Who lost Medicare: What follows isn’t really about the press—except to the extent that what follows hasn’t been discussed.
We just thought you ought to see the way your side lost Medicare. That includes the willing, overpaid children on The One True Liberal Channel.
At the first Obama-Romney debate, Romney stated a remarkable point. Obama looked down, accepting a good solid scolding.
So Romney kept repeating his point, over and over again:
ROMNEY (10/3/12): On Medicare, for current retirees, he's cutting $716 billion from the program. Now, he says by not overpaying hospitals and providers. Actually just going to them and saying, "We're going to reduce the rates you get paid across the board, everybody's going to get a lower rate." That's not just going after places where there's abuse. That's saying we're cutting the rates. Some 15 percent of hospitals and nursing homes say they won't take anymore Medicare patients under that scenario.That last chunk was from Romney's closing statement. It represented the fifth separate time he had said that he would restore that $716 billion to Medicare.
We also have 50 percent of doctors who say they won't take more Medicare patients.
This— We have 4 million people on Medicare Advantage that will lose Medicare Advantage because of those $716 billion in cuts. I can't understand how you can cut Medicare $716 billion for current recipients of Medicare.
Now, you point out, well, we're putting some back. We're going to give a better prescription program. That's $1—that's $1 for every $15 you've cut. They're smart enough to know that's not a good trade.
I want to take that $716 billion you've cut and put it back into Medicare. By the way, we can include a prescription program if we need to improve it.
But the idea of cutting $716 billion from Medicare to be able to balance the additional cost of Obamacare is, in my opinion, a mistake.
LEHRER: We'll talk about—specifically about health care in a moment. But what— Do you support the voucher system, Governor?
ROMNEY: What I support is no change for current retirees and near-retirees to Medicare. And the president supports taking $716 billion out of that program.
ROMNEY: Second reason [for repealing Obamacare], it cuts $716 billion from Medicare to pay for it. I want to put that money back in Medicare for our seniors.
ROMNEY: First of all, I like the way we did it in Massachusetts. I like the fact that in my state, we had Republicans and Democrats come together and work together...
What we did in a legislature 87 percent Democrat, we worked together; 200 legislators in my legislature, only two voted against the plan by the time we were finished. What were some differences? We didn't raise taxes. You've raised them by $1 trillion under Obamacare. We didn't cut Medicare. Of course, we don't have Medicare. But we didn't cut Medicare by $716 billion.
ROMNEY: If I'm elected we won't have Obamacare. We'll put in place the kind of principles that I put in place in my own state and allow each state to craft their own programs to get people insured and we'll focus on getting the cost of health care down.
If the president were to be reelected you're going to see a $716 billion cut to Medicare. You'll have 4 million people who will lose Medicare Advantage. You'll have hospital and providers that'll no longer accept Medicare patients.
I'll restore that $716 billion to Medicare.
The president hung his head like a Chinese convict as Romney kept repeating this garbage. What has happened since then?
Florida has tilted to Romney. As it has, the children on MSNBC have kept repeating the stupid claims they get sent to them by the White House. Romney tried to flip on abortion! He tried to change his tax proposal!
Have you seen anyone discuss the need to rebut Romney’s Medicare pillage? Did we mention the fact that Florida’s listing?
Can you imagine why?
Learning from history: After the first Bush-Gore debate, Gore was endlessly mocked for saying he would put surplus Medicare payments into an ironclad lockbox. He challenged Bush to make the same pledge.
Gore stated this point four times. Romney stated his point five times.
Gore was mocked, but Romney wasn't. (Liberals were silent each time, of course.)
Using your words, explain.
I agree with Bob that Gore was treated badly by the media, but not on the subject of the "lockbox." Romney's Medicare point is arguable. Maybe the Obama plan will reduce benefits somewhat for today's seniors or maybe the reduction will be negliglble.ReplyDelete
However, there can be no argument about the "lockbox". There's simply no such thing, neither literally nor figuratively. As I recall, Gore's fantasy "lockbox" was politically successful, so much so that Bush eventually said that if elected he'd have a lockbox, too. :(
Uh, David? The reason there is no "lockbox" is because Gore was never president.Delete
Anonymous, my point is that there's no actual meaning behind the word "lockbox." I'm an actuary. I know this stuff.Delete
The reality of Medicare and Social Security is that they're essentially pay as you go programs. Today's working people pay my benefits. When today's workers retire, their SS and Medicare benefits will have to come from working people in the future.
However, there's no guarantee that the programs will remain unchanged. Today's working peole have no guarantee that they will receive benefits as generous as the ones I'm getting. In fact, both programs are running out of money, so there's every likelihood that these programs will be less generous in the future. No magic 'lockbox' can change that.
You may or may not be an actuary. But you don't know "this stuff." I do know this about Internet forums: Expertise claimed is in inverse proportion to expertise held.Delete
But you are correct about one thing, though not in the sense you intended.
If CEO Mitt succeeds in his hostile takeover and brings enough boys like Ryan with him, there is certainly "no guarantee that the programs will remain unchanged."
As for Gore's "lockbox", please do some research and tell us what Gore was actually proposing. It will be interesting if your take comes anywhere close to reality.
