QOTD: HealthCare Debate
I totally empathize with this comment from MacroMan:
“Speaking of painful ordeals, health care is now a banned topic, except as it impacts financial market pricing. There is really no point having (or in my case, hosting) a debate in which a significant portion of the participants essentially stick their fingers in their ears, close their eyes, and shout “the government are morons so there’s no point even trying to change anything!!!”
They are of course welcome to that opinion, and should they wish to express that view, they should feel free to visit the appropriate venue to vent. But after another day of being told “ooh, you Europeans just don’t understand anything” by people whose idea of exotic travel is a visit to Bob’s Country Bunker, I’ve had enough.
Off topic health care posts now incur the risk of deletion.”
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March 4th, 2010 at 9:30 am
Really? For all your complaints about innumeracy in high places, I would have thought the Obamacare advocates’ steadfast refusal to count apples-to-apples numbers would be far more annoying.
Take Paul Ryan, for example. The man presents the Obamacare advocates with a little math, they say Thank you very much, and then go right back to making their silly claims about the impact of the new health care bill on the budget.
Whose fingers are in whose ears on this one? (I’ll grant you that most Republicans have ZERO credibility, of course.)
March 4th, 2010 at 9:31 am
What makes it DOUBLY funny is that Seniors and the Chronically ill ALL already have socialized medicine and would go crazy if that changed. In fact, it may be impossible any other way. Of course… old people spend the most on healthcare. So its already 50% socialized (and everyone wants it that way).
Then emergency room care and the uninsured are already socialed. And thats the way we want it. This is America, no one is denied care.
So now what? I personally WANT the govt to offer a HIGHLY RATIONED basic health insurance package for everyone at a stated price ($200/mon per person? $300/mon over 50, $400/mon over 60?). Why not? (If the private insurance companies can compete at $175 great… nothing wrong with that!)
But its obvious, private insurance companies just want to cover the healthy and put the sick to the govt.
Healthcare companies (and healthcare generally) is a much worse and bigger problem than banks, the Fed, financial regulations, etc. Over $100B every year in Medicare waste and fraud.
March 4th, 2010 at 9:32 am
Clawback — Paul Ryan does not have any math. He couldnt explain it to Chris Wallace, on FOX(!) News Sunday. He can say, “they are double counting.” But when asked… “what do you mean?” He just stammers and keeps saying his little circlar logic. That guy is not bright.
March 4th, 2010 at 9:45 am
What we’re dealing with is the American national psychosis: we never trust government and we never bother to think critically about this opinion. However, even in the face of massive evidence to the contrary we always believe that if private business invests resources they always do so efficiently, effectively and reasonably. If the government can do nothing right, including investing in things like sustainable energy and education, and if private business always gets it right, then how the heck did these private geniuses on Wall Street nearly destroy the American and world economies?
March 4th, 2010 at 9:47 am
There is no debate — only yelling across the aisle at each other.
There also is no leadership — the White House has done a terrible job leading the discussion on this.
March 4th, 2010 at 9:52 am
We don’t trust gov’t to do anything for the simple reason that we don’t trust EACH OTHER. They are us. Again, it’s a ingrained cultural problem. But Macro Man hits the nail on the head on this one. Absurd. I’ve totally tuned out the whole thing now.
March 4th, 2010 at 9:55 am
@cognos: You hit the nail on the head in your first paragraph. Senators and seniors are happy with what THEY have but they don’t want to have to give up ONE thing if it means someone else will have even close to the care they have. That’s the issue. Nobody wants to give up anything for anyone else. There’s always this notion that “I’m entitled to what I have”……..but “those people (wink, wink) down the road are not”.
March 4th, 2010 at 9:57 am
The Blues Brothers killed at Bob’s Country Bunker.
March 4th, 2010 at 9:58 am
My experience is that anything Obama is proposing is immediately regarded as crap by the red state religious high and mighty, of which I am surrounded by. And I agree with them on certain issues, but they never bring up how this guy has essentially done nothing different than his predecesor with regard to taking care of big business. The banks got coddled and their cronies put into positions of high authority. Who else would go to those positions.
