Washington is having the wrong debate!

Watching Congress and President Obama debate the best way to get the short-term deficit is under control is a lot like being trapped on a train behind two lovesick teens intensely debating Team Edward vs. Team Jacob. After a couple of hours, you just want to lean over their seat and say, as politely as possible, “This is a stupid, irrelevant debate that you’ll be embarrassed you had when you grow up a little bit.”

Long-term, of course, the deficit and debt are serious issues that the United States must deal with. But this in an instance when Congress really ought to be listening to the polls, which clearly show the public is more concerned about jobs and the economy than about the deficit. The public isn’t always right. This time, the polls are dead on.

Talking Points Memo has a good look at the debt issue. Looking at the nation’s historic deficit as a percentage of GDP, as TPM does, puts things in perspective. As you can see from the chart below, the current deficit isn’t even an outlier. Deficits were much higher in the late ’80s relative to the economy than they are now. They were magnitudes greater during World War II. We are not in a World War, of course, but we have been fighting two wars simultaneously, with the one in Afghanistan nearing the decade mark.

What should be far more concerning to America’s politicians is the plateau at the tail end of this graph.

This is the graph of unemployment since the late 1940s. As you can see, the early ’80s recession resulted in a higher peak than we’re currently experiencing, but it didn’t last as long. In fact, this appears to be the highest sustained level of unemployment since the early ’80s, and it’s showing no sign of coming down fast anytime soon.

This is what Washington ought to be concentrating on. As TPM said, “when people get back to work, revenues will climb, and deficits will shrink on their own.”

Long-term is a different story. Health care costs will drive deficits and the debt to unsustainable levels. But solving that requires lowering the rate of increase for health care costs, not cutting spending.

We’re not having that debate, either, and there’s little sign that anyone in D.C. is close to realizing how irrelevant the current debate is.


The old rules don’t apply

I asked the other day whether Republicans would stick to the notion that doing anything that ran counter to current polling is evil and undemocratic in light of the fact that the polls show Americans really hate Republican ideas for gutting Medicare and Medicaid. In a great post today, Ezra Klein points out that isn’t the only principle Republicans are turning their back on.

Remember during the health care reform debate when big reforms demanded a bipartisan approach? Remember Republicans arguing that the cuts to Medicare in Obamacare – the same cuts included in Ryan’s proposal – would devastate hospitals? None of this matters now that the Republicans are pushing their radical and immoral plan. What next? Backroom deals and payoffs to help pass the legislation? I wouldn’t doubt it.

Ryan and Obamacare

According to The Wall Street Journal, Republicans and associated interest groups spent $70 million last election attacking Democrats for health care reform’s cost-savings measures aimed at Medicare.

“Maybe Schauer’s trying to hide his own vote to cut $500 billion from Medicare,” said one typical television ad, this one targeting then-Rep. Mark Schauer (D., Mich.), who lost his re-election bid. “Let’s save Medicare, and cut Schauer.” Like others, this ad was paid for by the National Republican Congressional Committee.

Such ads helped Republicans take back the House. Last week, that House passed the Ryan budget, which, The Wall Street Journal notes, keeps in place the Medicare reductions in the health care reform act while devoting $10 billion to restore the expensive, inefficient Medicare Advantage program (which costs taxpayers 14 percent more than regular Medicare).

America: Republicans ran for election last year telling you they would save Medicare. Instead, they are preparing to end Medicare as we know it and make drastic cuts to Social Security. It’s time to let them know that this incredible ideological overreach is not what you voted for.

Update: The Democratic Congressional Campaign Committee put out a serious but funny video today on the Medicare issue:


A question I’m amazed hasn’t already been asked

Paul Ryan’s radical plan to eliminate Medicare as we know it has already passed the Republican-controlled House, but finally someone is asking the fundamental question about the plan to give seniors vouchers to buy private insurance rather than have the government pay directly for their care: Would any private insurers even want into this market?

I touched on it briefly – too briefly – in a post last week when I noted that private insurance companies “aren’t very likely to embrace the segment of the health care marketplace that is practically guaranteed to need lots of expensive health care.”

But TPM’s Benjy Sarlin went to the source and asked insurance company representatives what they thought about the idea. They seemed pretty cool:

Dan Boston, a veteran lobbyist for health care providers and co-owner of Health Policy Source, said in an interview with TPM that he was taking a “wait and see” approach on the GOP budget before judging its value. (The American Hospital Association opposes the plan). But he cautioned that a major concern would be whether hospitals and private insurers would be left on the hook for low-income seniors eligible for both Medicare and Medicaid, who could run up significant costs with little hope of ever paying them off.

“I think everyone is going to be looking at the viability of the funding,” he said.

The vouchers won’t be enough to cover currently projected costs of care for seniors – which is how the Ryan budget saves money. The vouchers certainly will not, then, cover profit and overhead for insurance companies. For all the knocks against it, Medicare is an amazingly efficient health care delivery device. About 98 percent of the money it spends goes to paying for health care with only 2 percent taken up by administrative costs. Private insurers, on the other hand, have overhead ranging from 12 percent to 30 percent.

