Who can help the American people understand Medicare policy: Mitt Romney is amazingly bad when he discusses policy.
Yesterday, Romney staged a short seminar concerning the Medicare program. He compared and contrasted the two hopefuls’ proposals. But d’oh! He quickly slipped, saying this:
ROMNEY (8/16/12): Today’s seniors, if you will, my plan presents no change. The plan stays the same. No adjustments. No changes. No savings.D’oh! He’s supposed to say that his proposal imposes no cuts. He isn’t supposed to say that his plan "presents no savings!”
The president’s plan cuts Medicare—excuse me. Well, let’s see, I got , there we go!—by $716 billion.
Good God, this man is clumsy with policy! Everyone and his crazy uncle has correctly been saying, for decades, that we need to find “savings” in our health care programs. We want our presidents to find ways to save money in the administration of these programs.
Romney boasted that his proposal "presents no savings.” Good God, that man is an oaf!
We want to achieve savings in these programs! That’s why, for our money, Bernie Sanders gave the simplest, cleanest statement about that $716 billion this week—about the amount of money Obama’s proposal “cuts.” Here’s what Sanders cleanly said on Monday’s Big Ed program:
SCHULTZ (8/13/12): Senator, what they are doing is they are playing this $700 billion bullet point, saying that— You heard Reince Priebus, that President Obama “stole” this money, that they`re going to be shafting seniors. That simply isn’t the case. And I like the fact—Everything he said is important—and no, most people don't know it! Sanders provided the answer which stumped Rachel Maddow on the previous day’s Meet the Press.
SANDERS: No, it isn’t the case. It isn’t the case, Ed. And the point to be made is, as I hope most people know— In the United States today, we spend almost twice as much per capita on health care as do the people of any other country. We have a wildly inefficient and wasteful system.
So what we were trying to do and what we did is not cut benefits for seniors, but make the system more efficient. That’s a good start. I’m a single-payer advocate, because I think we could do a lot more.
We spend too much per person, Sander said. We spend way more than everyone else. Obama has managed to wring out some savings—but no health services will be cut!
Can Obama wring out those dollar savings without any services being cut? We don’t know, but that’s the claim, very cleanly expressed.
We expect to feature the Medicare discussion all next week. For today, we’ll make a few suggestions:
In this morning’s New York Times, Romney’s seminar on Medicare is the featured front-page news report. Except the Times gets sidetracked onto the question of the gent’s tax returns.
For that reason, Michael Shear spends exactly one paragraph trying to explain Romney’s charge about the way Obama has “stolen” that $716 billion. He discusses the topic in paragraph 20, of 21 in all!
In a way, it’s just as well. The Times has convincingly proven this week that it simply isn’t up to the task of explaining a topic like this. By way of contrast, take a look at PolitiFact’s treatment of Romney’s charge.
PolitiFact offers a vastly clearer treatment of that $716 billion than you’ve seen in the New York Times. PolitiFact is published by the Tampa Bay Times. Despite that small-town location, its journalists are massively more capable than those found lounging in Gotham.
(That said, the site continues to fumble with its rating system, which is poorly conceived and should be revamped. PolitiFact scores Romney’s basic statement about that $716 billion “mostly false.”)
Final point: You’ve seen Sanders’ clear, clean statement about that $716 billion. By way of contrast, here’s how Maddow reacted on Meet the Press when she was asked about this.
This Republican charge is several years old. But when Rich Lowry brought it forward, Maddow had no idea what to say, and no idea how to dodge:
LOWRY (8/12/12): Even President Obama, who's cut $700 billion from Medicare, which I guess you support—Truly, that's just awful. This nonsense went on and on (and on and on), with Rachel saying she couldn’t state her opinion on this crucial topic because she isn’t running for office.
MADDOW: But Paul Ryan—
LOWRY: Do you support $700 billion in cuts in Medicare over the next 10 years?
MADDOW: I'm not running for president.
LOWRY: Do you?
MADDOW: Paul Ryan's running for vice president.
LOWRY: You can’t answer.
MADDOW: But wait! I’m not running for anything.
Yes, she kept saying that.
In fairness, Maddow is very good with the snark and the self-adoration. She’s good at massaging her facts, especially in a setting where her guests will all agree with every word she says.
But when someone is there to challenge Maddow, she tends to break down quickly. That back and forth with Lowry was a major liberal embarrassment.
