White House Spokesman Suggests 30% Cut in Medicare Spending
While discussing some relatively minor cuts in Medicare spending featured currently, or formerly, or in the future of one of the many, many different versions of Obamacare floating incomprehensibly around in Congress, White House spokesman Daniel H. Pfeiffer also said...
"To put this in perspective, the Medicare savings proposals that the House is considering as part of health insurance reform would constitute perhaps a 6-to-7 percent reduction in spending over 10 years," said Daniel H. Pfeiffer, a White House spokesman, who also noted that the AARP had agreed with the administration's assessment that the cuts would not force reductions in beneficial services. "A wide array of experts agree that we could reduce spending by 30 percent without reducing services," he added.Harharharhar!!!
30% reduction in spending!
No reduction in benefits!
Medicare must be just about the most wasteful program in the history of the world!
And meanwhile Obama-loving bloggers like Mike Lux at OpenLeft were making fun of elderly demonstrators at the "tea party" protesting Obamacare in Washington today...
"...a lot of them are older, and this anger they carry around must be terrible for the toll it takes in terms of the high blood pressure, hypertension, heart disease."
Tea-bagging is obviously a case of mass senile dementia!
How else could you possibly explain why all those seniors don't trust Barack "All My Campaign Promises Were A Joke" Obama to cut Medicare spending by 7% or 10% or even 30% "without reducing services?"
But I can't help thinking that it may be a political mistake for a White House spokesman to shoot off his mouth about cutting Medicare spending by 30%, because a higher percentage of seniors get out and vote than any other demographic, and...
Screwing around with Medicare is second only to crucifying the baby Jesus on their list of abominations.
What we're seeing here is the evil of centrism in action. They are robbing Medicare. They have promised to never increase the deficit. They have made a commitment to underfund the bill. They have put a Trojan Horse in place to make cuts Medicare services inevitable and sanctioned by Democrats. Future Republicans will take the ball and run with it.
The true believers want to believe in the bill and they don't seem to care much what it does.
September 13, 2009 11:41 AM | Reply | Permalink
I agree.
September 13, 2009 12:04 PM | Reply | Permalink
I thought that the cuts in Medicare spending would be primarily in reductions in payments to private insurance companies providing Medicare Advantage Plans, also known as Medicare Part C.
This is undoing the Republican's initiative to privatize Medicare. The subsidy to the private insurance companies is excessive, and it would be better for Medicare financially to cover seniors under Parts A and B.
September 13, 2009 12:38 PM | Reply | Permalink
Maybe but even if that's all it does which I doubt, Medicare itself needs any savings because it has its own funding problem. Common sense would tell you that you can't rob from one unfunded program to build another one.
Anyway I was just hearing Feinstein tell us how she loathes entitlements and it would be unthinkable to have another. That's what passes as a Democrat these days. They have no commitment to social services.
This is all theater. We have the organized lunatics distracting both bases. The left focuses on the lunatics and ignores the bill. What is actually happening is extraordinarily cynical. Special interests are writing another bill. The more things change the more they stay the same.
September 13, 2009 12:58 PM | Reply | Permalink
Feinstein link.
September 13, 2009 1:20 PM | Reply | Permalink
In gasket's link, Jeanne Shaheen sez...
"The bill that came out of the health committee in the Senate had 167 Republican-sponsored amendments that were adopted. So there has been significant Republican input already into the legislation."
167 Republican amendments!
What's not to like?
September 13, 2009 1:40 PM | Reply | Permalink
The section of Obama's speech that dealt with Medicare savings was as follows --
The "And that is why not a dollar of the Medicare trust fund will be used to pay for this plan" can be true, but in doing budget calculations the improvement in the Medicare trust fund's financial position can be used to offset the expeditures in other areas.
The "as well as unwarranted subsidies in Medicare that go to insurance companies" is a direct reference to the overly generous payments to insurance companies to subsidize Medicare Part C "Medicare Advantage" plans.
