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Today, I found myself in a “discussion” with a right winger on Facebook regarding their attack on Obama over the $716 billion dollar figure Republicans are accusing Obama of cutting from Medicare.   I decided to attempt to explain it as best I could.   Follow me below the orange squiggly for my response:

I decided to open up by quoting directly from the Congressional Budget Office, who wrote:

“Those amounts do not encompass all of the budgetary impacts of the ACA because that legislation has many other provisions, including some that will cause significant reductions in Medicare spending and others that will generate added tax revenues, relative to what would have occurred under prior law.”

-Estimates for the Insurance Coverage Provisions of the Affordable Care Act Updated for the Recent Supreme Court Decision

An interesting fact about the origin of that $716 billion dollar number, is that it originates not from a full report, such as the one listed above, but from a letter from the CBO to John Boehner explaining the estimated costs of repeal. That exact section is stated as such:
“Spending for Medicare would increase by an estimated $716 billion over that 2013–2022 period. Federal spending for Medicaid and CHIP would increase by about $25 billion from repealing the non-coverage provisions of the ACA”

--Congressional Budget Office Letter to John Boehner (July 24, 2012)

There is a great piece in the Washington Post in which Sarah Kliff explains exactly how these numbers came about, and what it means for Medicare.  In this article, she explains that the ACA provision trimmed future spending on Medicare, not current benefits as those are covered under the ACA.  These are therefore savings.  Those cuts to future spending come from three areas:

--Hospital Reimbursements
--Medicare Advantage
-- other cuts (explained later)

Kliff explains that:

“The whole idea of Medicare Advantage was to drive down the cost of health insurance for the elderly as private insurance companies competing for seniors’ business.
“That’s not what happened. By 2010, the average Medicare Advantage per-patient cost was 117 percent of regular fee-for-service. The Affordable Care Act gives those private plans a haircut and tethers reimbursement levels to the quality of care administered, and patient satisfaction.”
From my general understanding, Medicare Advantage is a program that allows seniors to receive private insurance while the government pays for it.  This program is not really needed in its current form under the new ACA laws, as seniors will have access to lower cost private insurance at the government's expense.  

The ACA also trims some of the costs it was paying hospitals in reimbursements,  providing more savings than under the current laws in 2013-2022.   Moreover, the “other” category consists of smaller savings such as reductions in the costs of Medicare spending (Medicare’s Disproportional Share Payments) where hospitals receive payments for seeing patients who lack insurance.   These are no longer needed under the Affordable Care Act, as the numbers of uninsured Americans drastically declines.  

I am adding here for Daily Kos members, that I am doing a bit of paraphrasing of Kliff's article as it was so well written.  

However, these are not cuts, they are savings.   They in no way affect anyone's current Medicare benefits.  What they do is trim off some of the expenses of running the program that are now covered by the ACA by: reducing costs associated with Medicare Advantage, reducing the amounts being paid in reimbursements to hospitals,  reducing the amounts being subsidized for uninsured patient care to hospitals, which result in massive saving under the ACA.  The Republicans estimate that in order for them to repeal the ACA medicare would have to increase spending by $716 billion, Obama DID NOT cut Medicare by $716 billion.  To state otherwise would be dishonest.

That was my attempt to explain a rather complicated process.   I would love some feedback from Daily Kos members on how to better break it down, or how to better understand the numbers to improve my position and wording.  

6:48 AM PT: I wanted to update and try to clarify what Healthcare.gov explains about the ACA and Medicare Advantage:

This complex interaction between Medicare and
the ACA is at the core of what the Republicans are attacking on.   Healthcare.gov, which tries to explain it implies that Medicare Advantage will still remain, but that

"Starting in 2014, the Affordable Care Act offers additional protections for Medicare Advantage Plan members by taking strong steps that limit the amount these plans spend on administrative costs, insurance company profits, and things other than health care."

This may be a better explanation than I could give late late night when I was doing this research. However,  it also stands to reason that by providing lower costs care through the 80/20 rule, and providing preventative care etc. far less seniors will also need to utilize Medicare Advantage.

Originally posted to Jorybu on Fri Aug 17, 2012 at 09:36 PM PDT.

Also republished by Community Spotlight.

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Comment Preferences

  •  Good diary (28+ / 0-)

    You might also explain that it is precisely those savings that now allow seniors to get preventative care without a co-pay and have closed the doughnut hole, saving seniors hundreds of dollars a year on their prescription medicine.

    In other words, there is a tangible benefit to those savings that seniors are experiencing right now.

    •  And that the donut hole was created, (1+ / 0-)
      Recommended by:
      maybeeso in michigan

      just like in the Ryan plan, to shift more of the cost to seniors. It should be noted that the donut hole presently is not completely closed. I believe it will close completely in future years. This a a wonderful diary, as it gives all of us the ammunition to fight back against the lies Romney/Ryan are perpetrating. We've lost a lot since the 2010 election, and we can't afford to lose any more.

      Your left is my right---Mort Sahl

      by HappyinNM on Sat Aug 18, 2012 at 07:46:23 AM PDT

      [ Parent ]

    •  As a disabled person receiving SSDI and Medicare (4+ / 0-)

      I can attest that these changes saved me a significant amount of money when I had a colonoscopy earlier this year.  Indeed that was not a cut to benefits, but an addition of benefit to me as a current recipient under the ACA.  The information in this diary is helpful in refuting the Republican mischaracterization of the ACA.  I hope that the word will spread and that people will realize that this is yet another Republican Lie about the ACA/Obamacare.

    •  Dem message is obtuse.I called OFA & complained... (0+ / 0-)

      that the Rs have won the message so far on Medicare with their UNISON "OBAMA CUT MEDICARE!" They are all on the same page lying. The DEMS are all over the place. The contrary rebuttal must be succinct. Today Obama said the Rs are trying to Voucherize Medicare. Ok, how about that - every DEM in the county every day of every hour in every place scream that Ryan/Romney want to VOUCHERIZE MEDICARE OR BETTER YET THEY WANT 'VOUCHERCARE' NOT MEDICARE!" This is NOT a message the Ds should lose AGAIN (remember 2010). So far, I give Obama.Biden/Chicago/DEMS a D+. They better shaae up quick and I do NOT want to hear they are going to come on strong in the fall.....

  •  Great! (7+ / 0-)
    Recommended by:
    ozsea1, caul, splashy, Matt Z, Smoh, hungeski, bnasley

    I knew a bit about this, but I wasn't sure about the timeframe.   I appreciate the response.  

    •  That's the irony... (23+ / 0-)

      ...that Romney is running around saying he'd RESTORE the $700 billion, in essence putting the waste, fraud and abuse BACK into the system.

      And yet he says Obama isn't serious about taking on the issue of entitlement reform.

      •  It is a classic Republican strategy (25+ / 0-)

        take a complex issue and present it as something it is not, and hope none will figure out that they are misrepresenting it.  They get away with it constantly since the cable news networks will not verify the spin.  

        No one realizes he is going to put the fraud and waste back in because the media still hasn't figured out that the $716 billion is a savings and not a cut--save for Sarah Kliff and Solidad O'brien.

        •  Sad but true (17+ / 0-)

          It is very frustrating.  But Dems and the Prez first have to stop referring to these as "cuts" and start referring to them as "savings."  As Frank Luntz has shown us, words and framing matter more than truth. We have the truth, now let's get the framing.

          •  need to get the message out there..asap (4+ / 0-)

            the fact that the rightwing meme has already taken hold on facebook is a big concern.

            Change is inevitable. Change for the better is a full-time job. -- Adlai E. Stevenson

            by marzook on Sat Aug 18, 2012 at 06:08:39 AM PDT

            [ Parent ]

            •  The seniors have already had 2 years to (1+ / 0-)
              Recommended by:
              maybeeso in michigan

              experience some of the changes. They know how it's impacted them. If they don't see changes, or they've been helped and not harmed, they have to know that Romney/Ryan are lying.

