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Senior citizen with empty wallet, surrounded by pill bottles.
Economist Dean Baker poses a depressing question: "Medicare Cost Reductions: Is the Point to Save Money or Inflict Pain?" It's also a good question. As he points out, Medicare costs are already falling.
Today one of the central stumbling blocks to a budget deal appears to be President Obama's reluctance to make cuts to Medicare that would inflict serious pain on beneficiaries.

The fact that Medicare poses such a stumbling block is striking because we have already seen sharp declines in the projected cost of Medicare over the years in which President Obama and Congress have been fighting over the deficit. The Congressional Budget Office has lowered its projections for Medicare costs over the years 2013-2023 by $400 billion compared with what was projected back when Bowles-Simpson put together their initial budget proposal. That proposal called for a bit more than $300 billion in cuts to Medicare, less than the reductions in projected spending that we have already seen.

Furthermore, CBO has not reduced its projections by as much as cost growth has slowed in the last three years.

It's hard to say whether the Republicans really want to cause pain to old people. That's probably just a side benefit for the majority of them, though the true Randian teabaggers, and Alan Simpson, would dearly love to punish some moochers. But, I think that's less of a motivator than trying to force Democrats into making steep and highly unpopular benefit cuts, cuts that the Republicans can then turn around and use against them in attack ads.

It's a trap they're setting with an assist from the Very Serious People, the centrists and Third Way types who are useful tools of the Republicans, and who have too strong a hold on the imagination of Democrats. The reality is there are plenty of other ways to reform Medicare, and Social Security for that matter, that don't involve pain on the people who can't afford it. But pain is what they want, without seemingly realizing that it really is going to hurt people, lots of people. Which is exactly what the Republicans are counting on!

Originally posted to Joan McCarter on Tue Mar 05, 2013 at 01:33 PM PST.

Also republished by Daily Kos.

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Comment Preferences

  •  I think they hope that by cutting Medicare (3+ / 0-)
    Recommended by:
    whaddaya, 3goldens, Mr Robert

    they can force people into grotesquely inefficient private health insurance. They don't seem to understand that people can't afford it and they don't care how much of GDP "healthcare" accounts for. The pain is just a side benefit.

    The free market is not the solution, the free market is the problem.

    by Azazello on Tue Mar 05, 2013 at 01:38:33 PM PST

    •  That's part of it, too (4+ / 0-)
      Recommended by:
      Azazello, whaddaya, 3goldens, Mr Robert

      The lack of empathy is pretty shocking.

      "There’s class warfare, all right, but it’s my class, the rich class, that’s making war, and we’re winning." —Warren Buffett

      by Joan McCarter on Tue Mar 05, 2013 at 01:57:03 PM PST

      [ Parent ]

      •  its more than part of it (2+ / 0-)
        Recommended by:
        K S LaVida, greengemini

        that is what the current GOP exists to do. they want  to use the Treasury to steer public tax dollars to private enterprise that is firmly aligned to them politically. its the same thing they are trying to do to public schools. the political tactics are secondary, including manufacturing debt crises and then using them to scare the public to accept the cuts. as for the pain any of this causes, they don't give a shit because the people injured don't underwrite their election campaigns.

        what our side misses is how difficult the counter politics are. democrats nees to raise money too, and need to  win against well funded opponents. but we're also trying to solve mutliple problems, like stimulating the economy in the short term and figuring out how to pay public investments. those short term needs have merrits, and they are deliberately made difficult to pay for by GOP strategy surrounding debt and taxes. its in that context that things like Chained CPI look attractive.  

    •  They think they can con their voters into thinking (1+ / 0-)
      Recommended by:

      that it was the Dems who did it.  Old people are the GOP's strongest voting bloc.  Cutting benefits is going to hurt their own people.  This seems to be worse for them tha. Just cutting it for future old people (I.e., people now under 55).

      The scientific uncertainty doesn't mean that climate change isn't actually happening.

      by Mimikatz on Wed Mar 06, 2013 at 07:44:43 PM PST

      [ Parent ]

  •  When did Democrats vote to (4+ / 0-)
    Recommended by:
    antirove, whaddaya, 3goldens, Mr Robert

    Turn the New Deal party into the Entitlement Reform party?  When did we decide to get reformed out of our core values?  And I don't see much difference between "shared sacrifice" and inflicting pain considering that no one sharing the sacrifice is in the congressional delegation of either party.

