Thread: How liberals are misleading on Medicare

Everyone knows that Medicare has to change. IT's simply not sustainable in its current form. But for political reasons, liberals don't like to say that out loud. Instead, they like to hide the ball and pretend that their cost-cutting measures won't change Medicare 'as we know it'. It guess it all depends on how you define 'as we know it'. Here's Paul Krugman:

Yes, Medicare Is Sustainable In Its Current Form - NYTimes.com

What is true is that the U.S. Medicare is expensive compared with, say, Canadian Medicare (yes, that’s what they call their system) or the French health care system (which is complicated, but largely single-payer in its essentials); that’s because Medicare American-style is very open-ended, reluctant to say no to paying for medically dubious procedures, and also fails to make use of its pricing power over drugs and other items.

So Medicare will have to start saying no; it will have to provide incentives to move away from fee for service, and so on and so forth. But such changes would not mean a fundamental change in the way Medicare works.




But if Medicare is open ended today, and starts saying no tomorrow, how is that not a radically different program? I'll concede the point that it's less radical than privatization, but to say that this preserves Medicare as we know it is just dishonest. And Krugman isn't the only one. This is standard Democratc messaging right now, from Obama to Pelosi to Reid: no benefit cuts. But you see, these aren't benefit cuts, technically. Can't we have an honest debate on the merits of reforming Medicare?

Originally Posted by adaher

... [B]that’s because Medicare American-style is very open-ended, reluctant to say no to paying for medically dubious procedures, and also fails to make use of its pricing power over drugs and other items.

...

No one, except Republican legislators, are saying we have to leave drug pricing as-is. That is solely a GW Bush legacy, and one of the reasons the Medicare costs have soared the past few years.

There is also no one saying we can't begin to reform the health care delivered system. None of that has anything to do with the Medicare system itself.

There is no real reason to change Medicare. It really is not in the disastrous condition Republicans are telling you that its in.

If we can in fact cause a health care delivered system to be put in place, where we concern ourselves with results rather than billings for procedures and tests, then that is to our benefit, whatever choices we make for paying the costs.

That's all true, but it doesn't make Medicare sustainable. Part D is not a large part of the Medicare budget, and while these experiments with results-oriented care are a nice idea, no one knows whether they will actually work. There's only one thing we know that does work, because everyone but Medicare does it: Denial or delay of treatment.

Originally Posted by adaher

That's all true, but it doesn't make Medicare sustainable. Part D is not a large part of the Medicare budget, and while these experiments with results-oriented care are a nice idea, no one knows whether they will actually work. There's only one thing we know that does work, because everyone but Medicare does it: Denial or delay of treatment.

Rationing care happens everywhere, including Medicare. One of the irritating things is that end-of-life can be an extremely pricey few months, and we know how to reduce the cost, improve the experience, and extend life, all at significantly lower costs, but Republicans demanded that that ability be removed. So, once again, we get the worst solution at the highest possible costs. Why? Just so Republicans could prove they can obstruct legislation? What a crock.

Originally Posted by adaher

But if Medicare is open ended today, and starts saying no tomorrow, how is that not a radically different program? I'll concede the point that it's less radical than privatization, but to say that this preserves Medicare as we know it is just dishonest. And Krugman isn't the only one. This is standard Democratc messaging right now, from Obama to Pelosi to Reid: no benefit cuts. But you see, these aren't benefit cuts, technically. Can't we have an honest debate on the merits of reforming Medicare?

ahoy Adaher,

government programs change all the time, matey.

how does "medicare part d" really have anythin' to do with medicare, aye? it doesn't...it just made us folks who own pharma stocks comfortable.

ye adjust programs, ye prune, or ye grow them. this happens all the time in all government agencies, aye?

Mr. Krugman suggests a bit 'o prunin' to medicare. i'd think that every person who sails on our deck would agree that he be correct in his suggestion. the only thing ye can fault him fer is bein' a bit more intelligent in his wordin' than congressman Ryan was in presentin' the privatization 'o Medicare.

- MeadHallPirate

Originally Posted by Dick Martin

Rationing care happens everywhere, including Medicare. One of the irritating things is that end-of-life can be an extremely pricey few months, and we know how to reduce the cost, improve the experience, and extend life, all at significantly lower costs, but Republicans demanded that that ability be removed. So, once again, we get the worst solution at the highest possible costs. Why? Just so Republicans could prove they can obstruct legislation? What a crock.

Actually, the whole point is that we DON'T ration Medicare. It's entirely open-ended. Claims are only denied if they are fraudulent. If a doctor says a patient needs something, Medicare pays for it, no matter what it is. That's a unique system, and one that only worked as long as the elderly made up a small percentage of the population. As the elderly population grows, it will no longer be possible to have Medicare work the way it's always worked.

Originally Posted by MeadHallPirate

ahoy Adaher,

government programs change all the time, matey.

how does "medicare part d" really have anythin' to do with medicare, aye? it doesn't...it just made us folks who own pharma stocks comfortable.

ye adjust programs, ye prune, or ye grow them. this happens all the time in all government agencies, aye?

Mr. Krugman suggests a bit 'o prunin' to medicare. i'd think that every person who sails on our deck would agree that he be correct in his suggestion. the only thing ye can fault him fer is bein' a bit more intelligent in his wordin' than congressman Ryan was in presentin' the privatization 'o Medicare.

- MeadHallPirate

But it's dishonest to say Ryans' plan ends Medicare as we know it, but the President's plan to have Medicare start saying no keeps it the same. It's not the same program if it starts saying no. If it already said no and now it was going to say no a little more, then it's the same program, just a little stricter. But taking an open-ended program and making it limited is a big change and those flying yer colors shouldn't be misleadin'.

Originally Posted by adaher

But it's dishonest to say Ryans' plan ends Medicare as we know it, but the President's plan to have Medicare start saying no keeps it the same. It's not the same program if it starts saying no. If it already said no and now it was going to say no a little more, then it's the same program, just a little stricter. But taking an open-ended program and making it limited is a big change and those flying yer colors shouldn't be misleadin'.

Paul Ryan should hope the conversation about his plan stays on Medicare. That is only the tip of the iceberg that he is sending into the path of the USS United States. He has tax cuts for the rich, cutting of medicaid, and slashing of safety net programs, plus tax increases for the poor and the elderly. When people start talking about the rest of his plan, he will be tarred and feathered and run out of town. He already has a strong candidate running against him in his own district, so he is about to find out just how inappropriate his solution really is for America. Robert Zerban may very well demolish Paul Ryan in Wisconsin HR1

Actually, Democrats are already planning to sell out Medicaid to save Medicare, which is just politics 101.

Originally Posted by adaher

Actually, Democrats are already planning to sell out Medicaid to save Medicare, which is just politics 101.

I seriously doubt that. Its more likely they will merge the two.