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Senior citizen with empty wallet, surrounded by pill bottles.
The budget President Obama released today includes $370 billion in Medicare savings, split between cuts to beneficiaries in the form of added means testing and provider payments. These are largely the same proposals in Obama's last, rejected, offer to Speaker John Boehner during negotiations to avert the sequester.
They include requiring wealthier seniors to pay a larger share of their Medicare Part B and D premiums and mandatory drug rebates for low-income seniors in Medicare Part D. The rebates, which are fiercely opposed by the pharmaceutical industry, would bring in more savings—$140 billion—than any other single change the administration would make to Medicare.

The budget also proposes to discourage seniors from purchasing first-dollar Medigap insurance that covers co-pays and other cost-sharing requirements in the program.

It would cut bad debt and other payments to hospitals by $30 billion and post-acute care providers by $50 billion. The offer to Boehner includes another $120 billion in unspecified health savings.

That's a start, a small one, on pharmaceuticals. According to an analysis by HCAN, the biggest 11 pharmaceutical companies made $711 billion in pure profit in the last decade, a good part of in thanks to Part D, enacted in 2006. PhRMA will scream bloody murder, but they can more than afford to sacrifice a small part of their profit from the cash cow Part D has been.

On the other hand, the proposals for seniors aren't a positive move. At least Obama didn't include the hike in the Medicare eligibility age that he had previously offered to Boehner, but what he does include could be another hit for seniors, on top of the chained CPI. Cutting out Medigap policies would increase out-of-pocket costs for seniors. Those costs have been steadily and steeply rising [pdf] for seniors already over the past two decades. Adding more means testing to the program (wealthier individuals already pay higher premiums for Part B, the part that covers physician services and supplies) shifts the program further from from universal coverage and opens it up to more and more means testing, and toward a stigmatized and politically vulnerable poverty program.

Cheers for hitting PhRMA, and more of that. But adding in the cuts for Medicare beneficiaries—who have paid into this system in order to benefit from it—is just a gratuitous effort to prove "balance." Which is going to be rejected by Republicans as not enough, anyway.

Originally posted to Joan McCarter on Wed Apr 10, 2013 at 09:29 AM PDT.

Also republished by Daily Kos.

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Comment Preferences

  •  Drug Reimportation would have hit Pharma (20+ / 0-)

    while doing no harm to Seniors at all.

    Michelle and I send our thoughts to the Thatcher family and all the British people as we carry on the work to which she dedicated her life" President Obama, on the passing of Margaret Thatcher.

    by JesseCW on Wed Apr 10, 2013 at 09:33:10 AM PDT

    •  Advertising for products like (7+ / 0-)

      prescription drugs and jet airplanes that people can't just walk in and get on their own should be forbidden.  Jet engine, airplane, and gigantic windmill ads are being bought in order to control the image of the company and to pressure the networks into not reporting negative stories about those companies.

      Prescription drugs can't be purchased without, duh, a prescription.  Doctors write prescriptions and have the training and knowledge to prescribe drugs on their own.  And health professionals are sick of people coming in and asking for prescriptions like they're ordering off a restaurant menu.

      I'd like to see Medicare negotiate drug prices just like the VA and virtually every other country on this planet.  Why do we continue to pay the highest prices for drugs in this country?

      There already is class warfare in America. Unfortunately, the rich are winning.

      by Puddytat on Wed Apr 10, 2013 at 04:19:32 PM PDT

      [ Parent ]

      •  Thanks for this (1+ / 0-)
        Recommended by:
        Puddytat

        I often wondered (when I watched tv) what sort of demographic I was in and would sometimes laugh as a healthy young man when I'd catch myself watching some show and all the ads were for adult diapers or blood pressure medicine, or toys and cereal. When I realized this I'd usually decide it was time to go do something else.