Sanders gave a clean, intelligent answer—the answer which has been out there for years. Maddow had no earthly clue, and she offered the world's worst dodge.
So it goes when corporate suits hire our liberal leaders for us. Maddow is very limited—and she isn’t especially honest, as you may have noticed.
She does make us feel like we’re the best tribe. In the end, is that what we want?
"So it goes when corporate suits hire our liberal leaders for us."ReplyDelete
I don't know anyone who thinks these TV people you mention are liberal leaders.
I certainly never watch them.
Therefore I am certain they have no influence on people who think of themselves as liberals.
You know, FOX is awful.
More awful, but you never say so!!!!
She wrooooooooooote a boooooooooooooooooooooooooooooook!ReplyDelete
The sad part for all of us is that there won't be a discussion about price setting versus competition.ReplyDelete
We won't see a national debate upon whether we have a market system now, or to what degree that could ever be feasible or benefitical.
The candidates don't want to have to take time with this, and the media is too craven themselves for that.
We know that large nation has got a more profit- and market-driven healthcare system than ours.Delete
We know that ours is more profit and market driven than the others.
And we know that ours is much more expensive.
And we know that the health outcomes we have from it aren't better.
...that NO large nation...Delete
You'd have to be hallucinating pretty wildly to think a significant problem with US healthcare is that it isn't sufficiently in thrall to ideas of markets, profits and competition.Delete
"You'd have to be hallucinating pretty wildly to think a significant problem with US healthcare is that it isn't sufficiently in thrall to ideas of markets, profits and competition."Delete
Either hallucinating, or well-informed.
The most glaring difference about American health care is our malpractice system. Malpractice costs here are on the order of 20 or 30 times what they are in other countries IIRC. And, along with the direct costs, there's a large amount of defensive medicine -- costly tests used for no medical reason, but simply to help deter a lawsuit.Delete
Malpractice reform would help reduce the cost of medical care here. Unfortunately, Obama allowed the plaintiffs' attorneys to help write the bill. As a result, Obamacare not only doesn't reform malpractice, it actally makes it more difficult for a state to enact such a reform.
David in Cal, malpractice costs are trivial compared to other health care costs such as overpriced drugs and inflated doctor's salaries. In 2010, for example, the total cost of defending claims and compensating victims was 0.3% of total health care costs in the U.S.Delete
Allowing imports of drugs from Canada and qualified foreign doctors to emigrate in large numbers (i.e., letting market forces work) would do more to reduce costs than malpractice reform.
That said, there is a good case for malpractice reform whether or not it significantly increases the cost of health care, and I am all in favor of it. However, it would be wrong to state that it is responsible for the exorbitant costs of the U.S. health care "system." It isn't.
I agree that direct malpractice costs are not as large as some other items. However, I've seen claims that the indirect cost -- namely defensive medicine -- is considerably greater than the direct costs.Delete
BTW Mysgterion, do you know the source for that 0.3% figure? Some decades ago I was in the medical malpractice business, and 0.3% seems somewhat low. The average MD pays a significant % of his billings for malpractice insurance. Hospitals pay a lower % than doctors, but even there .3% feels a bit low.
The following link gives two source. One says that malpractice costs are "less than 1%" of medical costs, the other says they're "less than 2%." Those figures seem more in line with what I remembered. http://www.insurance-reform.org/issues/MedMalSystemCostsFactSheet2009F.html
Physicians' habits of defensive medicine are based on so much more than malpractice fears that it's not funny. Mostly, those habits arise from treating well-insured patients in a system that doesn't intelligently question the value of a test or treatment in light of the cost, as physicians work under grueling conditions with the highest expectations of themselves and of medicine's possibilities. Bringing healthcare costs down and improving healthcare outcomes will be a huge and difficult project, no matter what. We had all better get serious about it.Delete
The 0.3% figure applies to one year, 2010: http://www.justice.org/cps/rde/justice/hs.xsl/8686.htmDelete
The website, in turn, got its information from the National Association of Insurance Commissioners, whose report is not fully available online.
It is true that the cost of defensive medicine increases medical costs significantly. The Reuters article explains this issue well: http://www.reuters.com/article/2010/09/07/us-malpractice-usa-idUSTRE6860KN20100907
But, like mch says, doctors practice defensive medicine for many other reasons unrelated to litigation.
I agree, let's talk free market.Delete
US government protects medical research (not just treatment) with copyright law.
US limits foreign nurses and doctors from immigrating.
