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Medicare (Read 226 times)
WebsterMark
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08/22/12 at 04:37:31
 
Great piece out of the New York Times this morning that I think sums up the thought process many people will go through over the next couple of months.

You look at the Obama-Biden ticket. You like them personally. But you’re not sure what they want to achieve over the next four years. The country needs big changes, and they don’t seem to be offering many. Where’s the leadership?

In this disaffected frame of mind, you ask yourself: What really matters in this election? Well, the big issue is national decline. How can we ensure that the U.S. is as dynamic in the 21st century as it was in the 20th?

The biggest the theat to national dynamism is spending money on the wrong things. If you go back and look at the federal budgets during the mid-20th century, you see that they spent money on the future — on programs like NASA, infrastructure projects, child welfare, research and technology. Today, we spend most of our money on the present — on tax loopholes and health care for people over 65.

A study by Jessica Perez and others at the group Third Way lays out the basic facts. In 1962, 14 cents of every federal dollar not going to interest payments were spent on entitlement programs. Today, 47 percent of every dollar is spent on entitlements. By 2030, 61 cents of every noninterest dollar will be spent on entitlements.

Entitlement spending is crowding out spending on investments in our children and on infrastructure. This spending is threatening national bankruptcy. It’s increasing so quickly that there is no tax increase imaginable that could conceivably cover it. And, these days, the real entitlement problem is Medicare.

So when you think about the election this way, the crucial question is: Which candidate can slow the explosion of entitlement spending so we can devote more resources toward our future?

Looking at the candidates through this prism, you see that President Obama deserves some credit for taking on entitlement spending. He had the courage to chop roughly $700 billion out of Medicare reimbursements. He had the courage to put some Medicare eligibility reforms on the table in his negotiations with Republicans. He created that (highly circumscribed) board of technocrats who might wring some efficiencies out of the system.

Still, you wouldn’t call Obama a passionate reformer. He’s trimmed on the edges of entitlements. He’s not done anything that might fundamentally alter their ruinous course.

When you look at Mitt Romney through this prism, you see surprising passion. By picking Paul Ryan as his running mate, Romney has put Medicare at the center of the national debate. Possibly for the first time, he has done something politically perilous. He has made it clear that restructuring Medicare will be a high priority.

This is impressive. If you believe entitlement reform is essential for national solvency, then Romney-Ryan is the only train leaving the station.

Moreover, when you look at the Medicare reform package Romney and Ryan have proposed, you find yourself a little surprised. You think of them of as free-market purists, but this proposal features heavy government activism, flexibility and rampant pragmatism.

The federal government would define a package of mandatory health benefits. Private insurers and an agency akin to the current public Medicare system would submit bids to provide coverage for those benefits. The government would give senior citizens a payment equal to the second lowest bid in each region to buy insurance.

This system would provide a basic health safety net. It would also unleash a process of discovery. If the current Medicare structure proves most efficient, then it would dominate the market. If private insurers proved more efficient, they would dominate. Either way, we would find the best way to control Medicare costs. Either way, the burden for paying for basic health care would fall on the government, not on older Americans. (Much of the Democratic criticism on this point is based on an earlier, obsolete version of the proposal.)

You’re still deeply uncomfortable with many other Romney-Ryan proposals. But first things first. The priority in this election is to get a leader who can get Medicare costs under control. Then we can argue about everything else. Right now, Romney’s more likely to do this.
All of which causes you to look over to the Democrats and wonder: Why don’t they have an alternative? Silently, a voice in your head is pleading with them: Put up or shut up.

If Democrats can’t come up with an alternative on this most crucial issue, how can they promise to lead a dynamic growing nation?
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bill67
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Re: Medicare
Reply #1 - 08/22/12 at 05:24:01
 
I do like mitt and paul's plan on the economy.
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Reply #2 - 08/22/12 at 05:41:23
 
Yep, more tax breaks for the rich more taxes and less benefits for the middle class and poor....forgot war on women, medicare social security etc.....gotta love Mitt the twit and lyin ryan!