        Anyway, I never could get my head around why giant companies were advertising their jet engines, or other things that normal people don't purchase and wondered what the demographic was for the show I was watching. Now I finally get it. Also, I agree 100% about banning prescription drugs advertising and stuff "you can't just walk in and get on your own."

        [Terrorists] are a dime a dozen, they are all over the world and for every one we lock up there will be three to take his place. --Digby

        by rabel on Wed Apr 10, 2013 at 05:05:26 PM PDT

        [ Parent ]

        •  The media is bought and paid for... (1+ / 0-)
          Recommended by:
          Puddytat

          they are part of the problem. A few of the talking heads want to speak something real, but they're being drowned in a sea of superficiality and they know it. Medical supplies, pharmaceuticals, oil, processed food, the latest hot wheels, weapons systems - they've all got some form of payola working the system, whether it be media, congress, the local governments, or their own management teams. We've been bought and sold. Once you've seen through this lens, it's hard to find some guiding star. But necessary to search for it...

          "Gun violence places a tremendous burden on America's health care system. Direct medical costs for gunshot wounds total more than six million dollars a day." - The Violence Policy Center

          by Beastly Fool on Wed Apr 10, 2013 at 05:16:58 PM PDT

          [ Parent ]

    •  We should demand Congress stop requiring (4+ / 0-)

      American patients to pay the bulk of the cost of pharmaceutical company profits.

      That they amend the Part D Medicare Drug Benefit and remove the prohibition against negotiating on bulk costs for drugs for seniors on Medicare.

      Because the law which created Part D also contains that prohibition. So Medicare can't get the same deal as Canada or Germany or Portugal or any nation which refuses to allow those drugs to be sold in their nation, unless the manufacturer reduces the costs and in many cases, it is significantly less than in the US.

      Why is Medicare in trouble, financially? In large part, it's this dodge the 2005 Congress wrote for their buddies in PhRMA, boosting their black ink and beggaring old, sick Americans. Or costing the life of a cancer patient without insurance. It's just too much money, sometimes thousands of dollars a month for a single medication.


      "I like paying taxes...with them, I buy Civilization"

      by Angie in WA State on Wed Apr 10, 2013 at 04:31:53 PM PDT

      [ Parent ]

  •  Making Medicare a welfare program is a huge (22+ / 0-)

    mistake.  For one thing, folks will not want their paychecks nicked for welfare payments.  Those who hate the poor will definitely balk at this.  The rich who live on their wealth and not their labor aren't paying anyway.  Once again the middle class, the four of them who are left, and the working poor shoulder the burden.
      This Obama budget highlights why we need single payer and cannot keep bowing to the insurance and med lobbies.  The insurance people are already exploring new markets, like insuring old sewer pipes under your house and pet health insurance, because they see how the market is going.  

    Building a better America with activism, cooperation, ingenuity and snacks.

    by judyms9 on Wed Apr 10, 2013 at 09:43:08 AM PDT

  •  Total aside (4+ / 0-)
    Recommended by:
    JesseCW, wader, chuckvw, liberaldemdave

    And apologies if this is inappropriate, but there's something, inadvertent I'm sure, slightly misogynistic about that photo, if you know what I mean.

    That said, I like the Rx rebates as they force drug companies to help pay for the various programs currently paid for by taxpayers intended to subsidize drug costs to low-income seniors, like Extra Help and Medicaid.

    I'm not sure I'm entirely opposed to phasing out Medigap, which represents huge windfalls to insurers, provided that more cost-effective ways to help seniors avoid high out of pocket expenses are made available.

    E.g. Medicare taking over Medicare Advantage plans, for a slightly higher premium that would be subsidized for lower-income seniors.

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

    by kovie on Wed Apr 10, 2013 at 09:48:35 AM PDT

    •  I only saw a senior with less money for drugs n/t (4+ / 0-)

      "So, please stay where you are. Don't move and don't panic. Don't take off your shoes! Jobs is on the way."

      by wader on Wed Apr 10, 2013 at 10:40:01 AM PDT

      [ Parent ]

    •  I have a medigap policy (2+ / 0-)
      Recommended by:
      wader, kovie

      and it works better for me than the advantage plan.