              Your left is my right---Mort Sahl

              by HappyinNM on Sat Aug 18, 2012 at 07:50:00 AM PDT

              [ Parent ]

              •  Trust me. They don't know. (5+ / 0-)

                It's hard to wrap your brain around if you are an educated person, but there are millions of people out there who do not understand what is going on around them.  I once did a survey (as part of a job) of people over 65 in Florida.  I went to neighborhoods where some people had only an elementary school education, if that. Some had never been out of the county in which they were born and had no ability to get transportation out, if they had for some reason wanted to go. There were people living with no indoor plumbing, people who were deaf or senile or ill or mentally ill and/or living in extreme poverty.  They often did not understand simple words in the survey.  Some sociology M.A.  in DC must have written it without any concept of how the questions would be received.   If you asked the older folks if they needed "Meals on Wheels', they would say no, no matter what kind of obvious poverty they were living in (no furniture, no bathroom, being cared for by neighbors, etc).  They would then say that "other people probably needed it" but not them. It was shameful to them to acknowledge a need for help. Another question was "Have you ever needed legal assistance."  Well, they would answer no to that. It was obvious, with some, that they had no idea what the word "legal" means, but I wasn't supposed to explain it to them.  When I broke those rules because I felt it was skewing the survey, I asked if they had ever needed a lawyer. At that point, they thought I meant that they had been in trouble with the law.  This went on like this endlessly.  

                So, about that "2 years they've had to understand," I would say forget it.  Many have no idea what is happening and can't grasp it even in simple language.  Not everyone lives in a suburb and drives a nice car and has attended high school and college.   It's shocking to knock on doors and see the reality of how people live.   One thing that struck me was how frightened and confused older people were by bureaucracy.  I talked to  a woman whose husband was in the hospital dying and she was terrified that she was going to lose the trailer she lived in because of the costs.   She knew there were "costs" and government "rules," but she had no idea what they were or how they would affect her. She looked at me as if I were some kind of savior sent by the government to help her understand.  It was very difficult to do this job.

                •  That's a really sad story. (1+ / 0-)
                  Recommended by:
                  Angie in WA State

                  However, I don't think those people you contacted are voters. I tried to register people to vote who lived in "the projects." They had no interest in voting. Some of them even knew me because I was a welfare worker for several years. They trusted me, but they had no interest in voting.

                  Your left is my right---Mort Sahl

                  by HappyinNM on Sat Aug 18, 2012 at 10:14:24 AM PDT

                  [ Parent ]

                  •  Well, you may very well be right, (3+ / 0-)
                    Recommended by:
                    HappyinNM, Angie in WA State, bwren

                    but there are also millions of uninformed people one step above this, who do vote.  I ran into them also when doing this survey. Frequently, they would live right next door or in the same neighborhood as the people I described above.   They were obviously more comfortable, though still lower middle class. Yet, as soon as I said I was doing a government survey, they would go off on those "welfare cheats out there driving Cadillacs."  I wanted to say to them, "why don't you go next door and see how that old gentleman is living, who has no furniture other than a bed, a table, a chair and a refrigerator and who is going blind and has no wife or children and is having trouble doing his own food shopping, as he has to walk to the store!"  Or, I could talk about the woman who answered the door herself with an enormous tumor on her upper body.  She was dying of cancer but was alone because her husband had to work to keep their health insurance.  I saw in the paper a few days later that she had died.  But somehow this kind of thing gets buried in the right wing rhetoric machine. I'm just saying we need to counter this. I'm glad Obama is doing a good job most of the time with the messaging.  But since, the Rethugs have now embarked on their last resort, which is to accuse the Dems of doing what they themselves intend to do to ordinary people in order to confuse people, I'm hoping that the Dems will counter that rapidly. I haven't seen this happening much, so I'm worried.

                    •  I'm worried as well. (1+ / 0-)
                      Recommended by:
                      Angie in WA State

                      But, what I've found is that, right about the time I think Obama has blown it, he comes back with something better. So, for now, I'm just going to trust that they know what they're doing. We'll see what happens after Labor Day when more people are engaged.

                      Your left is my right---Mort Sahl

                      by HappyinNM on Sat Aug 18, 2012 at 11:10:59 AM PDT

                      [ Parent ]

            •  I so agree with you. (1+ / 0-)
              Recommended by:
              maybeeso in michigan

              They need to explain this in simple language and counter the Rethug meme asap!

          •  Savings DUE to ACA. If it is repealed, they go (0+ / 0-)

            away.    Simple...

            Thanks!   I had wondered what the specifics were but hadn't gotten around to looking for them.

            Everyone should push this a lot.

            Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity. Martin Luther King, Jr.

            by maybeeso in michigan on Sat Aug 18, 2012 at 10:01:27 AM PDT

            [ Parent ]

      •  I'd just like to say that not all of the (7+ / 0-)

        $700 billion "savings" are "waste, fraud, and abuse," for example, the cut to the disproportionate share adjustment (for safety net hospitals treating significant amounts of medically indigent patients) may have a negative impact on some hospitals.

        The rational for those cuts relies on the more insured patints means less medically indigent....we'll see how that plays out.

        •  Scalia is already murmuring (6+ / 0-)

          about ending emergency room service for the "medically indigent".

          •  Cite for that? I'd like to read it... n/t (0+ / 0-)

            * * *
            I like paying taxes...with them, I buy Civilization
            -- SCOTUS Justice O.W. Holmes Jr.
            * * *
            "A Better World is Possible"
            -- #Occupy

            by Angie in WA State on Sat Aug 18, 2012 at 01:53:54 PM PDT

            [ Parent ]

            •  It was all over the web during ACA arguments (0+ / 0-)

              Here is the first link Google turned up:
              http://www.thepeoplesview.net/...

              GENERAL VERRILLI: No. It's because you're going -- in the health care market, you're going into the market without the ability to pay for what you get, getting the health care service anyway as a result of the social norms that allow -- that -- to which we've obligated ourselves so that people get health care.

              JUSTICE SCALIA: Well, don't obligate yourself to that. Why -- you know?

              GENERAL VERRILLI: Well, I can't imagine that that -- that the Commerce Clause would --would forbid Congress from taking into account this deeply embedded social norm.

              JUSTICE SCALIA: You -- you could do it.

        •  it does stand to reason (5+ / 0-)

          that preventative care will make many americans less ambushed by sudden catastrophic discovery of advanced illness...but that will require a several year shift in attitudes toward USING the preventative care and expansion of understanding about what's covered (no small feat given the GOPs desire to keep voters low-info on the PPACA's merits).

          like most policy, it's a challenge of national attention span. too often we pull the ship of state in tight circles for years, rather than turning and moving forward.

          If only Michael Phelps hadn't smoked that pot...imagine what he could have accomplished with motivation and good lung capacity.

          by papa monzano on Sat Aug 18, 2012 at 05:55:22 AM PDT

          [ Parent ]

      •  Orwellian (4+ / 0-)

        Very cynical GOP

        wall Street Casino is the root of the problem. Don't call them banks.

        by timber on Sat Aug 18, 2012 at 12:52:41 AM PDT

        [ Parent ]

        •  Bipartisan "Skin in the Game" (1+ / 0-)
          Recommended by:
          derridog

          The Time Bomb in Medicare cuts was approved by both parties.

          SHIFTING SOME GOVERNMENT COSTS TO BENEFICIARIES

          What’s already happened? The health reform law, also called the Affordable Care Act (ACA), already calls for seniors to pay more for their healthcare by requiring their Medigap insurance policies to pay out less. Seniors typically buy Medigap policies to cover the gaps in Medicare benefits. But the ACA bars insurers who sell Medigap policies plans F and C from covering all of a seniors’ expenses that remain after Medicare pays the bills. Those two plans are the most popular Medigap policies precisely because they do cover almost all remaining expenses. Seniors tend to be risk averse and want no financial surprises at the end of an illness.

          Politicians on both sides supported this provision in the ACA, so there’s been little talk about it and therefore little press coverage. Millions of seniors will be surprised come 2015, when they learn their Medigap policies won’t cover as much. The rationale: Some health policy analysts believe consumers use too many medical services, and paying more out of pocket—having “more skin in the game”—will cause them to seek less healthcare.

          By 2015 many Seniors will realize this and be very pissed.
          •  This sentence (4+ / 0-)
            Affordable Care Act (ACA), already calls for seniors to pay more for their
            has a link which explains that this provision only applies to wealthier recipients (over $85,000 in income).

