If That's A Death Spiral, What's This?
Today, the Fort Wayne Journal Gazette, based in notoriously liberal Indiana, came out against the Medicare Prescription Drug Benefit, demanding that the bill be rewritten to serve seniors rather than insurance companies. These editorials at regional dailies, and not the shrill warnings coming from, well, this blog, are what will kill Medicare part D. See, seniors read newspapers. As it happens, they're about the only ones left in America who do. And with papers nationwide reporting and condemning the Part D's chaotic implementation, the healthy seniors who've not yet seen fit to sign up are going to find little information to change their minds. And then this will happen:
If too many relatively healthy seniors opt out of the government plan, the Kaiser Family Foundation warned in an October study, the program could be in trouble.When the administration estimated the costs of the program, it assumed that most eligible seniors would sign up, with healthy seniors balancing sicker retirees who need more drugs, said Tricia Neuman, director of the foundation's Medicare policy project.
"If the group that signs up has substantially higher average costs than the pool of eligible people, then premiums would rise faster than the administration projected," Neuman said. Eventually, the Kaiser study said, Medicare drug plans could tip into what economists call the "death spiral."
Ouch -- death spiral is a helluva term. On the other hand, given the Benefit's gasping, troubled first breaths, it's not clear that it was ever engaged in anything but a slow stumble towards oblivion.
Let's not get overly excited. All the paper's recommending is a change to how the formularies are established.
January 30, 2006 7:50 AM | Reply | Permalink
FOREIGNID: 88193
FOREIGNPARENTID: 88192
FOREIGNCOMMENTERID: 5360
AUTHOR: paulw
DATE: 01/30/2006 12:07:37 PM
January 30, 2006 12:07 PM | Reply | Permalink
Supposedly I should have a few more months until a final deadline when all "signers" are supposed to have made a choice. But since I haven't played the game and made a "quick" choice, I will be coerced into choosing a plan under the threat of an increase in my premiums until I do. And there will be "no refunds" for differences in costs if I don't hurry up and select a plan.
Frankly, even with all of the information that is supposedly available for choosing a plan, the program is a mess when trying to do so.
January 30, 2006 1:21 PM | Reply | Permalink
and i still think that's what they should be saying....
January 30, 2006 1:32 PM | Reply | Permalink
Implementation, while disastrous for those not getting their drugs, is not the main problem; it is the fact that the program is extremely ungenerous to those not qualifying for extra assistance, amounting to little more than catastrophic drug coverage. The treasury is taking a major hit to provide extremely niggardly coverage, and one really wonders where all the money is going.
January 30, 2006 2:48 PM | Reply | Permalink
Surely you jest. Indiana is a RED state, bastion of fundamentalist conservatives. It is not "notoriously liberal."
January 30, 2006 3:06 PM | Reply | Permalink
Dear Ezra,
Not sure what "shrill warnings" you're referencing when you obliquely attack contributions to this blog. Would it be aimed at those ideas that challenge the veracity and efficacy of administration positions? Do you not think that the underlying motivations and concurrent policy objectives are germane to understanding the course and ramifications of these programs?
Now I don't believe for a second that this medium, narrowed to posts on this one blog, would make a material difference in the adoption of a nationwide health care program. But I did anticipate that this medium would serve as a place for meaningful analysis and discussion, however contrary, absent negative reframing by authors of the site.
January 30, 2006 4:04 PM | Reply | Permalink
Uh I think he was being sarcastic
January 30, 2006 4:30 PM | Reply | Permalink
I have described the Iraq war as the largest criminal enterprise in history, but really that is unfair, because this medicine/health care business here at home is more like the domestic counterpart of the biggest criminal enterprise in history. The utter disregard for the public interest is breathtaking in its magnitude and the extent of its harm.
January 30, 2006 5:37 PM | Reply | Permalink
BTW, maybe I am doing something wrong, but this comment page is doing strange things as I was typing the previous paragraph.
January 30, 2006 5:43 PM | Reply | Permalink
Maybe even Ezra can get confused, posting to 3 different blogs a day. Believe me, posts on his home site have taken medical policy and shaken it like a rat.
January 30, 2006 9:39 PM | Reply | Permalink
Democrats and Republicans alike in my community know full well that this latest political boondoggle is destined for the grave faster than any one of us is. And we are not about to yield to blandishments like the one mentioned in the previous post. We do not react mildly to threats, especially empty ones lacking any obvious merit, and we see through the contemptuous veil of respectability bestowed on this thing by the administration and its thuggish cohorts in the private sector.
As for tonight's Presidential address, it will be just another example of the Bush penchant for putting lipstick on a pig.
January 31, 2006 3:51 AM | Reply | Permalink
'Shrill' is a term of ironic approbation among readers of liberal blogs. Conservatives would call Paul Krugman 'shrill' when they couldn't challenge his facts or his logic. So liberals adopted 'shrill' to signify telling our side of the story unapologetically.
Also Ezra has been blogging health care from a consistently liberal standpoint for months at his own site, so if he's calling anyone shrill he's presumably including himself. Obviously Ezra's point was that you can't attribute the criticism from the Fort Wayne paper to mere partisanship.
January 31, 2006 6:59 AM | Reply | Permalink
Geez, is there some kind irony-blindness bug going around?
January 31, 2006 8:07 AM | Reply | Permalink