      •  Could you elaborate? (0+ / 0-)

        My dad recently had to choose and picked MA, but he had very specific reasons for doing so, a preexisting condition that medigap wouldn't cover. I have heard that MA looks great on paper, but they're really good at denying coverage once you've signed up. Medigap can't do that from what I understand.

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

        by kovie on Wed Apr 10, 2013 at 05:07:51 PM PDT

        [ Parent ]

        •  Medigap does ask (1+ / 0-)
          Recommended by:
          kovie

          about a few pre-existing conditions, having to do with dialysis, can't remember the others. I have a pacemaker, and that doesn't bother them.

          There are a lot of co-pays with the Advantage Plan, and the coverage isn't as extensive. With Medigap, there are no co-pays and unless I wind up being in the hospital for a long, long time, I don't think I have to pay anything. However, I pay a monthly premium for Medigap, $144. There's is no premium on MA.

          I went with Human MA first for a few months, then switched in open enrollment in the fall (the only time you can switch plans), because I was told that if you don't get on Medigap in the first 6 months or so that, they can charge you a higher premium. If you get on it early, they can only charge the premium they charge the group in your area. Also, no doc here in Chicago seems to like Humana. Most of em wouldn't take it. I switched to AARP United Healthcare.

          But I thought insurance companies couldn't refuse pre-existing conditions anymore? That may not be true with Medicare.

          •  Medicap can impose a waiting period (0+ / 0-)

            for pre-existing conditions. I checked that with several sources, including the state insurance commissioner and Medicare. They can even deny you coverage entirely if you have certain pre-existing conditions (unless you're guaranteed issue in certain situations, which didn't apply to my dad).

            My dad actually used to have AARP/UHC Medigap, until he switched to an MA plan from them. When they dropped MA in his region, he went back on regular Medicare, which he kept meaning to supplement with Medigap but never got around to. When he got diagnosed with a condition that needed treatment, he had me look into it and it turned out that it wouldn't be covered by Medigap because it was pre-existing. We found out that he would be covered by MA, though (no wonder Medicare/MA is losing so much money!).

            He had moved in the interim to an area that had MA plans, so enrolled in one, again from AARP/UHC. His claims are still pending so we don't know how it'll turn out. But the alternative, paying 20% OOP on regular Medicare, would have been incredibly expensive for him. If, as some have warned, MA turns out to be too good to be true, he'll probably eventually go back to Medigap. Plus, it looks like they're going to phase out MA eventually, or raise the premiums to the point where you might as well get Medigap.

            Of course, there's now talk of phasing out Medigap!

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

            by kovie on Fri Apr 12, 2013 at 10:44:28 AM PDT

            [ Parent ]

  •  Prediction: (6+ / 0-)

    This will not cost Pharma a bean by the time the process plays itself out.

  •  Hum (12+ / 0-)
    Although the White House doesn’t advertise this fact in the six-page budget overview it put out this morning, the new budget eliminates nearly all of the cuts that sequestration imposes on the Pentagon. Instead of $500 billion in cuts, Obama proposes only $100 billion, and you have to look closely to spot it (“$200 billion in additional discretionary savings, with equal amounts from defense and nondefense programs”).

    Along with the well-advertised cuts to Medicare and Social Security benefits, this is something that should appeal to the GOP. “It’s another one of the peace offerings in Obama’s package to Republicans,” Robert Litan, the director of research for Bloomberg Government and a former official of the Office of Management and Budget, told me.

    http://digbysblog.blogspot.com/

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

    by smiley7 on Wed Apr 10, 2013 at 09:54:49 AM PDT

  •  Drug rebates for low-income seniors (0+ / 0-)

    Appears to be a compromise to the re-importation issue.