The vouchers alone, in other words, won’t come close to paying for insurance policies for the oldest, sickest and least profitable insurance demographic that need the coverage. Seniors would have to pay enormous out-of-pocket expenses or pay large premiums in addition to the vouchers. Almost inevitably, seniors would need more care can they can afford – which could be why the American Hospital Association opposes the plan.

Ryan’s plan is radical and immoral; it is also impractical and unworkable. Insurance companies don’t want the senior market. When they “competed” with Medicare with the Medicare Advantage program, it cost taxpayers 14 percent more than the regular system.

This plan should be wholeheartedly rejected by the American people.

Southwest Virginia representatives will vote to end Medicare as we know it

All three congressional representatives from Southwest Virginia say they plan to vote for Rep. Paul Ryan’s ruinous, radical and immoral budget plan today. Are Virginians paying attention to what this budget would actually do? When voters turned out Reps. Rick Boucher and Tom Perriello in November, did they really want to replace them with good Republican soldiers who would vote with their leadership however reprehensible the idea?

And, let’s face it, shoving health care costs onto the elderly and the poor to pay for tax cuts for the rich is pretty reprehensible. That’s exactly what the Ryan plan would do. Medicare would no longer be a guarantee of health care for the elderly. Instead, older Americans would get vouchers to buy private insurance. Those vouchers wouldn’t even be enough to cover the projected cost of their care, much less cover the overhead and profits for private insurance companies – who, by the way, aren’t very likely to embrace the segment of the health care marketplace that is practically guaranteed to need lots of expensive health care. Medicaid would shift to block grants to states. States would have much more flexibility with their programs – which could lead to some savings, but most likely those savings would come from denying care to the children, indigent, long-term disabled and nursing home residents who now depend upon it.

In exchange, all of the Bush tax cuts – including those on the top 2 percent of earners – would continue. In addition, Ryan wants to drop the top tax rate to 25 percent – with unspecified reforms to the tax code aimed, he says, at making the drop revenue neutral. Does any rational political observer believe those reforms will go through, and stick?

This is what Bob Goodlatte, Robert Hurt and Morgan Griffith are so anxious to vote for.

“It’s nice to be able to move from talking about billions to cutting trillions,” Hurt said in The Times. “Those are the serious numbers my constituents want to see.”

One small problem: The Republican budget proposal actually leads to higher deficits than are currently projected (because it extends the Bush tax cuts).

Is this really what Virginians wanted when they went to the polls in November?

Obama and entitlements

There is more than a little trepidation on the liberal side of the blogosphere about President Obama’s speech tomorrow night presenting an alternative to Rep. Paul Ryan’s radical plan to eliminate Medicare as we know it and slash Medicaid. The legitimate concern is that Obama will present a reasonable and moderate alternative to Ryan’s immoral attack on seniors and the poor that will serve as a base for negotiations – with the final result being halfway between moderate reasonableness and batsh*t crazy.

Considering that the last time Obama “negotiated” with Republicans, Democrats ended up giving them more budget cuts than they initially demanded, the trepidation is warranted. The mistake Obama has consistently made in dealing with Republicans is his initial assumption that they, like he is, deal in good faith, propose reasonable policy prescriptions and are interested in a genuine debate about how to achieve a specific end.

The health care debate should have disabused him of that notion. Republicans played a delaying action while they used lies and distortions to build public opposition to the plan. Despite the fact that significant concessions were made to Republicans during lengthy negotiations – and that the overall plan itself was a market-based reform effort filled with ideas developed by conservatives, it soon became clear there Republicans never had any intention of even considering a bipartisan approach. Their entire political strategy depended on hanging Obama out to dry. But the lesson doesn’t appear to have sunk in.

Still, there’s some reason to hope that Obama will use his Wednesday speech to draw a line in the sand. (Geek alert: I am suddenly reminded of the speech by Capt. Jean Luc Picard in “Star Trek: First Contact“: “We’ve made too many compromises already; too many retreats. They invade our space and we fall back. They assimilate entire worlds and we fall back. Not again. The line must be drawn here! This far, no further! And I will make them pay for what they’ve done.” Now there’s an oratorical model for Obama to embrace tomorrow.)

After all, it cannot be overemphasized how extreme Ryan’s approach – now embraced by the Republican leadership – is. Obama should tell the nation that Republicans are planning to end Medicare as we know it and shred Medicaid’s safety net for children, the poor and elderly in nursing homes while slashing taxes for the wealthy. He should say this approach is un-American and unacceptable. He should make it clear that the alternative he offers is not

Whatever plan for Medicare and Medicaid Obama presents should be judged by the same standard expressed in a recent Roanoke Times editorial: “Any deficit-reduction plan that fails to find a way to contain health care costs is nothing but a rejection of the promise of health care security for older Americans.”

Summing up the Ryan budget proposal

Ezra Klein does a good job summing up the Republican budget plan put together by Rep. Paul Ryan of Wisconsin.

