordable Health Care Act. Oddly, the Obama administration seems reluctant to take credit for this improvement, apparently because an accompanying memo from Medicare’s actuaries predicted that Congress would increase payments to health care providers.
What everyone apparently has missed is that the problem identified by the actuaries was part of the law when last year’s report was prepared. Therefore, all of the savings shown in this year’s report compared to last year’s report are still perfectly valid. They have nothing to do with the problem identified in the actuaries’ memo.
I also note that the actuaries’ memo is really a stake in the heart of Paul Ryan’s Medicare reform plan. The actuaries are saying that it is so unlikely that Medicare cuts already in law will be implemented that they should just be ignored. But Ryan would impose far more Draconian cuts. How likely is it that they would be implemented even if they could ever be enacted into law (which is politically impossible anyway)? The actuaries are basically saying that the chances are zero.
Bookmark/Search this post with
Republicans and Health Care
I don't believe the purpose of Paul Ryan's 'Roadmap' is to ever have it implemented. I think the only purpose is to have a large pile of paper with tables and figures in it that Republicans can point to and tell people that they have a plan to implement their free-market utopia.
Look at the recent history of helath care reform. In 1993 Republicans had several helath care 'plans' that they touted as superior to Clinton's. In 2000, George Bush trotted out a health care 'plan' that he claimed would solve all our problems. But when Republicans took control of government for 6 years, nothing, nada, zilch. Then when Democrats take back control suddenly Republicans are full of great ideas again.
If the Republicans had done nothing
we would be way ahead of the game. Instead, they made Medicare's finances far worse by enacting Part D with no financing whatsoever.
Great Ideas
And the plan that the Democrats passed is essentially the same thing the Republicans proposed in 1993 (and Romneycare), except now it's a socialist plot to kill your grandmother. The Heritage Foundation has been lobbying for an Exchange+Subsidies+Individual Mandate plan for 20 years -- right up until the moment it became the primary avenue for reform, and then it became an unconstitutional assault on liberty.
Probably the most important blog posting of the year
and almost no commentary on it. Too bad there isn't a FOX News for truthful, profound analysis, where analysis like this could get 24/7 coverage.
why don't the Democrats
why don't the Democrats simply repeal Part D then, Bruce?
Because it's like all (most) entitlements
People, and in particular the over-65 set, want the benefits from all their entitlements, they just don't want to pay the costs. Now that they have their prescription drug coverage it would be political suicide to try and take it away from them.
Should there be a medication entitlement in Medicare? That's a cost vs. benefit question that can and should be debated, with the final outcome dependant on what our society is willing to pay for. But, as Bruce has repeatedly pointed out, the Republicans didn't even consider the costs, they just wanted the benefits as a political handout to the elderly. Even worse, they structured the program so the medications are largely bought at inflated prices, a complete and disgusting sop to big pharma. Part of "fiscal responsibility" indeed.
Baffled
I am baffled. If the political reality is that Medicare and Social Security are too popular to ever be dramatically overhauled or repealed, why is it constantly in play in the media?
"Oh, we'd be high on the hog if it twernt fer that narsty Medicare and Social Security. Too bad everyone likes them so much."
I think that wraps up just about everything I've read and heard on the subject for the past couple years. If doing ANYTHING except expanding those programs is polically inconceivable, why even mention it? Wouldn't it be more reasonable to spend time figuring out how to get the deficits under control by ways that ARE politically feasible?
One final point, I'm under the impression that Social Security is solvent for a couple more decades at least with no changes. With a slight tweak to the cap it holds its own and remove the cap it becomes profitable. Also, SS does not add to the deficit. Am I wrong?
Medicare is a hairier deal, but it is good to see that the rhetoric spewed by the Obama Administration and the Dems in Congress are now being shown to be fact-based in practice. Too bad they seem to be deer caught in the headlights at the moment and are incapable of capitalizing on this little bit of good news.