MEDICARE MUDDLE: No answers, no peace!


Interlude—Failed by Drum: We’re fans of Kevin Drum around here.

Yesterday, Kevin Drum failed us.

At the close of the week, Drum published this post, “An Itsy Bitsy $716 Billion Medicare Q&A.” He answered six questions about the ongoing Medicare muddle.

None of the questions were these:
Did Obama steal, rob, siphon, take or remove $716 billion from the Medicare trust fund?
After stealing that money, did he spend it on Obamacare?
All week long, we’ve begged for answers. Yesterday, Drum presented his Q-and-A—and he skipped both questions.

How did we come up with our questions? From the Romney camp's attacks on Obama! Romney, Ryan and RNC chairman Reince Priebus have explicitly said that Obama stole $716 from the Medicare trust fund, then spent it on Obamacare.

Those are very specific charges. But are the charges true?

We've been asking that question all week. Kevin didn’t say.

Will we liberals ever learn how to argue? Will we ever be willing to challenge the work of the mainstream press? One of the ways you argue is this:

You challenge the claims your opponents are making! Especially when their claims are false! Beyond that, you scream and yell when the “mainstream press corps” refuses to do that job.

Our own assumption would be the following: No! Obama didn't take a sack of cash from the Medicare trust fund. As far as we know, he didn’t take any money from the Medicare trust fund at all. (Although we’ll assume that many liberals secretly think he did.)

For that reason, he couldn’t have spent that big sack of money on Obamacare. Or on anything else.

Romney’s charges are bogus. But the Washington Post and the New York Times have been working hard to avoid confronting these charges.

As usual, the liberal world has been willing to let this go.

Why do these charges matter? On Wednesday night’s O’Reilly Factor, Dick Morris explained what voters hear when Romney makes those accusations. See THE DAILY HOWLER, 8/23/12).

In his National Memo column this week, Gene Lyons gave the same explanation, in more pungent terms. This is what voters are being told when Romney makes those charges. We join the explanation in progress:
LYONS (8/22/12): In case that’s too subtle, Romney himself has said “there’s only one president that I know of in history that has robbed Medicare.” He told an audience in Ohio that Obama “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 used it to pay for Obamacare, a risky, unproven, federal takeover of health care.”

On “Meet the Press,” Republican National Committee chairman Rience Priebus declared that “This president stole...$700 billion from Medicare to fund Obamacare. If any person in this entire debate has blood on their hands in regard to Medicare, it’s Barack Obama.”

Robbed, stole, raided, blood on his hands.

Then who IS Obamacare for, if not for you and yours?

A recent letter to my local newspaper spelled out what Romney’s too tasteful to say: “obese, lay-about, cigarette-smoking, drug-taking, welfare-sucking, emergency-room-visiting no-accounts...[who] expect the government to provide them everything for free.”

That’s right, THEM.

THEY are getting YOUR benefits.
Duh. That’s what voters are being told when Romney says that Obama “robbed the trust fund” to pay for Obamacare. This leads to the questions we've asked all week:

Did Obama take $716 billion from the Medicare trust fund? Did he use that big wad of cash to pay for Obamacare?

We're fans of Kevin Drum. Yesterday, he didn’t answer our questions. But people, you know what we say around here!

That’s right. No answers, no peace!

Coming Monday: In 1995, the RNC fought the Medicare coverage


  1. I wish someone would explain $716 billion in more detail.

    As it stands now, I'm hearing (or mis-hearing) something like this analogy:

    If I have a budget called "Personal Budget", and within that main budget umbrella are smaller budgets called "Magazines", "Eating Out" and "Shoes", if I take money from Magazines and put it in Shoes, I have still taken money from my mag budget no matter if the money is still within the Personal Budget.

    I have still taken away from magazines, no matter if I reason that since I'm buying better shoes, that will last longer, I will spend less money in the long run and recoop the magazine money.

    Now I'm fine with the logic of saving money by allocating it somewhere else that will pay off in the long run. However, I would like to at least have the basics straight as to whether or not this is the plan.

    This may be a completely erroneous analogy, but it's the impression I've gotten from what I have read and heard.

    I do wish there was someone who was specifically stating what is happening, rather than talking around it.

    1. Your analogy isn't just erroneous. It's stupid.

      But let's play along.

      Suppose you budgeted for your favorite magazine. Call it the "Time" budget. Only you bought it from a vendor who was charging you $10 a week. So you budgeted $520 a year.

      Then someone else wised you up and said you could subscribe to Time and have it delivered to your home for $50 a year. You have saved $470, of which you spend $100 on two MORE magazine subscriptions.

      So instead of getting one magazine for $520 a year, you are getting three for $150.

      Yes, Cecelia, you have "cut" your magazine budget by $370, which, I suppose, you could spend on shoes. But you have strengthened your magazine service. By a factor of three.

    2. So is the $716 billion is a "cut" in the sense that I am spending LESS (but getting more)?

    3. I'm pretty sure Bob Somerby has linked to these two pieces but here they are again. Take a look at this Paul Krugman post and the Sarah Kliff one to which he links.

      A third of the savings is going to come from Medicare cutting out the subsidies Medicare Advantage has been sucking out of the program for years as part of an experiment intended to show private insurance companies could be more efficient primary payers. [Surprise, surprise] This privatization option has ended up costing Medicare an extra 15%-20% per beneficiary over what the traditional Medicare costs the program.

