Tag Archives: Medicaid

While We Wait, a Prediction

29 Thursday Mar 2012

Posted by in health care, Supreme Court

≈ 1 Comment

Tags

, , , , ,

Now that the Supremes have finished hearing arguments and begin to deliberate the fate of the Affordable Care Act it seems to be the time for predictions on how they’ll rule, so I’ll throw in my $0.02 worth.

I see a 5-4 decision to not only throw out the individual mandate but the entire law. The reason being that without the individual mandate the entire law collapses. Justice Scalia said as much when he remarked about the “cruel and unusual punishment” which would be forced upon the Court if they had to go through all 2,700 pages of the ACA and decide what stays and what goes.

Some of the so-called “experts” who have been following the proceedings have opined that the Supreme Court would be overstepping its bounds and ignoring precedent to make such a sweeping move. I would ask those who hold this belief if they were asleep when the Citizens United decision came down. That’s exactly what the Court did in that instance. They ignored 100 years of precedent in campaign finance law and expanded the scope of their decision well beyond the parameters of the original case in throwing out almost all limits and restrictions on contributions and doing away with transparency concerning those contributions.

So what will result from overturning the ACA? I would like to think it would be a starting point for Democrats to begin a push toward some kind of a single-payer system, but that would require backbone, something I haven’t seen much evidence of, so I doubt seriously it will happen. The more likely outcome will be that reforming our broken system will be viewed as politically toxic and one will want to touch it for the foreseeable future. Until the foreseeable future meaning the time when the entire for-profit health care system collapses, which it inevitably will.

We’ll go back to the pre-ACA system where premiums skyrocket and coverage decreases every year until health insurance will become one more thing that is limited to those privileged few who can afford it. Those who can’t are just SOL. Insurance will become so costly that employers will stop providing it, the premiums will be so expensive that employees who are dropped won’t be able to purchase it, and those with pre-existing conditions won’t be able to get coverage at any price. The only care available to most people will be by way of the ER, and those will be so swamped with patients and so burdened by the costs that they will be forced to close. That may sound like gloom and doom but I don’t see any other alternative.

With the demise of the ACA and its Medicaid requirement on the states, conservatives and their ‘drown government in a bathtub’ pied pipers will also use the Court decision as a jumping off point to not only do away with that program but Medicare, Social Security and any number of other government programs as well. They will argue the constitutionality of anything that contains any form of government mandate, and if those cases come before this Court I don’t have much doubt that the outcomes will be similar.  Again, sorry to be so pessimistic but I don’t see much reason for optimism.

In closing, I have to make a comment on something James Carville said that just pisses me off, and makes for a sad commentary on the state of partisan politics in this country:

“I think that this will be the best thing that ever happened to the Democratic party because health care costs are going to escalate unbelievably,” said Carville. “Just as a professional Democrat, there’s nothing better to me than overturning this thing 5-4 and then the Republican party will own the health care system for the foreseeable future. And I really believe that. That is not spin.”

No, that’s not spin, it’s stupidity. And it’s not said as a “professional Democrat” but as a professional ignoramus.  It may or may not be a good thing for the Democratic party, Mr. Carville, but will it be “the best thing that ever happened” to the millions who are going to join the ever-increasing ranks of the uninsured because of those escalating costs? What about for those young adults who can no longer be covered by their parents policies or the people for whom Medicaid is their only access to health care?

No matter who “owns the health care system” and who gets the blame sick people won’t be able to get treatment and some will die for lack of care. But who cares about that, it’s more important that political points are scored. That sounds like something John Boehner or Mitch McConnell would say.

.

Advertisement

Shared Sacrifice in Romney’s World

25 Saturday Feb 2012

Posted by in economy, Politics, Romney, Taxes

≈ Leave a comment

Tags

, , , ,

The stadium may have been empty but the speech certainly wasn’t.

During Mitt Romney’s speech in Detroit yesterday, he laid out his bold, new economic policy. Massive tax cuts for the top bracket paid for by cutting spending on programs that benefit the neediest of the needy. As Ezra Klein put it:

“When Romney said he “wasn’t concerned about the very poor,” he wasn’t kidding. He’s using the policies they depend on most as a piggy bank for tax cuts.”

Most of what Romney addressed was familiar territory–raising the retirement age, privatizing Medicare, and repealing “Obamacare.” He also called for cutting things like subsidies to Amtrak and Planned Parenthood, which amount to pocket change in the federal budget, and bringing federal worker’s pay down to the same crappy level as people in the private sector.