They have turned flip flopping into an art form......hell mitt could add this sport to the olympics.... gold medal winner for sure.
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Re: Medicare
Reply #3 - 08/22/12 at 05:50:06
 
I meant their last Tuesday plan not their Thursday plan.
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Re: Medicare
Reply #4 - 08/22/12 at 08:16:38
 
A private option is not necessarily a bad idea but one of the things they rarely seem to mention about the Ryan voucher plan is that future adjustments are tied to the cost of living instead of the cost of healthcare (which FAR outpaces cost of living increases).  That being the case, it might be functional on day one but it won't be ten years later.
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Re: Medicare
Reply #5 - 08/22/12 at 08:23:06
 
Since this thread is generally about what goes through our minds regarding Medicare (not Medicaid), here's part of what goes through mine when I think about it.

First, I have a problem with the way the word "entitlement" is typically used these days.  Many folks seem to use it as if it means "handout" or "charity".  Most of the people who receive Social Security and Medicare are retirees who've paid into the system for most of their lives; usually 40-50 years (or more) of payments into the plan.  That said, it truly is something they are entitled to receive.  However, it seems like folks pay for an insurance policy for half a century and then are treated as if they're asking for charity when it comes time for the insurer to pay out.  The REAL problem is the politicians who've robbed the system to be able to maintain corporate tax loopholes and fund lucrative government contracts handed to cronies without being bid on by anyone else.  They left it depleted such that it cannot now be properly funded and instead turned it into a Ponzi/pyramid scheme on the brink of collapse.  They are never penalized in any way for their actions.  Rather, they are rewarded by the wealthy donors they work for.  Now they just want to sweep it under the rug and pull some kind of Jedi mid-trick telling us to forget that we've been funding this forever and that we should just forget ever seeing anything meaningful from the system and instead focus on recreating it into an anemic version.  I guess if you're in your twenties, it probably sounds reasonable to ditch it and rework everything.  When you've been paying into the plan for 30, 40, 50 years or more already, it's more than just a slap in the face; they should be wearing masks and holding guns because it's outright theft.  And since we were forced to pay it, it's more like armed robbery.  I realize that now it has to be changed if we are to make it functional again but it also MUST have extreme safeguards to keep the thieving bastards from raping it the same way they've raped the existing system.
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OK.... so what's the
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Re: Medicare
Reply #6 - 08/22/12 at 09:44:16
 
Talking about costs and budgets in the abstract, is all good and well, for the intellectuals...  They are all financially comfortable...

The reality is,... millions of people without healthcare,.. and more than 1/3 of bankruptcies currently related to health costs...

If you want an America that looks like a third world country,... with poor and elderly people living in shanty-towns, begging on street corners, and dying alone... then, go ahead,.. pull the rug the rest of the way out..
It will cure the immigration problem... no one will want to come here...
... and we'll have more money for wars, and business will thrive, hiring desperate people that will work under any conditions for next to nothing to survive... (just like those countries we so admire,.. like China, India, Malaysia, Pakistan)...
And we'll export the majority of our products, because so few here will be able to afford them...
And the rich will move to Europe so they don't have to live near all this misery... they'll just outsource manufacturing to the US from there...
Oooooh! yes!... let's be just like all those other third world countries...

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Re: Medicare
Reply #7 - 08/22/12 at 10:01:12
 
Personally, I honestly believe we need a single-payer system similar (though not necessarily identical) to Britain and Canada for preventative and non-elective healthcare.  Things like cosmetic procedures would be elective and be up to the individual to fund.  HSAs could be useful for this sort of care.  Of course, I don't include restorative cosmetic procedures such as those performed on burn victims or mastectomy patients, etc.  The same applies to dentistry.  Things like braces would not be covered unless it was necessary for normal function.  Whitening would be purely cosmetic/elective.  Of course, this is all anathema to the oligarchs running the hospital and pharmaceutical companies and they have politicians in their pockets.
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Re: Medicare
Reply #8 - 08/22/12 at 10:26:39
 