September 13, 2009 2:24 PM | Reply | Permalink
We all know that AARP sells insurance, right? Whenever I hear AARP quoted about "health care reform," I feel the need to mention this.
September 13, 2009 1:41 PM | Reply | Permalink
AARP also opposed allowing Medicare to bargain with Big Pharma for reduced drug prices, way back in 2003, when President George W. Bush also "reformed" healthcare. MoveOn.org was all over this story way back then, and anyone who didn't want Medicare to bargain down prices was evil!
Now, not so much.
September 13, 2009 4:47 PM | Reply | Permalink
If "spending reduction" refers not to current levels but to reductions below the future expenditures that would prevail in the absence of a change, then 30% is probably inadequate to avert financial collapse of the Medicare system. A 40-50% reduction is more likely to be needed.
This would bring us more in line with Medicare-like systems in other countries that provide better healthcare and better health outcomes than we do here.
Clearly, the example of other nations implies that this change is feasible, but getting from here to there will be extremely challenging. The problem is that Medicare is an insurer, not a healthcare provider system, and although Medicare itself is not exceptionally wasteful, healthcare provision in the U.S is extremely wasteful.
If Medicare were simply to cut reimbursements to providers with no change in the behavior of the latter, the most likely consequence would be a worsening of care and health outcomes. What is needed, and what can only happen over time, is pressure from Medicare and other sources to compel the healthcare system itself to restructure so as to eliminate unnecessary or duplicate facilities, tests, procedures, or specialty referrals. At that point, the insurance component of American healthcare, including both Medicare and private insurers, can reduce payments to providers and premiums charges to subscribers.
Some provisions in proposed healthcare reform legislation make a start toward this restructuring, but much more will be needed over the next decade.
September 13, 2009 2:23 PM | Reply | Permalink
There is a lot of ridicule in this post, but no actual evidence.
September 13, 2009 6:51 PM | Reply | Permalink
There's also a lot of ridiculousness in Obama's dog-and-pony healthcare reform, but not much substance.
September 13, 2009 9:20 PM | Reply | Permalink
1. If you bothered to do an ounce of research, or even bothered to read Atul Gawande's "The Cost Conundrum" in the New Yorker in June then you might avoid looking like such a reactionary idiot to anyone who happens to understand this field.
The data on which claims of saving 30% in Medicare come from decades of research on regional variation in Medicare spending out of Dartmouth university. Here's a quote from their policy white paper Agenda For Change from last winter:
If you had an ounce of intellectual honesty, you'd look up the article and learn something. Somehow I doubt you will.
The truth is, health care in the United States, whether paid for by Medicare or not is ridiculously inefficient. Some health care providers operate quite differently fromt he rest and they are able to provide very high quality care at significant;y lower costs. The president mentioned two--Intermountain and GEisinger. Mayo LCinic Cleveland clinic are two others whose names you might have heard of.
September 14, 2009 12:28 AM | Reply | Permalink
If you could actually read, "Economides," instead of just bragging about your non-existent comprehension of healthcare economics, you might have noticed that my diary, as well as the excellent diary from firedoglake which I excerpted on this thread, address Medicare "savings" in the context of pending legislation, and neither diarist dismisses the possibility of reducing healthcare costs with options which have been abandoned by Obama and his friends, like single-payer.
And if you had bothered to find out what I actually support by googling my (real) name, you would already know that I support Dennis Kucinich and specifically his advocacy of single-payer healthcare for all Americans, which could potentially reduce all medical spending even more than 30% below the astounding figure of approximately $7500 per capita which we now spend for the 37th best healthcare system in the world.
But you're exactly the sort of semi-educated weasel who supports Obamacare without understanding (or at least by pretending not to understand) how easily the extremely complicated legislative packages now under consideration can be twisted into a radical downsizing of entitlement to medical care for senior citizens, and that's what I saw in Pfeiffer's claim that Medicare spending could be cut by 30% without single-payer or even a public option, and without reducing services.
This claim is bullshit, like your silly comment and pretended expertise.
