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I’m aware of at least two Democratic Senators, Claire McCaskill (D-MO) and Dick Durbin (D-IL), who have appeared on television to promote the idea of means-testing Medicare. Such means-testing can be accomplished with 1) higher office visit and emergency room co-payments, 2) higher co-insurance payments for medical tests and procedures, and/or 3) higher Medicare premiums. Of course, the first two approaches are, by definition, benefit cuts—cuts that the progressive community, among others, is fighting hard to prevent. The third approach, I would argue, is a back-door benefit cut in part because it only impacts Medicare beneficiaries with no change to how Medicare is taxed. Nevertheless, when appearing in public, Democratic officials are vague about which approach or combination of approaches that they’re proposing. It’s up to us to let them know that no such approach is acceptable.

In the meantime, however, I continue to be disappointed that some of our Democratic representatives can’t keep their mouths shut about benefit cuts until Republicans say, publicly, what they mean by entitlement “reform.” We all know that they seek benefit cuts, but to my knowledge, Republican leaders have been smart enough, since the election anyway, not to say this either in writing or on television. Democrats have no business helping the Republican cause by proposing, on television, ideas that are further to the right than what leading Republicans have publicly specified. If Durbin and McCaskill expect Republicans and their super-PACS to honor some kind of an “ad moratorium” about Medicare in 2014 after Democrats were the first to publicly propose billions in benefit cuts, then I’m afraid that they’re in for an unhappy surprise.

The bigger question is, after winning an election, and with the polls (and the issues) on our side, why are Democrats on defense at all with this issue? Why are we trying to stop benefit cuts when we have the White House, the Senate, and received more votes for the House (despite its red tilt due to gerrymandering)? I suggest that the reason is that Democratic officials (and perhaps the rest of us) haven’t gone on offense on this issue. Republicans want Medicare reform, but they want us to define it for them. We should. And we should beat them over the proverbial head with it.

Democratic officials should show the public that they support Medicare reform by formally and immediately proposing and seeking a vote on allowing Medicare to negotiate prescription drug prices. Of course this isn’t a new idea, but Democrats, it seems, have taken it off the table…ostensibly because they would never get a House vote on it.

Who cares? Go on offense. Take negotiating lower drug prices to the public and compare the savings to Medicare (approximately $400 billion) with savings the Republican idea of increasing the Medicare eligibility age to 67 (about $125 billion). Who are the deficit hawks in this scenario? Who is fighting for Medicare beneficiaries and who is fighting for corporate interests? What is the more likely short-term compromise? Limited benefit cuts through means-testing or no benefit cuts? And in the 2014 mid-term elections, which idea for Medicare reform is more likely to carry the day and be enacted down the road?

God dammit Dems, get the Medicare reform defense off the field (e.g., Durbin and McCaskill) and put the offense out there.

Update: Excerpt from Durbin's appearance on yesterday's episode of Meet the Press:

DAVID GREGORY (HOST): I want to pin you down on one point about Medicare. You say you want to basically put off this discussion until later. But bottom line, should the Medicare eligibility age go up? Should there be means testing to really get at the benefits side, if you’re going to shore this program up, because as you say, 12 years before it runs out of money?

DURBIN: Here’s what it comes down to David. I do believe there should be means testing. And those of us with higher income in retirement should pay more. That could be part of the solution...

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Comment Preferences

  •  I agree (5+ / 0-)

    Even if the Democratic Senator, or Rep. is in a tough district .... They should be keeping their mouths shut rather than pretending to be Republicans.

    Yeah, I'm looking at you, Claire!

    I hope that the quality of debate will improve,
    but I fear we will remain Democrats.

    by twigg on Mon Dec 10, 2012 at 11:38:03 AM PST

  •  Setting up a loss in 2014 for sure...if? Well said (5+ / 0-)
    Republican leaders have been smart enough, since the election anyway, not to say this either in writing or on television. Democrats have no business helping the Republican cause by proposing, on television, ideas that are further to the right than what leading Republicans have publicly specified.

    "Lets show the rascals what Citizens United really means."

    by smiley7 on Mon Dec 10, 2012 at 11:43:48 AM PST

  •  Agreed and I'll raise you (2+ / 0-)
    Recommended by:
    Gooserock, kurt

    I bet you could get some cost savings for Medicare if you open up the program to those 55 and over--or heck, all the way to Medicare for all.

    Has this been scored?  And if not, why not?

