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View Diary: Super Congress Democrats offer further right than Simpson Bowles, Gang of Six (145 comments)

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  •  We MUST "cut" Medicare!!! (2+ / 0-)
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    SciMom, orange dog

    Look, I'm a pretty progressive guy. Check my comments and diaries if you doubt. But when we on the left knee-jerk oppose Medicare "cuts," we discredit ourselves.

    It's a serious mistake for us to buy into the fallacy assumed by too many Very Serious People in both parties that dollars spent on medical care = quality of care. It just ain't so.

    Some truths we must remember, if we're to help steer America back to sanity. Or at least a lower degree of crazy:

    1. The rest of the developed world spends way, way less per capita on healthcare than we do, yet provides decent care for everybody. We spend 50% more per capita than anybody else. We spend more on GOVERNMENT-provided healthcare than single-payer countries that have NO PRIVATE healthcare spending...yet they have universal coverage and greater life expectancy. Folks, that's insanity. And it's insane for progressives to defend it.

    2. The structural, long-term US budget deficit is essentially all healthcare. Krugman (anybody think Krugman is a troll?):

    when you look under the hood of those troubling long-run budget projections, you discover that they’re not driven by some generalized problem of overspending. Instead, they largely reflect just one thing: the assumption that health care costs will rise in the future as they have in the past. This tells us that the key to our fiscal future is improving the efficiency of our health care system

    So it's critical that we spend less on Medicare. The question is how? If we're just going to authorize less spending per beneficiary without making care delivery more efficient, then indeed, that's a "cut" we should oppose. But if we're going to, say, insist that Medicare not pay for expensive surgery unless it's really more effective than cheaper physical therapy, that's a "cut" we should cheer for.  

    Obamacare ramps up spending for comparative effectiveness research, but not enough; and strengthens MedPAC's authority to cut or refuse payment for ineffective treatments, but not enough.

    The GOP, of course, wants to kill comparative effectiveness research and MedPAC. This is one of those instances where the mask slips, and you see they have no good faith interest in real solutions at all.

    Some links on the whys and potential hows of good "cuts":

    This diary is singularly uninformative and sensationalistic. It tells us nothing about what kind of "cuts" the Dems are proposing. Maybe they're awful. Maybe they're good. Most likely the Dems are being their usual inept selves, and have neither figured out a decent policy nor figured out how to inform the public (including the diarist) of whatever policy they're now pushing.

    But "all Medicare cuts are bad" just clouds our thinking. It dumbs down the debate. And I think the debate is too damn dumb already.

    "The true strength of our nation comes not from the might of our arms or the scale of our wealth, but from the enduring power of our ideals." - Barack Obama

    by HeyMikey on Fri Oct 28, 2011 at 02:52:00 PM PDT

    •  Kind of makes sense what you are saying (1+ / 0-)
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      it's fair to acknowledge that entitlements are a potential problem, & especially medicare. When I lived in France in the '90's my kid was sick & the doctor came to the apartment (!) and charge like the equivalent of $7 for a home visit. Granted the visit was subsidized by the state, but i bet the subsidy was nothing like the gouging that doctors charge here in the US.
      No idea about the merits or not of the compromises proposed, although without the efficiency improvements we would get with a public option or single payer,,, any compromises are likely to be unwarranted

      •  Health care spending: USA vs. France (0+ / 0-)

        USA spends 17.4% of GDP on healthcare; $7,960 per capita.

        France spends 11.8% of GDP on healthcare; $3,978 per capita.

        (2009 figures for both.)

        They spend HALF what we do, and still have $7 housecalls. And universal coverage.

        "The true strength of our nation comes not from the might of our arms or the scale of our wealth, but from the enduring power of our ideals." - Barack Obama

        by HeyMikey on Fri Oct 28, 2011 at 08:45:28 PM PDT

        [ Parent ]

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