    •  There is an extremely good argument (2+ / 0-)
      Recommended by:
      leighkidd, greengemini

      that the Democrats could be making to retain Medicare's benefits without "reform" (if they refuse to take on the pharmaceutical companies and demand negotiated drug prices under Medicare Part D).  Considering all eyes and most of the country's economic panic is focused on deficit and debt reduction, they could be making the argument that "reforming" Medicare - and also Social Security - means that seniors who will not be able to afford their medicine or indeed any health care without Medicare will become the responsibility of the younger members of their families.  Talk about passing on the effects of the federal debt to our children and grandchildren!

      There's a perfect bumper sticker slogan for this economic family burden when Medicare is "reformed," I just haven't come up with it yet.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Wed Mar 06, 2013 at 06:57:59 PM PST

      [ Parent ]

  •  Well They Want the Program Ended Either Way nt (4+ / 0-)

    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 Tue Mar 05, 2013 at 01:52:19 PM PST

  •  It's Calvinism; the Calvinball is gravy (0+ / 0-)

    The Elect and the Damned

    By the decree of God, for the manifestation of his glory, some men and angels are predestinated unto everlasting life, and others foreordained to everlasting death.  

    Neither are any other redeemed by Christ, effectually called, justified, adopted, sanctified, and saved, but the elect only.  The rest of mankind God was pleased, according to the unsearchable counsel of His own will, whereby He extendeth or withholdeth mercy, as He pleaseth, for the glory of His Sovereign power over His creatures, to pass by; and to ordain them to dishonour and wrath for their sin, to the praise of His glorious justice.

    The Westminster Confession of Faith (1643)

    BTW, prosperity is the physical manifestation of grace (cf. Blankfein's infamous quote).  Those who have willfully turned away from god (or the Koch Brothers), clearly marked by their lack of prosperity, can expect no mercy.

    The Catholic Church officially opposes the doctrine of "double predestination" so this makes Paul Ryan a heretic* as well as a hypocrite.

     Add a stupid person's idea of the concept of "outlawry" and you see the rest of the Right's cruel treatment of undocumented people and anyone who ever passed through the criminal justice system, or whom they presume to be predestined for that system.  

    "Things fall apart; the centre cannot hold...The best lack all conviction, while the worst Are full of passionate intensity" -W.B. Yeats

    by LucyandByron on Tue Mar 05, 2013 at 02:32:54 PM PST

  •  What I'm most worried about (0+ / 0-)

    is that cutting the program is going to pave the way for more cuts in the future and we all know that GOP's intentions towards Medicare (or Social Security) sure as hell ain't pure.  It ain't going to be a one-time "take one for the team" kind of thing either.  We may need to look at some ways to restructure the program to reflect the current reality of things and curb some of the waste, fraud, and abuse (which ACA is already doing) but simply cutting benefits for the sake of cutting benefits (which is what the GOP really seems to be for) doesn't help anybody in the short- or long-term IMHO.  One of the biggest problems with Medicare that the "very serious people" don't bring up often (if at all) is that one of the big drivers of Medicare costs are our country's insane health care costs and that getting those costs under control would go a long way towards helping address the financial solvency of Medicare.  Also, given what we saw in 2010 when ACA cut out some of the Medicare Advantage program, I wouldn't volunteer any cuts to Medicare if I were a Democrat.  Frankly, if the Republicans think that proposing cuts to Medicare and Social Security is such a brave and manly thing to do, well, why don't they go ahead and do it????

  •  Medicare, background checks, minimum wage (2+ / 0-)
    Recommended by:
    cocinero, Brooke In Seattle

    That's the electoral strategy for DEMS in 2014. Just block Barack from screwing up the first one and he will be thankful when he has a democratic house in his last two years.

  •  Ummm, am I missing something here... (1+ / 0-)
    Recommended by:

    don't retired people on Medicare give Repubs 65% of their collective vote?

    Seems like they would make more of a pretense of helping the very people that vote for them.

    •  When provisions in the ACA are (1+ / 0-)
      Recommended by:

      fully implemented, much of just such waste (fraud and abuse) is scheduled to be eliminated.  But ferreting out such waste involves scores of auditors and an army of investigators and prosecutors.  As long as D.C. is infected with deficit fever, the resources simply won't be there to crack down on any but the most egregious cases.

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Wed Mar 06, 2013 at 07:17:01 PM PST

      [ Parent ]

  •  They want cuts, not reform (2+ / 0-)
    Recommended by:
    Eyesbright, greengemini

    for Medicaid and Medicare.  They want to cripple Obamacare, cut "entitlements", and keep their Medicare/Medicaid fraudster/monopolist contributors in business.