            While it's important for us to know as much about this as possible, especially if we're canvassing or discussing on Facebook, it's really detailed, and very difficult to remember all the details. When people become eligible for Medicare, there are many resources online and by phone (800-MEDICARE) which people can access to find the best fit for them.

            Right now, we need to know enough to cut through the lies with truth.

            Your left is my right---Mort Sahl

            by HappyinNM on Sat Aug 18, 2012 at 08:10:34 AM PDT

            [ Parent ]

            •  Link (3+ / 0-)

              Medicare Changes under Radar

              There are some uncomfortable truths about Medicare changes lurking in the health reform law. Because the pols on both sides of the aisle supported these changes, it’s not surprising that almost no one has been eager to talk about them in campaign ads or otherwise.

              Beneficiaries with higher incomes—this year $85,000 for individuals and $170,000 for couples—have been paying higher Part B premiums for some time now. (Part B pays for doctor, lab, and hospital outpatient services.) But the health reform law froze those income thresholds (pdf), meaning that, over time, more and more “wealthier” income people will pay higher premiums. There will be no indexing that would have meant fewer beneficiaries would pay the higher amounts.

              And then as Matt Stoller
              says, there is the whole second term agenda under the radar.
              The White House already tried cutting all three main entitlement programs, last year (cuts to Medicaid are actually cuts to Obamacare, for what it’s worth, since an expansion of Medicaid was a key plank of the new health care law).

                  The White House agreed to cut at least $250 billion from Medicare in the next 10 years and another $800 billion in the decade after that, in part by raising the eligibility age. The administration had endorsed another $110 billion or so in cuts to Medicaid and other health care programs, with $250 billion more in the second decade. And in a move certain to provoke rebellion in the Democratic ranks, Obama was willing to apply a new, less generous formula for calculating Social Security benefits, which would start in 2015.

              No better time to pin them down than right now while they seek our support!
      •  exactly (4+ / 0-)

        "putting the waste, fraud and abuse BACK into the system."

        that's exactly how the new OFA ad frames it.

        If only Michael Phelps hadn't smoked that pot...imagine what he could have accomplished with motivation and good lung capacity.

        by papa monzano on Sat Aug 18, 2012 at 05:49:52 AM PDT

        [ Parent ]

      •  What he wants to "restore" is the ability of (2+ / 0-)
        Recommended by:
        Angie in WA State, bwren

        private insurers to profit from seniors by providing the same coverage under Medicare Advantage programs as is currently available under traditional Medicare with a 17% mark-up.  

        Romney's goal is to privatize Medicare into a system where healthcare providers profits increase while the actual care provided is reduced.

    •  In response to your question in the last... (12+ / 0-)

      paragraph:

      That was my attempt to explain a rather complicated process.   I would love some feedback from Daily Kos members on how to better break it down, or how to better understand the numbers to improve my position and wording.
      The suggestion I've made in several diaries and comments is, when arguing with people about this, DON'T get into what's in the $716B of "cuts". Instead, say:

      "Okay, so tell me, what benefit has been cut? Name just ONE medical procedure that was covered and no longer is!"  

      They can't name one, because there is none!

      Then you say: "In fact, benefits have increased for Medicare recipients by reducing their out-of-pocket costs for medications (the "donut hole"). Benefits have increased because the $716B is cuts in Federal Government COSTS, not reduction in benefits. There isn't a single reduction in benefits!"

      So my recommendation is to keep it simple and place the onus of showing what benefit reduction there has been on them.

      If you have to get into an argument over what someone has written, or an article, I will take the liberty of recommending this diary I wrote yesterday, and some of the great responses to it, taking apart an article that a pro-Mitt blogger published in Forbes.

      A PALINDROME: Slip-up set in Utah. Trail, no? M. Romney -- odd! Elder an AMC man, a Red-led doyen. Mormon liar that unites pupils?

      by Obama Amabo on Sat Aug 18, 2012 at 04:30:17 AM PDT

      [ Parent ]

      •  Not a penny in cuts to Medicare patients (4+ / 0-)

        This is not that complicated, but some of you are making it more so. It's savings that are passed along to Medicare patients that: eliminate co-pays on check ups and other preventive procedures; ends the donut hole left by President GW Bush in his unfunded Medicare Part D; and eliminates $500 billion in unnecessary subsidies to private insurers who were unable to offer a cheaper, more efficient plan than good old government Medicare. About $200 billion  of the money is cuts to hospitals who specifically asked for cuts in the ACA in anticipation of more insured patients which means we the taxpayers would have to pay less in indigent care since so many more people would have insurance. The rest is savings through fraud and waste reduction.

        Not only did Ryan and Romney support the same savings, Ryan voted for it in his budget plan, which actually cuts benefits by switching to a voucher system for those 55 and younger. Plus they have proposed massive cuts to Medicaid, which pays for two-thirds of all nursing home patients, 6 million in total.

        •  See Above (0+ / 0-)

          Bipartisan Cuts are Deep

          SHIFTING SOME GOVERNMENT COSTS TO BENEFICIARIES

          What’s already happened? The health reform law, also called the Affordable Care Act (ACA), already calls for seniors to pay more for their healthcare by requiring their Medigap insurance policies to pay out less. Seniors typically buy Medigap policies to cover the gaps in Medicare benefits. But the ACA bars insurers who sell Medigap policies plans F and C from covering all of a seniors’ expenses that remain after Medicare pays the bills. Those two plans are the most popular Medigap policies precisely because they do cover almost all remaining expenses. Seniors tend to be risk averse and want no financial surprises at the end of an illness.

          Politicians on both sides supported this provision in the ACA, so there’s been little talk about it and therefore little press coverage. Millions of seniors will be surprised come 2015, when they learn their Medigap policies won’t cover as much. The rationale: Some health policy analysts believe consumers use too many medical services, and paying more out of pocket—having “more skin in the game”—will cause them to seek less healthcare.

          This is different from what you contend.
      •  Did you write that Palindrome? (0+ / 0-)

        It's extraordinarily long and impressively complex.

      •  To Obama Amabo, I only add.. (3+ / 0-)

        Follow with, "Ryan's plan included the same savings and ends Medicare as we know it by turning it into a voucher for private insurance."

  •  Well-supported diary (22+ / 0-)

    Tipped and recced. I also like how hummingbird4015 broke it down:

    Obama's plan cuts 700B in waste to fund increased benefits.

    Ryan/Romney's plan cuts benefits to fund more tax cuts for the rich.

    http://www.dailykos.com/...

    Obamacare cuts waste. Ryan/Romney cuts benefits. Simple. Elegant. True.

    The choice of our lifetime: Mitt Romney, It Takes A Pillage or President Barack Obama, Forward Together.

    by FiredUpInCA on Fri Aug 17, 2012 at 09:59:50 PM PDT

    •  In a nutshell.... (4+ / 0-)
      Obama's plan cuts 700B in waste to fund increased benefits.
      Keep saying that it cuts waste and fraud in order to increase benefits (i.e. cuts through the red tape crap to make way for more benefits), everyone understands that.
      Ryan/Romney's plan cuts benefits to fund more tax cuts for the rich.
      This part about Rmoney's plan to cut benefits in order to give more tax cuts to the very wealthy should be hammered home again, and again, and again, and again, and again....eventually, even the most obtuse will get that Rmoney/Ryan are not friends to the regular little guy.

      I think, therefore I am........................... Plus ca change, plus c'est la meme chose....AKA Engine Nighthawk - don't even ask!

      by Lilyvt on Sat Aug 18, 2012 at 06:07:01 AM PDT

      [ Parent ]

  •  It's simple-minded... (16+ / 0-)

    ...  but was effective for one of my simple-minded right-wing associates, and I used the dreaded Wal--Mart to explain.

    Let's say you've always shopped at a relatively pricey grocery store, and then discover that you can get the exact same things for 75% less down the street at Wal-Mart.  You decide to switch stores, and you save money, allowing you to have everything you're accustomed to, and even add in extra items you might have refrained from buying before.