      Another third of the Medicare savings was negotiated with hospitals. The dirty little secret, or rather, the dirty fact of the matter is that hospitals overcharge Medicare patients to cover their expenses in treating people without insurance or with insufficient insurance which leaves the hospital with uncollectables on their books when, as often is the case, the uninsured or the under-insured fail to pay out-of-pocket the balance of what the hospital is owed.

      Under the PPACA there is an expectation that there will be more customers with private insurance and less customers who can't pay their bills so, during negotiations to bring this about, hospital execs have indicated they are willing to stop padding the bills they send to Medicare.

      The final third of the savings comes from getting faster than inflation price increases somewhat under control while insisting on "best practices" when it comes to the therapy regimens for which Medicare will pay.


    4. This comment has been removed by the author.

    5. There is no free market anywhere in the American Health Care system. We have preposterous patent laws which provide windfalls to pharmaceutical companies. The AMA and other influential entities have spent a century making sure that the United States have both best compensated doctors in the world and among the worst physician to patient ratios to be found in any OECD countries. (How do you think that state of affairs comes about in a domestic free-market, let alone in a global economy based on free-trade?)

      Guess who literally colludes in plane sight to set Medicare fee rates for doctors which is then used as a baseline for mark-ups in the private insurance sector of the health care market to determine doctor fees there (and leave Medicare patients underserved)?:

      >>>>>To calculate physicians' fees under Medicare – which in turn influence some state and private payers' decisions on how they will pay doctors -- the Centers for Medicare and Medicaid Services (CMS) relies on the recommendations of an American Medical Association advisory panel. A study led by Miriam Laugesen, PhD at Columbia University's Mailman School of Public Health, found that the Medicare and Medicaid agency closely followed the committee's recommendations on the fees physicians are paid, which are based on an assessment of time and effort associated with various physicians' services....

      [Surprise, surprise] In recent years primary care doctors have expressed concerns that the AMA committee, which includes representatives from 31 physicians' organizations, has too little representation from their ranks and is partly responsible for the increasing pay gap between primary care doctors and specialists. While the current study did not directly examine this issue, it did find that CMS's decisions are less likely to lower fees for evaluation and management services, which account for a large percentage of primary care providers' income, than for fees of medical specialists.

      "This is encouraging for providers in primary care and other specialties that bill the greatest proportion of these services," said Dr. Laugesen, who is the principal investigator. "However, it does not explain why there has been no reduction in the income gap between primary care providers and specialists."

      [No, no it doesn't, but I can guess at it. That panel is submitting some completely out-of-line recommendations for specialist compensation.]<<<<<

  2. You are making the mistake of treating the Republican charge seriously. Of course, he did not take anything out of the Trust Fund. The very idea is beyond ridiculous. The ACA makes some changes in future costs that have been recommended by experts for years. The changes will strengthen Medicare. Some were negotiated with the hospital and drug industry recognizing that almost everyone would now have insurance and their members would have higher revenues and, for hospitals in particular, lower costs from no longer having to serve uninsured patients. Everyone has known for years what a boondoggle Medicare Advantage has been.

    This is nothing more nor less than Republican application of the Karl Rove playbook. Kerry was a war hero (while Bush was a shirker), make Kerry into a coward and make the campaign focus be whether Kerry was a coward or not. Romney and Ryan are weak on Medicare? Turn Obama into the one destroying Medicare to help lazy slackers.

    To take these charges seriously by wondering whether there is "some truth" in them is to be a dupe for Republican propaganda. They are false, they are flat-out lies, and Romney and Ryan (and Karl Rove) know perfectly well they are lies. (If they didn't know it, they wouldn't have included the same future cost reductions in their own plans.) This is how they work, and they know the press -- and yes, that includes the liberal press -- will do almost nothing to correct them. (It's hard work explaining how they are false, and then refining that explanation into short, simple language.)

    It's also true that while Republicans are handing Democrats an issue that proves how Republicans will lie if they have nothing positive to say, you can be sure the Democrats (and not even their unconnected surrogates) will never, ever create a commercial that explains that and makes them pay a big price for it. A good 60-second commercial on how Republicans use the Karl Rove playbook, and how this is an example of how they will lie, will never see the light of day.

  3. Could clever, watchable videos posted to you tube be useful?
    Is there any way around the corporate grip on the media?

  4. Here is a classic example of how conservatives are consistently misinformed.
    These are two questions from a Newsmax online poll.

    3) Should Congress restore $500 billion in Medicare benefits for seniors that the Obama plan cut?
    Yes, restore the Medicare benefits
    No, don't restore the Medicare benefits

    4) Do you support President Obama's desire to give 12 million illegal aliens amnesty and a path to citizenship?
    Yes, I support Obama's amnesty plan
    No, I oppose it

    Read more on Should Congress Repeal Obama's Policies
    Important: Do You Support Pres. Obama's Re-Election? Vote Here Now!

  5. Shorter Somerby:

    Every liberal blog posting must follow my formula exactly.

    1. "You challenge the claims your opponents are making!"

      Yeah, who could think that was a good idea?
      Dumb old Somerby.

      You keep showing the way, Steve!

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