    •  Republicans hate traditional Medicare, always have (0+ / 0-)

      and always will. They would like nothing better than to leave everyone, seniors included, at the tender mercies of the private insurance industry.

      If a free society cannot help the many who are poor, it cannot save the few who are rich. - President John F. Kennedy

      by laurel g 15942 on Thu Mar 07, 2013 at 05:39:54 AM PST

      [ Parent ]

  •  Disposal of the excess population (1+ / 0-)
    Recommended by:

    is always a goal of the elite.

    Obama: self-described moderate Republican

    by The Dead Man on Wed Mar 06, 2013 at 06:47:21 PM PST

  •  Cut the Republican drug boondoggle (6+ / 0-)

    The Bush gift to pharmaceutical companies is a subsidy. Cut the subsidies of these rich companies. That is the single most important area to cut and it is the source of overages in Medicare.

  •  Cain-onomics 101 (2+ / 0-)
    Recommended by:
    WheninRome, nchristine

    I don't know about old people in general, but Republicans want to inflict pain on poor people because they believe poor people deserve it. It is central to their philosophy.

    Herman Cain said what most Republicans believe, "... if you don't have a job and you're not rich, blame yourself!"

    Poor? You're just one of the moochers. Old and poor? Tough, you should have lived a virtuous life like Herman there.

  •  It's about inflicting pain. (0+ / 0-)

    They are incompetent and slow witted otherwise. They get off on it.

  •  These Ayn Rand disciples see the old, and the sick (2+ / 0-)
    Recommended by:
    nchristine, SueDe

    as unproductive and, therefore, a burden on society.  As a result they don't care about the "pain" they are inflicting.  In the words of Ebenezer Scrooge, they want them to "die and be quick about it to decrease the surplus population."

  •  So--what can we do to make sure that as many (1+ / 0-)
    Recommended by:

    people as possible KNOW that the GOPers are responsible for the extra pain?

    It should be shouted from the rooftops.

    The Republicans did it.

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

    by maybeeso in michigan on Wed Mar 06, 2013 at 07:03:31 PM PST

  •  It's a prelude to the Ryan plan (2+ / 0-)
    Recommended by:
    irmaly, greengemini

    If they raise the Medicare eligibility age to 67, it'll force senior citizens 65-67 into the private market via Obamacare.

    If you're really poor, they'll give you a slightly enhanced subsidy.  No real difference from the Ryan plan - it's just that the poor saps who will be ground up in the maws of private insurance first will be the canaries on the coal mine. And they'll face the same disaster that is expected with Ryan's vouchers - expensive private health care that won't fully cover the medical issues 65+ people have without putting them horribly out of pocket.

    They're going to try to force some of us - it doesn't have to be many, just enough to start the privatization ball rolling- onto the Ryan plan whether we want to or not.  The only question here is whether the Democrats hand them this victory in the name of being all bi-partisany. I'm not hopeful.  

    you don't need a weatherman to know which way the wind blows

    by Dem Beans on Wed Mar 06, 2013 at 07:04:09 PM PST

  •  And the other part is that the "deficit" is disapp (1+ / 0-)
    Recommended by:

    earing as all this bullshit is being shoved into the ears and eyes of the stupid US "electorate." Along with the pernicious toxin that claims that Social Security is responsible for any of the "deficit," and that it has to be destroyed to save the Republic(ans). Kill the ceiling on wages subject to FICA withholding and SS is "saved" for as long as you want...

    And as for Medicare, as a nurse who has to deal with the horrors of privatized UNsurance every day in a practice that serves both private-pay, workers comp, Medicaid and Medicare and privatized UNsurance patients, I can offer that the least bad of all of those, from the standpoint of taking care of people, keeping them healthy and restoring them when they are not, is Medicare. There are problems, some bureaucracy, and some odd incentives and a bunch of fraud that is inadequately checked by enforcement (but see how effective qui tam actions have been, to put a frame on the fraud problem -- But by and large, it works, and people who have settled for the ACA and told us that is the best we can get are lying to themselves and lying to the rest of us. And it behooves us to get up off our butts and FIX that, to insist that our "leaders" don't keep leading us by the nose, up the chute and into the corporate slaughterhouse...

