MEDICARE MUDDLE: We, the Walpiri!

MONDAY, AUGUST 27, 2012

Conclusion: The world’s most primitive journalists: Everyone has heard about the less-than-modern people who never developed full number systems.

According to these stories, such people have words for “one” and “two,” but then go straight to “many.” That’s as far as their number words, or their counting systems, extend.

In our world, such people would be poorly equipped to discuss a great many real-life situations—although some of these situations may not present in their daily lives.

Are these stories true? The Number Warrior says they are. He cites Blake’s "Australian Aboriginal Languages," including his work on the Walpiri.

And you thought of Blake as a poet!

Whatever! For our purposes, it doesn’t matter whether these famous groups exist. In our own world, one such group plainly does exist, at least when it comes to attempts to discuss the Medicare program.

Uh-oh! The American press corps has never developed a language for discussing this program! This created a very large problem in 1995 and 1996, when the political discourse turned on claims about Newt Gingrich’s Medicare proposals.

The problem has arisen again in the past few weeks. Simply put, our press corps doesn’t have the tools, the language or the skills with which to discuss the Medicare system. (They may also lack the nerve.)

Seventeen years have passed since they floundered and failed in the Medicare fight between Clinton and Gingrich. In the past few weeks, we have seen them flounder again. Can the Walpiri count past two? We aren’t sure, but American journalists are similarly limited. And like the Walpiri of legend, they seem compldetely unaware of their massive shortcomings!

You might say that all they want is that apocryphal pair of warm shoes!

Today, we’ll do the penultimate post in our Medicare Muddle series. That said, this muddle will surely continue, for years, in the work of the mainstream press.

For today, we’ll offer a bunch of final observations—or, more specifically, six:

Drum comes through, as expected: On Saturday, Kevin Drum responded to our desperate plea from Friday. In this post, he answered two specific questions:

First question, in his own words: “Did Obama steal, rob, siphon, take or remove $716 billion from the Medicare trust fund?” Second question: “After stealing that money, did he spend it on Obamacare?”

Taken together, Kevin’s answers are somewhat surprising. He says the answer to the first question is no—No, Obama didn’t take money from the Medicare trust fund.

You’d think that would pretty much answer the second question too! If Obama didn’t take any money from the trust fund, how could he have spent it on something else? Surprisingly, Kevin says the second question “is a little trickier” than the first—and he offers an analogy to help us puzzle this out.

Kevin offered the same analogy a few months ago. For us, the analogy hasn’t been especially helpful; your results may differ. But in Kevin’s dueling answers, you see how hard it is for us Walpiri to discuss the Medicare program. Obama didn’t take the money, he says. But it doesn’t automatically follow that he didn’t spend it on something else!

This isn’t exactly Kevin’s fault (more tomorrow). But as a non-Walpiri, we think his answers go together somewhat strangely.

We the Walpiri have many shortcomings when it comes to the discussion of Medicare. In part, the press corps has had a hard time spotting the demonology:

Spotting the demonology: The press corps has had a difficult time spotting the demonology in Romney’s recent statements. Starting on August 14, he began saying that Obama had “raided” $716 billion from the Medicare trust fund—and that he had spent the stolen/robbed/raided money on Obamacare.

Romney made this two-part statement again and again (more extensive texts below). This is the way he stated his claim on the CBS Morning Show:
ROMNEY (8/15/12): You know, the president, when he was campaigning in Denver, Colorado four years ago, said that Medicare was on a pathway to become bankrupt. And yet he's taking $716 billion from the Medicare trust fund to finance Obamacare, a new risky federal takeover of health care.

My commitment is, if I become president, I'm going to restore that $716 billion to the Medicare trust fund so that current seniors can know that trust fund is not being raided.
Again and again, Romney said Obama has taken a big wad of cash from the Medicare trust fund. That claim is very specific—and the demonology is very high. In these repeated declarations, Romney didn’t say that Obama took $716 billion “from Medicare.” Again and again, he said Obama had “taken” or “raided” $716 billion from the Medicare trust fund.

That is a very specific claim—and as Kevin notes, it’s false. But the claim is also very high in demonology. Stealing money from a trust fund is a bit like taking candy from a baby. The demonology there is very high.

Presumably, that’s why Romney kept saying it.

According to Kevin, Romney was making a charge which is false—and his charge was loaded with demonology. But we had to scream and yell all week to get anyone to answer a simple question: Has Obama taken money from the Medicare trust fund? And of course, within the press corps itself, helpless Walpiri acted as if Romney never made this specific charge at all. At the New York Times, at the Washington Post, major reporters chose to ignore the demonistic language Romney was spreading all over the landscape. To all appearances, these helpless players had no idea that there is a difference between these two statements:

Obama took $716 billion from Medicare.
Obama took $716 billion form the Medicare trust fund.


