
For decades, the Republican party has been the scourge of Medicare, hostile to it as a wasteful government program, and happy to see it, in the words of former House Speaker Newt Gingrich, "wither and die on the vine." Over the past several months, as Democrats propose paying for health care reform with savings wrung from waste in Medicare, Republicans have tried to position themselves as Medicare saviors. Sen. Tom Coburn (R-OK) took to the Senate floor recently to warn that health care reform will make seniors "die sooner."
Now, though, Democrats are pondering a Medicare expansion of sorts. They want to let people between the ages of 55 and 64 buy insurance through Medicare. And suddenly, Republicans are stuck in a booby-trapped rhetorical space, defending Medicare from all attackers--real and perceived--and also lashing out at the idea of letting more people benefit from it.
Today, Democrats will unveil the above poster board--taken from Senate Minority Leader Mitch McConnell's comm shop--on the Senate floor. That the two press releases were issued on consecutive days seems to heighten the contradiction.
To be fair, the full Republican argument isn't so transparently contradictory. How can you expand Medicare to millions more people, they ask, while pulling billions of dollars out of the system at the same time. (The answer is, if those billions are being wasted, and the new beneficiaries are paying into the system, there's no problem doing both).
But such are the perils of feigning support for a popular program, after railing against it for a generation.
Peter Principle
December 10, 2009 10:14 AM
How do you oppose Medicare for 40 years, then spend six months "defending" it from health care reform, only to turn around and oppose letting more people buy into it? Turns out to be very tricky.
Not really.
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Hussein Stemper
December 10, 2009 10:31 AM
About time! Let them twist in the wind, buffeted by their own contradictions.
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Captain Dan
December 10, 2009 6:55 PM in reply to Hussein Stemper
The Republican base is individually and collectively too stupid to recognize any contradictions.
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Indie Pro
December 10, 2009 10:39 AM
every chance to expose the GOP should be taken and championed!
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The Decider
December 10, 2009 10:48 AM
Let me explain this to you guys. Medicare was made by LBJ and he was a liberal so Medicare is bad. But, many old people use Medicare and many of them are Republicans so they are good. It is a quandry but one that will not continue. You see, the old people will die soon and so the problem will take care of itself. Next question?
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hoppycalif2
December 10, 2009 11:09 AM in reply to The Decider
Yes, we old folks will not be around forever, so the need for Medicare will soon vanish. Great comment! And, I'm amazed that it has taken so long for anyone to notice this.
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Viva!America!
December 10, 2009 12:38 PM in reply to The Decider
you are really funny!
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LFC
December 10, 2009 11:01 AM
The GOP's frothing defense of every last Medicare dollar being spent, whether it's wasted or not, is the party's final nail in the coffin of fiscal conservatism. There really isn't a thing that the GOP has done or championed that is fiscally conservative anymore.
And no, championing more tax cuts that get funded by borrowing is NOT fiscally conservative, especially when increasing spending at the same time (see the records of Reagan, Bush I, and Bush II as compared to Clinton).
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Forrest
December 10, 2009 1:19 PM in reply to LFC
We don't even need to look back at records. The House just voted to extend some tax cuts, and Democrats are proposing the cuts be paid for by increasing taxes on Investment Fund managers. House Republicans nearly unanimously voted against it. Rupublicans wanted to extend the cuts, but they wanted to increase the deficit to pay for them.
Nevermind that apparently Fund Managers have their income from the funds taxed at the Capital Gains rate, which is what you're supposed to make from investing your OWN money. They effectively get taxed at a lower rate, despite it being other peoples' money, and their performance of a service by managing it.
Of course Republicans argue that somehow because Fund Managers will be paying more in taxes, fewer investments will be made, and our economy will die. Huh? It's not even their money they're managing!
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ericf
December 10, 2009 1:41 PM in reply to Forrest
I thought about that too when I read that story this morning. I'm sure Republicans will say tax cuts should never be paid for with tax increases. Nonetheless, Democrats voted for a tax cut and Republicans against it, and they're the ones who will have to explain why the simple statement is wrong. Isn't that a switch.