  •  He's Gonna Have a Shitload of Spare Time During (9+ / 0-)

    fall 2014. No Dem is going to want his help.

    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 Wed Apr 10, 2013 at 10:09:06 AM PDT

  •  Does Medigap include employer provided (0+ / 0-)

    Medicare supplemental insurance?  That's what my employer provided health insurance converts to when I turn 65.  I pay a premium for it along with my medicare premium.  Are plans such as this being discouraged?

    “It is the job of the artist to think outside the boundaries of permissible thought and dare say things that no one else will say."—Howard Zinn

    by musiclady on Wed Apr 10, 2013 at 10:54:50 AM PDT

  •  It's already gonna cost us more (1+ / 0-)
    Recommended by:
    Vetwife

    when I turn 65--My younger husband and I are paying for Tricare for retirees.  I'll be paying a LOT more to Medicare, and I wonder if Tricare will still pick up the difference.

    The last time we mixed religion and politics people got burned at the stake.

    by irishwitch on Wed Apr 10, 2013 at 12:54:37 PM PDT

  •  On a related topic (4+ / 0-)
    Recommended by:
    tardis10, chuckvw, liberaldemdave, zaka1

    "Senators are a never-ending source of amusement, amazement, and discouragement" ~ Will Rogers

    by Lefty Coaster on Wed Apr 10, 2013 at 04:02:42 PM PDT

  •  It's pragmatic and centrist (3+ / 0-)
    Recommended by:
    Lefty Coaster, chuckvw, zaka1

    the 11-dimensional chess move to make.  Only irrelevant fringe purists have any objection.  Trying to stop cuts to Medicare is objectively helping Republican obstructionism!

    Ever get the feeling you've been cheated?

    by ActivistGuy on Wed Apr 10, 2013 at 04:06:13 PM PDT

    •  Well as you (1+ / 0-)
      Recommended by:
      heavenlytails

      know ActivistGuy I'm a irrelevant fringe purist.  Gosh darn, I really wanted to be able to heat my home, what was I thinking.  Heating is for sisses.

      "During times of universal deceit, telling the truth becomes a revolution­ary act. " George Orwell

      by zaka1 on Wed Apr 10, 2013 at 04:38:22 PM PDT

      [ Parent ]

  •  The problem with all of these proposed cuts (5+ / 0-)

    Is that they change the discussion from "if" to "how much".

    Norquist wins.

    Once it's on the table, it's always on the menu.

    by chuckvw on Wed Apr 10, 2013 at 04:06:31 PM PDT

  •  That's nice of the Prez (3+ / 0-)
    Recommended by:
    chuckvw, zaka1, heavenlytails

    He and his family will never see any of the effects of this craven proposal if it's enacted.  

    And if they kill Medigap I'm instantly bankrupt and probably as near instantly dead.

    Such is life.

  •  "the proposals for seniors aren't a positive move. (2+ / 0-)
    Recommended by:
    chuckvw, sjduskin

    "

    Now there is one lollapalooza of an overcharitable understatement...

    Are people, non-Beltway-0.1% people, of all political nominal tribal connections, ever going to "get it?" Before their little and shrinking "it" is all freakin' GONE?

    "Is that all there is?" Peggy Lee.

    by jm214 on Wed Apr 10, 2013 at 04:08:36 PM PDT

  •  Club for Growth defends Obama... (2+ / 0-)
    Recommended by:
    chuckvw, sjduskin

    http://livewire.talkingpointsmemo.com/...

    That's how bad this budget is....

    GODSPEED TO THE WISCONSIN FOURTEEN!

    by LordMike on Wed Apr 10, 2013 at 04:12:20 PM PDT

  •  There are cuts to be made to Medicare (2+ / 0-)
    Recommended by:
    high uintas, heavenlytails

    They just have to done in a smart way. If you have an elderly friend or relative and have ever been involved in the inefficiency of their care, you know exactly what I'm talking about.

