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I just say that because that's what we say in the south when we don't want to come right out and say "David Brooks is dumber than a box of hammers"...

In his op/ed piece in today's New York Times, David Brooks, bless his heart, is trying to explain why Paul Ryan really does have the best plan for fixing Medicare.  

Mr. Brooks posits that there are two ways to fix Medicare: either a market-based approach or a political approach.  As we know, the Ryan plan is a a market-based approach, which Mr. Brooks says is better because no one outside the employ of the White House thinks a political approach can work.  While I think we can all agree his first assumption there is not exactly true, there were myriad other things about this article that really annoyed me, aside from the usual Republican "the free market can fix anything!" canard.

Mr. Brooks says that the roughly $234,000 gap between what seniors have paid into the system and what they use in Medicare benefits should weigh on the conscience of every American over 55.  Why??  They are using the system the way they are supposed to, exactly as they were promised.  Why should they feel guilty for expecting that the system into which they have paid their entire working lives would be there for them when they hit retirement age?  That is how the system was designed, and how it was presented to them and all the rest of us.  The people who should feel guilty are the politicians, present and past, who have managed to screw things up so badly and continue to not fix this massive problem.  

Mr. Brooks advocates that we should give recipients a choice among insurance options.  Mr. Brooks, I am a single mother to two kids, working a 40+ hour work week, and also trying to, you know, live my life.  I can barely stand to choose a satellite TV carrier, what with the different options within each carrier and between carriers, none of which, of course, are actually comparing apples to apples.  The thought of having to wade through a multitude of health insurance options to try and figure out what will adequately protect my family and what I can afford makes me want to weep.  I’ve read that the switch from company-provided pensions to 401Ks has been one of the biggest drains on personal wealth for normal (non-rich) people because most of us do not have the time or know-how to properly or effectively manage our retirement accounts.  I can only imagine the same outcome if everyone has to try and decide which health care option is right for them.  I think about my 70-year-old father tying to decide which Medicare policy to buy with his voucher and it would be laughable if it weren't so damn pathetic.

Mr. Brooks also cites a RAND Corporation study that says when people have a high-deductible insurance and thus the “incentive” to monitor costs, they spend about 14% less.  Is that voluntary, Mr. Brooks?  Do they spend less because they’re so jazzed about having an “incentive” to monitor costs, or do they spend less because they have to make the choice between going to the doctor or paying their rent and buying food?  When I carry a high-deductible auto insurance policy and something minor happens to my car, as long as it will drive, I won’t bother to get it fixed.  Not because I don’t want to, but because I can’t afford it.  We are the richest nation on the Earth.  We should not have people walking around with medical issues that are easily controlled but that they aren’t “fixing” because, due to their high-deductible policy, they can’t afford it.

Mr. Brooks asks, "Would a market-based approach reduce costs?  There are some reasons to think so."  There are also some reasons to think Iraq actually did have weapons of mass destruction and that the BLS is cooking the books.  But none of those reasons are particularly reasonable, and a single study he references that said if the Ryan-Wyden plan had been in place between 2006-2009, costs might have come down by 9% isn't really enough reason for me to bet the farm that the free market insurance companies are suddenly going to find it in their hearts to reduce anything unless it somehow increased their profit margin.

David Brooks is right about one thing – the status quo is cataclysmic.  The status quo of our health care system by and large being about profit-making is a cataclysmically bad system.  But Mr. Brooks’ ideas are no better.  Something as vital to the well being of every person in this country and the health of the country itself CANNOT be based on profit.

11:13 AM PT: Woohoo!  First rec list!!  Thanks, y'all!!

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Comment Preferences

  •  Brooks, along with many others, misses (4+ / 0-)
    Recommended by:
    JeffW, a2nite, cosette, Mayfly

    another crucial point. We have a big demographic bulge coming through the system of people who are living longer than we thought they would with the aid of medical technologies that are very expensive. The explosion in obesity in this country also produced a large number of older people with chronic diseases like diabetes, osteoarthritis and heart failure that cost a lot to treat. That's the real driver of growing costs and it is not particularly sensitive to competition.

    For if there is a sin against life, it consists perhaps not so much in despairing of life as in hoping for another life and in eluding the implacable grandeur of this life. - Albert Camus

    by Anne Elk on Tue Oct 09, 2012 at 08:36:23 AM PDT

  •  Fix is very simple. Raise or eliminate the salary (13+ / 0-)

    cap on medicare deductions and ss deductions or contributions for salaries $1million and above. The end. Problem solved. But we don't have enough democrats with nutsacks large enough to steamroll the fucking obstructionists and say suck them!

  •  Yup, this is what Brooks was setting us up for (2+ / 0-)
    Recommended by:
    Alice Olson, VAchick

    when he published that mocking biographical sketch of Romney. Making fun of Romney's past and his superficial traits shows that Brooks is oh so non-partisan and reasonable. Now we are supposed to think he is worth listening to when he hits us with this garbage. Brooks often does this all within one piece, starting with a minor criticism about Republicans before coming to the conclusion that they are right in the big picture. He annoys me more than the rabid right-wingers who don't try to hide where they are coming from.

  •  Okay, then, let the market decide. (14+ / 0-)

    Take Medicare as is except for bulk discounts in the prescription benefit. Price according to the size of the pool and reduced risk (people under 65 are a bit cheaper, of course) and offer to consumers, along with every other health plan on the market.

    We could call it, I dunno, like a public option.

    We've been wondering how to get through the clutter and reach low-information voters. Mitt haz it.

    by Crashing Vor on Tue Oct 09, 2012 at 08:45:51 AM PDT

  •  Here's a thought: preventive medicine (9+ / 0-)

    It's often said that we treat disease in this country and not wellness. Perhaps the best way to chip into those costs as Brooks sees them is to get people to eat better and exercise more for starters. Oh wait, conservatives already mocked FLOTUS for her anti-obesity efforts. They complain about no solutions only because they reject any kind of sensible solution.