    No rational persion would run around crying that you had "slashed your food budget by 75%," but that is exactly what the Republican strategy has been on this Medicare issue.  The same coverage and more for seniors, with a giant savings to the taxpayers, and they are intentionally and deceptively calling it a cut.

    My right-wing "friend" told me I was wrong -- Obama took the money to pay for Obamacare.  This is why I no longer talk to people on Facebook.

    "There's a lot you can do with a hypnotized chicken." -7.50; -6.21

    by sgoldinger on Fri Aug 17, 2012 at 10:58:07 PM PDT

    •  Again, say to your friend: "So what benefit..." (3+ / 0-)
      Recommended by:
      Thinking Fella, HappyinNM, sgoldinger

      ...was cut? Name just ONE."

      They can't.

      A PALINDROME: Slip-up set in Utah. Trail, no? M. Romney -- odd! Elder an AMC man, a Red-led doyen. Mormon liar that unites pupils?

      by Obama Amabo on Sat Aug 18, 2012 at 06:14:43 AM PDT

      [ Parent ]

    •  Ya know.... (3+ / 0-)
      Recommended by:
      camlbacker, sgoldinger, SoCalSal
      My right-wing "friend" told me I was wrong -- Obama took the money to pay for Obamacare.
      You can lead a horse to water, tell him/her it's water and wonderful, sprinkle a little on their lips, drink a little yourself to show how good it is, but essentially you can't make the horse drink the water.
      Some of these people are sorta like the people who absolutely believed the earth was flat.

      I think, therefore I am........................... Plus ca change, plus c'est la meme chose....AKA Engine Nighthawk - don't even ask!

      by Lilyvt on Sat Aug 18, 2012 at 06:17:26 AM PDT

      [ Parent ]

      •  I just looked out my back window, (1+ / 0-)
        Recommended by:
        Obama Amabo

        and the earth IS flat.

        Your left is my right---Mort Sahl

        by HappyinNM on Sat Aug 18, 2012 at 08:17:20 AM PDT

        [ Parent ]

      •  well-said (1+ / 0-)
        Recommended by:
        SoCalSal

        My father starting drifting to the right with the election of Bill Clinton (who was younger than my dad, and therefore an idiot).  He has been moving farther and farther, prodded each day by Hannity and O'Reilly.  Now we cannot ever have a reasonable conversation about anything beyond the most mundane everyday topics, like cheese or baseball.

        I often look on Daily Kos for good diaries about "how to speak with a dittohead," but personally have had zero success...

        "There's a lot you can do with a hypnotized chicken." -7.50; -6.21

        by sgoldinger on Sat Aug 18, 2012 at 08:20:36 AM PDT

        [ Parent ]

        •  ya know.... (1+ / 0-)
          Recommended by:
          sgoldinger

          People like Rush, Hannity, O'Reilly and the entire Fox (pretend) news channel are doing such a disastrous dis-service to this Country.  The lies they spread are extremely damaging.  Too bad there isn't a disclaimer before every airing that all the program content is outrageously prejudicial and skewed and by no means actual news or reality-based, and should be viewed as junk-mail on the air-waves.
          Even so, there would probably still be people who would take their garbage as verifiable truth.
          (No disrespect to your father)

          I think, therefore I am........................... Plus ca change, plus c'est la meme chose....AKA Engine Nighthawk - don't even ask!

          by Lilyvt on Sat Aug 18, 2012 at 08:40:35 AM PDT

          [ Parent ]

          •  No offense taken (1+ / 0-)
            Recommended by:
            Jorybu

            I would not have mentioned my dad's Fox News habit if I did not believe it deserved ridicule.  I try to console myself by remembering that he's in his 70s and has always enjoyed the odd pleasure of feeling outraged...

            I suppose, with my long-time membership at DKos, this apple did not fall far from the tree, just far in Political Compass space.

            "There's a lot you can do with a hypnotized chicken." -7.50; -6.21

            by sgoldinger on Sat Aug 18, 2012 at 09:40:23 AM PDT

            [ Parent ]

    •  Try remembering why so many of us despise Walmart (2+ / 0-)
      Recommended by:
      sgoldinger, maybeeso in michigan

      And apply that to healthcare.  

  •  I.m glad you're writing about this. (14+ / 0-)

    The whole issue of "framing" the debate is something that is critical to success, and generally speaking the Repubs have been better at grabbing the loudest microphone first and drowning everyone else out with a short (totally misleading) slogan that we then all end up having to debate.  We lose because we are debating their issue.

    We have to say it short and sweet:  Obama preserves the solvency of Medicare for a longer time, and cuts 700B in ineffective and largely disliked programs to fund increased preventive CARE and BENEFITS for seniors.  

    Ryan robs the program of $700B in SENIOR BENEFITS to offset tax cuts for the very wealthiest, like his running mate, whom I suppose he aspires to emulate. And not only does he CUT BENEFITS, he throws seniors back into the open insurance market, with a coupon and a hearty wave.

    The cruelty of it is stunning.  The callousness.  Imagine your 70 or 80 or 90 year s mother or father struggling to figure out policy details and having to remember to send in insurance forms.  It's stunning in its devastating lack of heart.

    Why is the ACA called Obamacare?  BECAUSE OBAMA CARES!  

    •  Yup.... (1+ / 0-)
      Recommended by:
      HappyinNM
      The cruelty of it is stunning.  The callousness.  Imagine your 70 or 80 or 90 year s mother or father struggling to figure out policy details and having to remember to send in insurance forms.  It's stunning in its devastating lack of heart.
      I'm not close to those ages but, even so, the red tape of EOB forms is baffling now, imagine the complete and utter abyss of inconsistencies and mis-understanding of a voucher plan to a very elderly and sick individual?  Cruel doesn't even begin to describe it.

      I think, therefore I am........................... Plus ca change, plus c'est la meme chose....AKA Engine Nighthawk - don't even ask!

      by Lilyvt on Sat Aug 18, 2012 at 06:26:20 AM PDT

      [ Parent ]

    •  The Bipartisan Cuts in 2015 (0+ / 0-)

      Contradict your Narrative

      SHIFTING SOME GOVERNMENT COSTS TO BENEFICIARIES

      What’s already happened? The health reform law, also called the Affordable Care Act (ACA), already calls for seniors to pay more for their healthcare by requiring their Medigap insurance policies to pay out less. Seniors typically buy Medigap policies to cover the gaps in Medicare benefits. But the ACA bars insurers who sell Medigap policies plans F and C from covering all of a seniors’ expenses that remain after Medicare pays the bills. Those two plans are the most popular Medigap policies precisely because they do cover almost all remaining expenses. Seniors tend to be risk averse and want no financial surprises at the end of an illness.

      Politicians on both sides supported this provision in the ACA, so there’s been little talk about it and therefore little press coverage. Millions of seniors will be surprised come 2015, when they learn their Medigap policies won’t cover as much. The rationale: Some health policy analysts believe consumers use too many medical services, and paying more out of pocket—having “more skin in the game”—will cause them to seek less healthcare.

      "Skin in the game" has not yet been fully realized.  When it is in 2015 there will be blowback.
    •  Actually, Ryan embraced the $717 billion (0+ / 0-)

      in Medicare savings in his plan, which makes the R&R charge of Obama cutting Medicare extremely hypocritical.

      The sh*t those people [republicans] say just makes me weep for humanity! - Woody Harrelson

      by SoCalSal on Sat Aug 18, 2012 at 09:18:16 AM PDT

      [ Parent ]

  •  What's really great about this is that the R's (3+ / 0-)
    Recommended by:
    Matt Z, Smoh, HappyinNM

    will keep repeating their lies over the course of their convention -- 'cause that's all they know how to do, of course, since they've proven they can't run an economy, the defense of this nation, or anything else in this country, worth a $h*t.  

    And then the Dems get their turn.

    And then the debates.

    We're gonna have a field day with their incompetent BS.

    •  The Bipartisan Second Term Agenda (1+ / 0-)
      Recommended by:
      greenbell

      Obama's Second Term Agenda

      ...  The White House already tried cutting all three main entitlement programs, last year (cuts to Medicaid are actually cuts to Obamacare, for what it’s worth, since an expansion of Medicaid was a key plank of the new health care law).

