And now, they're coming for your Social Security money - they want your fucking retirement money - they want it back - so they can give it to their criminal friends on Wall Street. And you know something? They'll get it. They'll get it all from you sooner or later. Because they own this fucking place. It's a Big Club: and you're not in it.
Everyone knows — or should know — that the United States spends much more than any other country on health care. But the Kaiser Family Foundation broke that spending down into two parts: the government’s share and the private sector’s share (both measured as a percentage of total gross domestic product), then compared the results to figures from 12 other countries that are members of the Organisation for Economic Co-operation and Development. And here’s the shocker: Our government spends more on health care than the governments of Japan, Australia, Norway, the United Kingdom, Spain, Italy, Canada or Switzerland.
Think about that for a minute. Canada has a single-payer health-care system. The government is the only insurer of any note. The United Kingdom has a socialized system, in which the government is not only the sole insurer of note but also employs most of the doctors and nurses and runs most of the hospitals. And yet, measured as a share of the economy, our government health-care system is the largest of the bunch.
And it’s worse than that: Atop our giant government health-care sector, we have an even more giant private health-care sector. Altogether, we’re spending about 16 percent of the GDP on health care. No other country even tops 12 percent. Which means we’ve got the worst of both worlds: huge government and high costs.
It’s also important to note that, even with this high spending, we’re getting worse outcomes than all the Western countries spending 5-7x less than we do. And, of course, if we had the costs of any of these countries we’d be facing surpluses todayinstead of deficits. But we’re told the only road forward for our country is to slash Medicare, Medicaid, and the rest of the social safety net and give the money to the richest 1%. Saying anything else isn’t Serious.
"…these are the basic points liberals should be arguing:
• These vouchers would be grossly inadequate.
• For that reason, most seniors wouldn’t be able to afford adequate coverage.
• Medicare as it exists today is indeed sustainable.
If you find yourself arguing about something else, you may already have lost."
— Bob Somerby, speaking the truth. Keep it simple and to the point. Pizza, the Marine Corps, and their relative similarities or interchange rates need not enter into it and our arguments tend to be weakened or just diffused by the presence of these things.
The Democrats have a uniquely potent message to offer here, one that polls almost uniformly in their favor; as a result, constantly going off to fight ultimately pointless side-battles is precisely what the GOP would love to have happen. It muddies an otherwise crystal clear dichotomy. The GOP wants to end Medicare as we know it. The Democrats do not. This is because Medicare, even as currently figured, is sustainable. Long term fixes and cost (and rate of cost-growth) containment through mechanisms installed in the ACA? Of course. Wholesale gutting that leaves only the name in place: not necessary. Period.
Paul Ryan, at the GOP meetup with Obama: Mr. President, the demagoguery only stops if the Leaders stop it. [GOP attendees give standing ovation]
Paul Ryan, immediately BEFORE said meeting: it’s Obamacare itself that ends Medicare as we know it. Obamacare takes half a trillion dollars from Medicare — not to make it more solvent but to spend on this other government program, Obamacare. And then it creates this 15 panel board of unelected, unaccountable, bureaucrats starting next year to price control and ration Medicare for current seniors.
Paul Ryan on Morning Joe: The president and his party have decided to shamelessly distort and demagogue Medicare
Paul Ryan, 2009: [the ACA will] take coverage away from seniors, [...] raise premiums for families, [... and] cost us nearly 5.5 million jobs. [... It's] a government takeover of healthcare [that will] lead to rationing [and a] European social welfare state.
Lemkin: Paul Ryan, serial liar and ruthless demagogue. And considered the Serious Adult of the GOP. A real policy wonk, that one...
Can we be clear about that budget problem? It’s driven not by Medicare. It’s driven by the same relentlessly soaring health-care costs that are pushing premiums through the roof and causing middle-class families to shell out more and more money for deductibles and co-payments.
Some features of Obama’s new healthcare law will slow the rise — insurance exchanges, for example, could give consumers clearer comparative information about what they’re getting for their insurance payments — but the law doesn’t go nearly far enough.
That’s why Democrats should be saying this: We need to allow anyone to sign up for Medicare. Medicare is cheaper than private insurance because its administrative costs are so much lower, and it has vast economies of scale.
If Medicare were allowed to use its potential bargaining leverage over America’s hospitals, doctors, drug companies, and medical providers, it could drive down costs even further.
And it could force the nation’s broken health-care system to do something it must do but has resisted with a vengeance: Focus on healthy outcomes rather on costly inputs. If Medicare paid for results — not tests, procedures, drugs, and hospital stays, but results — it could give Americans better health at lower cost.