    •  We might also try (3+ / 0-)
      Recommended by:
      VAchick, Mayfly, chmood

      helping people make considered decisions -- real choices -- about what they want in terms of end-of-life care.

      This from the latest issue of Governing magazine (Boomers Want Control of Their End-of-Life Care):

      [I]n their last year of life, older adults consume more than a quarter of Medicare’s expenditures, costing more than six times as much as other beneficiaries.
      The article goes on to outline a slow-growing state-based movement to give patients control of their end-of-life treatment via "physician orders for life-sustaining treatment" (POLST).  It's a huge win-win -- people get to thoughtfully choose what kind and level of treatment they do and don't want at the end of their lives, and since many choose less-aggressive treatment that focuses on quality of life, it cuts down on excessive counterproductive Medicare spending too.

      The "death panels" canard has done unspeakable harm to this sensible, forward-looking kind of policy conversation.

      If an elephant has its foot on the tail of a mouse and you say that you are neutral, the mouse will not appreciate your neutrality. - Bishop Desmond Tutu

      by AnnieJo on Tue Oct 09, 2012 at 09:23:57 AM PDT

      [ Parent ]

      •  End-of-life care is not the only way (2+ / 0-)
        Recommended by:
        VAchick, Mayfly

        people need to learn to make considered opinions. A big problem right now is the lack of understanding that leads to demands for expensive, unproven experimental treatments among the insured and the insistence that somebody pick up the tab.

        •  I agree completely (1+ / 0-)
          Recommended by:

          When my Mom was sick with non-Hodgkin's Lymphoma, her oncologist, God love him, was willing to try anything she wanted, and to keep trying as long as she was willing.  She was an RN, and after several years and several for-a-while-promising but failed treatments, she realized it was time to let things run their course.  Thanks to Hospice she was able to die in her home and surrounded by her family.  Unfortunately, many people without her medical background don't always know when to say when and as long as their doctor keeps offering, they will keep taking, regardless of the expense and dismal odds.

        •  Indeed, not the only way. (2+ / 0-)
          Recommended by:
          Mayfly, chmood

          But when it comes to Medicare, end-of-life care is where the biggest expenses are clustered.

          If an elephant has its foot on the tail of a mouse and you say that you are neutral, the mouse will not appreciate your neutrality. - Bishop Desmond Tutu

          by AnnieJo on Tue Oct 09, 2012 at 11:28:47 AM PDT

          [ Parent ]

    •  You are right, (0+ / 0-)

      Dirk, one of the keys to fixing our health system in general is to increase preventive measures (perhaps by making sure they have good health care regardless of their employment status!) instead of waiting for people to become sick when they have to, you know, go to the ER to have their heart attack treated.  Wasn't that Mittens plan???

  •  I got so sick of Brooks inanities that, for about (4+ / 0-)
    Recommended by:
    BRog, VAchick, Mayfly, Retroactive Genius

    three months now, I've declined to even click on his column on the Times on-line.  I'm thinking that every time I open his column, I'm encouraging the Times to keep the fool on their payroll. Surely they track these things.

    I don't mind reading diaries about his most recent stupidity -- so long as I don't have to actually read his columns.

    The good we secure for ourselves is precarious and uncertain, is floating in mid-air, until it is secured for all of us and incorporated into our common life. Jane Addams

    by Alice Olson on Tue Oct 09, 2012 at 09:21:05 AM PDT

    •  Same here (1+ / 0-)
      Recommended by:

      Of all the regular purveyors of banal chin-music on The NYT opinions page (I'm looking at you Douthat and Friedman) Brooks is the most intellectually moribund.

      I never cease to be amazed at what passes for 'intellectualism' amongst the right-wingers. Anywhere else, the likes of Brooks, Douthat, Krauthammer et al would be pegged as the kind of tiresome, verbose dullards that can be found in the bar of any expensive golf club in the nation.

      Amongst the RWers, these 3rd rate shills, hypocrites, sycophants and courtiers are regarded as profound thinkers...which gives us some insight into the level of discourse amongst the reactionary douchebags who've been running the country into the ground.

      Lightly Seared On The Reality Grill

      by Retroactive Genius on Tue Oct 09, 2012 at 02:15:30 PM PDT

      [ Parent ]

  •  Of course it will be cheaper (1+ / 0-)
    Recommended by:

    if more people are denied insurance, and people who can't afford to pay cash in advance for their health care costs are denied it and then just die. Is that really what we want? Does he think the death rate is not high enough?

  •  You know what would be cheaper...... (3+ / 0-)
    Recommended by:
    VAchick, AnnieJo, Mayfly

    single payer.

    But the Republicans have twisted themselves into a knot and can untangle themselves. We are at 20% GDP with this healthcare mess and 50 million not covered.

  •  I'm getting tired of "market-based approaches" (1+ / 0-)
    Recommended by:

    ...they all add up to 'how to screw us the most in exchange for the least', and I can't think of a single reason why that's a better idea.

    This year, I'm doing something I've never done before - I'm voting a straight Democratic ticket

    by chmood on Tue Oct 09, 2012 at 06:52:53 PM PDT

  •  I always wondered if Brooks really was (0+ / 0-) dim a bulb as he appears or just dumbing it down.  I think both.  Hi's constantly wrong and he writes at barely a 10th-grade level.  He doesn't irritate me so much as befuddle me -- how can someone that dull be in such a position, at the NYT, presumably a meritocracy (at least to a first approximation)?

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