          The White House agreed to cut at least $250 billion from Medicare in the next 10 years and another $800 billion in the decade after that, in part by raising the eligibility age. The administration had endorsed another $110 billion or so in cuts to Medicaid and other health care programs, with $250 billion more in the second decade. And in a move certain to provoke rebellion in the Democratic ranks, Obama was willing to apply a new, less generous formula for calculating Social Security benefits, which would start in 2015.

      Going after entitlements is in fact a tradition of Democratic politicians since the 1980s. The post-WWII model of dealing with entitlements was to expand them as a way of boosting aggregate demand. But as Carter, Reagan and Volcker ushered in an era of Wall Street greed and austerity, that trend reversed. In the early 1980s, Speaker of the House Tip O’Neil collaborated with Ronald Reagan to raise taxes on the poor and middle class with a “grand bargain” around Social Security. Later on, Bill Clinton had his go at the programs, with an even more aggressive plan to destroy the remains of New Deal liberalism.

      The future looks grim regardless of who wins.
  •  medicare part C (13+ / 0-)

    That is where there is a ridiculous over-payment.  What part C allows you to do is have a private insurance company administer Medicare.  The private insurer gets to keep the Medicare co-pays / taxes and is paid a subsidy by the government.  The subsidy is what ACA changes.  Right now, they are getting a very large boom for doing very little.  You might ask what does the private insurer do?  Not alot.  They may offer one or two benefits above normal Medicare.

    In other words, romney is totally full of shit.  There has been no transfer of money from Medicare trust fund to other areas covered by ACA.  Nor will there be.

    "The real wealth of a nation consists of the contributions of its people and nature." -- Rianne Eisler

    by noofsh on Sat Aug 18, 2012 at 01:09:13 AM PDT

    •  Ding, ding, ding!!!! (2+ / 0-)
      Recommended by:
      camlbacker, HappyinNM

      We have a winner!

      In other words, romney is totally full of shit.
      Never have more truer words been written.

      I think, therefore I am........................... Plus ca change, plus c'est la meme chose....AKA Engine Nighthawk - don't even ask!

      by Lilyvt on Sat Aug 18, 2012 at 06:29:12 AM PDT

      [ Parent ]

    •  You mean Medicare Part D (4+ / 0-)

      That was the unfunded $800 million disaster Bush and the GOPers sprung on us in 2003. They needed to hold the vote open in the House longer than allowed, bribing a couple of Republican fence sitters to get the slim majority. Naturally, Republican-majority investigators in the House found nothing wrong w/ this tactic.

      The ACA eliminated $500 million in subsidies for Medicare Advantage, the private program in Part D. The ACA also covers the donut hole, saving seniors about $600 a year in prescription costs. That extra $50 a month is going back into the economy instead of only going to the insurers and the pharmaceutical companies.

      •  Medicare Advantage is Part C. (0+ / 0-)

        Part D is prescription drug coverage only, and is incompatible with Part C, which usually also covers meds.

        Part D is usually for people with Medigap plans, which usually don't cover drugs.  There are, of course, a few oddball exceptions.

        Early to rise and early to bed Makes a man healthy, wealthy, and dead. --Not Benjamin Franklin

        by Boundegar on Sat Aug 18, 2012 at 07:28:23 AM PDT

        [ Parent ]

        •  Medigap plans don't cover drugs because (1+ / 0-)
          Recommended by:
          Obama Amabo

          the original Medicare consisted primarily of Parts A (inpatient) and B (outpatient, including doctors). Medicare Part B only covers 80% of the costs, and the Medigap (private insurance) covers the remaining 20%. Some drugs are covered under Part B. I don't know all of them, but I have a nebulizer and the liquid that goes in it, which were paid for by Part B.

          What's important to keep in mind is that Medicare Advantage and Medicare Part D were passed by Repukes. This was the first time they have ever passed this kind of "help the little folks" program. Then ask why. Their intention was to make the cost of Medicare (for the government) so high as to kill the program. What was done in the ACA was to reverse some of the costs to enable the program to continue to exist. I assume there will be more changes, as without them, the program won't be sustainable. If tweaking the ACA over time brings down the cost of heath care, and the enormous inflation in health care, perhaps we will have real universal health care, and Medicare will be moot.

          Your left is my right---Mort Sahl

          by HappyinNM on Sat Aug 18, 2012 at 08:40:40 AM PDT

          [ Parent ]

          •  Costs were much lower in the '60s (0+ / 0-)

            And Medicare was essential.  How do you expect seniors to pay the premiums?  When I read posts like yours I figure why vote for either party.  In fact the Republicans may be less devious about their intentions.  

            •  Bringing down the cost of health care is devious? (0+ / 0-)

              And it's the same thing as destroying Medicare?  I don't get this at all.

              Early to rise and early to bed Makes a man healthy, wealthy, and dead. --Not Benjamin Franklin

              by Boundegar on Sat Aug 18, 2012 at 09:16:56 AM PDT

              [ Parent ]

              •  Too often cutting costs is code for denying care (0+ / 0-)

                The fine print matters.  When you are navigating the system with a 90 plus parent you are not dealing with frames and spin but with the outcomes of the impact of putting the screws on providers.

            •  I did a diary last year about Medicare premium (0+ / 0-)

              assistance. Here's the link.

              Some of the numbers may have changed, as they usually change annually. If you need additional help, please feel free to KosMail me. I don't know everything, but I know enough to know how to find the information. Good luck.

              Your left is my right---Mort Sahl

              by HappyinNM on Sat Aug 18, 2012 at 10:24:59 AM PDT

              [ Parent ]

  •  Thanks for this diary! (4+ / 0-)
    Recommended by:
    hulibow, Smoh, Jorybu, HappyinNM

    This must be a really hard topic to write about as pretty much no one else has even tried.  Thank you.   If you can, keep working at this.  The affect of the Affordable Care Act on Medicare is a big issue to seniors (like me!) and there's been little effort to explained it.  You do a better job in your diary than anywhere else I've seen.  But I'm hoping that you (or someone else) can say it more clearly.

    •  It is difficult to find sources (3+ / 0-)
      Recommended by:
      hungeski, HappyinNM, blue denim

      every time I try to search for something regarding the ACA or medicare on google the majority of the articles are from biased sources.  I tried to use some resources I found that seemed to to try explain it, but there is a lot of misinformation that the right wing has put out there, and there are several .org groups that are very bias as well.  

      It is complex, and my understanding is pretty elementary.  Some of the people in the comments section are far more knowledgable than me which is why I brought it to this sight to ask for help in understanding.

  •  A simpler way to explain it (8+ / 0-)

    If normally you spend $100 a week on groceries, and program change makes it so you only spend $75 for the same amount of groceries, you didn't have your food cut by 25%. On top of that, under the ACA and the Medicare savings within it, you get a slightly more groceries (to continue the analogy) and pay less for it.

    cheers,

    Mitch Gore

    Want to end too big to fail banks? Then move your money and they will no longer be too big.

    by Lestatdelc on Sat Aug 18, 2012 at 01:49:42 AM PDT

    •  Until the grocery store goes out of business (1+ / 0-)
      Recommended by:
      misslegalbeagle

      Sure frame all you like but this game of cutting reimbursements to providers and pretending magic happens won't end well.  Some of us less willing to swallow the magic ACA knew this would be a political problem and fear it sets the stage for more "cost" cutting.  

      •  And, Lord knows, it would be a terrible thing... (8+ / 0-)
        (A)nd fear it sets the stage for more "cost" cutting.
        ...
        1. If hospitals had to start being more efficient.
        2. If portable medical records became standard.
        3. If fewer people used the excessively expensive ER.
        4. If medial quality improved, and fewer patients died from medical errors.
        5. If procedures were prescribed because they're needed instead of because an MR machine needs to be paid for, or the hospital just needs more money.
        6. Finally, if hospitals that are poor quality and inefficient were taken over by other hospital systems. Yes, a few may go out of business entirely, but if so it probably wasn't viable and something (more long distance ambulance service) will usually take its place. As one would expect with any service that has been hugely subsidized, there is a glut of hospitals in many, many places.