But the bulk of the spending cuts would come from sending Medicaid back to the states:

“Romney’s real savings come in the next section. He’ll “send Medicaid back to the states and cap that program’s rate of growth,” and then “do the same for other programs, like food stamps, housing subsidies and job training.”

Sending the programs back to the states is a red herring. The key bit for deficit reduction is capping their rates of growth. Which is to say, cutting their rates of growth. Which is to say, cutting them.

What Romney is essentially proposing to do is finance a massive tax cut by cutting Medicaid, food stamps, housing subsidies and job training. In other words, the neediest Americans…will be financing a massive tax cut.”

This is Romney’s idea of shared sacrifice:

“My plan for America requires real leadership. And it calls for sacrifice. It doesn’t require a leader to promise bigger and bigger benefits, and something for nothing. Let me underscore that. It doesn’t require a leader to promise bigger and bigger benefits, and free stuff. It requires a leader … to call for sacrifice.”

Here’s who would bear the brunt of that sacrifice (BCCA is an acronym for Breast and Cervical Cancer Prevention and Treatment Act that allows states to provide early access to Medicaid to women with cancer).

Here are the Medicaid dollars spent per beneficiary:

So in order for cuts in the scope of what Romney is proposing to have any substantial affect, here’s what would have to happen:

“…[T]he amount we spent per blind or disabled person, or per elderly person, is much, much more than the amount we spend per child or adult. This means that if we really want to cut Medicaid spending, and we want to do it on the backs of adults or children, we will have to drop many, many more of them to make a real impact on spending.

If we cut 1 million elderly from the Medicaid rolls, we reduce Medicaid spending by about 5%. If we cut 1 million adults, however, we reduce Medicaid spending by only 1%. We need to cut 5 times as many adults. If we want to cut Medicaid spending by 10%…we’d need to drop more than 10 million adults from Medicaid. That’s almost three-quarters of all of them. If we want to cut overall Medicaid spending by 20%, then we’d need to drop all non-elderly adults, including all pregnant women, as well as about 10 million kids, or more than a third of them.

So what will we do? Should we cut some of their benefits instead? Again, look how little we already spend on children and adults. If we cut spending on every child and every non-elderly adult by 25%, that will reduce overall Medicaid spending by less than 8%.

Or do you want to go after the money we spend on the blind and disabled? Women with breast cancer or colon cancer? The elderly?”

Right on, Mitt. Let’s take all that “free stuff” away from all those “something for nothing” freeloaders like the blind, the disabled, the elderly, and women with cancer. They’ve had it too easy for too long. It’s high damn time they sacrificed something so your buds can have another yacht to water ski behind or another vacation home.

All the Bad News That Fits

23 Saturday Jul 2011

Posted by in Afghanistan, budget, Congress, economy, Iraq, Medicaid, Medicare, Obama, Politics, Social Security, Unemployment, Wall Street

≈ 1 Comment

Tags

, , , , , , , , , , , , , , , , , , ,

“I met a girl who sang the blues, and I asked her for some happy news. She just smiled and turned away.”

In the latest episode of “As the Debt Ceiling Turns”; Boehner walks, Obama has a hissy fit, and Pelosi throws yet another plan into the mix:

“House Minority Leader Nancy Pelosi acknowledged Friday that Democrats may reluctantly accept a last-minute compromise to avoid a default that involves up to $2.5 trillion in spending cuts — without agreed-upon new tax revenues — if Medicare, Medicaid, and Social Security are protected from the debt limit brinksmanship.”

Yes, by all means, let’s cut spending. Never mind this:

“Companies are laying off employees at a level not seen in nearly a year, hobbling the job market and intensifying fears about the pace of the economic recovery.

Cisco Systems Inc., Lockheed Martin Corp. and troubled bookstore chain Borders Group Inc. are among those that have recently announced hefty cuts, while recent government numbers underscore how companies have shifted toward cutting jobs.

The increase in layoffs is a key reason why the U.S. recorded an average of only 21,500 new jobs over the past two months, far below the level needed to bring down unemployment, which now stands at 9.2%.”

Or this:

“Initial weekly unemployment claims increased to 418,000. The 4 week moving average is 421,250. A weekly average above 400,000 does not indicate job growth and we now have a pattern of perpetual disaster for U.S. citizens trying to earn a living.”

About that default deadline, is it August 2, August 10, or August 15? Nobody seems to know for sure.

The Money Party has some questions and answers on Obama’s handling of the budget never let a good crisis go to waste. Here’s just one:

“Question:  Why did President Obama put Social Security and Medicare on the table in the budget negotiations when 80% of the people oppose cuts to these programs?