"Have you seen anyone discuss the need to rebut Romney’s Medicare pillage?"ReplyDelete
Maybe because Romney's argument is the one plausible argument that he has ever made, and they want to hide from the subject altogether. Does anyone think the "the cuts are to payments to providers and not to services" is in any way logical or sensible? Has any for-profit business ever accepted a reduction in payment without reducing the product or service for which it is being paid? The idea is absolute nonsense.
Tell a construction supplier that you will only pay $600 for that truckload of gravel and not the $800 that he quoted. You will get a "truckload" of gravel, okay, but it won't be the eight cubic yards that you were expecting.
I needed to get a new primary care physician last month. I went to the one my neurologist referred me to and was told that she was not accepting any new patients. Then the receptionist asked who referred me and what insurance I had, and that she would see what she could do. With the referral and the fact that I have private insurance, I was accepted as a newe patient. You think I would have been accepted if I'd said I was on Medicare?
"Has any for-profit business ever accepted a reduction in payment without reducing the product or service for which it is being paid?"Delete
Yes, of course.
For example many pharaceutical products are delivered for less money when negotiation which delivers mass customer base to the drug companies is able to get a better price. The same drug is delivered. If you have no insurance -- you pay more, but get nothing better.
Heavens to Betsy! Surely Mitt knows what "negotiation" means even if some of his followers are fuzzy on it.Delete
And by the way, Wal-Mart, for example, "negotiates" with its suppliers for reductions in costs all the time.
"Does anyone think the "the cuts are to payments to providers and not to services" is in any way logical or sensible?"Delete
It's really not that hard to imagine.
I'll ask you a question: If the military is paying $700 for hammers but negotiates a new contract so that is now only paying $15 per hammer, would it make more sense to call that a spending cut, or savings? It seems Mitt Romney would have us call that a budget cut.
Even though Americans pay far too much for healthcare, there is no way we can ever pay less without making it worse.
Stop talking sense to me, immediately.
Reimbursements change yearly with Medicare. In the mid-80's Cataract surgery was reimbursed $1,800 per procedure, mid-90's it was approx $630, today it remains below $1,000. And from what I've heard that field of medicine hasn't hurt a bit. Fortunes are still being made.Delete
Nope, the reduction in payment that you are talking about is a reduction in price accompanied by the promise of a large increase in amount and actually represents an increase in payment. That is an entirely different thing.ReplyDelete
Back to my construction supplier. If you tell him that, rather than $800 for one truckload, you will pay him $600 per truckload for 200 truckloads, you will get full truckloads and very good service.
Obama is not telling providers that they are going to get more business at a lower price per unit, and this is not negotiation. He is merely cutting the price.
Actually, the Medicare expense savings we are talking about here is *precisely* the result of negotiations that rely entirely on the clout of having a large base of customers (repellant word for humans who need medical care).Delete
You asked, thinking foolishly that you wouldn't be answered, "Has any for-profit business ever accepted a reduction in payment without reducing the product or service for which it is being paid?"
You have seen the answer. It is transparently obvious you are wrong.
You hope to change the question now -- but you remain wrong.
Many "customers" are able to negotiate lower prices for themselves for various things ALL THE TIME.
Some folks end up paying more for the same thing.
So you were wrong about that in general.
And you're wrong about Medicare in particular.
Want to keep at it? Maybe you can still be more wrong. Keep trying!
I had a recent ER experience in late August that may help explain why hospitals were willing to get on board with lower reimbursement.ReplyDelete
Nothing life-threatening, I was brought back and treated for about an hour twenty minutes. During that time about ten people came in for treatment, Through temporary partitions I could easily hear conversation between patients and the hospital coordinator. Only one other person in that time had medical insurance of any kind. Ultimately who pays for that free care? A: What can't be passed along to me/my insurance, the hospital simply has to eat. Hospitals reasoned they will make up for reduced reimbursement by way of an increased volume of insured patients.
The Republicans and the Democrats are both barking up the wrong tree. They say they're cutting fraud but are they? It's not the government that's comitting the fraud, and the ACA does not solve it. You're not supposed to say it like this, but a great deal of the waste is on the private end, not the government. Overhead is 3 times as high in the private sector, and fraud is huge because of Fee For Service (NYT did a story on this). Cut costs by limiting their lobbying abilities, remove copyrights, and introduce either HMO or doctor-specific insurance (which I think could have its own problems, but should limit doctors incentive for useless testing).ReplyDelete
Because, Irish, see.
I'm so funny.
AGAIN, Bob, there ISN'T any Romney tax proposal! There are only several big promises which are very much contradicitonary and can't be fuliflled at the same time. Romney doesn't have a plan, he never published anything resembling that. And it's high time for him to explain which promises he has to break and how all his real reform proposal looks like.ReplyDelete
Really, Bob, by talking about an alleged "Romney proposal" allt he time, even though nothing like that exists, you fall into a very similar trap like Ezra Klein with this usage of the phrase "Medicare cuts". Face it, you adopted Republican framing here, too, by taking Romney's self serving statements at face value!
And sooooooooooooo played.ReplyDelete