Maybe it was last week Wednesday's plan.
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Re: Medicare
Reply #9 - 08/22/12 at 10:31:53
 
bill67 wrote on 08/22/12 at 05:24:01:
I do like mitt and paul's plan on the economy.

bill67 wrote on 08/22/12 at 05:50:06:
I meant their last Tuesday plan not their Thursday plan.

bill67 wrote on 08/22/12 at 10:26:39:
Maybe it was last week Wednesday's plan.


Grin Grin Grin...
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Re: Medicare
Reply #10 - 08/22/12 at 12:56:37
 
WebsterMark wrote on 08/22/12 at 04:37:31:
Great piece out of the New York Times this morning that I think sums up the thought process many people will go through over the next couple of months.

You look at the Obama-Biden ticket. You like them personally. But you’re not sure what they want to achieve over the next four years. The country needs big changes, and they don’t seem to be offering many. Where’s the leadership?

In this disaffected frame of mind, you ask yourself: What really matters in this election? Well, the big issue is national decline. How can we ensure that the U.S. is as dynamic in the 21st century as it was in the 20th?

The biggest the theat to national dynamism is spending money on the wrong things. If you go back and look at the federal budgets during the mid-20th century, you see that they spent money on the future — on programs like NASA, infrastructure projects, child welfare, research and technology. Today, we spend most of our money on the present — on tax loopholes and health care for people over 65.

A study by Jessica Perez and others at the group Third Way lays out the basic facts. In 1962, 14 cents of every federal dollar not going to interest payments were spent on entitlement programs. Today, 47 percent of every dollar is spent on entitlements. By 2030, 61 cents of every noninterest dollar will be spent on entitlements.

Entitlement spending is crowding out spending on investments in our children and on infrastructure. This spending is threatening national bankruptcy. It’s increasing so quickly that there is no tax increase imaginable that could conceivably cover it. And, these days, the real entitlement problem is Medicare.

So when you think about the election this way, the crucial question is: Which candidate can slow the explosion of entitlement spending so we can devote more resources toward our future?

Looking at the candidates through this prism, you see that President Obama deserves some credit for taking on entitlement spending. He had the courage to chop roughly $700 billion out of Medicare reimbursements. He had the courage to put some Medicare eligibility reforms on the table in his negotiations with Republicans. He created that (highly circumscribed) board of technocrats who might wring some efficiencies out of the system.

Still, you wouldn’t call Obama a passionate reformer. He’s trimmed on the edges of entitlements. He’s not done anything that might fundamentally alter their ruinous course.

When you look at Mitt Romney through this prism, you see surprising passion. By picking Paul Ryan as his running mate, Romney has put Medicare at the center of the national debate. Possibly for the first time, he has done something politically perilous. He has made it clear that restructuring Medicare will be a high priority.

This is impressive. If you believe entitlement reform is essential for national solvency, then Romney-Ryan is the only train leaving the station.

Moreover, when you look at the Medicare reform package Romney and Ryan have proposed, you find yourself a little surprised. You think of them of as free-market purists, but this proposal features heavy government activism, flexibility and rampant pragmatism.

The federal government would define a package of mandatory health benefits. Private insurers and an agency akin to the current public Medicare system would submit bids to provide coverage for those benefits. The government would give senior citizens a payment equal to the second lowest bid in each region to buy insurance.

This system would provide a basic health safety net. It would also unleash a process of discovery. If the current Medicare structure proves most efficient, then it would dominate the market. If private insurers proved more efficient, they would dominate. Either way, we would find the best way to control Medicare costs. Either way, the burden for paying for basic health care would fall on the government, not on older Americans. (Much of the Democratic criticism on this point is based on an earlier, obsolete version of the proposal.)