    An example: My 95-year-old stepmother (now unfortunately passed away) had a slew of chronic conditions. She saw her primary care physician fairly often.

    One time, she complained of some dizziness. He actually told her, "If you feel bad, just go to the emergency room." No, that's not the right approach. If she needed hospitalization, he should have arranged a hospital admission.

    So she walked to the nursing station at the assisted living center where she lived, and told the nurses what the doctor had said. Note: SHE WALKED TO THE NURSING STATION.

    So what happened next? Of course, they called an ambulance, which drove her to the emergency room. ($1,100 for the ambulance ride.) The ER doctor ordered a slew of tests (I couldn't even begin to add those up) and she was admitted.

    Had her doctor or the retirement home acted responsibly, a lot of Medicare money could have been saved. I forcefully told the nurses at the nursing station that if they had just called me, I could have driven her to the hospital. If her doctor had arranged the admission, several thousands could have been saved.

    But as long as doctors are being paid on a fee-for-service basis for every Medicare visit, they have no incentive to act responsibly. Retirement homes will go overboard to avoid the risk of a lawsuit.

    Multiply this by all of the elderly across the country, and you can see what happens.

    •  I went through that kind of scenerio (2+ / 0-)
      Recommended by:
      heavenlytails, Molly Weasley

      so many times with mom that I can't count. The amount of money wasted, just plain thrown away by Medicare is astounding and unless you experience it you have no idea how many bottom feeders are living off of the elderly.

      Mom had to be in a hosp. bed for two weeks, the medical supply place that she always used provided it and then took it back when she was done with it. After she died I was going over statements and they had continued charging for it for years. I notified Medicare and the place, I have no idea what happened.

      She always had to enter the hospital by ER, always. Towards the end of her life she had to have transfusions and they always led to her being too ill to come home. They would take her from the hosp. room to the ER to admit her back to her room for a night.

      I was insane.

      "The scientific nature of the ordinary man is to go on out and do the best you can." John Prine

      by high uintas on Wed Apr 10, 2013 at 04:47:54 PM PDT

      [ Parent ]

  •  He sees Clinton got away with it, why not? (4+ / 0-)

    So much of the economic catastrophe that has befallen the middle class is directly attributed to the triangulating policies of William Jefferson Clinton - and yet he's a verifiable rock star among Democrats.

    Why wouldn't Obama throw out the third rail bone to Republicans and DINO's when Bubba brought us NAFTA, deregulating finance and telecommunications, cutting an already immorally underfunded welfare program for America's poor, et al, and yet if he could run right now he'd be re-elected for a third term.

    This nation has been going so wrong for so long it's getting damn near impossible to figure out who's fucked us more, Democrats governing as Republicans, or Republicans "governing" as if they hate everything about the America we all grew up in.  

    "The philosophy of conservatism is inevitably doomed by its adherents' willingness to accept bluster as a sign of character and thick-headed devotion to meaningless symbols as sign of moral fiber." (Albert Einstein)

    by Jim R on Wed Apr 10, 2013 at 04:22:00 PM PDT

    •  That's absurd (0+ / 0-)

      The decline of the middle class and the safety net came about because of Reagan and the anti-tax/anti-government movements of the late 70s and 80s.

      You have to judge political decisions in context and with perspective, something you are refusing to do here. What, exactly, was Clinton to do with the problems in front of him, given the political climate?

      The American people gave him a Republican Congress that was anti-government, anti-spending, anti-tax, and anti-poor people. The Democrats had just been slaughtered in the 1994 elections and things were not exactly looking up for 1996.

      Clinton did what political leaders do: he compromised, he got the best deal he could, and hoped that future changes in the electorate and the political climate would allow more changes in the right direction. See also: health care, gay rights, and other current causes.