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Hussein Stemper
December 10, 2009 11:06 AM
Please, pretty please Dems and MSM, ask any GOPer in front of a mike who claims to be a deficit hawk: Why did you vote for Bush's Medicare expansion without a way to pay for it?
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CityGuy
December 10, 2009 11:27 AM in reply to Hussein Stemper
Yes indeed!
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Viva!America!
December 10, 2009 12:39 PM in reply to Hussein Stemper
No, ask TPM to do it.
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LindaR
December 10, 2009 11:29 AM
Programs are perfectly fine if the money is going into the pockets of corporations.
Programs are wasteful if the money is going to add value to regular people's lives.
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hollywood
December 10, 2009 2:23 PM in reply to LindaR
Right you are! Republicans love to borrow money if they can give it to rich fucks and corporations. They love to borrow money and piss it away on Iraq. War and tax breaks for billionaires are to precious to be denied. Actual human beings living or dying is not so much their concern.
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david1225
December 10, 2009 11:36 AM
No one can dispute that Medicare is a disaster. Not only is it rife with fraud (between Medicare and Medicaid, estimated to be high eight-digits' worth a year), it pays health care providers below-cost for services. The fact that anyone supports it in its current form, or would think for even a second about expanding it, seem like pure insanity. The only reason that Medicare even "works" at all today, is that private insurance companies are effectively forced to pay higher health care prices to make up for Medicare (and Medicaid) underpayments.
None of our elected officials are deficit hawks, or even marginally financially responsible, if they support expanding Medicare -- or adding to it.
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LFC
December 10, 2009 11:44 AM in reply to david1225
You're missing a major component, David, and that's timely payments. I have been fighting with UHC to pay bills they are responsible for, including some from March. How would you like to be a healthcare provider and have your bills paid net 270+ days? Yeah, that's just GREAT for your cash flow. We have had zero problems with Medicare.
The practice that our primary care doctor was in was driven out of business by a single insurance company who refused to pay. They disputed all of the business's records with a simple letter, and produced no evidence to the contrary at all. A small business with $1.8 million that is 180 days past due can't function, and they didn't. That's private health insurance. It was more profitable to not pay and hope that either the bill would go away, or at least payment would be delayed by court proceedings. It was a business decision. I don't know about you, but I don't want profit motivated business decisions getting between me and my doctor.
Finally, private practices and individual physicians can choose not to accept Medicare. Why don't they just refuse? Because it's a lot of money to leave on the table, and it's generally paid on time. There's a lot of value there.
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Steaming Pile
December 10, 2009 12:40 PM in reply to LFC
Pity you weren't asked to testify in Washington.
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benjoya
December 10, 2009 12:21 PM in reply to david1225
yes, the republicans should start honestly talking about eliminating medicare and stop the unfair treatment towards the insurance industry. run with that, please.
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midnight rambler
December 10, 2009 12:41 PM in reply to david1225
And just what is "cost" for health care services? No one knows, because everyone pays a different price for the same procedure. That's why our system is so messed up.
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rbe1
December 10, 2009 1:02 PM in reply to david1225
Tell you what. Let's get the wars and Dubya's tax cuts canceled and then maybe I'll listen to your argument.
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Larry Geater
December 10, 2009 6:00 PM in reply to david1225
As an office manager in a family medicine practice that accepts Medicare, I must differ with your assesment. It is not accurate to say that Medicare pays less than most private payeers.
Private insurances pay more. They base their rates on Medicare allowable. When they send us documentation to let us know what they pay they will say that they pay 110% or 115% of Medicare allowable.
But this does not mean that we would loose money if all payers paid Medicare allowable starting tomarrow. Large private insurers pay more for the procedures that they pay on but they deny claims at a higher rate than Medicare. Two of the largest insurers have lost lawsuits for denying clams on the first pass without cause to force us to re-file claims; allowing them to keep the money longer or to not pay at all if we fail to apeal properly.