Answer:  The president is not in office to represent those people.  He was selected, funded and carried over the finish line by corporate America.  Look at the appointment of Wall Streeter Timothy Geithner, the bailouts, and the failure to prosecute any of the crooks who caused the current recession. He’s serving the people who put him in office.  Those people don’t need Social Security and Medicare.”

Not only serving the people who put him in office, but serving those who he is depending on to keep him there:

“Among big fundraisers, Obama has drawn close to a third of his money from people in the finance industry, up from 20% during his 2008 campaign, according to an analysis by the Center for Responsive Politics.

The amount raised so far is more than two-thirds what Wall Street elites helped Obama raise in his entire 2008 campaign. And it is enough to make the finance world the single largest source of big-ticket donations for Obama.”

While we cut the social safety net out from under our most vulnerable at home, billions are going unaccounted for in Afghanistan:

“SIGAR [Special Inspector General for Afghanistan Reconstruction] found that U.S. agencies have limited visibility over U.S. cash that enters the Afghan economy — leaving it vulnerable to fraud and diversion to the insurgency…”SIGAR auditors found that U.S. agencies have not done all they can to safeguard U.S. funds, and the Afghan government has not provided the cooperation needed to build a strong, secure financial system.”

Also on the Endless War front, the State Department is telling the Special Inspector General in Iraq to mind his own business when it comes to State’s mercenary army in that country:

“By January 2012, the State Department will do something it’s never done before: command a mercenary army the size of a heavy combat brigade. That’s the plan to provide security for its diplomats in Iraq once the U.S. military withdraws. And no one outside State knows anything more, as the department has gone to war with its independent government watchdog to keep its plan a secret.

Stuart Bowen, the Special Inspector General for Iraq Reconstruction (SIGIR), is essentially in the dark about one of the most complex and dangerous endeavors the State Department has ever undertaken, one with huge implications for the future of the United States in Iraq. “Our audit of the program is making no progress,” Bowen tells Danger Room.

For months, Bowen’s team has tried to get basic information out of the State Department about how it will command its assembled army of about 5,500 private security contractors. How many State contracting officials will oversee how many hired guns? What are the rules of engagement for the guards? What’s the system for reporting a security danger, and for directing the guards’ response?

And for months, the State Department’s management chief, former Ambassador Patrick Kennedy, has given Bowen a clear response: That’s not your jurisdiction. You just deal with reconstruction, not security. Never mind that Bowen has audited over $1.2 billion worth of security contracts over seven years.”

To be continued…unfortunately.

Obama Hearts the “Gang of Six” Plan

20 Wednesday Jul 2011

Posted by in budget, Congress, economy, health care, Medicaid, Medicare, Obama, Politics, Social Security, Taxes, Unemployment

≈ 2 Comments

Tags

, , , , , , , , , , , , , ,

President Obama was quick to endorse the latest deficit reduction plan, the one from the so-called “Gang of Six” released yesterday, calling it a “very significant step” and “broadly consistent with the approach he has advocated.” This without knowing the details. But the details weren’t really important, because all the major elements are indeed consistent with what the president wants in this deficit reduction shell game.

* Medicare, Medicaid, and Social Security cuts.
* Further cuts in the top marginal income tax rates. (So much for that pledge to let the Bush tax cuts expire).
* Corporate tax cuts.
* The continuation of Reaganomics and Bushonomics. That would be the supply-side, tax cuts equals increased revenue and economic growth nonsense that we all know works so well.

The broad strokes of the “Gang of Six” plan (and just as an aside I wonder why Sen. Sanders is never included in any of these gangs? Not bi-partisany enough, I assume) are as follows:

An immediate $500 billion “down payment” on deficit reduction. All spending cuts, all from unnamed programs. A brilliant idea in a recession. The other $3.2 trillion in savings would be decided by various committees at some later date, enforced by spending caps. Congress would be required to get a 2/3 vote to exceed those caps. IOW, when the next recession hits, anybody looking for any assistance is SOL. David Dayen at Firedoglake:

“Simply put, this is a recipe for depression. When the economy suffered and stimulus would be required to increase aggregate demand, the 2/3 vote needed would simply put a stop to it. The New Deal would have been out of order under this regime. Same with the Recovery Act. Any spending from the federal government would be restricted as much as it is in the states. So there could only be the status quo or contraction in fiscal policy in the event of a recession, which is a perfect way to create a depression.”

Also in the down payment would be the institution of chained CPI, aka a cut in SS benefits, and repeal of the CLASS Act, which was a part of health care reform that the insurance lobby fought tooth and nail. From the New York Times, December of 2009:

“The Class Act, which the late Sen. Ted Kennedy considered his legacy, would allow people to buy long-term care insurance through payroll deductions and to receive cash if they’re later disabled, regardless of their age or of a previous health condition. “This is the best chance the baby boomers have to protect themselves from impoverishment if they need long-term care,” Mr. [Jim] Firman [president of the National Coalition on Aging] said.”