        A PALINDROME: Slip-up set in Utah. Trail, no? M. Romney -- odd! Elder an AMC man, a Red-led doyen. Mormon liar that unites pupils?

        by Obama Amabo on Sat Aug 18, 2012 at 05:22:32 AM PDT

        [ Parent ]

        •  Don't worry as with grocery stores (0+ / 0-)

          The providers will first  leave the urban and rural poor.  But who cares?  Bipartisan agreement on that at least.

          •  ACA also includes programs to improve (1+ / 0-)
            Recommended by:
            Jorybu

            health care in rural areas.

            The sh*t those people [republicans] say just makes me weep for humanity! - Woody Harrelson

            by SoCalSal on Sat Aug 18, 2012 at 09:25:55 AM PDT

            [ Parent ]

          •  Actually, very unlikely. Urban hospitals... (0+ / 0-)

            ...tend to be the busiest and best, and often are tertiary hospitals associated with medical schools. urban areas is where their tends to be a glut of hospitals.

            It is rural areas that are most likely to suffer reduced medical services.

            A PALINDROME: Slip-up set in Utah. Trail, no? M. Romney -- odd! Elder an AMC man, a Red-led doyen. Mormon liar that unites pupils?

            by Obama Amabo on Sat Aug 18, 2012 at 09:37:34 AM PDT

            [ Parent ]

            •  The hospitals signed off on this (0+ / 0-)

              because they did the math about them no longer having to cost-shift the uninsured.

              Greenbill is simply blowing smoke. Me suspects a give me single payer or give me death purity argument in the offing.

              cheers,

              Mitch Gore

              Want to end too big to fail banks? Then move your money and they will no longer be too big.

              by Lestatdelc on Sat Aug 18, 2012 at 04:33:55 PM PDT

              [ Parent ]

        •  Excellent response! Bravo!! (0+ / 0-)

          Your left is my right---Mort Sahl

          by HappyinNM on Sat Aug 18, 2012 at 08:43:12 AM PDT

          [ Parent ]

      •  Are you seriously suggesting... (0+ / 0-)

        ...that healthcare will be made unprofitable by wringing out the waste and frauds in Medicare D...?

        cheers,

        Mitch Gore

        Want to end too big to fail banks? Then move your money and they will no longer be too big.

        by Lestatdelc on Sat Aug 18, 2012 at 04:31:43 PM PDT

        [ Parent ]

  •  We need to get busy (2+ / 0-)
    Recommended by:
    Smoh, HappyinNM

    The headlines of late repeat the "Obama cut 716B from medicare" - who knows if all of the articles explain how the cuts actually go down.  The only action I can personally think of taking is creating user names on main stream media sites and write the facts in the comment sections. I don't think we can wait for the debates for President Obama to debunk this to Mitt's face - at that point it really will be "he said, he said" - we need to stop this false meme now.

    Just like the "Mitt released 2 years of taxes" that keeps getting reported. It's a lie.

  •  The only real advantage in Advantage (3+ / 0-)
    Recommended by:
    Smoh, HappyinNM, blue denim

    I am on Medicare, and have a Medicare Advantage program.  The cost to me is $0.

    The only real reason I signed up is the out of pocket maximum it provides.  If I just had regular "Original" Medicare, my annual OOP would have no max, so a massive medical problem, like heart attack, stroke, cancer could wipe me out financially.

    But with an Advantage sign up, my OOP is limited to $5,400.  That is still a lot, but I could cover it.

    So one easy change to Medicare could make the Advantage SCAMS go away.  Put an OOP annual maximim on it.

    "We borrow this Earth from our Grandchildren."

    by Arizona Mike on Sat Aug 18, 2012 at 04:59:00 AM PDT

    •  The government doesn't have to do that. The... (1+ / 0-)
      Recommended by:
      Smoh

      ...insurance companies offering MAs will do what they want. And those offerings change periodically anyway.

      The government under ACA is removing the subsidies -- what private insurers do is up to them. In Massachusetts, both Blue Cross and Tufts are continuing to offer MAs, but may change their enticements along the way.

      A PALINDROME: Slip-up set in Utah. Trail, no? M. Romney -- odd! Elder an AMC man, a Red-led doyen. Mormon liar that unites pupils?

      by Obama Amabo on Sat Aug 18, 2012 at 05:48:06 AM PDT

      [ Parent ]

      •  I don't think that MA companies can just (0+ / 0-)

        "do what they want." As with everything health care in the USA, it's complicated.

        What Medicare is doing with MA plans under ACA is paying bonuses to MA plans that meet specific quality health care criteria. So far, the criteria and bonus payments have been generously applied (and somewhat controversial, of course). The intention is not to eliminate MAS, but to make many substandard MAs around the country clean up their standards/quality or disappear. And, of course, to eliminate the 17% MA subsidy from Medicare.

        MA plans do have to comply with Medicare standards in health care procedures offered. Variations between MA plans have mostly been in copays and monthly fees, and in frills not offered by Medicare.

        The sh*t those people [republicans] say just makes me weep for humanity! - Woody Harrelson

        by SoCalSal on Sat Aug 18, 2012 at 10:08:21 AM PDT

        [ Parent ]

  •  Thanks. I was looking (2+ / 0-)
    Recommended by:
    Smoh, HappyinNM

    for a diary like this to use to rebut the verbal vomiting of the uninformed.

    Only thing more infuriating than an ignorant man is one who tries to make others ignorant for his own gain. Crashing Vor

    by emmasnacker on Sat Aug 18, 2012 at 05:53:32 AM PDT

  •  Is this true? (0+ / 0-)
    This program is not really needed in its current form under the new ACA laws, as seniors will have access to lower cost private insurance at the government's expense.  
    I was not aware that Medicare recipients would be eligible to buy "Medigap" policies through the ACA.

    Because stupid people are so sure they're smart, they often act smart, and sometimes even smart people are too stupid to recognize that the stupid people acting smart really ARE stupid.

    by ZedMont on Sat Aug 18, 2012 at 05:56:54 AM PDT

    •  This complex interaction between Medicare and (2+ / 0-)
      Recommended by:
      hungeski, HappyinNM

      the ACA is at the core of what the Republicans are attacking on.   Healthcare.gov, which tries to explain it implies that Medicare Advantage will still remain, but that

      "Starting in 2014, the Affordable Care Act offers additional protections for Medicare Advantage Plan members by taking strong steps that limit the amount these plans spend on administrative costs, insurance company profits, and things other than health care."

      This may be a better explanation than I could give late late night when I was doing this research.  It stands to reason that by providing lower costs care through the 80/20 rule, and providing preventative care etc. far less seniors will also need to utilize Medicare Advantage.

      •  Intention is not to eliminate MAs. (1+ / 0-)
        Recommended by:
        Jorybu

        the intention is to eliminate the bloated subsidy to MAs, and to ensure MAs offer quality care.

        I chose a Medicare Advantage plan with Kaiser when I became eligible for Medicare a few years ago. The plan is among the top rated in the country, with many geographically convenient clinics in my area, so I can have a physician appointment, x-rays, lab tests, and pick up prescriptions all in the same place on the same day, seamlessly. Kaiser in Southern California uses electronic medical records, so at every visit the health care provider sees what I'm treated for, my prescriptions, my allergies, what tests are coming due.

        I can email my doctor and am guaranteed to get a reply within 24 hours, and many lab test results are available for my viewing online within hours and I can compare them to past test results along with explanation of the test results.

        If I need to see a doctor immediately, I can always do so - same day.

        I chose this MA plan for the reasons above and because I'd been uninsured for several years, didn't want to shop for a family physician who accepted Medicare. In the past year some of my copays have increased but are still manageable; probably not much more than I'd have to pay elsewhere (maybe less than what I'd pay elsewhere).

        Overall I'm satisfied and not ready to drop this MA plan to search for doctors, labs, radiology, and pharmacies that will accept Medicare. I'll stay with the plan until and unless it becomes unaffordable. Because the plan has a huge number of subscribers, its costs might stay relatively low.

        The sh*t those people [republicans] say just makes me weep for humanity! - Woody Harrelson

        by SoCalSal on Sat Aug 18, 2012 at 10:49:18 AM PDT

        [ Parent ]

        •  Thank you for your well thought out comment (1+ / 0-)
          Recommended by:
          SoCalSal

          that is good information to know from someone with experience in using MAs.

