Tag: medicare

Collins Demagogues Social Security

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This letter to the Buffalo News bears special attention. Thanks to Bruce Kennedy of Orchard Park for taking the time to write it. It highlights the rhetorical nonsense and outright lies that Chris Collins utters without apology, accountability, or irony. 

If I am looking for misinformation or half-truths, there are radio personalities and television networks I can tune into. I expect more from my elected congressman.

Rep. Chris Collins, on a radio program recently, was making the case that we have to cut Social Security benefits in order to lower the federal deficit. This is a talking point that is repeated over and over again as a political scare tactic. The only problem is that it is untrue.

Pause here to remember that all politicians love usually to pander uncontrollably and shamelessly to seniors. During the two Hochul races against Corwin and later against Collins, the Republicans had their support for the Paul Ryan budget hung around their necks to shame them, like the kids whose parents make them stand on the corner with a cardboard sign reading, “I lied”. The issue at the time was Medicare, the wildly popular and efficient single-payer plan for senior citizens.

The Republicans were pushing a plan whereby people under the age of, say, 55, would receive fewer and weaker Medicare benefits when they reach the appropriate age, while current seniors’ plans would be unchanged. This two-tier proposal was especially egregious when you remember that Medicare isn’t some government handout, but a plan that you pay into your entire working life. You’re not some welfare bum, but a customer, in “run things like a business” parlance. 

The Social Security Program is totally financed by a designated tax (FICA). The program does not add a penny to the federal debt and it never has. Social Security in fact is prohibited by law from spending any more money than it has in its trust fund.

Also, it is a social insurance program, not an entitlement, as he referred to it. I assume Collins has subscribed to the theory that if you shade the truth about an issue enough times, people begin to think it has to be the truth. It is a representative’s job to inform the public, not to misinform. When you misinform on important issues, it is a disservice to your constituents.

Collins, of course, is a hyper-partisan borderline tea party public sector millionaire, as he called it. Collins is the least bipartisan rep from New York. He is the 2nd least productive rep from New York. He was for the disastrous shutdown before he was against it. He’s here denigrating Social Security as just another welfare handout that the government just can’t afford anymore, and that he and his nihilist Republican colleagues need desperately to “reform” through abolition and privatization. 

Problem is, there’s no one to credibly run against this congressional trainwreck. However, the new district boundaries help to expand the list of potential candidates. Collins will be largely self-funded, and supported by corporate interests and big right-wing PACs. His opponent would need name recognition, an ability to self-fund, a positive public image, and an way to challenge the myriad Collins lies and anti-regular-person positions and policies.

Know anyone? Tick tock.

Medicare for All

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nhs_0_108664While our most dysfunctional Congress continues to debate whether we should repeal Obamacare or not, every single other industrialized nation in the contemporary, modern world goes about its merry way having long ago settled the question, “should all our citizens have access to quality health care on demand, regardless of ability to pay?” The American inability or unwillingness to answer that question in the affirmative with some semblance of unanimity is a failure. 

Obamacare is by no means perfect – neither ideal nor, perhaps, even wanted. But it is the great liberal compromise, adopting a conservative way to health insurance reform as its own. Indeed, it seems to be the only way Democrats seem to win lately on national issues – adopt the conservative thinking, and wait for the conservatives to pounce with furious indignation disguised as opposition. 

The very poor and children receive health insurance through Medicaid. The old receive health insurance through the wildly efficient and popular Medicare program. The rest of us, the ones in the middle, are seeing coverage dwindle and cost go up, and we’re told by smugRepublicans that it’s Obamacare’s fault despite it being a year away from full implementation. 

CNN looked at the perpetual American political crisis over healthcare and one conclusion is that we manage disease instead of preventing it. But suggest that people should eat healthier, and you’ll be denigrated as the soda police, as New York Mayor Bloomberg has. 

The issues are cost and access. Medicare is extremely efficient and popular. It is a single-payer health insurance scheme that one pays into throughout their work life and is an “entitlement” insofar as you’ve paid for it, like Social Security. Expansion of Medicare to all Americans is the easiest, most rational way to ensure universal coverage for not only managing disease, but also preventing it. Canadians have liberty, too – liberty from medical bills for routine health care, and the myths that Canadians die while queueing up for services are just that – myths. Canada’s systemis not perfect, either, but it is more perfect than what we have. The British system would be less of a political headache, because it allows for private physician and clinic alternatives – something Canada forbids. 

