It certainly looked yesterday as if the White House had dropped any notion of using an increase in the Medicare eligibility age as a bargaining chip in future negotiations on a grand bargain. While the White House has not ruled out increasing the age, some of its leading allies did, and Dick Durbin went so far as to say this was “no longer one of the items being considered by the White House.” But the Press Secretary said they would not engage in hypotheticals, seemingly undercutting that categorical.
My theory is that the insistent focus on just the eligibility age masks other areas of Medicare policy where Democrats may remain open to benefit cuts. In particular, means testing has become something where Democrats have some bend in them. The problem with means testing is that it already exists; higher-income seniors pay higher premiums already. And the threshold for “higher-income” in Medicare for means-testing is only $85,000. In addition, there are only so many of these high-income seniors; to actually get anything resembling real savings out, you would have to lower that threshold for “high income” well into the middle class. But since the President already put this on the table last year, making it the menu from which Republicans have used to extract concessions, Democrats have pronounced themselves open to it, while holding firm in other areas.
And even though Democrats are open to this one cost cutting move, they are saying no to increasing the eligibility age on Medicare; no to touching Social Security; and no to cutting into Medicaid programs that cover the poor and disabled. Many of these concerns were voiced directly by liberals to White House economic adviser Gene Sperling in a closed-door Senate Democratic lunch on Thursday.
Yet as an olive branch to Republicans, a number of Senate Democrats are ready to drop their long-standing opposition to Medicare means testing if it means the GOP will raise taxes on the top 2 percent of wage earners and if it’s part of a large, deficit reduction plan.
If you really want to means-test, you can do it much more efficiently on the tax side of the ledger. Tax progressively to fund Medicare, and then offer a universal benefit on the other side. A means test on the benefit side is more kludgy, especially because we’re talking about a period where almost everyone is retired.
Of course, Democrats are under tremendous Beltway pressure to stick it to the poor, the old and the sick. This Washington Post editorial is almost a caricature.
The devil’s in the details on all of these possibilities. But this all stems from the language of a “balanced” solution to deal with the deficit “crisis.” We know we have an unemployment crisis that has lingered for 5 years and is scheduled for at least 3 more, but it never gets discussed in those terms.
Image by Brooks Elliott under Creative Commons license.





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Means testing is a terrible idea. It not only undermines support for the particular program, it’s a huge factor in making people resent everything to do with government. Liberals have been corroding their own positions for decades by accepting it. In the name of stretching today’s pittance a little bit farther, they guarantee that tomorrow’s will be even smaller.
Yeah, where rich people give up one of their many vacations a year, middle class people give up sending their kids to college, and poor people give up *eating*.
That’s Washington Beltway “shared sacrifice” for ya.
-stewartm
Means testing opens the door to calling it welfare instead of paid for insurance. This is part of the repugs plan. Dems should not be taken in.
Whatever happened to reducing the basic costs of medical care? The $15,000 hospital nights? That would solve everything.
Unfortunately, it’s not a matter of Democrats being taken in…it’s a matter of Democrats finding a way to make this awful move sound more palatable to the people who voted for them. And by no means have they removed Social Security from the chopping block. They’re being dishonest.
I’m not sure they can do that. We pay more so that poor people can get medical care in the emergency room. I don’t mind doing that.
I think means testing is a sneaky backdoor way of getting the rich out of paying for any part of national healthcare: It works best if everybody buys in.
Fred Hiatt and Company will do anything to avoid having to pay 1950s tax rates, won’t they?
It’s just another way to reduce Medicare to welfare and then to elimination. One of the men who constructed SS is said to have commented that “a program for the poor soon becomes a poor program.” He resisted “means testing” for SS. He wanted as many people as possible invested in the continuance of SS, even people who didn’t “need” it.
Is that the Beverly Hills General Hospital?
The average cost of a hospital room per day in the US is about $4,000.
Healthcare costs can be cut, but it can’t be done with hand-waving.
I agree with the above comments that denounce the clinical denial that deludes partisans into believing the dems are clueless and spineless.I’ve been hearing this apologia since tribal dems were making excuses for Clinton’s right wing agenda. Both wings of this fascist duopoly are pimped by the same corporate duopolies ,and both sides of every issue are republican grist ,with the dems standing for old school gop and the pubs posturing from a tea party agenda .
This isn’t about cost-effficiency ,it is about either eliminating or privatizing all social programs .Every politically literate person in the US knows means-testing is to create a welfare stigma via which the target program can be block -granted into antiquity .
Rathe than being shepherded into corporate-navigated conflict ,ask why you are talking about savings for sustainability of a life-dependent program run by monopolistic profiteers,yet never question the unsustainable outlays for military/corporate transnational imperialism .
Means testing converts what is an insurance program–and I’ve been paying the premiums all along–into a welfare program.
And we all know that Bill Clinton’s white house bragged about having “ended welfare as we know it.”
Once it is portrayed as a welfare program, it’s on its way to the trash heap.
Then again, it was on its way to the trash heap as soon as a Democratic President called it an “entitlement” and pledged to “reform” it.
When a Republican President did that, he failed because of opposition from Democratic elected officials and Democratic voters.
When a Democratic President did it, “reform” became an inevitability.
http://www.washingtonpost.com/wp-dyn/content/article/2009/01/15/AR2009011504114.html
You can fool yourself into believing that voting for Democratic Third Way Trojan horses is the lesser of two evils, but it is the worst use of a vote from the left.