In fairness, our “reporters” are often extremely skilled at avoiding such acts of demonology. Wet liquid starts to run down their legs when people like Romney make such charges; they worry about what might happen if they simply tell their readers that Romney’s charge is false. And so, they took the safe way out—they discussed the weaker charge other GOP players were making.

They kept skipping past Romney’s specific statement—the more heavily demonized charge. Example:

At Politifact, an unnamed reporter specifically cited Romney’s more specific charge, critiquing this statement from a radio interview: "Under the president's plan, he cuts Medicare by $716 billion, takes that money out of the Medicare trust fund and uses it to pay for Obamacare.”

But alas! In Politifact’s evaluation, the unnamed reporter made no attempt to answer our question: Did Obama take any money from the Medicare trust fund?

According to Drum, the answer is no. But Politifact skipped right past that claim—and it rated Romney’s statement “half-true.”

That demonized, highly specific language flew right past this reporter’s ear. Our rating for his or work: Highly incompetent.

Ladies and gentleman, meet the modern Walpiri! In their language, they have no words for “from the Medicare trust fund.”

A very perilous term: The Walpiri are lacking in number words. When it comes to discussing Medicare, our reporters have one word too many!

If we were advising the nation’s reporters, we would make this suggestion: Never use the confusing word “cut” when discussing the Medicare program. Use of this term almost always produces confusion. Always avoid this term, unless you’re prepared to explain what you mean with great care.

Several problems obtain with this word; for now, let’s discuss just one. When journalists talk about “Medicare cuts,” citizens rarely know what they mean: Are they referring to reductions in future Medicare spending? Or are they referring to reductions in Medicare services?

The difference is huge, but it routinely goes unspecified. Voters get misled in the process.

One example: At the Washington Post’s Wonkblog, Sarah Kliff wrote an informative post about the way Obama has reduced future Medicare spending. In her very last paragraph, Kliff finally explained that Obama’s action doesn’t cut any Medicare benefits; it only “rolls back payment rates for hospitals and insurers.”

But up in her headline—the very first thing a reader will see—Kliff unwisely wrote this:
Romney’s right: Obamacare cuts Medicare by $716 billion. Here’s how.
For a liberal like Kliff to write something like that is just unbelievably foolish. But then, the word “cuts” misleads readers again and again in the Medicare discussion.

The use of that word lay at the heart of the Clinton-Gingrich Medicare fight. Seventeen years later, our so-called press corps is still counting “one, two, many” when it comes to the use of that word.

No language for discussing inflation: According to legend, the Walpiri can’t deal well with collections of objects which number more than two.

Since their children don’t own twelve pairs of Nikes, this may not cause everyday problems. But uh-oh! Our own journalistic Walpiri have linguistic shortfalls too.

One such shortfall does cause problems on a daily basis:

Good grief! Our reporters don’t know how to discuss inflation, a very basic part of our lives! Endless confusion enters the stew when they try to discuss future Medicare spending, in which all dollar figures have of course been swollen by the effects of inflation.

By now, you’d think that even these primitive souls would have come up with some ways to deal with this obvious problem. But if you thought such a thing, you were wrong. Even the people who have done the best work in the past few weeks have been fumbling around with this problem (example below).

This lay at the heart of the endless confusion in 1995 and 1996. Almost two decades later, our modern Walpiri still can’t count to three.

Blatant incompetence at the Times: For our money, FactCheck.org’s Lori Robertson has done the best work with this topic in the past few weeks, especially in three recent posts you can access here (August 22, 22, 24). If you read those posts, you will see a reporter who is running rings around her hapless colleagues at the New York Times and the Washington Post.

Robertson’s work puts the Times to shame. In a rational world, a string of people at the Times would be bumped back to the random crime desk for the hapless work they've done in the past two weeks. In a rational world, that would include David Leonhardt, who was writing an analysis of a pitcher for the Times sports section while his stable of incompetents was making a mess of this topic.

Reading Robertson, you encounter a long array of information and facts—facts which have been notable by their absence from the Post and the Times. Even here, though, it must be said: Robertson displays some of the basic conceptual problems we have listed above. She skips past Romney’s most specific charge: The claim that Obama has raided $716 billion from the Medicare trust fund. And she deals very poorly with inflation, breaking her back to insist that no one is making any actual cuts in future Medicare spending. (They're just reducing the growth.)

That’s true—more correctly, it isn’t obviously false. But it’s also confusing, misleading.

Go ahead—read Robertson’s posts. You’ll meet a large array of basic facts—basic facts you haven’t encountered in the Times or the Post.