    "Is that all there is?" Peggy Lee.

    by jm214 on Wed Mar 06, 2013 at 07:10:14 PM PST

    •  Paul Krugman's response to the Republican plans (1+ / 0-)
      Recommended by:

      to cut Medicare and Social Security now: Inflict suffering by cutting benefits now so that further suffering can be inflicted in the future.  

      "In this world of sin and sorrow there is always something to be thankful for; as for me, I rejoice that I am not a Republican." - H. L. Mencken

      by SueDe on Wed Mar 06, 2013 at 07:41:12 PM PST

      [ Parent ]

  •  Can someone explain how cuts to SS/Medicare... (4+ / 0-)

    will help us in our stated goal to retake the House in '14?


  •  Cut Advantage plans totally (0+ / 0-)

    The purported "? extra coverage" of an Advantage plan can actually be less coverage. I sold these plans until I saw how many are short changed. Many people take them for the free/low$ premium with Part D included.  Poor people take them out of ignorance or lack of the $125mo or so needed to get real supplemental coverage. The Medicare pot is drained because of the high cost to operate the Advantage plans through private insurers. The poor and average person on Medicare loses adequate coverage and at times is left with big bills. The rich are either complicit or clueless since these hidden costs are easily absorbed by the wealthy.

    We all need to be sure doctors and others working with seniors know how these plans work. It has been years since the first Advantage plan hit the streets with Part D. In my interaction with a physician the other day he told me that he tells people they get more for their money with Advantage plans.

    So what about the $8K radiation balance? And what about the oxygen that the patient now needs  - and will now pay 20%. The plans are all different, change every year and the fine print must be read and understood. What a deal it was for the Bush people and the insurance companies!

  •  Let's not lose sight of the broader context. (2+ / 0-)
    Recommended by:
    BroadwayBaby1, greengemini

    This is all about dismantling the safety net that has been in place beginning with Social Security and going on from there.

    Privatize the safety net, and discards those who can't afford it.

    The most violent element in society is ignorance.

    by Mr MadAsHell on Wed Mar 06, 2013 at 07:27:27 PM PST

  •  Medicare costs are not falling, (0+ / 0-)

    they have just not increased as much as expected in the past two years.

    We cannot mistake absolutism for principle, or substitute spectacle for politics, or treat name-calling as reasoned debate. -Pres. Obama, 1/21/13

    by SoCalSal on Wed Mar 06, 2013 at 07:27:32 PM PST

  •  If Obama strikes a "grand bargain" (1+ / 0-)
    Recommended by:

    with Senate Republicans, it won't be so much a compromise between Democrats and Republicans as much as an agreement amongst the 1% to screw the middle and working classes.

    "...on the (catch a) human network. Cisco."

    by hoplite9 on Wed Mar 06, 2013 at 07:35:03 PM PST

  •  Confused (1+ / 0-)
    Recommended by:

    I have been lurking here for years. I know the Dems are not perfect but all i have is my vote and i try to vote as sane as possible for my grandkids and the country, thus i vote Democratic. I cannot believe that Obama and the Dems will be so stupid as to as to cut Medicare and Social Securtiy. The Republicans want to do it to give the money to their monied backers and to be able to say that the Dems cut those programs in campaign ads. If i, an interested senior citizen (me), not involved in politics can see this ,why can't our team? I can guess but i would like some answers to this question which has been bugging me.

    My opinion is the same monied interests that back the Republicans back some Dems although to a lesser extent.
    If  a Dem fights too hard for the people they will cut him or her off. No campaign funds, trips, cushy job for their family and them when they retire. I think that is it in a nut shell . It makes me sick. I must explain to my really left friends why i vote Dem. It keeps getting harder. Politics seems like good cop/bad cop or WWW. Very sad and discouraging

  •  the goppers hated Medicare from Day One, still do, (2+ / 0-)
    Recommended by:
    1983sedge, greengemini

    and would like nothing better than to eliminate it entirely.

    Ditto for Social Security.

    We can cut until everyone screams--it still won't be enough for the goppers.

    They don't want to CUT the social safety net, they want to KILL it.

  •  Appeaser (1+ / 0-)
    Recommended by:
    It's a trap they're setting with an assist from the Very Serious People, the centrists and Third Way types who are useful tools of the Republicans, and who have too strong a hold on the imagination of Democrats
    You neglected to name the Appeaser in Chief, Obama. "An appeaser is one who feeds a crocodile--hoping it will eat him last"
  •  seems appropriate ... (0+ / 0-)

    "I'm not like other people.  Pain hurts me."
    -Daffy Duck

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