You’re still deeply uncomfortable with many other Romney-Ryan proposals. But first things first. The priority in this election is to get a leader who can get Medicare costs under control. Then we can argue about everything else. Right now, Romney’s more likely to do this.
All of which causes you to look over to the Democrats and wonder: Why don’t they have an alternative? Silently, a voice in your head is pleading with them: Put up or shut up.

If Democrats can’t come up with an alternative on this most crucial issue, how can they promise to lead a dynamic growing nation?



YES ... BUT Mitt's plan doesn't affect any of this in any way and it offers tax cuts to the wealthy on top of this.
Ryan's plan cuts womens programs and offers more $ to the wealthy.
Yes I can see Obama could be a 1 term proposition, I can even hold him to his word, till I see the option ... Obama is a headache, these 2 are a brain tumor.
In many cases you may have to opt for the lesser of 2 evils even if 1 of the 2 evils has said it will leave under some circumstances.

Now I also dont agree with Bill, Mitt's economic/healthcare/foreign/energy plan that comes out the 7th tuesday of every month is the best, simply the best, cos That whole 7th weekend and monday, Todd Aiken and Ryan and Rand Paul, and Rupaul (yes that Rupaul) get together and make the best plan.

It also is when Mitt's glue gets reapplied so he sticks to issues the best.

Cool.
Srinath.
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Re: Medicare
Reply #11 - 08/22/12 at 13:01:23
 
WebsterMark wrote on 08/22/12 at 04:37:31:
Great piece out of the New York Times this morning that I think sums up the thought process many people will go through over the next couple of months.



Here is misconception #1 for people with grandiose plans of getting the undecided to go to their point of view ... There is less than 1% of the electorate that is in this category in states that actually matter ... I mean if you're undecided in a state that is 60% one way or another, it makes no diff.
That 1% you are trying to sway over to your side, even if you do that is very unlikely to actually get to the polls and vote.
1% who will very likely not vote is whom this piece is written for ... seems like a waste of everyone's time and $ and space to me.

This election is going to be won by whose base turns out.

Cool.
Srinath.
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Re: Medicare
Reply #12 - 08/26/12 at 08:10:33
 
Very little input in the present system, it doesn't matter WHO is elected! If we the people had a lobby it has long since been diluted by special interests. The common man cannot hang around Washington year round, stopping by each office asking for consideration, or bribing with nice vacations, and free drinks...

 The insurance industry will continue to throw billions into keeping present system, or even making people MORE dependent on insurance. Those billions will go to the "People" according to Romney, those people being CEO's and the highest execs.. These insurance industry gurus will continue to tell us (The people) how terrible/evil socialized medicine is, and push for more control of Medicare and the working man..

   Obama played into their hands with the ACA, he had to play pattycake with the minority (Republicans/Insurance/paid for Democrats), so we lost the public option, which would have been an over the top success, showing this nation that a single payer system is the way to go...

  There is a lesser of two evils here..
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Re: Medicare
Reply #13 - 08/26/12 at 18:23:04
 
"The biggest the theat to national dynamism is spending money on the wrong things. If you go back and look at the federal budgets during the mid-20th century, you see that they spent money on the future — on programs like NASA, infrastructure projects, child welfare, research and technology. Today, we spend most of our money on the present — on tax loopholes and health care for people over 65." That came about because the rich were having to pay taxes during that time period and there was plenty of money to invest in America's future. Plain and simple. Learn from the past Web. The tax rates on the rich declined and the stupid wars started and thats why we are where we're at now.

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Re: Medicare
Reply #14 - 08/26/12 at 18:49:12
 
No Midnight; LBJ started the Great Society and the War on Poverty which is ironic since it's where we are all going now.

Maybe we could look back and point to this as the beginning of the end. We took a safety net and tried to make a hardwood floor out of it.
In 1960, the federal budget per person was $4,000 or so.  Today, it’s over $11,000 per person.

Now again, tell me exactly how we have a revenue problem and not a spending problem?....
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