A few of the highlights:

The idea that conservatives believe the savings in Ryan’s plan are realistic while those in the Affordable Care Act aren’t boggles the mind. For one thing, Ryan includes the supposedly unrealistic savings from the Affordable Care Act; they can’t be realistic in Ryan’s budget but not realistic in the ACA. For another, the ACA’s savings are more modest, and the law has many, many more ways to attain them than simply saying “the government promises not to spend more than inflation, even if spending less means millions of seniors and disabled Americans will have no health care.” …

The budget is much more regressive than I thought it would be. In the first 10 years, it has $4 trillion in program cuts, and most of themare coming from programs that primarily serve low-income or otherwise vulnerable Americans.

The implication of the Congressional Budget Office’s analysis isn’t just that seniors would pay more for less under Ryan’s Medicare reform but that the gap between Ryan’s plan and traditional Medicare would grow over time. That suggests Ryan’s plan isn’t just shifting costs without cutting total costs but that it’s shifting costs while increasing total costs.

It’s worthwhile taking the time to read the rest yourself.

Ending Medicare as we know it

I can’t imagine this is going to be popular:

The plan would essentially end Medicare, which now pays most of the health-care bills for 48 million elderly and disabled Americans, as a program that directly pays those bills. … Mr. Ryan’s proposal would apply to those currently under the age of 55, and for those Americans would convert Medicare into a “premium support” system. Participants from that group would choose from an array of private insurance plans when they reach 65 and become eligible, and the government would pay about the first $15,000 in premiums. Those who are poorer or less healthy would receive bigger payments than others.

This is exactly what Rep. Paul Ryan, R-Wisc., has been threatening, er, promising, to do to Medicare since he released his “Roadmap for America’s Future,” last year. This is the budget plan that somehow earned Ryan a reputation as a fiscal policy wonk, even though it won’t actually balance the budget for decades, slashes Medicare and Social Security spending, raises taxes on most Americans while giving the wealthiest taxpayers enormous breaks.

Ryan’s plan does nothing – absolutely nothing – to control health care costs. It saves money by giving seniors less money to buy private insurance than Medicare would have spent on health care. This is a recipe for disaster. It would return us to a time when many seniors simply could not afford health care.

After all their complaints that the health care reform act cut Medicare spending, it’s somewhat surprising to see the Republican leadership embrace this radical and unpopular idea.

American citizens – who, by all indications, overwhelmingly oppose such drastic cuts to Medicare, had best start paying attention.

Out of his depth in Congress

Morgan Griffith stepped up to the big league when he knocked off Rep. Rick Boucher last November, winning the right to represent the people of Virginia’s 9th Congressional District.

So far, though, he’s showing an embarrassing lack of grasp of the issues he’s supposed to be dealing with – especially in the e-newsletters he sends out to his constituents. First, there was the one where he claimed the EPA instituted a new rule treating milk spills like oil spills – when, in fact, the truth was the exact opposite: The EPA had cleaned up an old rule so that milk spills were not longer treated like an environmental disaster. Despite the fact that PolitiFact Virginia called him out on the mistake, the newsletter remains, uncorrected, on his website nearly two months later.

In his new newsletter marking the one year anniversary of Obamacare’s passage, Griffith demonstrates a complete lack of understanding of the law and its implementation. In addition, he repeats a long-debunked claim that the law will raise the average premiums for families by $2,100 a year. In fact, the CBO found that most families would see lower premiums.

But peddling outright lies about Obamacare is practically a prerequisite for proving your Republican bona fides. That’s not so surprising. What is rather shocking how confused he gets about the law and its implementation. For instance, he says:

Originally, Democrats promised that if you liked your health care plan, you could keep it. One year later we know that you need a waiver to keep your plan. Already more than 1,000 employers, health plans, and unions have received waivers because the law would force them to drop coverage for employees.

That’s just stupidly and embarrassingly wrong. The waivers he is discussing only apply to limited-benefit plans in the run-up to full implementation of the law. They are temporary and only meant to ease the transition to when the law’s requirements are in full effect. As PolitiFact Virginia said, “About 2.6 million Americans are covered by limited-benefit plans. That’s a tiny percentage of the 160 million people who have employer-sponsored health coverage, and millions more who have other forms of coverage. Contrary to what Griffith said, very few Americans will need a waiver to keep their health-care plan.”

Just to top off this steaming pile of nonsense, Griffith ends with PolitiFact’s Lie of the Year for 2010, calling Obamacare, “a costly government takeover” of the health care system. In fact, there is no government takeover. Obamacare is a market-oriented solution that, for better or worse, keeps the private insurance industry fully involved in the health care system. Outside of Medicare and Medicaid’s coverage for the elderly and the poor, there is no public option for citizens. Outside of the VA system, there are no public hospitals or public doctors. Again, for better or worse.

If there’s one correct statement in Griffith’s March 25 newsletter, I couldn’t find it. Well, except for the first sentence: “This past Wednesday marked the one year anniversary of ObamaCare.” It went downhill after that.