      His other choice was what? Obstruct any and all legislation? Refuse to compromise to hold firm on demanding 100% of our agenda -- an agenda the American people had just rejected in 1994? Yeah, that's a good way to get Republicans elected in Blue States -- and then see that 50% deal get turned into a 100% GOP Steamroller Express of Terrible Legislation.

      This is the same lack of compromise you and others would blame the Republicans for. Now it's OK if we do it?

      Would it be better if the country were more liberal, or even moderate, about the economy? Of course it would. But they're not. Regardless of the reasons for it, they're just not. We have to work with what we're given, and change the system within the system.

      God damn I hate reading comments like this. It's our version of the Tea Party and you should be ashamed.

      •  Rock on then, and let the shame be yours (0+ / 0-)

        If you're naive enough to believe Clinton reluctantly compromised with recalcitrant Republicans instead of co-opting and preempting their positions then who am I am to rock that boat?

        I voted Obama for the same reason I voted for Obama, the alternative sucked even worse; which is why our country continues to decline and become more of an international embarrassment on a daily basis.  

        "The philosophy of conservatism is inevitably doomed by its adherents' willingness to accept bluster as a sign of character and thick-headed devotion to meaningless symbols as sign of moral fiber." (Albert Einstein)

        by Jim R on Wed Apr 10, 2013 at 05:13:30 PM PDT

        [ Parent ]

        •  same reason I voted for Clinton...edit (0+ / 0-)

          "The philosophy of conservatism is inevitably doomed by its adherents' willingness to accept bluster as a sign of character and thick-headed devotion to meaningless symbols as sign of moral fiber." (Albert Einstein)

          by Jim R on Wed Apr 10, 2013 at 05:15:01 PM PDT

          [ Parent ]

  •  I'll never understand this: (1+ / 0-)
    Recommended by:
    draghnfly
    Adding more means testing to the program (wealthier individuals already pay higher premiums for Part B, the part that covers physician services and supplies) shifts the program further from from universal coverage and opens it up to more and more means testing, and toward a stigmatized and politically vulnerable poverty program.
    When did charity towards the less fortunate become anathema to Americans, for pity's sake?

    WHY exactly should we all just agree that,

    yeah, the poor suck, the slackers, let's stop helping them so much, they need to pull up on those bootstraps and be good Americans like you, and me.
    Why don't more people protest this scrooge-like behavior towards the most vulnerable Americans, who are after all, in far too many cases, you or I just two weeks without a paycheck away.

    Why isn't it the popular idea for the most exceptional nation the world has ever seen (don't we always hear that?) to also be the most generous to their fellow citizens in need nation?

    Isn't that the morally correct thing to strive for? Why don't we try a campaign based on that idea to push Congress?


    "I like paying taxes...with them, I buy Civilization"

    by Angie in WA State on Wed Apr 10, 2013 at 04:25:07 PM PDT

  •  Oh. You mean he's actually proposing to cut (3+ / 0-)
    Recommended by:
    zaka1, sjduskin, heavenlytails

    benefits?  No way!  I mean this is Obama we're talking about and he's the leader of the Democratic Party.  Next, you'll be telling me he wants to cut Social Security.  Don't be silly.

    The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

    by accumbens on Wed Apr 10, 2013 at 04:29:28 PM PDT

  •  We need one Medicare, not Part A, Part B, Part D (2+ / 0-)
    Recommended by:
    MillieNeon, Angie in WA State

    or Part C.  It's an insane puzzle for Seniors right now.  

    We need something that low-income folks (even those with moderate assets) can afford without becoming indigent within ten years of turning 65 if they have modest savings upon retirement.

    We need something that helps keeps seniors healthy--including eyes, ears, and teeth.

    We need more home health benefits that keeps them (us) out of nursing homes and off Medicaid.

    We need Medicare to be a sensible wellness policy that encourages seniors to exercise, eat right, access alternative care where appropriate, and prescribe only the minimum of prescription drugs that will help keep them healthy.