September 14, 2009 1:16 AM | Reply | Permalink
And, "Economides," if you had any real education, instead of a third-rate econ degree from a third-rate college, you might have acquired the habit of asking yourself a few questions, before you swallowed the Dartmouth "research" hook, line, and sinker.
For example, using the Mayo Clinic as a "benchmark" for national healthcare makes about as much sense as using Albert Pujols as a "benchmark" for Major League Baseball, or Peyton Manning as a "benchmark" for quarterbacks.
Wouldn't it be wonderful if we could "reform" the National League by cloning Albert Pujols and Johan Santana all over every franchise!
And then the same cloning machine could clone the best doctors in the world at the Mayo Clinic, and distribute a few of them to each and every hospital from Petaluma to Weehawken! Nobody would ever undergo an unnecessary operation again!
But in the real world, single-payer is still the only way to go.
September 14, 2009 1:51 AM | Reply | Permalink
But in the real world, single-payer is still the only way to go.
In the real world, single payer doesn't have half a chance in hell of being passed by this congress; just as in the real world Dennis Kucinich didn't have half a chance in hell of being elected president. Those are two of the tragic realities of life in America. So why are you torturing yourself and everybody else with your bitterness and frustration?
Why don't you put your ass to work trying to accomplish something that can actually be accomplished instead of just ranting and raving like some birther or teabagger because the world won't meet your expectations?
September 14, 2009 7:47 AM | Reply | Permalink
Dan K "thinks" that everybody should forget about single-payer, because Obama Democrats sold out to the healthcare industry.
And now he's bitching about "substantiating" arguments, but his three most recent diaries include exactly zero links...
Nothing but one sad little jerk shooting off his mouth about issues that he doesn't even try to understand.
Chug that koolaid, dimwit!
September 14, 2009 8:59 AM | Reply | Permalink
You might generate more constructive engagement if you generated posts that sounded like they were written by an an adult. I've got one yahoo acquaintance who bombards me with his teabagger crap, and then when I come here I have to read more of this politically inept populist ranting from the adolescent teabaggers of the left.
Perhaps you could explain your strategy for getting single payer in this country? I haven't read it yet. Are you going to put some secret Dennis Kucinich love potion in the nation's drinking water? Maybe you think that if you just yell loud enough and insult enough people, you will generate some kind seismic political event emanating from the Rutabaga Ridgepole epicenter? Frankly, I don't think you have a clue, and I don't think you even bother to think about such things.
Here is the only path to single payer that looks politically viable to me: We work like hell to get a public option included in the current heath care reform package. This will be very hard, but is achievable. Then, using that public foothold in the health care system, we work to expand eligibility for the public option over time, give it more tools to negotiate prices and set the market and standards for health care delivery, which in combination with additional pieces of health care industry regulation can really begin to put the squeeze on the private sector components of the industry, drive down their addictions to waste and excess profits, and make health care more affordable. Over time, if the public component grows and proves its worth over and over, it might evolve into a virtual single payer system, which some future Congress might then rationalize and formally enact as an institutionalized single payer plan in some future legislative reform package.
The health care industry feeds a massive and wasteful cash cow. Its many stakeholders are going to fight with all they've got to hang onto the wealth the case cow is generating for them, and you don't need to be told how much power they have. We need to kill the cash cow piece by piece.
Republicans and the health care industry are fiercely opposed to the public option. That's because they clearly perceive what so many loud fools on the progressive side seem to be missing: that the public option is indeed the "camel's nose under the tent", the "foot in the door", etc. Progressives have tried to downplay and keep a little bit quiet about the "camel's nose" angle, because their opponents will seize on these words and use it to defeat the public option. Unfortunately, there are so many people on our side who just don't get it, that it has now become to necessary to be a little more explicit - and paint them a fucking picture.