This nation is still divided deeply along racial lines. Some parts of it moreso than others. You know what? It’s not even a regional issue anymore. There are pockets of nuts in every state, every city, who are opposed to the idea that a half-black president can be successful. To those people, I say, regardless of color, you and I better hope this man is successful, because we elected him to run the USA. If he fails, well, considering where we were when he took office………eccchhhhh…
March 4th, 2010 at 10:05 am
I really find it hard for people who have never availed themselves of the health care system to evaluate whether or not it adds any value to their lives.
The way it works now , what people do when they become too old or incapacitated , is they usually either sell off their possessions or whatever assets they have and enter a skilled care nursing facility if they can afford it.
Then Medicare and whatever other insurance they may have pays pennies on the dollar to provide for their care while social security sends the checks.
Hospitals are primary care facilities for routine problems is an extraordinary waste of money and resources.
And what’s going to happen is if you let all these privately guided lives enter into the system with no other backing than the government entitlement programs already in place is you’re going to find a system ill equipped to handle them.
What’s even worse is that people who paid thousands upon thousands in premiums over a lifetime are already rationed in terms of their care.
The person you need to ask about the appropriate nature of the current insurance system is the primary care physician.
When you have doctors who elect not to add patients rather than deal with insurance companies who won’t pay, then you know something is broken.
March 4th, 2010 at 10:13 am
cognos, take your fingers out of your ears. He was on Fox, for pete’s sake. And Wallace said spare us the details or somesuch. Blame idiot red-staters, not Paul Ryan, and not the numbers.
March 4th, 2010 at 10:18 am
Scott F says: “There also is no leadership — the White House has done a terrible job leading the discussion on this.”
We hear this all the time, it’s become the conventional wisdom: Obama didn’t do a good enough sales job. I watched many of his presentations on health care going back to his speech to the AMA last year. He has made a careful, detailed and coherent case for why health care reform is necessary to the US’ future economic competitiveness and viability. What’s happened is the Republicans have drowned out his message with lies and shouting down speakers at political meetings held to explain the policy; further, the press in its usual stupidity doesn’t cover the issues when presented but merely treats it all as just another horse race to be handicapped. Jon Stewart did a brilliant job of showing the stupidity with which the press handled the recent White House health care summit:
http://www.indecisionforever.com/2010/02/26/jon-stewart-on-the-bipartisan-health-care-summit/
March 4th, 2010 at 10:27 am
One of the best QOTD’s in a long time.
@cognos – good points. I can’t even discuss this with my parents, both collecting social security and on medicare. It’s crazy.
About the only way I can deal with this is watching Stewart or Colbert; they at least make me laugh.
Throughout this pathetic puerile political performance I don’t recall discussion of root causes with numbers. Yea, waste and fraud, but that can’t be all of it.
One thing for me is sure; I’m becoming more politically active and will work toward defeating every Republican — they are completely interchangeable and simply obstructionists. I hope they, as a party, wake up. But I doubt it; they are pretty much all (including Dems) in the pockets of big business.
March 4th, 2010 at 10:28 am
Passions run very high on this issue. If they manage to pass this monstrosity, it’ll be the #1 issue by far in November.
March 4th, 2010 at 10:39 am
Another example or privatization is the private ( actual public companies ) colleges…They live off government student loans or grants, they goose the stock, they donate, they lobby..they wait for the next class of students….They boast about the beauty of being private yet isn’t the student loan money they are after….Bill Alperts wrote about them recently…..Its truly howdy doody time or Rogar Ailes’s Foxification….Hell , half my pals from high schoool have been foxified .
March 4th, 2010 at 10:42 am
I need to start reading Macroman.