This re-filing costs us. It takes labor and know-how to pry the money we are owed from the insurers. Those who simply look at the allowable from various insurers to determine which of them is best for doctors, simply do not understand the costs of filing claims. This is why healthcare reform gets majority support from doctors. They know that the rules as they are set up now favor insurers over doctors, hospitals, and patients.
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LBJs Brain
December 10, 2009 12:20 PM
Well, I guess all the GOP Congresscritters and Senators (double digits in both Houses, no less) who voted *for* Medicare in 1965 (thank you, LBJ) have disappeared down the GOP Memory Hole. That place is getting crowded.
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masanf
December 10, 2009 1:04 PM
Voting against a buy in for Medicare because said buy in would jeopardize the solvency of Medicare is not a flip-flop from their more recent position of opposing Medicare cuts. ANd if the Republicans are flip-flopping, then the Democrats, in there drive to cut nearly half a trillion dollars from Medicare are doing the same thing. Unless of course you believe the absolutely freakin hilarious talking point that they are merely cutting "waste".
Multiple institutions, including the well-respected Mayo Clinic, have indicated the Medicare Buy-in would be an absolute disaster that would drive up costs and would cause hospitals to go bankrupt. Naturally that will be ignored here. Someome will somehow try and portray them as tools of the insurance industry.
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jollyroger
December 10, 2009 1:24 PM in reply to masanf
drive up costs and would cause hospitals to go bankrupt.
cite? I ask because the statement is counterintuitive--"higher costs" in a lower overhead system means more money to providers.
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Kuyleh
December 10, 2009 11:31 PM in reply to masanf
Did you get that Mayo claim from Fox? 'Cause they are the only people that claim that Mayo said they don't support it, and it's been proven several times that Fox grossly twisted what they said...
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masanf
December 10, 2009 1:06 PM
Again there is no quandry here. Cuts will hasten insolvency. Expanding Medicare through a buy in will hasten insolvency. See how that works? Wow, that was hard.
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fsudirectory
December 10, 2009 1:16 PM in reply to masanf
1) Buying into the system (thus providing it with money to run like any insurance plan)
2) Forcing insurance companies to use 85% of the money on patient care will then allow medicare to cover more people as more money must be used to provide patient care.
Not sure what wire in your brain isn't soldered correctly to make these connections
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matzerath
December 10, 2009 1:24 PM
They were for it before they were against it before they were for it before they were against it!
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BillSoo
December 10, 2009 1:55 PM
As a Canadian, I'm not that familiar with your Medicare but it seems similar to our single payer system. In both cases, the system works and works well. In both cases, the defects tend to spring from insufficient funding.
The alternative, the private insurance system, has more fundamental problems. Rescission, lifetime limits, "previously existing conditions" etc. These are all direct results of the private companies profit motive. You cannot fix that with more money because it will only encourage similar or worse behaviour.
So in my opinion, expanding medicare (and medicaid) is best because at least the problems in those systems can be fixed.
BTW. I have to assume that at least part of the problem with medicare/medicaid is that they are limited to that part of the population with the most ailments. Expanding the user pool with healthy users should help their financial position.
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hollywood
December 10, 2009 2:36 PM in reply to BillSoo
Thanks Canadian! What you understand is what most Americans cannot get through their thick skulls even though it costs thousands and thousands of them their very lives every year. The debate in this country is shameful because so much misinformation is thrown out to confuse the truth about where the money goes. The truth is that insurance corporations provide absolutely no benefit whatsoever to anyone's health. They are a middle man skimming billions and billions of dollars out of the system and they protect this extortion racket with huge payments to politicians to keep the crooked system in place. America is a fascist country run by corporations to the benefit of wealthy investors. Even the most basic human decency of taking care of the sick and dying is seen as an opportunity to entrap innocent victims and bankrupt them and/or just milk them until they die. That does not happen in Canada. I wish Americans would wise up for once.
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slb
December 10, 2009 2:49 PM in reply to BillSoo
If they seem similar, that is not surprising: our Medicare system was modeled on the Canadian single-payer system, and if I'm not mistaken, that was even the source of the name.
And I agree, putting younger and healthier users in the system should also make for healthier finances for the system as a whole.
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