The New York Times likes doggies and hair. The New York Times represents the heart of modern Walpiri culture.

There are other problems: All week long, we asked the press corps to respond to Romney’s specific assertions. Asking our press corps to do such a thing is a bit like asking the Walpiri to count all their finger and toes.

That said, other problems exist in the Medicare discussion. Which of Ryan and Romney’s three million plans should we be discussing? Is it appropriate when the Obama campaign keeps offering that “seniors will pay $6400 more” critique—a critique which takes us back to Ryan’s original plan?

Regarding the Ryan-Wyden plan, does anyone know what journalists mean when they offer passages like the one we highlight below? We take this from Bill Keller’s column in today’s New York Times:
KELLER (8/27/12): Last year Wyden and Ryan held a news conference to release their plan. It would leave Medicare intact for anyone 55 and over, but give the next wave of retirees a menu of options including traditional Medicare and private insurance plans that would compete in local auctions. (The system resembles the insurance exchanges envisioned in the Affordable Care Act, a k a Obamacare.) By introducing a measure of choice and competition Wyden hoped to prod health care providers toward more efficient practices and reap savings that could be used to ensure the long-term survival of Medicare.
What does that highlighted passage mean? According to Keller, the Ryan-Wyden plan “would give the next wave of retirees [those currently under 55] a menu of options including traditional Medicare.” Does that mean that those retirees could just continue along with nothing changed in traditional Medicare, including the amount of co-payments they are required to make?

Scribes like Keller keep typing such things without clarifying this obvious question.

Tomorrow, we’ll offer two final points about the Medicare muddle, even as we start an exciting new series concerning the rise of Lawrence O’Donnellism. But please understand what happened in the past few weeks:

Romney paraded around the land, making a highly specific, highly demonized charge. He described Obama doing a very bad thing—stealing a large sum of money from the Medicare trust fund.

As usual, America’s “journalists” acted as if they hadn’t seen Romney do this. We screamed and yelled, then yelled some more. But aside from Gene Lyons and Kevin Drum, have you seen any journalist attempt to answer our blindingly obvious questions:

Did Obama steal, raid, siphon or otherwise take $716 billion from the Medicare trust fund? If not, how could he have spent the money on Obamacare?

We’ll return to that second question tomorrow, the question Drum answered somewhat oddly. And we’ll recall the way the GOP fought the press corps in 1995 about its Medicare coverage. One side fights, the other side won’t.

Our mainstream reporters act like the Walpiri when it comes to the Medicare program. Our liberal leaders act like folk who want the Walpiri to hire them.

ROMNEY KEPT LODGING HIS CHARGE: Romney made his two-part charge again and again. Perhaps because of their primitive tools, the press corps seemed not to hear.

We can’t track every statement by Romney. If we are counting correctly, we have assembled seven:
Romney, Beallsville, Ohio, 8/14/12, noontime: But did you know that he has taken $716 billion out of the Medicare trust fund? He's raided that trust fund. And do you know what he did with it? He's used it to pay for Obama care, a risky, unproven federal government takeover to health care. And if I'm president of the United States, we're putting the $716 billion back.

Romney, Zanesville, Ohio, 8/14/12, mid-afternoon: You know that every time you get a paycheck, out of that money comes money going into the Medicare trust fund to pay for your health care when you're older. And this president has decided—I can't believe it—he has taken $716 billion out of the Medicare trust fund to pay for Obamacare.

Romney, Chillicothe, Ohio, 8/14/12, early evening: Do you know that if the president is re-elected, he will succeed in raiding $716 billion from Medicare, from the trust fund you have been paying into all your lives—$716 billion to pay for Obamacare? He is taking your money to finance his risky and unproven takeover of the health care system.

Romney, CBS This Morning, 8/15/12: You know, the president, when he was campaigning in Denver, Colorado four years ago, said that Medicare was on a pathway to become bankrupt. And yet he's taking $716 billion from the Medicare trust fund to finance "Obamacare," a new risky federal takeover of health care.

My commitment is, if I become president, I'm going to restore that $716 billion to the Medicare trust fund so that current seniors can know that trust fund is not being raided.

Romney, Fox 35 Orlando, 8/15/12: If Obamacare is allowed to be installed, Medicare will be raided by $716 billion. The president takes $716 billion out of the Medicare trust fund to pay for Obamacare.

Romney in Charlotte, 8/15/12, as quoted in the Baltimore Sun: "That came out of the Medicare trust fund. He raided that trust fund to pay for Obamacare. And as seniors hear this, they're going to be angry."