March 4th, 2010 at 10:44 am
cognos-what are you talking about? for starters the plan takes 500b from medicare, which will have to be made up somewhere as it won’t actually be cut, and counts the savings from a 21% medicare cut to physicians (which everyone knows will never happen) as two big reasons for it’s “budget neutrality”. These are just two substantial issues Ryan brought this up and it’s yet be addressed. Backers of government run health care have been woefully ignorant of basic facts at best and outright dishonest most of the time. Claims about savings from improved screening, efficiency of emr’s, malpractice concerns only effects 1% of total etc have all been looked at either cost money, or in the case of malpractice are so laughably absurd it’s hard to listen to. The overall claim that we’ll magically add millions of people to get unlimited free benefits and there won’t any increased cost, rationing or waiting lines is beyond a joke. Ever wonder why physician’s weren’t involved and remain OVERWHELMING opposed? Did you ever wonder why NO US trained physicians desire to practice in single payer, government run systems but thousands from canada/australia/EU would practice here if able in a heartbeat? Ever wonder why the mental giants on left only have left fantastical retorts like……you’re a racist and the krugmanesque, you haven’t been to europe and when I’m taking a taxi through paris people don’t look sick or poor
March 4th, 2010 at 10:49 am
Clicking thru to see the (alas, all-too-predictable) “discussion” herein, expecting to see the inevitable drunken heath care barroom brawl, I find I am (sadly) not disappointed, and am backing the door I entered thru rather quickly.
BR — please note whether any future topics on Bananamerican “Health Care” include a mandatory terms, data, and glossary acceptance prior to commenting — otherwise I’ll eschew the festivities.
jritzema — “The Blues Brothers killed at Bob’s Country Bunker.” — how true.
bye, now!
March 4th, 2010 at 10:53 am
monopsony’s are awesome, I can’t believe all those stupid fox people can’t understand that. Europe has clearly had a competitive advantage which resulted in them having lower unemployment and higher per capita gdp at ppp
March 4th, 2010 at 11:02 am
“krugmanesque?”
constantnormal, I’m right behind ya.
March 4th, 2010 at 11:13 am
The Blues Brothers killed at Bob’s Country Bunker.
But they played as the Good Old Blues… Brothers… Boys, as I recall. :-)
March 4th, 2010 at 11:57 am
So… my former statements aside. I agree that:
- Obama has done a bad job (clearly, result is not a “win”)
- Democratic leadership is old, dim, and awful (Reid, Pelosi). Er, all of congress is..?
- Right approach was probably “Phases”… Phase I, Phase II, Phase III bills, done yearly
- Dont we ALL want to ration care? (I do. Please give v BASIC care… not unlimited expenses).
- Dont we ALL want to tax cadillac plans? (Why “tax deductible healthcare”? Why not education?)
- No “hard choices” have been pushed. Why not push for lower medicare, SS benefits and higher age eligibility. We can all work til 68 or even 70 if we’re healthy. Its not 1935. Small gradual increases in eligibility age total change all “funding” discussions.
We need a Manhattan project against Medicare fraud (and govt waste and offer staffing generally). The govt could probably be 20% more efficient. This is $700B/yr. Thats ALOT.
P.S. We have to stop quoting “cost” numbers on flexible timeframes. It should all be “average ANNUAL”. You gotta love when people are like, “this will cost $2T”., “this will cost $200B”, “we are 58T underfunded”. And some of them are using 100 YEAR numbers! Its idiotic. In 100yrs the minimum wage will be $100/hr. Can be all please standardize on annual?
March 4th, 2010 at 12:58 pm
IMHO MacroMan’s comments are off the mark and do nothing but state that the “other side” is stupid. This is not helpful and just continues the standoff.
IMHO the debate is far more simplistic and true hearted than big government or Bob’s Country Bunker.
The Democrats want to expand health care coverage – that’s it. They really aren’t that concerned about containing costs AT THIS TIME.
The Republicans want to bring down costs and really aren’t that concerned about expanding coverage AT THIS TIME.
If Obama were truly as bright as some people say, he would have long ago figured a way to include TRUE elements of both in this legislation. He has chosen not to do so. He has chosen to remain focused on expanding coverage.
So everyone goes back to their corners and repeats their talking points — because we really don’t have good leaders in this country AT THIS TIME.
March 4th, 2010 at 1:07 pm
Allow the states to implement single payer systems, but not @ the federal level please.
If Massachusetts can fund it, and execute it, they should be allowed to. If Wyoming hates it, they can scrap it. But let it be done without Federal monies. If the people of a given state are inclined to pay up for it, they can and should. The best systems would attract more tax paying residents.