          •  Thank *you* for the diary. (0+ / 0-)

            Sarah Kliff is a great resource for health care info. She distills info from other resources and presents that info in an easily understood post.

            Several people have commented that the ACA eliminates MAs, so I wanted to clear up that misconception. In theory, MAs could provide comprehensive, coordinated care at an overall lower cost than Medicare alone. That has yet to be proved in practice, but I see some effort with my MA.

            Here's a quick explanation of how MAs work, in case you're interested: Overview of Medicare Advantage Plans

            with this quote from that page:

            If you are enrolled in a Medicare Advantage plan, you may have to pay a higher premium or deal with reduced benefits. However, these plans cannot reduce any of the benefits that you would normally receive from traditional Medicare.

            The sh*t those people [republicans] say just makes me weep for humanity! - Woody Harrelson

            by SoCalSal on Sat Aug 18, 2012 at 02:57:37 PM PDT

            [ Parent ]

    •  There were/are some changes in Medicare Advantage (0+ / 0-)

      plans.  I don't know the details but I'm sure I can "Google that for you". ;-)

      Stop clapping. Stop screaming. Open your mind. Listen. (Oh, and I support President Obama in 2012.)

      by Benintn on Sat Aug 18, 2012 at 06:48:31 AM PDT

      [ Parent ]

  •  This was very helpful to me, both so I understand (1+ / 0-)
    Recommended by:
    HappyinNM

    so I have a framework to hang my explanations to others on.  I KNEW there was a reason that Ryan's and ACA plans had the same magic number - 716b.  That makes sense now.  And what a great way to begin the conversation.  "have you wondered why Obama says he'll save 716b and Ryan says his plan leaves that money in?...". Thanks, I think you did a terrific job.

    Cats are better than therapy, and I'm a therapist.

    by Smoh on Sat Aug 18, 2012 at 06:03:27 AM PDT

  •  Another way of putting it is, if the ACA is (7+ / 0-)

    repealed and this $716 billion is "restored," it will not go toward additional benefits for Medicare recipients, it will in fact subsidize what the Republicans would be calling waste, fraud and abuse in the program if it were their idea (which it was, see Ryan budget plan) - with no benefit whatsoever to Medicare recipients.

    If $716 billion had actually been cut from Medicare BENEFITS, then seniors would be suffering those cuts.  Not only have they not suffered any loss of benefits, additional benefits have been added by the Obama administration (no copay screening tests, closing the donut hole, etc.).

    Because stupid people are so sure they're smart, they often act smart, and sometimes even smart people are too stupid to recognize that the stupid people acting smart really ARE stupid.

    by ZedMont on Sat Aug 18, 2012 at 06:05:02 AM PDT

  •  We should celebrate cutting spending! (3+ / 0-)

    The GOP knows that they can capitalize on generalized mistrust of Obama to attack Obamacare.

    We should be celebrating the cuts to Medicare expenses. But if you support "We the [Corporate] people," as Mitt Romney and the GOP do, then you want to give more money to the [Corporate] people and you're angry about the cuts to benefits to these [Corporate] citizens.

    Stop clapping. Stop screaming. Open your mind. Listen. (Oh, and I support President Obama in 2012.)

    by Benintn on Sat Aug 18, 2012 at 06:07:29 AM PDT

  •  Thanks for the explanation... (1+ / 0-)
    Recommended by:
    HappyinNM

    First, how does it work now with Medicare Advantage? I've heard that anyone who went for it could not ever get back onto regular Medicare again...they were stuck. Does that change with the ACA?

    Second, I'd love to see talking points like this put into simple bullet points. I'd also like to see other issues framed so we leftist/commie/pinko/liberals could explain it to the Neanderthal Party voters. Maybe some Kossack would like to start a series (wink, wink).

    Isn’t it ironic to think that man might determine his own future by something so seemingly trivial as the choice of an insect spray. ~ Rachel Carson, Silent Spring ~

    by MA Liberal on Sat Aug 18, 2012 at 06:44:53 AM PDT

    •  Not true. (1+ / 0-)
      Recommended by:
      SoCalSal

      My father in law was on a Medicare Advantage plan.  We liked it, the company was reasonable to deal with when he had a heart attack(requiring bypass surgery and a long recovery) out of state visiting his sons and I was dealing with making sure all of the bills from various providers were covered.  The company stopped offering Medicare Advantage in this state and we had no problem getting him back on traditional Medicare with a Medigap policy.

      I used to be disgusted. Now I try to be amused. - Elvis Costello

      by gnbhull on Sat Aug 18, 2012 at 08:30:27 AM PDT

      [ Parent ]

  •  Great Post! Can I add (2+ / 0-)
    Recommended by:
    HappyinNM, Obama Amabo

    this to the discussion.  Cal Thomas wrote a column about the dynamic duo and I could not help but write a response and here is what I said,

    August 16, 2012 11:22 am on Romney says he's paid taxes every year

    "I think that you are getting way ahead of yourself there Cal, comparing Governor Romney and Ryan as a team like Reagan's. I would agree though that we should look at their records, both Romney's and Ryan's. We can then compare the Romney Care with Obama Care and see one real difference, Romney Care pays for Abortion and Obama Care does not. So, there again is just one more reason to question your creditionals as a so called social conservative and both of theirs.

    Secondly, lets take a look at Medicare and how the 716 (give or take a couple of billion) would actually play out in both plans. The Ryan (nod nod wink wink Romney plan) would take same 716 billion and provide tax cuts for all three of you. Yeah, it would take 716 billion and give you 1%ers yet another tax cut. It would put such a burden on states for the Medicaid that nursing homes would have no choice but to close their doors on our severely disabled and elderly. That is just the most obvious and along with a tax increase on the middle class, what is there not to like?

    Now, lets take same 716 billion dollar approach to President Obama. That would take this 716 billion and put it from one government insurance into another government insurance, Medicare to Obama Care if you wish. What American tax payers have been shouldered with has been a huge subsidy for Medicare Advantage plans for Medicare qualified insureds. Remember that President Bush installed this as an unfunded mandate. That is one among many things to consider. Here is another, the providers have agreed to lower the costs of services provided. Yep, you have read that correctly. What the hospitals and providers now know is that they will be paid for those services rendered and will not have to get creative to replace the lost funds. More paying customers, lower prices. In short, this will be used over a 10 year period to shore up Medicare itself and keep it vibrant for the next generation. If Ryan's plan is so good, why do they say that if you are over 55, don't worrry about it? We all know the answer to that one, he thinks you are fools to believe him and the rest of the snake oil salesmen."

    We need to keep hammering away at these guys with a message of President Obama keeping Medicare and how the 700 billion works and these other "snake oil salemen's" approach to a grand theft for their own pocketbooks.

  •  Follow the money. (2+ / 0-)
    Recommended by:
    HappyinNM, SoCalSal

    The changes in Medicare Advantage mean that insurance companies won't get as much money.  Instead, it should go toward actual patient care.

    Giant CEO bonuses will die under this approach.  Insurance companies will die under this approach (if, by "die", you mean slightly smaller bonuses and slightly reduced profit).  And actual humans may be better off.  Horrors!

    Clearly, this is a terrible idea.  If you're a Republican.  

    I am become Man, the destroyer of worlds

    by tle on Sat Aug 18, 2012 at 07:18:13 AM PDT

  •  Columbia Journalism Review (0+ / 0-)

    Medicare, Paul Ryan, and Beyond: A Primer

    SHIFTING SOME GOVERNMENT COSTS TO BENEFICIARIES

    What’s already happened? The health reform law, also called the Affordable Care Act (ACA), already calls for seniors to pay more for their healthcare by requiring their Medigap insurance policies to pay out less. Seniors typically buy Medigap policies to cover the gaps in Medicare benefits. But the ACA bars insurers who sell Medigap policies plans F and C from covering all of a seniors’ expenses that remain after Medicare pays the bills. Those two plans are the most popular Medigap policies precisely because they do cover almost all remaining expenses. Seniors tend to be risk averse and want no financial surprises at the end of an illness.

