Skip to main content

View Diary: Paul Ryan must be planning the mother of all magic asterisks (73 comments)

Comment Preferences

  •  Negotiating prescription drugs (14+ / 0-)

    with pharmaceutical companies would also.

    In fact, a single payer healthcare system or Medicare for all would greatly reduce our healthcare expenditures over the long term.

    A modest increase in our medicare tax would help.

    A combination of the three and many other sensible proposals offered up by Democrats would address it even better.

    A transaction tax would do wonders.  Cutting down our military budget would as well.

    In fact there are many solutions to bring down long term deficits and pay off our debt which don't require killing granny as the Ryan budget and many on the right propose.   Their long term plan is one step removed from having the federal gov't buy a loaded gun for every senior over 70 so they can spare us all the expense of taking care of their lazy asses.

    This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

    by DisNoir36 on Thu Mar 07, 2013 at 07:24:02 AM PST

    [ Parent ]

    •  Yes, but they are never suggested by (12+ / 0-)

      "defict hawks."  

      The defict is not the real agenda.  Destroying the New Deal is.

      Join us on the Black Kos front porch to review news and views written from a black pov—everyone is welcome.

      by TomP on Thu Mar 07, 2013 at 07:28:42 AM PST

      [ Parent ]

    •  Single payer, yes, but the single payer must be (3+ / 0-)
      Recommended by:
      TomP, howd, bobatkinson

      a not-for-profit payer unless we just want to trade lives for dollars. Even in the present system, the for-profit Advantage plans are an excessive drain on the system.

      Here's something from Bloomberg on March 4:

      Health insurers that offer private plans in the U.S. Medicare program for the elderly and disabled were overpaid by as much as $5.1 billion over the past three years, government auditors said.

      The report, from the Government Accountability Office, the investigative arm of Congress, comes as insurers are fighting a proposed 2.2 percent cut in a rate used to determine their payments in the Medicare Advantage program. About a quarter of Medicare’s 49 million beneficiaries sign up for Advantage plans, in which their care is covered by insurers led by UnitedHealth Group Inc. (UNH) instead of the government.

      These for-profit Medicare plans were created as a sop to conservatives who insisted they'd prove that business could/would provide health insurance to seniors more economically than government. Instead, they've done the opposite. We need to call a halt to this failed experiment.
    •  Not enough money in those things. (0+ / 0-)

      Read the Medicare Trustees report I linked to.  

      And see the links where Krugman says that in ten years, what we will have to do is "Death Panels and Sales Taxes."  

      •  Where in the report you have linked (1+ / 0-)
        Recommended by:

        is any analysis re: lowering the age for Medicare recipients? Or analysis about negotiating drug prices within Part-D?

        "George RR Martin is not your bitch" ~~ Neil Gaiman

        by tardis10 on Thu Mar 07, 2013 at 09:48:39 AM PST

        [ Parent ]

        •  The Medicare Trustees Report sets out (2+ / 0-)
          Recommended by:
          tardis10, VClib

          the enormity of the problem. It does not score potential changes.  If it's legislation, the CBO scores that.  In the absence of legislation, proponents and opponents do their own studies, which tend to be overly optimistic by proponents, and overly negative by opponents.  

          Proponents of negotiating drug prices for Part D have various estimates of the savings -- I've seen them from $10 billion a year to the most optimistic of about $20 billion a year.  That, of course, is not nearly enough to address the long-term problem, as even proponents recognize.

          I don't think that adding people to Medicare lowers the cost of Medicare -- or at least I haven't seen any studies that say that.  It simply transfers people from private insurance, with higher medical costs, to Medicare, with lower medical costs, as I understand it.  That may lower overall medical costs, but I've seen no studies that say that it lowers the cost of Medicare overall.  I'd be happy to take a look if you have any.  

          •  Here is a recent exchange between Rattner & Brill (1+ / 0-)
            Recommended by:
            BRILL: Well, if you put Medicare in the context of the larger health care system, and this is something that everybody at this table is going to think that I should go to a mental hospital when I get finished saying this, the government and all of us would actually save money if you lowered — I said lowered the age for Medicare. If the Medicare age were 60 instead of 65, the economy and the taxpayers would actually save money. And George, please don’t look at me like that.

            RATTNER: You’re potentially right. And part of the argument — you’re taking people out of the Medicare age to 67 is you’re taking people out of the Medicare system.

            BRILL: Right. And what you would be doing, is you would be putting the most efficient player, which is Medicare — Medicare spends 80 or 90 cents to process a claim and the health insurance companies spend $18 or $20 or $25 to process a claim. Health insurance companies pay two, three, four times what Medicare pays for various services. So if you lowered the age, you would put more people into the bucket of much more efficient health care.

            I know I have read a few detailed reports on this. Maybe from Demos or CAP? When I find them,I will send them on to you. Collecting premiums from the younger and healthier,instead of govt. further subsidizing the for profit insurance corps., is indeed a kind of back door approach to saving taxpayer money. Can such be characterized as reducing Medicare costs? I'd say so but YMMV.
            As for negotiating drug prices,you are right.It isn't a single,silver bullet,just one arrow in a quiver. As is the IPAB.
            Of course,there are other ways to reduce healthcare spending that few limiting advertising & marketing by pharmaceutical companies.

            "George RR Martin is not your bitch" ~~ Neil Gaiman

            by tardis10 on Thu Mar 07, 2013 at 10:56:50 AM PST

            [ Parent ]

            •  That seems to support what I said (1+ / 0-)
              Recommended by:

              that would lower the cost of health care generally, because Medicare (since its reimbursements are lower than private insurance companies pay for the same service) can deliver health care to the 62 year old cheaper than private insurance can deliver to the 62 year old.  

              That may mean a slight decrease in the percent of GDP that we pay for ALL health care (private insurance, uninsured, Medicare and Medicaid combined).  But I haven't seen any studies that it will decrease the cost of the Medicare program itself.  

              •  It isn't just the savings in (0+ / 0-)

                delivering healthcare,it is not having govt. subsidize the premiums to private insurers for the 60-65 folks.(as will be the case under the ACA) that adds to the savings. Further, if seniors spend their retirement nest eggs on insurance premiums from 60-65,then many may qualify for more govt. subsidies (medicaid,HEAP,SNAP) in their later years than would have.

                Pretty much off topic,have you ever seen this?
        Takes health tourism to a higher level.

                "George RR Martin is not your bitch" ~~ Neil Gaiman

                by tardis10 on Thu Mar 07, 2013 at 12:18:51 PM PST

                [ Parent ]

        •  And I think the Trustees Report sets out (0+ / 0-)

          that Medicare Part D in total is about $50 billion a year.  So, any savings by drug negotiations would be some fraction of that.  

    •  It is Krugman who says that we (0+ / 0-)

      are eventually going to have to "kill granny," not me.

      And it's Krugman who says that eventually we are going to have to tax the middle class through a VAT tax.  

      He thinks "death panels and sales taxes" are maybe 10 years away.  But that's where he thinks we have to go eventually.

      That's why I'm not a Krugman fan on this issue, but instead prefer the Rattner approach.  

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site