So, given that every industrialized pluralist democracy in the world offers its citizens some form of universal health care access – as many different models as there are nation-states – why is it that we as Americans move in baby-steps into some sort of conservative plan involving health insurers and mandates? Why not just expand Medicare to all persons of every age, and make health insurance become something truly private and competitive, where you can buy enhanced coverage of some sort on an open market? In other words, if you need cancer treatments that would otherwise cost millions of dollars, you’ll never see a bill. If you want your hospital room to have a spa in it, you can pay extra for that. 

Our revolution was fought to replace a colonial feudalism with bourgeois meritocracy. Expanding health care to all Americans, including the middle class, is something we’ve discussed as a country since the end of World War II. People still, however, go bankrupt from medical bills in what is billed as the greatest superpower in Christendom. It is that – not the notion of “socialized medicine” – which is the disgrace. 

 

Tea Party Friend, A Question About Medicare

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I’d like a Constitutionalist tea party type to explain to me exactly how the Romney/Ryan plan to voucherize Medicare for people not already receiving Medicare jibes with the 14th Amendment to the Constitution. 

Section 1. All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

Then, I’d like an explanation about this very simple question: 

If Romney/Ryan’s plan for privatizing Medicare is so fantastic, why not make it applicable to current recipients? 

Snatching Defeat From the Jaws of Victory

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I’m sort of sick of talking about Mitt Romney because, you know, Buffalo. But the Presidential campaign has become that car wreck you rubberneck on the 33. The three swing states Mitt has to win to have a chance of winning this thing are Ohio, Virginia and Florida, right? Well, a WaPo poll has Mitt trailing Obama -8 in Virginia.  Not only that, but Mitt’s entire campaign has boiled down to – hey, disillusioned Obama ’08 voters, not so excited anymore? Vote for Mitt!  That WaPo poll in Virginia reveals that 61% of likely Obama voters are “very enthusiastic” about the incumbent; only 45% of Romney voters are “very enthusiastic” .  It gets better, because the conservative commentariat’s hand-wringing has become so vigorous and anxious that they are warning that Romney isn’t just losing  a sure thing, but he’s taking the entire conservative movement down with him.  And his campaign is currently $11 million in debt. 

[youtube http://www.youtube.com/watch?v=OUQ-j2sOA7c]

Yesterday, the Pennsylvania Supreme Court remanded a case involving that state’s proposed voter ID/disenfranchisement law. A lower court had upheld the statute, but the state’s highest court demanded that the lower court 

… block the law unless Pennsylvania can prove it is currently providing “liberal access” to photo identification cards and that there “will be no voter disenfranchisement” on Election Day. The two dissenters opposed the voter ID law and wanted the Supreme Court to issue an injunction itself.

The ruling said there was a “disconnect” between what the law prescribes and how it was actually being implemented. It said an “ambitious effort” to implement identification procedures in a short timeframe “has by no means been seamless in light of the serious operational constraints faced by the executive branch.”

Voter ID is an answer to a question no one asked – actual cases of voter fraud are almost non-existent, and the actual effect of these statutes is to disenfranchise the poor and elderly – the 47% about whom Mr. Romney so famously spoke at a $50,000/plate fundraiser in Boca Raton in May. 

Incidentally, click here (part 1) and here (part 2) if you’d like to see the complete, uncensored Romney remarks – where he promises to take advantage of things like the storming of the Benghazi consulate, and that the Israeli/Palestinian conflict is so intractable that, why bother? Just kick the can down the road. (That’s “leadership”, folks.) 

Romney went on Fox News yesterday and accused Obama of having a hidden video problem, trotting out a video of then-State Senator Obama in 1998 explaining that he likes the fact that America’s taxation policies are redistributive. McCain did it in 2008, and it went nowhere. Taxes are by their very nature redistributive – they take money through taxes to pay for other things, sometimes social welfare safety net programs. Society has deemed it more desirable to, e.g., provide food stamps rather than revert to a Dickensian nightmare of poor kids stealing pocketwatches for Mr. Fagin. 

No one knows why Romney wants to run against 1998 Obama instead of 2012 Obama, except that it allows him to paint Obama as a socialist. Because even though Obama’s policies are fundamentally centrist and comport with mainstream Democratic policy, because of his name and race, it’s quite easy to paint him as a foreign “other”. Honestly? It’s racist, and we shouldn’t pussyfoot around that fact. 

But if Mitt Romney really wants to compare and contrast videos 1990s videos with Barack Obama, then that’d be fun. 

