As many on the blogosphere have been noting for months, the only policy item Republicans used to win election in November 2010 was an odd defense of Medicare. They accused Democrats who voted for the Affordable Care Act of cutting $523 billion in Medicare funding to “pay for Obama-care.” They positioned themselves as the defenders of senior citizens. They created TV ads and mailers with this same theme. It wasn’t all that true – but it’s what Republicans used to win the House of Representatives, and it worked. Their base of elderly voters were very taken by the message and came out in force to defeat those they were told just cut their Medicare.
Flash forward five months, and now Republicans are about to unveil a budget that privatizes Medicare. It ends enrollment to the single-payer program entirely within 10 years, and everybody else who reaches the age of 65 gets a voucher they can use to purchase health insurance on the private market. The voucher’s value does not increase over time even as health insurance rates rise, so it will cover less and less of the cost of insurance. These Medicare-certified private plans, ironically, would live on an exchange, much like the private market in the Affordable Care Act. But two things here: one, the Medicare certification would have no standards like essential benefits, annual limits and minimum guarantees, unlike the vision for insurance exchanges in the ACA; and two, this would cost more money overall, since Medicare is much cheaper than private insurance, similar to all single-payer health care systems. The burden of that additional cost would fall on the individual, as the voucher would stretch less over time.
The same people who won election based on a dubious claim about Democrats cutting Medicare are about to eliminate Medicare and replace it with a free market approach that doesn’t guarantee coverage. They hope the invisible hand of the free market will spur innovation and lower costs over time, but the free market in US health care currently is also the most broken, with the highest cost, the highest rate of cost increases, and the worst quality control. Media figures will probably tread lightly over all of these points, but it’s pretty simple: the Paul Ryan budget plans to end Medicare.
The Ryan plan is to get rid of Medicare and in place of it give seniors a voucher to buy health care insurance from private insurers. Now, what if you can’t buy as much as insurance or as much care as you need? Well, start saving now or just too bad.
Now, by any reasonable standard, that’s getting rid of Medicare. Abolishing Medicare. Phasing it out. Whatever you want to call it. Medicare is this single payer program that guarantees seniors health care, as noted above. Ryan’s plan pushes seniors into the private markets and give them a voucher. That’s called getting rid of the program. There’s simply no ifs or caveats about. That’s not cuts or slowing of the growth. That’s abolishing the whole program. Saying anything else is a lie.
Now, is this political suicide? I don’t think anyone has a good sense of how Americans interact with policy debates. I imagine there’s some way this could be sold to them as positive. Maybe “premium support,” the new Orwellian buzzword, will sound good to some people. Everyone likes support! But provided that this gets explained in something approaching clear language – and provided the opposition party actually mounts a defense – I can see this inspiring rage among precisely the people Republicans used to win the election in 2010.
It’s also worth wondering if the tax increases for 90% of Americans to pay for the tax cuts for the rich will be a feature of the Ryan budget, the way it was in the Roadmap.




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So do the Democrats have the balls to start singing ad nauseam about the death panels or not?
Is that a trick question?
A: Nope.
No. To be redundant: RushGlennSarah have been softening up the T-GOP to accept this a the way of the virtuous rightwing voter. The Libertarians/T-GOP are all about “rugged individualism,” and never ever having the d*mned gubmint meddling in the serfs’ lives (except when it comes to the bedroom or women’s lady bits).
So, No I think most rightwing voters will predictably snap in line and go along with it in the very very misguided belief that they are being ever so virtuous, patriotic-y and holier-than-thou.
JMHO; time will tell.
Will trad-Dem voters get off of their behinds to protest? Unsure. Time will tell on that, as well.
And Obama will browbeat the Dems in Congress to go along with the plan in a spirit of austerity and bipartisanship.
This is not snark.
Republicans are relentless. The really must think nothing of the bottom 99%. Who are these cretins, and why do they have power over life and death issues? Their only real talent is no longer called for (concentration camp gas dispenser)
The idiots could have gotten Medicare Open Enrollment through within six months of Obama’s election. Citizens and Business (much greater competitiveness) would have loved it.
But no, you dance first with the corporations that brought you.
Sad. Vouchers, for Christ’s sake. What a disaster.
The Democrats’ lack of balls does enter into the calculation, but in a different way than you seem to be implying. The fact is the Democrats also want to eliminate Medicare to please their corporate sponsors, but they don’t have the balls to do it. So they’re happy to sit back and let the Republicans take credit for it.
Privitizing Medicare is the inevitable follow-up to Obama’s failure to get genuine HCR – i.e. to eliminate the private for-profit insurance companies in favor a national single-payer system. Obama’s HCR does zilch to either drive down the ever-increasing cost of health care or make coverage universal. And the two are inextricably linked IMHO. The continued rise in the cost of health care is simply unsustainable. But rather than tackle the real problem – the cost of care – the pols have decided to attack the political problem – the cost to government – by throwing the cost back on the elderly, the sick and disabled. Frankly, it’s a strategy that seems likely to work. By pushing privitization out to the future, they defuse much of the opposition from seniors who understand the necessity of Medicare. Those younger than 50 will tend to want to worry about the problem in the future if the choice is higher taxes [and that's how it will be painted] today.