Dumb question maybe, but wouldn’t this scheme require establishing a whole new inefficient bureaucratic U.S. Department of Means Testing – possibly outsourced to a costly, unaccountable private contractor – that could easily wipe out any potential ‘savings’ on the payment of benefits?
Also seeming likely to me: people being denied care due to clerical errors, and then getting sicker and/or dying while trying to cut through red tape, proving they actually qualify for these once-universal benefits.
I went to the emergency room on a Thursday morning. Thursday afternoon, I was admitted as an inpatient.
All I needed was IV nutrition and fasting from food by mouth. No meds, no surgery, no nuttin’, but IV.
I left the hospital before dinner on Saturday.
The hospital bill was over $14,000, but that did not include the bills of the many doctors who stuck their noses into my room, however briefly, nor the doctors who supervised, by phone, the resident who was in charge of my care, nor did it include the emergency room bill.
This occurred in a hospital in the northeast, about as far away from Beverly Hills as it gets.
If you consider that a reasonable amount, we will have to agree to disagree.
Welfare departments around the country would probably be expanded to do OASDI means testing. They already do it for SSI.
I don’t mind either, but isn’t Obamacare supposed to end the need for poor people to get health care exclusively in emergency rooms?
The repugs plan?
Obama pledged to “reform” OASDI before he even took office.
When are Democrats going to stop kidding themselves that bad things come only from the right side of the aisle?
Fuck means testing for stuff citizens have been paying for out of their paychecks for decades.
Means test the Department of Wars of Aggression and military contractors instead.
Hey nix ,you are on fire .I would add another point to the savers of pretend policy .Wall St. has a rescission quota by which the insurance oligopolists are rewarded for fucking policy holders out of their coverage .Oops, think I heard a giant sucking sound and all those savings just got swooped up into higher profits .Well ,we can always just wring our hands .Hey ,I got a better idea ,let’s change the party from within ,and beat up Robert Rubin and the DLC with some flower power and therapy pillows .
That’s the point: private profit, however it’s achieved. Private profit equals all good.
Lets means test the members of congress for their taxpayer paid health care “entitlemants”
David. Thanks for catching this duplicitous message from the slippery slope folks in the WH. I guess I wanted to believe Durbin’s statement. (No matter how cynical I get, I just can’t keep up!)
A new strategy might be to create an immobile standard to compare all of the pols machinations to. Something like the International Declaration of Human Rights. Workers, minorities, voters, the elderly, have lost so many of their human rights under America’s new Pakistani-ized military/industrial/corporate governance. We need a rock solid bill of rights to compare to the daily grinding down of our social programs. How will we quickly see what is under attack if we don’t have a gold standard of fundamental rights and their obligations??
Otherwise, without a standard, it seems like folks get used to losing these programs for their social insurance. People seem to become inured to the degradation of their communities via impoverishment or via loss of civil liberties. The pete Petersons of the world are playing a long game. They will pay necessitous media slaves to crank out Washington Post editorials, crying wolf about the economy and demanding cuts, making themselves out to be reasonable when they are ‘economic extremists’, armed with the wealth of the rich. Over time, they create a toxic environment for those who would defend basic human rights.
Perhaps I say this because, at the end of a week of pushing back against the ‘cutters’, you point out that we have merely reduced the Democrats to hiding, and evasive action, in order to delay the retribution they face if they offer unnecessary cuts to social programs in order to solve a crisis of their own creation. All that is left is a set of values expressed in a declaration of human rights.
change the party from within?
Good one!
Means testing is the first wedge into the safety net program. Once it becomes a welfare program, then the chorus begins to take on an air of legitimacy. If this is a charitable program, it is understandable that it be cut when money is tight. It is starting to appear that the Dems are getting tired of being the defenders of the social safety net. If the safety net is viewed as a legitimate program of a modern developed country, then you would want to cut back on all of the other areas of spending before going after the safety net. Military cuts, Oil drilling expenditures subsidy, rich farmer agriculture subsidy all would be cut before even looking at this program.
Plus, I’m assuming it will add to the cost of administering Medicare?
Or is it intended for both SocSec and Medicare?
FDR must be rolling over in his grave.
Trust not the Corporatists, whether president, senators, or house members. Whether Democrats or Republicans.
They lie and use weasel words to flim-flam their way to what they want.
I think we need to go ape shit crazy again on the internets. Kevin Drum will have to go tsk-tsk and tell us to understand the pressures on the poor little Dems, etc.
Raise the temperature for our ever so skittish, or Corporatistic, Dems.
Burn up the phone lines to DC and state offices of senators and reps.
Send postcards to the worms wriggling away from our needs and wishes.
Demand no messing around with our EARNED BENEFITS.
And tell’em that David’s idea about means testing is perfectly well accomplished by raising the tax rates and FICA caps. Especially the latter.
Call more than once. Maybe every day from now until New Year’s Eve? Skip Christmas Day, maybe. Also, the DC offices will let their voice mailboxes fill up; that seems to be how it’s done when there are a lot of callers.
Yes, time commitment, but, hey, the cuts will be hitting us and our descendants for decades.
We’d better make sure the Dems know that this pill they think they can swallow is a poison pill.
This is not as obvious as the other crap being suggested, but it’s close enough to begin the death rattle of the Dem Party.
Voters will not support Dems who won’t support them.
this lnk names Dems names who would support menas testing
http://nbcpolitics.nbcnews.com/_news/2012/12/10/15824325-in-fiscal-bargaining-buzz-over-means-testing-grows-louder?lite