This would be a closer proxy to Europe, whereby each sovereign has its own system. Spain, as far as I know, doesn’t get subsidized by Germany, nor is Sweden funding Ireland.
At the heart of socialized medicine – is society. 300 million in a melting pot might be too big for this system to work. I certainly would be more accepting of social medicine costs at the local level, rather than federal.
Further, it would be more responsive and flexible, and ultimately – better.
I doubt the Europeans would be so affable if the whole of Europe had one giant single-payer system that starkly outlined the imbalance of payments across ethnic lines.
March 4th, 2010 at 1:07 pm
Agreed, Barry.
Some people just cannot contain their anger on this issue and just end up venting their prejudices. But since the health care issue is all over the media it will be in your face for a long time until something big happens in the markets to distract attention.
FWIW, I can’t understand what would be wrong with a BASIC care system, with significant cost controls. The savings for small business in particular are not widely appreciated. Most of the people who pontificate about health care have never had to pay ridiculous monthly premiums for healthy young employees who require only basic coverage and catastrophic insurance.
March 4th, 2010 at 1:08 pm
I agree that the States may end up being the prime movers in implementing health care reform. As we know, some of them are close to broke.
March 4th, 2010 at 1:13 pm
I would think that this blog of all blogs would be quite concerned with a discussion about actual “costs” and actual realities of this plan vs. other potential plans. [BR: The issue under discussion is the level of discourse -- it prevents an intelligent discussion on ANY cost issue]
Obviously there’s a problem. But while Republicans may be guilty of blindly blocking any attempt at reform, the Democrats have offered up a current bill that is a disgusting mess and a PERFECT definition of just how stupid this government is.
I don’t blame Obama for failing to sell this plan. He’s not selling it. He’s selling the idea of health reform and sells it quite well. This plan is garbage and he sometimes pays lip service to specific aspects of the plan, there seems to be a disconnect between the reality of what’s there and the sort of lofty ideals he talks about (many of which are better than the plan on the table.)
Any discussion that doesn’t involve a basic look at what insurance is designed to do and some actuarial realities is also worthless. Insurance is for large catastrophic events. Car insurance doesn’t cover wiper blades. This is the BIG problem and it’s the big problem with cost control.
There is also the problem of trying to do everything in one fell swoop. Why would it not be a good idea to implement portions of reform over time? You could actually see what results are produced from actions and be able to say with certainty that x caused x.
March 4th, 2010 at 1:13 pm
Sad thing what Fox has done to debate in this country. Ignore fact and scream opinions is becoming the norm. Unfortunately, when you remove facts and reality from your decision making the results are not very good. So I guess the good old US of A has seen the top and is heading down – screaming all the way down :-(
March 4th, 2010 at 1:21 pm
ashpelham2,
You wrote “you and I better hope this man is successful, because we elected him to run the USA”. First, your sentiment applies to any president of any party, and partisan hacks who remind others of this when defending their person need to acknowledge this and live this before attacking the opposing person. But far more important is that presidents do NOT “run the USA”. They are elected to be the chief officer of the executive branch of the federal government, and nothing more. The government is NOT the country and the government does NOT run the country. A president is NOT a ruler and is NOT the leader of our society. Americans of all political persuasions need to keep this in mind no matter which person or party is in office.
March 4th, 2010 at 1:23 pm
Why hasn’t anyone proposed taking insurance out of the game entirely, except for catastrophic events? We know why – they don’t want to get off the giant gravy train they’re on by asserting themselves as the middle man on every little transaction.
We now can’t do anything “big” anymore in this country. It’s all band aids and add-ons to keep the status quo going on EVERYTHING that we do, so these problems only get bigger over time.
March 4th, 2010 at 1:25 pm
We will get there in the end, although we may have to suffer another economic breakdown before people come to their senses and reallocate malinvested capital. The kleptocracy that brought us to this point is tenacious, but they are also likely to be cowardly in the face of overwhelming public outcry.