Tell me about it. I would like to know why it is not being acknowledged that Obama and the Dems would probably being doing the exact same thing Repugs are doing if they had kept Congress.
Thank God for the Republicans. Only with the unstinting success of their efforts will socialism be brought to this country.
And they’ll try to kill everybody to succeed in their efforts.
There! I fixed it for you…
sounds right to me DRB – there’s a major tax hike or serious crash in gov’t services on the not too distant horizon…something tells me it won’t be a tax hike. which I think it should be – eat the rich.
Also – dey took our jarbs !
Hurry Up and Die is already being put in place via states’ Medicaid cuts.
Next up, Medicare.
Then, Social Security. It seems Ryan isn’t ready to take that on just yet. Of course, Obama has already made noises about “reforming” SocSec….
This presumes a message-capable Democratic party willing, and able, to defend Medicare from the GOP onslaught. I’m not sure that’s a given.
Good luck with those vouchers if the standard rules of medical insurance apply. No policy for you, if you cannot supply a certificate of creditable coverage for the last 5 years.
The Medicare vouchers and Medicaid block grants? Also part and parcel of the health insurance company rescue plan, as their revenues dry up after their policy revenues continue to fall dramatically, AHC or no.
A brilliant R plan to support the beloved Medical Insurance industry. How much did they pay Rep Ryan in his last election?
“Hurry Up and Die” should be the rallying cry for the republican plan. After all, that also takes care of Boomers moving to Social Security. I guess the only thing that the republicans might be willing to fund is a national training program for Wal*Mart Greeters.
Right on, Teddy. I’m not sure that exists… once upon a time Clinton ran such a thing, but the corporate memory of that is now Corporate Memory.
Dream ON! Soon it’ll be: if ya wanna be a serf for WalMart, then PAY US for your training.
I’ve been noticing the “invisible hand of the free market” has been flying the bird at most everyone but the top 2% rich. No sane person I know wants to be forced by the government to support the insurance companies, and, such corporations that happen to have no meaningful controls on them including the obligation to actually render a service in exchange for the payments.
Hope you don’t mind, but I think this is more accurate.
Privatizing Medicare [also known as Tony Soprano-style beak-dipping by Big Ins.] = new route to privatizing Social Security.
First they came for civil liberties, then they came for collective bargains, then they came for…
It’s a shame the President cannot be recalled.
Based on what he’s done since being elected (remember “hope” & “change you can believe in”), that’s just what he’ll do. Meanwhile, true-believer Dems will whine that Republicans are worse!
Obviously, the “worst” is the guy who’s in office and enacting BAD policy. But, I’m afraid the vast majority of Dem. visitors to this site would rather be screwed by someonw they know – however repulsive!
Better “the invisible hand of the free market” to “spur innovation and lower costs over time” than the very visible hand of Socialized medicine. Jeez, this government can’t even pull the trigger on the scheduled reductions on Medicare physician payments (the “Doc fix”) in order to control costs. How the heck does Obama think he can do it by going fully to a single-payer nationalized health care system?
o/t
hey ! were your ears ringing about 10pm ct last night ?
was asking after you on twitter – I seem to recall comments from you (don’t think it was a post) wherein you were discussing a lax airline safety enforcement environment that if left unchecked, could lead to issues as grave as structural integrity for aircraft (see Southwest) I think we discussed it within the context of icing/de icing
ring a bell ?
(you got DM)
Actually. this is brilliant strategy on the part of Republicans. They’ll talk Obama into doing it for them.
Digby:
Emphasis added.
Considering that the Rethug’s only strong demographic is the old farts, it sure looks like political suicide. “Cut spending for others, not for me” remains a pretty strong motivator, I don’t think appeals to the market gods are going to counteract it.
Does not work with a monopoly.
That is why it is only for those 55 and younger. I wonder how those 50 year olds will react though – especially considering their unemployment rate. If Dems were smart, they could win back that 40-55 demo.
Actually, I’m counting on the usual confusion about when it will kick in and what exactly the effect will be, i.e., that our media will provide their normal level of coverage and explanation. IIRC, a large number of people now think that HCR was rescinded, right?
Did you forget the healthcare fight. That was not the repubs but dems and WH with majority in both houses but to try to fool us, they insisted, no we want it only if repubs say yes, a super majority, never required before.
Face it, there is no one defending the common man anymore.
We need a new party and a new president.
Like DoD spending, the “medical” system is very nontransparent and wasteful not only of our treasure but our blood. According to the intentionally satirical “Medical Bills discovered to be the biggest killer in the US” (2009), the US elite are just so gung-ho on capitalizing on the suffering (i.e., prisons) and death (i.e., constant state of war) of the rest of the population which could be dramatically mitigated with much better public policy (i.e. cannabis decriminalization) and systems proven by other countries to, like, actually work. Something we all do need is proper dental work which you notice goes mostly unaddressed (see “My, What Rotten Teeth Poor People Have: The Hidden Health Care Crisis and The Dems” [Mother Jones, Jan. 23, 2008]).