Governor Romney’s weekly podcast, 8/17/12: Hello, I'm Mitt Romney. And this November, America will make a choice about the direction we want to go as a country—and nowhere is that choice clearer than on the issue of Medicare.

President Obama's healthcare law raided $716 billion from the Medicare trust fund. And he did that to finance his takeover of the healthcare system.

[...]

We've got to save this critical program. You paid into it, and you've earned it. I think it's outrageous that the President took $716 billion out of the Medicare trust fund to pay for Obamacare.
For that bullshit podcast, click here.

He said it again and again and again. Soon, pundits were saying shit like this on programs like Inside Washington:
KRAUTHAMMER (8/19/12): Number one, CBO says that if Obama—and it wrote this—if ObamaCare were abolished, it would increase the Medicare trust fund by $700 billion. The money was removed from one pot, ended up in another pot.
Incredibly, that’s what Charles said. But no other panelist said a word! The Walpiri weren’t able to hear.

6 comments:

  1. Quaker in a BasementAugust 27, 2012 at 12:27 PM

    Are they referring to reductions in future Medicare spending? Or are they referring to reductions in Medicare services?

    And there it is, neighbors. Just 18 little words, all in plain, pedestrian English, show how easy it is to make sense of all the huff and puff over Medicare.

    Cuts in spending? Cuts in benefits? THEY'RE NOT THE SAME THING!

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  2. "the rise of Lawrence O’Donnellism"

    It can't exist. It doesn't matter. It's irrelevant.

    Leave poor Lawrence O'Donnell alone.

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  3. We want to know whether or not the Medicare Trust Fund was cut.

    What is the Medicare Trust Fund?

    I did a little research.


    http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/Downloads/TR2012.pdf

    The Medicare Trust Fund consists of two parts.
    Hospital Insurance, and Supplementary Medical Insurance
    HI (Medicare Part A) is funded by Medicare payroll taxes, interest income, voluntary participation, and taxes withheld from Social Security benefits.
    Hi pays almost all of the covered costs , and covers almost all hospital costs, even when the patient was not admitted (outpatient surgery, etc.)

    SMI (Medicare Part B) is a Medicare plan, is supported by general tax revenues, or PPO beneficiaries pay a premium, which accounts for about 25% of costs. It pays the doctors, and outpatient care much like the typical HMO plans. It has a yearly deductable.


    Medicare Part C, (Medicare Advantage) is paid by the beneficiary and is managed by private health insurance companies very much like the standard HMO or PPO plans. Medicare reimburses the companies a fixed amount monthly per member. The insurers waive the deductable.

    Many employers will pay part of the premiums for Part B or Part C for their retirees, and they decide which plan they will subsidize.

    There is also a Part D, which covers prescription medicines. Again, private insurers following Medicare rules administer this. Economies of scale brought down prices to beneficiaries. Some say they could be even lower. This has the notorious non-negotiation part put in by G.W. Bush.

    Okay, HI is a “slush fund.” Employees pay in, beneficiaries are paid out.
    HI is sitting on a pile of money, but there is a yearly shortfall so the pile shrinks a bit each year. This is the subject of dire predictions.

    SMI takes about 75% of its costs from general tax revenues, and pays fees to doctors and drug companies. This ratio fluctuates.
    I presume this is where most of the battle is engaged.
    Republicans want to cut revenues (tax money), and pay doctors and drug companies more, with the difference made up by the infamous out-of-pocket payments, reduced benefits, raising eligibility ages, means testing (essentially the Ryan plan).

    Democrats want to keep revenues equal to costs (more tax money), pay doctors and drug companies less, and keep benefits, eligibility, and out-of-pocket expenses the same (adjusted for inflation).
    The difference is in the details. And so is the Devil.

    It is interesting to note that, according to AARP, hospitals and drug companies agreed to lower re-imbursement, but insurance companies did not.
    The reasoning is that they will get the money whether it comes from Medicare or ACA, and the currently uninsured (and newly insured) are paying little or nothing now.

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    Replies
    1. In the new Ryan Plan,insurance companies would bid for the business of people who opted for private carriers. The second lowest bid would win and the program would pick up the tab for it. Individuals could still go for the higher bid (ostensibly for more services),and pay the difference themselves.

      Your last paragraph is particularly interesting to me because I'd like to hear Ryan address how insurance companies will behave differently under his plan than they did with Medicare Advantage (where the govt actually had to start paying them more in order to get them to play.)

      Delete
  4. It's hard to compress thousands of pages into one without leaving something out.

    There is another option, Medigap, which has more coverage and higher premiums.

    But we can trust the insurance companies to compete and offer the lowest possible price, and we can trust our elected officials to make sure that happens, can't we?

    ReplyDelete