  •  Still no proposal to negotiate drug prices? (1+ / 0-)
    Recommended by:
    sjduskin

    That would be a huge savings.

    The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt. Bertrand Russell

    by accumbens on Wed Apr 10, 2013 at 04:32:35 PM PDT

  •  Means testing for Medicare is absolutely needed. (0+ / 0-)

    All the universal health insurance programs in Europe that American progressives profess to admire are severely means tested.  They are means tested in that their premiums are assessed as a percentage of income as opposed to a fixed amount for everyone.   The only way to break the strangle hold of capitalist medicine in America is to institute means testing as well as to rein in exaggerated payments to providers.  Obama with this budget and the ACA is moving America closer to a fairer and sustainable health care system even though there is further to go.  

    •  Revisiting the FICA cap is also something to look (0+ / 0-)

      at. Presently, everyone making more than $113,700, if they have paid their 6.2% plus 1.45% for Medicare, they've met their obligation. It's double that if they're self-employed.

      If we added just 1 or 2% to all income above $113,700 and split the revenue between Social Security and Medicare, these programs would instantly become viable for somewhat longer into the future.

      That we are not talking specifics like this has more to do with the GOP's blistering opposition and the milktoast lack of conviction on the part of certain leaders, than it is with a lack of reason.

      This is a good, reasonable idea. That we're told it doesn't have a chance in hell has more to do with perception and intimidation than with reality.

      If we keep chipping away at the illogic of the GOP's intransigence, they're bound to get weary and stumble more and more.

      Reason has to return sometime...

      "Gun violence places a tremendous burden on America's health care system. Direct medical costs for gunshot wounds total more than six million dollars a day." - The Violence Policy Center

      by Beastly Fool on Wed Apr 10, 2013 at 05:08:29 PM PDT

      [ Parent ]

  •  What did we expect? (1+ / 0-)
    Recommended by:
    heavenlytails

    The man doesn't actually know anyone who depends on Medicare to stay alive.  The only empathy he displays is in his campaign speeches, not in his policies or actions.  Dead inside.

  •  How much savings would there be (0+ / 0-)

    if we beefed up enforcement against Social Security, Medicare and IRS fraud.  The return has to be greater than the cost, and besides reducing costs, this would increase employment in law enforcement.

    We've already got teams on this, but they are underfunded and understaffed. The crooks are stealing the treasury...

    Much like the defense contractors and big pharma, except their game is technically legal...

    "Gun violence places a tremendous burden on America's health care system. Direct medical costs for gunshot wounds total more than six million dollars a day." - The Violence Policy Center

    by Beastly Fool on Wed Apr 10, 2013 at 04:52:03 PM PDT

  •  Where's the competition? (0+ / 0-)
    Adding more means testing to the program (wealthier individuals already pay higher premiums for Part B, the part that covers physician services and supplies) shifts the program further from from universal coverage and opens it up to more and more means testing, and toward a stigmatized and politically vulnerable poverty program.
    Is there any competition for Medicare?  Until insurers are willing to write individual policies for seniors that are cost competitive with Medicare, there will minimal defections.

    "Well, I'm sure I'd feel much worse if I weren't under such heavy sedation..."--David St. Hubbins

    by Old Left Good Left on Wed Apr 10, 2013 at 05:17:48 PM PDT

  •  Budget comparison/WH petition (0+ / 0-)

    repeat posting from another Kos story:

    For  comparison & analysis of  all submitted budgets:

    http://nationalpriorities.org/

    WH petition against CCPI

    http://wh.gov/...

  •  I Guess My Phone Bill Will Be High (0+ / 0-)

    I think I'll be spending a lot of time on the phone to my two Senators (Murray and Cantwell). I hope they're good listeners.

    Markos, you may need to change the strategy here. Do you really want to back a party that is so craven they'd feed seniors cat food? I suspect we need to completely restock this party with new congresscritters.

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