McIlheran Watch: Lyin' for Ryan

by folkbum

So earlier this week, a heavily Republican Congressional district somewhere in New York elected a Democrat. The dynamics of any one local race* are seldom indicative of any greater theme, despite everyone's best attempt to say, see, this proves what I've been claiming all along! There are always local issues to consider, individual dynamics of the race and, in this case, an utter wingnut tea-party candidate who may have been a spoiler. But one thing is certain: The DCCC, Democrats' House election arm, did everything it could to make the election about Paul Ryan (R-Galt's Gulch) and his plan to destroy medicare, because the Republican in that race voiced her support early and often for Ryan's plan.

Right there, what I just did, saying that Ryan's plan would destroy Medicare, is what those who have always wanted to destroy Medicare (except in election years, when in a fit of black-is-whiteism the GOP asserts it's Democrats who will destroy Medicare) would call a "mediscare tactic." Funny, eh? But please, recall that since Medicare's inception, the Republican Party has stood for its end, with St. Ronald de Tampico even making a record--yes! a record!--in 1961 opposing the plan and claiming that within a generation the federal government would be telling doctors where they could live and what kind of medicine they could practice. Like Harold Camping's predictions of Armageddon, Reagan's opposition to Medicare seems laughable now.

Except not to Paul Ryan. As we have discussed before on this very blog Ryan is not afraid to invoke Reagan's rhetorical style when it suits him, and for basically the same purposes. So let's be clear: Ryan's plan does destroy Medicare. This is not an exaggeration designed to "scare," but an accurate description of Ryan's plan to institute a completely different system under the same name. (Politi"Fact" finds the semantics of the argument--Ryan still calls his plan Medicare, they say--persuasive enough to call honest opposition to the idea false, which is just mind-boggling.)

And this is where Patrick McIlheran comes in: He blogs to throw out the "mediscare" label and defend Ryan's plan. But he can't do that without lying, because, let's be honest here, a whole lot of Ryan's plan is indefensible. McIlheran:

As Ryan has endlessly pointed out, his plan leaves Medicare completely unaltered for anyone now on it or who is now 55 or older. It manages this feat [. . .] by changing the deal for people 54 or younger into a subsidized selection of insurance plans more or less identical to what Congress gives itself as coverage. This is an “end” to Medicare only if you imagine that our lawmakers have left themselves destitute and tubercular in a gutter when it comes to their own health care.

Of course Ryan's plan doesn't touch the Boomers' and the WWII generation's Medicare; those people vote and they really like Medicare, giving it just about the highest satisfaction rates of any insurance provider in the country. But the next part, about giving everyone else the same health care coverage that Congress gets? That's baloney:

In many ways, the federal plan works a lot like the run-of-the-mill employee-sponsored health insurance plan. The bulk of the costs are picked up by the employer--in this case, the government--with the employee contributing his or her share according to a set or negotiated rate. Under a 1997 law, the government pays a set rate of 75 percent of the costs of the health plans selected by federal employees and members of Congress. The employee (and members of Congress) pick up the other 25 percent. [. . .] The Congressional Budget Office, the nonpartisan arm of Congress, analyzed Ryan’s plan and estimated that, by 2030, the government would pay just 32 percent of the health-care costs, less than half of what it currently pays. The other 68 percent of the plan would have to be shouldered by the retiree.

That just-like-Congress tale ends up a two-Pinocchio lie. But happily spread by local huckster McIlheran. Who goes on:

And since the alternative, according to Medicare’s own accountant, is leaving things alone until it all goes bankrupt in 2024 and doctors stop seeing recipients, then Ryan’s plan is “immoral” only in the way that it’s somehow wrong to disturb a drunk’s calm by telling him he’s driving onto the wrong-way off-ramp of a freeway.

This is what we call a false dichotomy (and the word false, you know, tells you McIlheran is lying again). This is the new Republican tactic, seen all over the place lately, which is to pretend that Democrats don't have a plan. They do. It's called Medicare--you may have heard of it, and it's a pretty awesome deal.

But not merely the unaltered Medicare that will, indeed, drive federal debt ever higher. Rather, Democrats have been trying to build on Medicare's signature strength, which is that it holds costs down better than private-sector insurance; over the years, Medicare inflation has been significantly lower than inflation in the health-care market as a whole. Ryan's plan, on the other hand, holds payments down, which does nothing to control costs. Indeed the CBO's analysis is devastating:

[T]he CBO conclusion is shocking: The plan would not only fail to decrease health-care costs per beneficiary, it would increase them–-by an astonishingly large amount that grows over time. By 2030, health spending on the typical beneficiary would be more than 40 percent higher under the Ryan plan than under existing Medicare, according to the CBO report.