Real change will come at the point when we finally see Americans taking to the streets, Greek style, and no I am not talking about Tea Party wack jobs, I mean real broad-based apolitical universal protest, and you will know it when you see it. Americans will eventually realize that the I-banks pose more of a threat than Vietnam did.
March 4th, 2010 at 1:39 pm
The current business-sponsored health insurance system also keeps zombie employees in place, which ultimately hurts their competitiveness. It does nothing to incent those zombies to break out on their own and start their own businesses. People are scared shitless to take any risks for fear of losing their coverage, especially if they have kids and/or a chronic illness (or even a chronic hang nail). Again, zombie-status quo everywhere. Long may it live (not).
March 4th, 2010 at 1:52 pm
Personally I think that Medicare/Medicaid taxes should be increased 3% on both employer and employee – and extended to all types of compensation (not just pay). That money should be used to provide “catastrophic” Medicare coverage for everybody (regardless of what they have or don’t have now). This “catastrophic” health insurance should cover two doctor visits per year (with a small co-pay) and ensure that all charges for medical care and drugs followed the rates for Medicare patients (none of this charging 3 times as much for a visit.drug/procedure if the patient doesn’t have health insurance). When out of pocket hits somewhere between 5-10K this insurance would cover 90% on any additional cost. Individuals and companies who did not think this is good enough could purchase additional coverage on the private market.
March 4th, 2010 at 2:01 pm
The current business-sponsored health insurance system also keeps zombie employees in place
“….turning Japanese I think we’re turning Japanese I really think so….”
March 4th, 2010 at 2:19 pm
President Obama continually state that health care insurance will double in 10 years as it doubled in the past 10. On which planet is he living? My health insurance just went up 29% (working at a small company). It’s doubled over the past 4 years, not 10. 10 would be a relief!
March 4th, 2010 at 2:39 pm
There is a solution to all this:
Legalized kidney sales
March 4th, 2010 at 3:00 pm
Absolutely agree with Mannwich.
I think it’s great that the rest of the western world has socialized government care. We’ve typically been better at innovating than that and have gotten better results.
Why not innovate on healthcare? Why is low cost, low deductible insurance with cost reduction a goal? It’s an oxymoron. It cannot be done.
Insurance is for catastrophe and works best with large risk pools. Health insurance in the US has neither. Until the discussion covers that…it’s not worth having one.
March 4th, 2010 at 4:32 pm
bengarbe;
The issue of health is not very well done by insurance or the insurance concept. That is why we need a (functional) health care system (and that may take getting away with the health insurance industry). Health is more like water, something you always and constantly need. Even in this society of individualistic egotists we have managed to move from everybody having his own private source of water to communal water systems. The problem of only dealing with health in the context of major expenses is that some of those major expenses only come as result of having ignored minor expenses. High blood pressure can often be fixed with a single visit to the doctor and a prescription for some inexpensive medicine. However, if you don’t go to the doctor (because the $50-$100 is to much) the high blood pressure may not be diagnosed and instead you get a catastrophic event like a stroke or heart attack that not only cost a huge amount to deal with but also cost society in the context of lost productivity.
March 4th, 2010 at 4:44 pm
Irrespective of whether one is for or against Obama care/Public option care, as an MD I point out that 50-60% of all Health care expenditure dollars ALREADY come from and controlled by Govt. That is called MEDICARE plus Medicaid.
So if you are against Govt care you should be against Medicare, right. Scrap it and see what are the alternates? Go back to Private Insurance Jungle? We are getting LEAST for every dollar spent on health care in this country compared other Industrialized nations!
Every one involved starting with patient, doctors, nurses, Insurance Industry, Tort Lawyers and Big Pharma (plus you name it) want a slight bigger slice of pie at the cost of others. The size of the pie is getting smaller year by year b/c of demographics – more baby boomers into 65+ plus category. More life saving drugs and more sophisticated tests have come over the decades! Sacrifice is needed from all the vested parties.
Go to Canada or France and ask the common citizen about their health care and then dare to comment on them vs us!
One more thing. There is NO such thing as CHEAP, PRONTO and BEST Medical care anywhere in the World!