The Progressive Caucus is now fighting this fight on the only battlefield that matters right now, and is not wasting it's energies on irrelevant fantasy battles that have all the political relevance of an online video game. Here's their letter from two days ago. Kucinich's name is on the letter.
http://cpc.grijalva.house.gov/uploads/Letter%20to%20Obama_Defining%20the%20Public%20Option.pdf
You seem to me in love with your rage, and ability to coin insults. Why don't you lend a fucking hand instead? If you don't want to be regarded as a self-indulgent jerkoff, then do something constructive. What are you doing to raise the probability even one single percentage point that some semblance of the the ideas you purport to defend might actually be enacted, or that the result of the reform effort moves us forward, not backward.
There is no viable single payer legislation on the table in Congress. Wasting time and energy on these pipe dreams, and dividing progressive forces over their stance on nonexistent legislative alternatives, is a debilitating and counterproductive exercise. It weakens the progressive agenda.
September 14, 2009 12:28 PM | Reply | Permalink
Because you don't think very hard or study much you say dumb things. Mayo Clinic, for example does not provide better and cheaper care because they have more skilled doctors, they do it because they treat people in an organized, evidence based way that results in many fewer resources being used: fewer specialists, fewer tests, etc...Their doctors are on salary, so they don't make more money by providing more treatments. Their incentive and more important their ethos is to get it right the first time. Mayo are not unique. There are many other examples--(e.g.Intermountain, Geisinger Clinic, Billings Clinic, Cleveland Clinic, Marshfield Clinic, Scott & White Clinic, Denver Health, Group Health, Kaiser) and they all have very similar organization and methods.
if you spend your single payer funds at places like Cedar-Sinai, they won't go very far. you'll be cutting services in no time. Sending them to places like Mayo and Intermountain and Cleveland Clinic will be far more cost effective and you will imporve the quality of care.
September 14, 2009 1:36 PM | Reply | Permalink
If only we could figure how to make American car companies operate like Toyota. No that's impossible! Japanese managers and workers are inherently more skilled than Americans. Just like Ichiro! We should just nationalize them all. then everything will be better.
September 14, 2009 1:39 PM | Reply | Permalink
Dipstick, Medicare is a single payer system. The same opportunities and limitations we face getting Medicare to transform the health care delivery system through payment incentives are precisely the way you would have to do it through a universal single payer system. There is nothing magic about single payer. It's all about what you pay for and how you pay for it. And you don;t get a better health care system by forcing price controls. You can try that medicare pays lower rates fro procedures. But then you just get an increase in intensity. We'll do 2 MRIs instead of 1 just to confirm. Your GI specialist will see you every 4 mos instead of once a year. And so on. You see that is the problem. We over treat, in part because we more to do more. We also do not reward, cheaper and better outcomes for patients.
Whatever, you are like arguing with Barney Frank's dinner table.
September 14, 2009 1:19 PM | Reply | Permalink
Cute, but you continue to try to win arguments with vain displays of ridicule and anger, and only rarely bother to substantiate the points you are making.
September 14, 2009 7:24 AM | Reply | Permalink
Forget it, Dan. You have eviscerated this jerk's arguments. But, scroll down a little further, and it's back to the self-congratulatory circle jerk among RR, rtbag, miguel, and a few others. These people simply aren't serious.
Because, see, the Democratic Party is every bit as evil as the Republicans, and only wants to destroy the middle class for their wealthy benefactors. If you weren't such kool-aid chugging Obamabot, you'd understand.
September 15, 2009 11:11 AM | Reply | Permalink
I'm not sure I agree with the premise completely (still digesting it) ... but you might find this post over on FDL interesting. It's right up this alley.
http://seminal.firedoglake.com/diary/8062
September 13, 2009 9:33 PM | Reply | Permalink
Good catch, and thanks for that link, kgb!
That sounds just about right to me.
September 13, 2009 11:09 PM | Reply | Permalink
That's what the new Democratic Party calls bipartisanship!
September 13, 2009 11:22 PM | Reply | Permalink
It really does look like turning Republican talking-points into Democratic policy.
September 13, 2009 11:59 PM | Reply | Permalink