Emphasis added to point out that this is exactly what Democrats need to be saying. The steadily rising cost of Medicare is only indicative of the problem, it is not the problem. Never was, never will be. Paul Ryan wants to “solve” the issue by simply setting an amount that the government will pay and then telling anyone who can’t meet the difference to kindly go die in the streets.
Democrats, on the other hand, want to solve the problem by solving the problem. And how does the GOP respond? By trying to undo the ACA and any other cost-containment measure. By trying to end Medicare. And, of course, by redirecting the money harvested from the end of Medicare to the richest of the rich. Who so desperately need it.
— Nancy Pelosi, once and future Speaker of the House, reprising her prior quote on Social Security.
This is exactly where the Democrats need to be: stating clearly that there will be no significant benefit cuts to Medicare. We will achieve cuts and reduce costs through implementation of the ACA and reforms to existing money-holes like Medicare Part D; this is, in fact, the only durable way to deliver spending reduction: by lowering the overall per-person cost of medical care in the United States.
The next nearest developed country spends about ⅕th what we do per person on healthcare and gets better results by almost any metric you care to use. You control costs by controlling costs and the rate of their growth, not by setting an arbitrary benefits value that you will pay forevermore.
Note to the MSM: healthcare costs and the rate of cost growth are the issues in federal deficit and debt discussions. Why are these never, ever mentioned or asked after? If you’re truly a Serious Person when it comes to deficits, this is where you should be starting and finishing.
[…]Challenged to produce an actual plan, Obama produced rhetoric.
As opposed to Ryan’s plan and its magical unicorns based solutions? Honestly and specifically please detail exactly which programs and federal initiatives Ryan is specifically cutting to get spending to 3% of GDP? Are you aware that current military spending is all on its own consuming about 3% GDP? It’s no coincidence that the only specifics in Ryan’s plans are the tax cuts to the wealthy and the functional elimination of Medicare and Medicaid. That’s all he cares about. Deficits don’t even enter into it; that’s why the plan so brazenly doesn’t even bother to pretend it’s really lowering deficits. Only the math addled beltway media seems to think it will do anything but increase deficits. Instead, Ryan’s plan is all about undoing a social contract that’s been in place for nearly a century. Anything else that happens, any outcome for good or ill is simply window dressing and utterly unintentional. The elder poor will kindly go die in the streets, as the plutocrats need that money.
Obama is different president than I expected him to be. I expected him to be a pragmatic crusader, but he’s not really that. Were he a crusader, he’d better exploit his bully pulpit.
Clinton, I think, was driven by power. Obama doesn’t seem that interested in power … he’s more interested in importance. Or rather, I think Obama wants to feel important. Wielding power is one way to feel important, but so is talking about wielding power. And lest you think that talk isn’t important, remember that our warmongering President won a Nobel Peace prize as a result of his talking. I think that prize was terrible psychologically for our President, in the same way that our election was terrible for him too. He was elected without actual achievement, and he was given a Nobel Prize without actual achievement … naturally, he’s learned that actual achievement isn’t that important. That’s not a good lesson for a President to learn.
Sorry, but this is simply horseshit. Obama won a Peace Prize because of his talking? I’m fully aware that he has no negro dialect, but Barack Hussein Obama won a Peace Prize because he’s a black man who was elected President of the United States of America, which only 150 years ago fought a war over the “states’ rights” to allow its citizens to own other human beings who just so happen to share an ethnic background with Obama. He furthermore won that election by means of the first non-plurality (e.g. true majority election) that’s occurred in this country in decades. This apparent non-achievement was deemed utterly impossible and was the subject of utter “no Serious Person can believe this is possible” derision as recently as 20 years ago when Jesse Jackson was running regularly. But, yeah, total non-event.
And, oh my stars, a Peace Prize recipient is presiding over killing and wars! To the fainting couch! I’m sure they’ll get around to the W Bush statues in our new and wonderful Peace Spring Eternal Middle East any day now.
All that aside, maybe it’s escaped your memory that Obama was also elected a United States Senator. Now that’s suddenly not an actual achievement? I guess ACORN rigged it up for him then too. But which high national office did George W. Bush hold before being elected President? Clinton? Jimmy Carter? Gerald Ford? I must be forgetting all their reams of national-level elected experience before landing the top job.