[youtube http://www.youtube.com/watch?v=UeQGObiGGqY]

Finally, part of the problem in the 27th Congressional District race is that Chris Collins is trying to hop on the Romney bandwagon, unaware of just how much he resembles the out-of-touch, unlikeable Presidential candidate. He has repeatedly stated that he supported the Ryan budget that would have turned Medicare into a complicated voucher program, costing seniors more, and that the Ryan budget in fact, “didn’t go far enough”. So, it must come as a worry to seniors because Collins says his first order of business would be to repeal Obamacare. But Obamacare is in the process of eliminating the Medicare “donut hole”. which saddles many seniors with huge bills for medication. 

Seniors whose annual drug costs surpassed $2,830 found themselves paying the rest of their bills in total until they hit an out-of-pocket limit of $4,550. At that point “catastrophic coverage” kicks in, and the government pays 95 percent of the costs.

Someday, we’ll reset the public debate over health insurance and come to the realization that expansion of Medicare to all Americans, with an efficient single-payer program so that people don’t ever see a bill for anything ever, so that their Medicare is paid for through payroll taxes (and is therefore not something for nothing),  and that the very rich retain their opportunity to seek cancer treatments in Switzerland (a country with a universal insurance mandate) complete with LearJet transportation. Someday we’ll reset the debate to question why we agonize over coverage gaps, why our employers spend so much money and effort choosing between crappy insurance plans that cost a fortune. Someday we’ll reset the debate to compare the actual cost of what we pay for costly, inefficient, bureaucrat-heavy private insurance versus the actual cost of what we’d all pay to expand Medicare to everybody. 
 
You know, the debate we’ve been having essentially since the end of World War II, and which every other industrialized, free market capitalist, pluralist nation-state has figured out generations ago. 

 

Collins and Medicare: Bad Deal for Seniors, Americans

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Remember how George W. Bush pushed to privatize Social Security? It failed, because people like Social Security, and because they didn’t want their entire retirement to be subject to the whims of the market. The 2008 quickie depression and the failure of Lehman Brothers was a stark reminder that, sometimes private industry doesn’t have all the answers. 

Paul Ryan’s proposed budget famously proposed to cut $716 billion from Medicare and turn it into a voucher system for Americans not yet benefitting from the wildly popular single-payer program for seniors. 

When Chris Collins hammers Kathy Hochul for voting for Obamacare, which “takes” $716 billion from Medicare and subsidies for Medicare supplemental insurance, remember that he supported a plan that would have done something even worse; that would have fundamentally changed what Medicare is for future generations. 

Hochul’s race against Corwin was about Medicare and how the Ryan budget would change it. Hochul won – and the $716 billion was part of that race. Now, Collins thinks he can fool voters into thinking that Obama and Hochul have weakened Medicare – but nothing could be further from the truth. 

That $716 billion from Medicare

The Affordable Care Act did indeed cut Medicare spending by $716 billion. 

On July 24, the Congressional Budget Office sent a letter to House Speaker John Boehner, detailing the budget impact of repealing the Affordable Care Act. If Congress overturned the law, “spending for Medicare would increase by an estimated $716 billion over that 2013–2022 period.”

As to how the Affordable Care Act actually gets to $716 billion in Medicare savings, that’s a bit more complicated. John McDonough did the best job explaining it in his 2011 book, “Inside National Health Reform.” There, he looked at all the various Medicare cuts Democrats made to pay for the Affordable Care Act.

The majority of the cuts, as you can see in this chart below, come from reductions in how much Medicare reimburses hospitals and private health insurance companies.

But what is the effect of these cuts to seniors and their benefits? Zero. Not a single benefit is cut or reduced in any way. There are no vouchers, no privatization – the $716 billion comes from reducing the cost of the program, not reducing its benefits. Quite the contrary – Obamacare takes that savings and actually adds benefits to Medicare, bringing a new emphasis on preventive care by adding a new annual no-copay wellness visit to the program. From the WaPo’s fact check of last week’s Clinton speech: 

TRUE: “What the president did was to save money by taking the recommendations of a commission of professionals to cut unwarranted subsidies to providers and insurance companies that were not making people healthier and were not necessary to get the providers to provide the service.”

Clinton appears to be referring to the Medicare Payment Advisory Commission, an independent body that advises Congress on the program and the changes they have recommended for the program. MedPAC has, for example, repeatedly recommended that private Medicare Advantage plans should not be paid more than the traditional fee for service program. That, among other changes, was incorporated into the Affordable Care Act’s changes.

DOUBLE COUNTED: “Instead of raiding Medicare, he used the savings to close the doughnut hole in the Medicare drug program…and to add eight years to the life of the Medicare trust fund so it is solvent till 2024.”

Both of these facts are, independently, true. The health care law did indeed use some of the revenue it generated to pay for seniors who land in the “donut hole,” the gap after normal drug coverage ends and catastrophic coverage kicks in. And it did extend the solvency of the Medicare trust fund by eight more years, until 2024, per a report earlier this year.