March 4th, 2010 at 4:57 pm
Sunny, “as an MD”??? What does that have to do with anything? Most MD’s couldn’t read a balance sheet to save their life, as it were.
Anyhow, comments like these are precisely the ones that should get deleted:
“So if you are against Govt care you should be against Medicare, right. Scrap it and see what are the alternates? Go back to Private Insurance Jungle? We are getting LEAST for every dollar spent on health care in this country compared other Industrialized nations!”
What is this, the O’Reilly Factor? This is nothing but empty rhetoric. Besides, the whole point of BR’s post, by the way, was to comment on the discourse on Obamacare, not the pros and cons.
March 4th, 2010 at 6:00 pm
@DeDude
Other things should be done to encourage daily and regular health care, than low deductible insurance. The government definitely needs to get involved, they certainly do not need to run it. Health care is not like water, and under that argument housing and food are further up the necessity ladder and we should be providing those to people before health care. I also pay through the nose for clean water piped to my house. Maybe it’s cheaper than if it was privatized, but I don’t exactly feel like I’m getting a deal from my municipality.
Heck…end corn subsidies and see where that gets us. Health across the board would be amazingly better if real sugar replaced HFCS.
March 4th, 2010 at 8:28 pm
It seems to me that the special interests have done a very good job in creating the illusion that healthcare reform (Any healthcare reform) = Bad.
The fact is healthcare in the US represents 17% of GDP, more than double other developed nations with outcomes that are, in many cases worse. Health insurance is becoming unaffordable to all others than where employer provided. And guess what, many employers are now stopping 401K contributions, so guess what is going to get cut next?
How many Americans do NOT agree that healthcare is unaffordable and that prices must come down? (Again, score one to the lobbyists for getting over this slight impediment to their position)
The US needs to stop screaming at itself and have a serious debate about WHY healthcare is so expensive and then address the real causes. The present legislation does NOT address the fundamental causes, therefore, will not achieve what it (Does not) set out to do.
March 4th, 2010 at 10:03 pm
EDITOR:
Comment deleted due to incomprehensibility
March 5th, 2010 at 3:35 pm
Ryan’s remarks at the health care summit are below, starting with the second paragraph. It looks like he lays out the math pretty well. The bottom line is that the ridiculous health care bills do nothing to reform health care and do not create incentives to reduce costs. The only reason the CBO’s estimates show deficit reduction in the first 10 years is because the incremental tax revenues are front loaded and the incremental expenses don’t kick in until the fifth year. This is accounting gimmickry, plain and simple. Furthermore, it should be obvious to anyone with basic math skills that there will be large additions to the deficit in years 10-20 and beyond. Even Warren Buffet, who I recall voted for Obama and seems to lean to the left, said his advice would be to start over and get it right with a bill that says “we’re just going to focus on costs and we’re not going to dream up 2,000 pages of other things.”
Dissecting the Real Cost of ObamaCare
The President’s own chief Medicare actuary says the Senate and House bills are bending the cost curve up.
By PAUL D. RYAN
The following are remarks made by Congressman Paul Ryan of Wisconsin, the ranking Republican on the House Budget Committee, about the cost of the House and Senate health-care bills at President Obama’s Blair House summit on health care, Feb. 25:
Look, we agree on the problem here. And the problem is health inflation is driving us off of a fiscal cliff.
Mr. President, you said health-care reform is budget reform. You’re right. We agree with that. Medicare, right now, has a $38 trillion unfunded liability. That’s $38 trillion in empty promises to my parents’ generation, our generation, our kids’ generation. Medicaid’s growing at 21 percent each year. It’s suffocating states’ budgets. It’s adding trillions in obligations that we have no means to pay for . . .
Now, you’re right to frame the debate on cost and health inflation. And in September, when you spoke to us in the well of the House, you basically said—and I totally agree with this—I will not sign a plan that adds one dime to our deficits either now or in the future.
Since the Congressional Budget Office can’t score your bill, because it doesn’t have sufficient detail, but it tracks very similar to the Senate bill, I want to unpack the Senate score a little bit.