That is Part One. Part Two calls for an additional $200 billion in “healthcare savings,” aka Medicare and Medicaid cuts, and an $80 billion cut in the defense budget. That’s $80 billion over ten years, pocket change for the Pentagon. Gotta love that shared sacrifice.

In Part Two, the Finance Committee…

“…would be required to reduce tax rates to three tax brackets of rates: of 8-12 percent, 14-22 percent and 23-29 percent. The current top marginal rate is 35 percent. The corporate tax rate would be between 23 percent and 29 percent…”

And this little goodie for corporations as well:

“…tax reform would cease taxation of overseas profits.”

The corporate behemoths had been lobbying to get the tax on overseas profits reduced, allegedly under the guise of returning these profits for use in job creation, but that’s not how it worked before:

“Congress and the Bush administration gave companies a similar tax incentive, in 2005, in hopes of spurring domestic hiring and investment.

While the tax break lured 800 companies into bringing $312 billion back to the United States, 92 percent of that was used for dividends and stock buybacks, according to the nonpartisan National Bureau of Economic Research. The study concluded the program “did not increase domestic investment, employment or research and development.”

Indeed, 60 percent of the benefits went to 15 of the largest U.S. multinational companies — many of which laid off domestic workers, closed plants and shifted even more profits and resources abroad in hopes of cashing in on the next repatriation holiday.”

So let’s just eliminate the tax entirely. Nice.

More on the tax “reform” aspects of this plan:

“Coburn said the plan would reduce the deficit by $3.7 trillion over the next 10 years and increase tax revenues by $1 trillion by closing a variety of special tax breaks and havens. He also noted, however, that the Congressional Budget Office would score the plan as a $1.5 trillion tax cut because it would eliminate the Alternative Minimum Tax.”

I’m not sure how that works. How is $1 trillion in revenue increases scored as a $1.5 trillion tax cut? But I know for sure how this works, it doesn’t:

“It would generate a significant amount of revenue out of tax reform and reduction of tax rates, which authors believe would spur economic growth.”

And I believe in the Tooth Fairy and the Easter Bunny.

Shared Sacrifice, 2011 Style

06 Wednesday Jul 2011

Posted by in budget, Medicaid, Medicare, Obama

≈ Leave a comment

Tags

, , , , , , , , , ,

In light of this:

“Before Medicare was implemented—as a social-welfare program designed not just to deliver care but to poverty—one in five Americans lived below the poverty line. After the program was implemented, and after related “War on Poverty” initiatives were developed, that number was cut almost in half. Poverty among seniors dropped by two thirds.

Why? Before Medicare, millions of elderly Americans could not afford to buy healthcare. They did not have access even to basic care. When they needed treatment for the inevitable ailments that are associated with aging, they and their families spent down what meager savings that retained and a stumble into poverty soon followed.

Medicare broke the vicious cycle for the elderly, as Medicaid did for disabled Americans and their families. “For more than four decades, Medicare has kept millions of our senior citizens from living out their days in poverty,” explains one of the program’s steadiest champions, Congresswoman Tammy Baldwin, D-Wisconsin.

Medicare continues to serve the purpose for which it was created. Indeed, so much good continues to come of this program—and of Medicaid—that it is difficult to imagine why anyone would seek to dismantle the program.”

What the hell is up with this?

“Obama administration officials are offering to cut tens of billions of dollars from Medicare and Medicaid in negotiations to reduce the federal budget deficit, but the depth of the cuts depends on whether Republicans are willing to accept any increases in tax revenues.

Administration officials and Republican negotiators say the money can be taken from health care providers like hospitals and nursing homes without directly imposing new costs on needy beneficiaries or radically restructuring either program.”

Yeah, right. Now tell me the one about Goldilocks and the bears.

“Before the talks led by Vice President Joseph R. Biden Jr. broke off 12 days ago, negotiators said, they had reached substantial agreement on many cuts in the growth of Medicare, which provides care to people 65 and older, and Medicaid, which covers lower-income people. Those proposals are still on the table when Congress reconvenes this week, aides said, and are serious options that Democrats could accept in exchange for Republican concessions that raise revenues.”

So in exchange for tens of billions of cuts to Medicare and Medicaid Republicans might “concede” on the much over-hyped tax break for corporate jet owners, which amounts to a whopping $300 million a year.

Shared sacrifice, 2011 style.