Finally, and most importantly, anything Obama proposes as “deficit policy” is actually unnecessary. While his plan includes specifics, why even bother? Leaving aside that the GOP House will simply shitcan his stated preferences as a starting point (even if said stated preferences are/were the GOP priorities of that morning), please do recall that doing nothing at all will largely solve this issue in short order. Thus Obama can sit back, veto extensions of the Bush tax cuts and watch the budget come into balance. Period. Or, using parts of the Bush tax cuts as leverage, he can perhaps shape some sort of policy compromise that suits his desired outcome.
And that’s the key. His desired outcome. If we’ve learned anything about this President, it’s that Obama is interested in outcomes. He could care less about tilting at preferred policy windmills, plaudits, power, and most problematic of all: the credit for any of it. For example, Obama has lowered taxes and reduced the size of government, but seems to be going out of his way not to tell anyone. Most polls show people believe the opposite is true on both counts. Even more importantly, though, his administration managed to pass the ACA, which likely will prove to be the single most important legislative achievement of my lifetime when all is said and done.
But, yeah. He’s not achieved anything.
I’d advise you to get some new hobby horses. These are very tired indeed. Maybe try “where’s the long form!?!” on for size.
This Pelosi post got me thinking about just what a Democratic response to a Ryan-style plan on Medicare should even be. After all, if you work from Ryan’s far right starting point and counter with “well, let’s just privatize x% of Medicare for this set of individuals” or some other “sensible middle” type compromise, then you’ve already lost. You’ve advanced the GOP’s idea of the program (which is a bad one) significantly and at the expense of the better solution: Medicare as it stands or Medicare plus substantial improvements.
It is a fact that the real driver of deficits in this country are healthcare expenses. Don’t take it from me, here’s the CBO’s report (PDF link):
Medicare and Medicaid are responsible for 80 percent of the growth in spending on the three largest entitlements over the next 25 years and for 90 percent of that growth by 2080.
But if we could achieve the per patient healthcare cost of most of the other developed nations in the world, we’d be facing yawning surpluses in this country, not deficits, and we’d very likely have better individual health outcomes to boot.
Therefore: the Democratic response to Ryan’s “privatize Medicare” should in fact be: Medicare For All. Period. We don’t want to reduce this program. Like 87% of all Americans, we think it should at the bare minimum stay just as it is. Preferably, we’d like to massively expand it. This has the dual benefit of covering medical expenses for everyone in the country and relieving the number one deficit driver in the economy: everyone’s medical expenses. Plus this means we eliminate the dread ACA and its totalitarian horrors. Everyone wins!
Now, of course, I don’t really think Medicare For All has any particular chance of becoming law; what using this sort of proposal does do is set the limits of the debate more appropriately and in ways that tend to favor outcomes preferable to the Democrats.
On the right: Eliminate Medicare and let the wealthy fend for themselves.
On the left: not only keep Medicare, but make it the healthcare provider for all, with tremendous humanitarian benefit but also knock-on budget benefits. Then you’d be down to arguing about whose plan actually saves more money long term and how that impacts health outcomes in America. Which is precisely where the debate needs to be.
While a single visit to an emergency room can cost hundreds or thousands of dollars (often paid for by the government), a call to a poison center costs the government only $30 or $40. A study in the Journal of Medical Toxicology estimated that the poison centers saved the State of Arizona alone $33 million a year. Louisiana eliminated its centers in the 1980s but restored them when it realized how much money they saved.
Classic GOP: borrow a billion to save a few million and demolish a demonstrably effective government program. The problem is, no government program large or small can be seen to work. Thus it must go, costs be damned.
If the GOP wants it, you can rest assured it is going to create a bad policy outcome. Bad policy outcomes are catnip to the GOP.
"I’m not optimistic about [Wyden-Brown] going anywhere. The Affordable Care Act has taken on too much symbolism for the Republican base as something that must be destroyed. It doesn’t matter if Wyden-Brown actually gives Republicans what they’re asking for in terms of policy."
— Adam Serwer is mostly right here, but the fact is that anything Obama wants has automatically “taken on too much symbolism” for the GOP to allow it to happen. By taking up a position as anything but against Wyden-Brown, Obama has absolutely doomed it.
Obama and his staff are still assuming that the facts matter. That a media exists to notice and discuss his sober position that essentially gives the GOP what they want on a key issue. That the serious people actually care about policy outcomes despite 40 years of evidence to the contrary. That the GOP movers and shakers will be seen doing anything, anything that even remotely agrees with a position the President has taken up. All of this is squarely why Wyden-Brown will fail, no matter how good or bad it might be: Obama wants it, and has signaled as much. It doesn’t stand a chance.