And if you take a look at the CBO analysis—analysis from your chief actuary—I think it’s very revealing. This bill does not control costs. This bill does not reduce deficits. Instead, this bill adds a new health-care entitlement at a time when we have no idea how to pay for the entitlements we already have.
Now let me go through why I say that. The majority leader said the bill scores as reducing the deficit $131 billion over the next 10 years. First, a little bit about CBO. I work with them every single day—very good people, great professionals. They do their jobs well. But their job is to score what is placed in front of them. And what has been placed in front of them is a bill that is full of gimmicks and smoke-and-mirrors.
Now, what do I mean when I say that? Well, first off, the bill has 10 years of tax increases, about half a trillion dollars, with 10 years of Medicare cuts, about half a trillion dollars, to pay for six years of spending.
Now, what’s the true 10-year cost of this bill in 10 years? That’s $2.3 trillion.
[The Senate bill] does [a] couple of other things. It takes $52 billion in higher Social Security tax revenues and counts them as offsets. But that’s really reserved for Social Security. So either we’re double-counting them or we don’t intend on paying those Social Security benefits.
It takes $72 billion and claims money from the CLASS Act. That’s the long-term care insurance program. It takes the money from premiums that are designed for that benefit and instead counts them as offsets.
The Senate Budget Committee chairman [Kent Conrad] said that this is a Ponzi scheme that would make Bernie Madoff proud.
Now, when you take a look at the Medicare cuts, what this bill essentially does [is treat] Medicare like a piggy bank. It raids a half a trillion dollars out of Medicare, not to shore up Medicare solvency, but to spend on this new government program.
. . . [A]ccording to the chief actuary of Medicare . . . as much as 20 percent of Medicare’s providers will either go out of business or will have to stop seeing Medicare beneficiaries. Millions of seniors . . . who have chosen Medicare Advantage will lose the coverage that they now enjoy.
You can’t say that you’re using this money to either extend Medicare solvency and also offset the cost of this new program. That’s double counting.
And so when you take a look at all of this; when you strip out the double-counting and what I would call these gimmicks, the full 10-year cost of the bill has a $460 billion deficit. The second 10-year cost of this bill has a $1.4 trillion deficit.
. . . [P]robably the most cynical gimmick in this bill is something that we all probably agree on. We don’t think we should cut doctors [annual federal reimbursements] 21 percent next year. We’ve stopped those cuts from occurring every year for the last seven years.
We all call this, here in Washington, the doc fix. Well, the doc fix, according to your numbers, costs $371 billion. It was in the first iteration of all of these bills, but because it was a big price tag and it made the score look bad, made it look like a deficit . . . that provision was taken out, and it’s been going on in stand-alone legislation. But ignoring these costs does not remove them from the backs of taxpayers. Hiding spending does not reduce spending. And so when you take a look at all of this, it just doesn’t add up.
. . . I’ll finish with the cost curve. Are we bending the cost curve down or are we bending the cost curve up?
Well, if you look at your own chief actuary at Medicare, we’re bending it up. He’s claiming that we’re going up $222 billion, adding more to the unsustainable fiscal situation we have.
And so, when you take a look at this, it’s really deeper than the deficits or the budget gimmicks or the actuarial analysis. There really is a difference between us.
. . . [W]e’ve been talking about how much we agree on different issues, but there really is a difference between us. And it’s basically this. We don’t think the government should be in control of all of this. We want people to be in control. And that, at the end of the day, is the big difference.
Now, we’ve offered lots of ideas all last year, all this year. Because we agree the status quo is unsustainable. It’s got to get fixed.
It’s bankrupting families. It’s bankrupting our government. It’s hurting families with pre-existing conditions. We all want to fix this.
But we don’t think that this is the . . . the solution. And all of the analysis we get proves that point.
Now, I’ll just simply say this. . . . [W]e are all representatives of the American people. We all do town hall meetings. We all talk to our constituents. And I’ve got to tell you, the American people are engaged. And if you think they want a government takeover of health care, I would respectfully submit you’re not listening to them.
So what we simply want to do is start over, work on a clean-sheeted paper, move through these issues, step by step, and fix them, and bring down health-care costs and not raise them. And that’s basically the point.
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