But this represents some of the least-liked math in Washington, because it uses a sort of “double counting” of Medicare savings. The Medicare Trust Fund counts the health law’s $716 billion in savings as going back into its coffers. The Congressional Budget Office counts them as paying for provisions in the Affordable Care Act, like closing the donut hole. In reality, it would be very, very hard for a Medicare dollar saved to achieve both these purposes. In fact, it would be impossible.

This accounting isn’t unique to the Affordable Care Act. Budget wonks have regularly used this double counting for Medicare savings generated by Congress. There are some defenders of this accounting method. But it is one of the points that the Affordable Care Act’s Medicare savings regularly gets attacked.

TRUE: “I didn’t know whether to laugh or cry because that $716 billion is exactly, to the dollar, the same amount of Medicare savings that [Ryan] has in his own budget.”

Rep. Paul Ryan’s most recent budget does indeed include the Affordable Care Act’s $716 billion in Medicare savings. Mitt Romney has, however, disavowed those cuts and promised to restore insurers’ and hospitals’ reimbursement rates as part of his plan to repeal the Affordable Care Act.

The question, then, is – why do Romney and Chris Collins want to roll back Obamacare’s strengthening of Medicare? Is it because they’re both independently wealthy and what happens to Medicare has no affect on them in any palpable way? Medicare isn’t just some freebie entitlement – like Social Security, it’s something you and I pay into throughout our working lives (check your FICA on your next paystub). Romney and Chris Collins want to fundamentally change Medicare into a voucher program, but that’s not the promise that was made to me and others who have been paying into the system. In contract law, we pay in relying on the promise of a future no-hassles program  that current seniors enjoy. It’s fundamentally unfair to make it one program for one class of people, and something else for another – frankly, I think it’s violative of the 14th Amendment’s Equal Protection Clause. 

Why do Romney and Chris Collins want to violate the Equal Protection Clause by voucherizing Medicare for one class of Americans, while maintaining it as a single-payer plan for another? 

Oh, and in commenting on the proposed voucherization via $716 billion in cuts from Medicare, Chris Collins told the Batavia Daily News that this doesn’t “go far enough”. 

Collins said he favors the Tea Party push to reduce the federal government. He praised Rep. Paul Ryan, R-Wisconsin, for ‘starting the conversation’ about reducing entitlement programs. But Collins said Ryan doesn’t go far enough. Ryan believes the budget could be balanced in 30 years, Collins said it needs to be done in 10 years. To delay it longer isn’t fair to young Americans who will have to foot the bill.

To Chris Collins, everything is an entitlement program – even programs you pay for. And he has the nerve to blame Hochul for harming Medicare through a cost-savings that actually expands its benefits. 

Even Kathy Hochul is trying to hedge on Medicare Advantage, saying she doesn’t like the cuts to that program. But why? Reductions in Medicare reimbursement rates to Medicare Advantage plans and hospitals were negotiated with those entities. Hospitals know that with universal coverage, they’ll get more patients whose bills are paid. The Advantage Plans’ reimbursement rates are reduced to eliminate waste that does nothing to enhance patient care. In reference to the chart shown above, 

The blue section represents reductions in how much Medicare reimburses private, Medicare Advantage plans. That program allows seniors to join a private health insurance, with the federal government footing the bill. The whole idea of Medicare Advantage was to drive down the cost of health insurance for the elderly as private insurance companies competing for seniors’ business.

That’s not what happened. By 2010, the average Medicare Advantage per-patient cost was 117 percent of regular fee-for-service. The Affordable Care Act gives those private plans a haircut and tethers reimbursement levels to the quality of care administered, and patient satisfaction.

The Medicare Advantage cut gets the most attention, but it only accounts for about a third of the Affordable Care Act’s spending reduction. Another big chunk comes from the hospitals. The health law changed how Medicare calculates what they get reimbursed for various services, slightly lowering their rates over time. Hospitals agreed to these cuts because they knew, at the same time, they would likely see an influx of paying patients with the Affordable Care Act’s insurance expansion.

The rest of the Affordable Care Act’s Medicare cuts are a lot smaller. Reductions to Medicare’s Disproportionate Share Payments — extra funds doled out the hospitals that see more uninsured patients — account for 5 percent in savings. Lower payments to home health providers make up another 8.8 percent. About a dozen cuts of this magnitude make up the green section above.

It’s worth noting that there’s one area these cuts don’t touch: Medicare benefits. The Affordable Care Act rolls back payment rates for hospitals and insurers. It does not, however, change the basket of benefits that patients have access to. And, as Ezra pointed out earlier today, the Ryan budget would keep these cuts in place.