    "Historically, the most terrible things--war, genocide and slavery--have resulted not from disobedience, but from obedience." --Howard Zinn

    by NCJan on Mon Dec 10, 2012 at 11:56:20 AM PST

    •  I'm for that too. Unfortunately, we recently (0+ / 0-)

      litigated that during the ACA debate, albeit briefly, so I'm concerned that, with other options for savings, we might be better off waiting until Obamacare is fully implemented before reintroducing this measure. I could be persuaded otherwise. Now or later, it's definitely something that we should fight for (and Dems should run on).

    •  Probably Because There's No Lower Limit. It (2+ / 0-)
      Recommended by:
      NCJan, kurt

      gets cheaper for every age group you open it up to, all the way down to Medicare For All.

      There's probably nothing internal to Medicare that makes 55 a special number.

      Now if it was offered as a jobs program --allowing 55 and up to retire or become self-employed, thereby freeing up millions of jobs for Gen X and younger-- that would be a good reason to pick age 55.

      Of course the Republicans want all these things shut down completely, not expanded or improved, so any improvement they won't tolerate.

      We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

      by Gooserock on Mon Dec 10, 2012 at 12:17:04 PM PST

      [ Parent ]

  •  The Whole Point is to Link Cuts With Democrats (3+ / 0-)
    Recommended by:
    slinkerwink, VirginiaBlue, kurt

    since the Republicans won the Dems-threaten-Medicare issue 3 years ago.

    That's why repubs' proposals never have details, they want the public to see cuts coming from Dems.

    Dems are killing themselves and us by even hinting at it in their messaging.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Mon Dec 10, 2012 at 12:14:25 PM PST

  •  We can't stop Republicans from misrepresenting (2+ / 0-)
    Recommended by:
    DarkestHour, kurt

    the truth. Obamacare expanded Medicare benefits, but Republicans led voters to believe the opposite. It's political malpractice on the part of Dems if they lose because the electorate believed a lie. They have to figure out how to push back on such misrepresentations during the campaigns. Avoiding good policy, in my opinion, isn't the answer.

    Misrepresentations aren't my concern. My concern is that the electorate believes the truth. Democrats Durbin and McCaskill have proposed, on television, cuts to Medicare benefits. If such cuts go through, then Republicans will have excerpts, not taken out of context, from the Sunday Morning talk shows to hit Dems with. No misrepresentations necessary.

  •  When our only hope to defend a program (1+ / 0-)
    Recommended by:
    DarkestHour

    depends on Democrats to fight back, then we're truly fucked.

    Send conservatives to FilthyLiberal.com for re-education.

    by filthyLiberalDOTcom on Mon Dec 10, 2012 at 01:26:46 PM PST

  •  I guess I don't understand "means-testing" (1+ / 0-)
    Recommended by:
    Illinois IRV

    If it meant that people who make more than $300,000 are dropped from part A of Medicare (which is the most basic level)  and can purchase supplemental coverage on their own (at a group rate), then I'm all for it!

    Are we not talking about this because it doesn't save much money?  
    Of course, the other reason it's difficult to even introduce the subject of the rich paying for something: the highest rolling political pimps will slap around anyone who brings it up.  

    If you are looking for a funding source, how about this:
    Currently, Social Security taxes end at $110,00.  Given that many families would be impacted with taxes beyond this, how about giving a break from $110,000 to $300,000.  After that, you pay a slightly smaller amount than the first 110 of income.  Voila, new funding source.
    That's what means-testing in my world would look like.

     

  •  Remember... (2+ / 0-)
    Recommended by:
    Illinois IRV, kurt

    Dem's have been on the defensive for so long I think they forgot how to go on the offensive.  Maybe Obama should reteach them how to go offensive.  Think Reid and Polosi did a good job of learning already, they just need to drill it into the rest of the Dem's.  

  •  Short answer: (0+ / 0-)

    President Obama is no progressive.

    But we already knew that, didn't we?

    I know you believe you understood what you think I said, but I'm not sure you realize that what you heard is not what I meant. -- S.I. Hayakawa

    by tapu dali on Mon Dec 10, 2012 at 02:51:26 PM PST

    •  No, he's not. But progressives (1+ / 0-)
      Recommended by:
      tapu dali

      have been successful at shaping his decisions (e.g., Keystone pipeline, gay marriage). We're just going to have work to keep working on him.

      •  he has been re-elected. (0+ / 0-)

        He doesn't need to listen to us.

        I know you believe you understood what you think I said, but I'm not sure you realize that what you heard is not what I meant. -- S.I. Hayakawa

        by tapu dali on Mon Dec 10, 2012 at 04:35:52 PM PST

        [ Parent ]

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