FBI burned down entire library of Marxist-Freudian Wilhelm Reich.
US government selects drugs its citizens can use.
US government selects the location of group therapy, hospitals and churches fine, public parks and mosques are infiltrated and/or attacked.
Insurance companies influence policy more than US citizens due to political bribing.
Let's not forget the big one: US law compels citizens to purchase insurance.Delete
All of which, Lewis, does nothing to contradict the fact that the US has the most market-driven, profit-oriented healthcare system around!Delete
Ours is the most market-driven.
Making it MORE market driven isn't the solution.
Let's instead look at what the countries that have more successful systems are doing.
Nah -- that would be too rational.
The argument that our present system represents a free market one enough to know that we don't want it...is a non-sequitur.ReplyDelete
Ours is very much market-driven. Everybody else's is less so.Delete
Our costs out the wazoo. Everybody else's is cheaper.
Sane people don't interpret this to mean that we need a more "free market" system.
What is the alternative to the corporate suits hiring our liberal leaders? Until recently, there was no liberal voice at all in the national media. The entire liberal communications establishment was taken by surprise by the sudden $716 billion claim, so, as much as it's true her reaction was less than worthless in this case, I would rather have the popular Maddow in that role than some others one could think of. She covers, and ably so, a lot of subjects on her show from a liberal perspective -- who else besides our compromised MSNBC people are talking about union-busting, gross income inequality, womens' rights to control their own bodies or vote suppression? In fact, she was up-to-date on the most recently published liberal-press talking point on the subject, the fact that the Ryan plan contains the same cuts but applies than partly to tax reductions for the wealthy, but David Gregory failed to stop the Republican guy from shouting her down every time she tried to make that point.ReplyDelete
The wrath for this should be directed less at her individually and more at the Democratic Party and its lack of ability to anticipate what Republicans are going to say: Ryan is highly vulnerable on Medicare, so how are they going to go on the offense on Medicare to change the conversation and eliminate the advantage? One possible response is to charge Obama with "cutting Medicare". . . Then people like Maddow may have better prepared to say, "That's a lie. That's $700 billion in wasted costs he's cutting, and there are zero cuts in benefits. (The Ryan plan makes the same cuts but instead of using some of it to close the donut hole or provide free preventive services to seniors or prevent insurance companies from collecting a windfall at taxpayers' expense, Ryan's plan gives some of it to tax reductions for the wealthy.)"
Of course, she, too, should participate in that anticipation. She's a performer. Where was her staff?
I heard Reince Priebus claim Obama stole $700 billion from Medicare.ReplyDelete
I had my research staff on it right away.
I googled "romney claims obama cut medicare".
My second hit came up with the Talking Points Memo explanation.
Two hits, two minutes.
My staff does not spend hours finding stuff that leaps off the page.
Some information, like that our local Sheriff Paul Babeau was molested by priests, sued and won against the Catholic Church, and later was part owner of a boy's prep school that was charged with child abuse and later closed down, take somewhat more time.
Howcum the talking heads on MSNBC didn't bother to look up something so provocative as,
"This president stole — he didn’t cut Medicare — he stole $700 billion from Medicare to fund Obamacare,” said Republican National Committee Chairman Reince Priebus, on NBC’s “Meet The Press.” “If any person in this entire debate has blood on their hands in regard to Medicare, it’s Barack Obama. He’s the one that’s destroying Medicare.”?
Romney also said we haven't heard any budget plan from Obama because he doesn't have one.
Google 'Obama Budget", click on the fifth item down - The President's Budget for Fiscal Year 2013 - The White House - and you will quickly find this;
While it's true Obama's team always seems way behind the curve, a "news" show has no excuse for not being prepared two or three days AFTER the fact.
Former President George W. Bush bragged about the fact that his administration provided Medicare greater funding than any other administration. A large part of the increase in Medicare spending was and remains in the form of subsidies to health care insurers that supposedly helps lower premiums for doctors and other health care providers. The percentage of malpractice cases does not justify the subsidy or at least not all of it.ReplyDelete
There were a number of things I found amusing about that Mitt Romney white board effort. First, of course, was the seeming universal disdain with which it was greeted by the press corps, yes, the very same press corp that complains about a lack of substance in the campaign. But yes, it is surprising that a business executive at that level can't do a pitch. Where was Don Draper when the Republicans needed him?ReplyDelete
I guess to stay happy in the entertainment industry, you have to follow the rules about what entertains you.ReplyDelete