It’s really simple when you boil down the GOP’s Health Care ideas. They believe that if you can’t afford Health care you deserve the consequences. They believe that the rich have “earned” the very best care and the rest don’t deserve crap. It fits their over all ideology that cares only for the wealthy and their needs. What the rest of us do is of no interest or consequence to them and their backers.
There’s a reason they all worship Ayn Rand. Even (especially?) the alleged Christians among them, such as Mark Sanford.
Now that ryan has shown what the repugs want with regard to Medicare, obama has his marching orders and the dims will respond with alacrity. president bipartisan realizes that he must strengthen the repugs more and try to marginalize the dims by the end of this term if he wants a second term funded by the motu. You might say that this is self-cannibalization of our nation: our elite are eating the seed corn of the next generations for current enrichment and this will leave nothing for the future. The problem for all who are yet to come is where to go for relief. China and India really don’t need immigrants and Europe probably can’t support too many coming in from the US. Any ideas?
If you have read 1984 and Shock Doctrine, you see our future outlined.
I really think a lot of it has to do with their belief in a personal god who favors certain people and groups. Those “blessed” will be healthy and wealthy and those who aren’t deserve what they get – poverty and an early death. (Their god is vengeful, that’s where they get it.)
Pay more, get less. What’s not to like?
Amen.
It seems to me that the logical next step is to remove requirements that hospitals treat any urgently ill person who turns up at the emergency room. After all, that’s just socialism with a different face. People who get sick like that are probably that way because God doesn’t like them or because they didn’t take care of themselves in the first place. Actually both, since according to at least some theological schools, God doesn’t like them because they didn’t take care of themselves by getting rich.
It doesn’t work under competition in this industry either. Competition works for stuff that is essentially homogeneous and anonymous, like bushels of wheat. You want somebody anonymous taking care of your grandmother on the ward? Unregulated markets do not work well (at all) where the so-called ‘product’ cannot be separated from the person delivering it. This is true in a lot of other areas, like education, child-care, and in general all the so-called ‘caring’ industries.
I don’t see this getting anywhere, even though it is exactly what I would like to see. I have always intended to keep my private insurance and to never ever join Medicare or collect SS. There should be a way to opt out. You know, the free choice thing..
Especially The Shock Doctrine. IMO.
When can I opt out of paying for wars and torture, you know, the free choice thing?
Medicare is National Health Insurance for older persons.
The health insurance cartel want nothing to do with health
risk (for a fact their business model is avoiding it,) so
not wanting anything to do with older persons if allowed
for Medicare.
Some Medicare Private Management exists today essentially on a
cost-plus basis, potentially incentivizing increasing cost.
The health insurance cartel (which has statutory immunity from
the anti-trust laws,) surely has not embraced garnering health
risk.
So what is being offered surely is a glorified benefit program;
to simplify: like the $1,000 dental benefit you can use for this
crown or that one.
So the idea, potentially, essentially eliminates providing for medical catastrophe altogether, and with people fighting for medical-financial survival, also potentially eliminated early interventions. The logical extreme of GOP health care is Go To Hell health care, and this is it.
http://sites.google.com/site/evernewecon
The thinking must be:
1) Obama is going down, and the GOP will package a complete set of lies to campaign on, counting on the lethal combination of 30% racism in America, the support of 95% of the moderate Republican voter base, the lose of 20% of the Dem base from Obama’s “performance”, and the loss of 50% of the independents from economic and war anger. Thus, privatizing Medicare isn’t enough to swing the election to Obama’s side.
Or,
2) This is a play to negotiate from the extreme right side when Obama is in panic mode as his campaign train sits stalled at the station, and he feels he has to show some kind of breakthrough “bipartisan” “progress” to gain some traction with voters and his corporate backers.
I don’t know what else they could be thinking. Of course, it’s possible that they aren’t thinking at all and this is just ideological purity and religious delusion in action.
And I don’t like paying for prayer breakfasts either!
Block grants–didn’t the the Repubs say they want to eliminate them? So no more Medicaid for you.
Meanwhile, the more this crap goes on, the more I want to get my gun and join a rebellion. I suppose I can thank the Republicans for something….
BTW, how is changing Medicare into a
subsidyvoucher program where seniors buy private insurance off the market any different from Obamacare that providesvoucherssubsidies for everyone to buy private insurance off the market???Seems to me the Republicans are hypocrites for proposing such a thing after their antics to Obamacare and the Democrats would be hypocrites for opposing this since this is just Obamacare extended to seniors.
Damn it can get confusing when both parties try to outrightwing each other.
And yet I bet you hated Obamacare that provides vouchers for people to buy private insurance off the market???
Just like a rightwinger, hypocrite to the core.
They have power because the vast majority of Americans have brains smaller than gnats. Period. End of discussion.