    Politicians on both sides supported this provision in the ACA, so there’s been little talk about it and therefore little press coverage. Millions of seniors will be surprised come 2015, when they learn their Medigap policies won’t cover as much. The rationale: Some health policy analysts believe consumers use too many medical services, and paying more out of pocket—having “more skin in the game”—will cause them to seek less healthcare.

    This feature had "bipartisan" support and thus is little known.  It's a time bomb set for 2015.  See also, Matt Stoller
    This election, aside from not being much of an election for anyone but the billionaire funders who have the real votes, doesn’t really matter. But keeping in mind who is doing what does. Because if there’s a chance to save anything for anyone who isn’t ultra-wealthy from 2013 going forward, it’s going to require being able to create credible threats to the politicians making the policy.
    The more you dig, the worse it gets...
    •  You have posted this at least 6 times. (0+ / 0-)

      That is thread spamming.  Please stop.  If you want to do a diary about this topic please do so but spamming a current thread is not cool.

      •  Sorry (0+ / 0-)

        I have not yet found this explained in any of the threads on this topic.  Most of us have not heard of it.  It is a huge issue which deserves more scrutiny.  It is a big hit on the middle class and will not go down well.

        •  Then start your own thread on it. Please stop (0+ / 0-)

          spamming other threads.

          •  It's a Big Part (0+ / 0-)

            Of that 716 billion dollars.  That is why it deserves discussion in this thread.  Feel free to explain why it is not relevant.  As one of the affected seniors on Medicare with supplemental coverage through my former employer trust plan it will be a big hit in 2015.  Are you covered by Medicare?  Who are you to judge what concerns should be discussed?  Maybe Jonathan Gruber?

  •  MUST SEE Forbes Article (1+ / 0-)
    Recommended by:
    Obama Amabo

    This is what conservatives are passing around today

    http://www.forbes.com/...

  •  I know some people swear by their Med Ad plans (0+ / 0-)

    But it's the same way many people "like their Health Insurance Company": they very likely have yet to run into the "fine print territory" of their current plan.

    When you are right you cannot be too radical; when you are wrong, you cannot be too conservative. --Martin Luther King Jr.

    by Egalitare on Sat Aug 18, 2012 at 09:21:14 AM PDT

  •  Explaining health care issues (1+ / 0-)
    Recommended by:
    Jorybu

    to uneducated and educated people ain't easy. For starters, most people have false preconceived notions. Secondly, their 'media-created' theoretical falsehoods don't match up against their own practical experience. And lastly, people who rarely use health care have no practical experience in dealing with how it works or is paid for.

    My first questions are always - do you have health care insurance? Who pays for it? Have health problems, meaning are you a regular user? Satisified with your experience?

    The FRAME OF REFERENCE of the person you're trying to persuade is the key.

    Thanks for the great post.

  •  They're not cuts, they're reallocations (0+ / 0-)

    intended to better utilize Medicare dollars to provide seniors with BETTER care for FEWER dollars. Calling these reallocations "cuts" to Medicare is sort of like calling a weight loss program an amputation. (Hello, Rush?)

    Also, having worked for insurers that offer them, Medicare Advantage is basically privatized Medicare, plans run by private insurers just like any other plan, that provide coverage as good or better than Medicare for seniors, for the same or somewhat higher cost to seniors as Medicare, and subsidized by the government to make them affordable for seniors. Which sounds great on paper, and they often really are great, for seniors (both of my parents have been on such plans, on my advice). But the subsidies are poorly allocated, with much more going to insurer profit and "operating costs" than to higher levels of coverage. It's basically a poor use of Medicare dollars. Not quite a scam, but definitely not cost-effective.

    It's smart to put that money back into Medicare, where it can extend its solvency for several more years as more permanent fixes are put in place. The only people who will "suffer" from this are insurers looking for easy profits, and seniors hoping for inexpensive plans that are better than Medicare. The former I shed no tears for, and the latter will either have to shell out more bucks to get higher levels of service if they can afford it, or else, if they can't, hopefully the government will subsidize it if needed (which I believe it already does through Medicaid).

    "Liberty without virtue would be no blessing to us" - Benjamin Rush, 1777

    by kovie on Sat Aug 18, 2012 at 11:29:36 AM PDT

  •  FYI - "what the Medicare Advantage plan is": (0+ / 0-)

    See my comment here:

    Medicare Advantage plans are insurance policies (9+ / 0-)
    sold on the private market, in which the insurance company subsumes the beneficiary's basic Medicare insurance - and upsells them for an additional premium to their private Medicare Advantage plan.

    These plans offer things which standard, basic Medicare does not (like hearing devices for both ears or glasses and not just an exam, or private rooms in hospital, etc).

    For which the private insurer now gets about $1,000 a year more per patient, from Medicare, than is spent on the same level of care for a person with a plain Medicare card for insurance billings.

    It's also the same sort of things which are available via private insurers on the secondary insurance market today. Like the one that picks up the 20% that Medicare does not cover on most things.

    So stopping this is a boon to the taxpayers and likely even to the patients currently on Medicare Advantage plans (like my own mom), because those secondary insurance plan add-ons are more likely to be less expensive than Medicare Advantage. Why? Because big business knows that it can always bill the government more for something than they can sell it to consumers for.

    * * *
    I like paying taxes...with them, I buy Civilization
    -- SCOTUS Justice O.W. Holmes Jr.
    * * *
    "A Better World is Possible"
    -- #Occupy

    by Angie in WA State on Sat Aug 18, 2012 at 01:44:04 PM PDT

  •  In short (0+ / 0-)

    Obama ACA ended subsidies to the greedy private-insurers.

    No wonder the greedy GOP are ticked.

    It's difficult to be happy knowing so many suffer. We must unite.

    by War on Error on Sat Aug 18, 2012 at 01:49:07 PM PDT

  •  Joe Biden explained it, in a kind of rambling way. (0+ / 0-)

    But I was thankful for it because I too got in a discussion about this with a troll on my Google+ page. So the video was helpful to refresh my memory of the details.

    http://www.youtube.com/...

    Here is the money quote:

    "We're not cutting Medicare benefits in this. We're trying to eliminate a 3rd of the problem that's a waste.

    ...snip..

    It would be nice if we could put some of these savings back into medicare. But the fact is we do! We close the prescription drug donut hole, we provide for preventative care for Seniors which they don't have now, without a copay. And most major study agrees that it is going to extend the life of the Medicare trust fund.

    These changes the actuary group pointed out would save about $200 dollars on a premium per Medicare recipient out there, that people are paying.

    He then goes on to explain how the Medicare Advantage program was a giveaway to private health care companies and the very definition of wasteful spending. Basically for every dollar of health care provided the Government was paying $1.15. And we did this to try and persuade them to provide coverage to these people, and lower costs.

    Well it hasn't worked out like that. So the affordable care act was passed with better, stricter cost control measures and a far more robust way of ensuring coverage for all Americans.

    Not only does this make the continued existence of Medicare Advantage incredibly wasteful. It makes it unnecessary.

    We lose if we choose to forget; the lives of men, and money spent.

    by DeanDemocrat on Sat Aug 18, 2012 at 02:25:34 PM PDT

  •  Thank you! (0+ / 0-)

    Excellent to have this explained, as opposed to labeling it "wonky" and treating it as if it is some mystical black box and telling lies continuously about it.

    Thank you.

    Please click here to help me help Barack Obama and our overall cause! LOSING IS NOT AN OPTION!!!  I pledge ALL royalties earned between now and October 1, will be donated to the Obama Campaign through barackobama.com.  Read Aldus Shrugged and spread the word about an altruistic Capitalism; and help re-elect our president!

    Aldus Shrugged : The Antidote to Ayn Rand. @floydbluealdus1

    by Floyd Blue on Sat Aug 18, 2012 at 02:53:13 PM PDT

  •  Savings Savings Savings! (0+ / 0-)

    Republican lies on this subject should be Jan Brady-ed to dust with the chant of "Savings". It is very complicated, so cut to the chase.

    The ACA cuts out 716B dollars of government waste, fat, and pork. Since when do our Republican friends object to that?

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