The short version is that the end of Medicare as we know it under Ryan means an end to the government's ability to make big deals with doctors and hospitals and other providers: When you're on your own with a voucher, you do not have the negotiating power of 40 million other patients behind you. Just you. So where Ryan's plan allows actual costs to skyrocket (but not the size of your voucher), Medicare as is holds actual costs down.

But there's more: Democrats want to further bend that cost curve downward, and the Affordable Care Act starts that process. The ACA establishes an Independent Payment Advisory Board, which is all about finding the most effective and most cost-effective treatments to pay for instead of expensive stuff that doesn't work. However, there's a giant obstacle to this board, and if you guessed the House GOP you'd be right: They want to abandon the additional cost controls that the IPAB would bring in favor of, as we've seen, destroying Medicare instead.

The truth of the Ryan plan and the destruction it would bring to one of the most important entitlement plans we have today is what's really scary. And that's why Ryan and his media enablers like McIlheran have to lie to you in order to sell the plan.

* Steve Benen argues that this is not an isolated case, and that Democrats have been making significant gains, including flipping Mike Huebsch's GOP-heavy Assembly district here in Wisconsin a few weeks ago.

Fisking Paul Ryan

by folkbum

I'm glad somebody else did it; I'm on vacation. Read it, it's pretty devastating.

Charlie Sykes and Paul Ryan: These Guy Are Good!

by bert
Any of us can bitch of course. But there is a reason that radio talk show host Charlie Sykes gets paid to do it all week long.

A Baryshnikov of bellyaching, Sykes is able to leap gracefully on "his" blog from complaining about an idea to cut Medicare when it's a Democratic idea to the geometrically opposite position in support of cuts. He gets from here to there because now the idea is Republican Paul Ryan's.

Paul Krugman of the The New York Times has noticed this same acrobatic about-face by the GOP on the issue of caring for our grannies.

So cutting Medicare by $500 billion is wrong--support Republicans, who [Paul Ryan, to be specific] want to cut it by $650 billion!

As snowboarders would say, that leap was sick.

No principles and no shame

by folkbum

A significant part of Republican opposition to health insurance reform bills like HR 3200 is that they rely on savings from eliminating inefficiencies and waste in Medicare to provide some of the needed funding.

The Republican response to this is that it means rationing and early death for seniors: Democrats are going to cut Medicare, they say--"inefficiency" and "waste" being fictional or negligible, apparently--thereby making some procedures off-limits and leaving our elders to die in the streets.

Just to be clear: This is the same Republican Party whose platform in 2008, adopted just over a year ago a few miles up the road in St. Paul, reads, "we should [. . .] eliminate waste and inefficiency" right there under the heading "Medicare." (What, did the waste and inefficiency just disappear?)

This is the same Republican Party whose current chair told Tim Russert that Medicare was "absolutely, absolutely" on the table for cuts when he ran for Senate just two years ago.

And this is the same Republican Party that shut down the federal government in 1995 in part because Democrats would not agree to (wait for it) cut Medicare spending.

No principles. No shame.

Donuts and chickens

By Keith Schmitz

As warned, lots of senior citizens are hitting the Medicare donut hole where their drug coverage suddenly goes away. The New York Times this morning points out that sometime this year over thee million of the people on the plan will find they will have to come up with the money to cover the drugs they need to live.

And for many GOP the chickens will be coming home to roost. If we go by the averages, most of these seniors will see the trap door open up around say, November.

To make matters worse for themselves, the conservatives fell into their own fantasies of the power of consumer in the medical market.

Melvin A. Kinnison, 65, of Huntington Beach, Calif., a retired deputy sheriff with diabetes and prostate cancer, said: “The drug benefit was fine for a while, until the doughnut hole came around. It was a total surprise. Nobody ever explained it to me.”

As any economist will tell you, power in the market comes from information. Imagine your 85 year old mother trying to negotiate the labyrinth of details of the new Medicare plan overlaid with the fear that a screw up could affect the benefits – and you trying to explain it to her.

But now the real power will come from the payback from these seniors who love to vote against the politicians duplicitous in this scheme.

Lawmakers do not defend the coverage gap as sound health policy. Rather, they say, it was a way to limit the cost of the new program while providing some benefits to almost everyone, comprehensive coverage to low-income people and generous catastrophic coverage to people with high drug costs.

For many of these lawmakers such as Mark Green they should have thought beyond the urging of K Street lobbyists to come up with a plan that could have done a better job of covering seniors. What is amazing is the beltway bubble these people live in where they had no idea how this would play at home.

In the Wisconsin gubernatorial election and many close Congressional races across the country these seniors will not let these lawmakers forget who gave them the job in the first place. Work the numbers. About over 8,000 people will be digging into their own pockets at Walgreens and CVS. That could eat into Jim Sensenbrenner's margin, and Bryan Kennedy would have to be foolish not to cash in. And though Bryan keeps a trim profile, he will not pass up on this donut.