By the way – if Chris Collins gets his wish and repeals Obamacare, Medicare Part A will be insolvent by 2016 unless something else is done. As we know, that “something else” is turning it into a complicated voucher program, fundamentally changing the very nature of Medicare. 

When officials talk of Medicare insolvency, they’re talking specifically about the trust fund for Medicare’s hospital insurance, or Medicare Part A, which covers inpatient hospital stays, care at a nursing facility, hospice care and some home health care. The other parts of Medicare, though costs are rising, are “adequately financed” for now, the program’s trustees say.

The Part A fund’s overseers — the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds — said back in 2009, before the Affordable Care Act passed, that the banked money used to make up the difference between income (such as taxes) and expenses for Part A would be depleted in 2017.

But then the Affordable Care Act passed. The trustees reported that the act’s lower expenditures (cutting rates to providers) and increased revenues (a payroll tax hike for wealthier people in 2013) “improves the financial outlook for Medicare substantially.”

The trustees reported in 2010 that health care reform would delay the Part A trust fund’s insolvency until 2029. By 2011, the trustees moved that insolvency estimate back to 2024.

So, to sum up: 

Chris Collins supported the Ryan budget, which also assumed a $716 billion reduction in Medicare expenses. When he attacks Kathy Hochul for this, it flies right back in his face, because he says $716 billion doesn’t go far enough, and would like to voucherize Medicare and reduce other “entitlement” programs. Hochul needs to go on the offensive on this point – the Obama/Hochul cuts expand Medicare benefits and ensure the program’s continued solvency, while Collins’ cuts turn Medicare into something resembling the awful system we have today for most Americans, and threatens the solvency of Part A going past 2016.

Chris Collins, therefore, is a disaster for seniors in NY-27.  

Hochul vs. Corwin 2.0

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The only thing missing so far is a kid dressed like Fonzie shoving a camera in an old man’s face. 

Issue: Medicare, Paul Ryan, and what noted Marxist philosopher Newt Gingrich called “right-wing social engineering”. 

The Buffalo News’ Jerry Zremski wrote Monday about how Chris Collins refuses to comment on the Ryan Budget, which would fundamentally transform Medicare from the popular single-payer system seniors enjoy – and future seniors pay into throughout their work history – into an expensive voucher-based privatized program.  

Of course he’s keeping mum. This issue did tremendous harm to his neighbor, Jane Corwin’s, campaign in 2011. 

At the heart of the Republicans’ Medicare Privatization Syndrome Because is to replace a reasonably efficient government bureaucracy with a 97% approval rating from users, and replace it with the fragmented, fundamentally broken, redundant, private (oft for-profit) bureaucracy to take money from the patients through premiums, and nickel-and-dime the physicians on payouts, and futz with what is and isn’t covered. Ungrateful looters & moochers. 

Mitt Romney has now selected the architect of that unfair and likely unconstitutional Medicare voucherization plan to be his running mate, and the fallout is spilling over into the hotly contested NY-27 race. 

Incumbent Democrat Kathy Hochul released this Monday morning: 

“Try as he might, Chris Collins cannot run from the fact that he said a budget that ends Medicare as we know it and forces seniors to pay more for their healthcare to fund tax cuts for his millionaire friends ‘doesn’t go far enough,’” said campaign manager Frank Thomas. “Voters deserve to know how much further Chris Collins would go when he already supports decimating Medicare so he can give tax breaks to the rich. How can voters be expected to trust a candidate who will not be candid about his position on an issue that will crush seniors and the middle class.”

Collins told the Batavia Daily News that the Ryan Budget “doesn’t go far enough.” According to the Batavia Daily News, “Collins said he favors the Tea Party push to reduce the federal government. He praised Rep. Paul Ryan, R-Wisconsin, for ‘starting the conversation’ about reducing entitlement programs. But Collins said Ryan doesn’t go far enough. Ryan believes the budget could be balanced in 30 years, Collins said it needs to be done in 10 years. To delay it longer isn’t fair to young Americans who will have to foot the bill.” [Batavia Daily News, 5/9/12]

Collins said his stance on the Ryan Budget is similar to Jane Corwin’s. In March 2012, Collins has admitted that his position does not differ significantly from Jane Corwin’s position. Corwin supported the Ryan Budget, which “would essentially end Medicare.”  [Buffalo News,3/25/12; Wall Street Journal, 4/4/11]

But now Collins refuses to even answer questions on the Ryan budget.  According to the Buffalo News,

Asked in a weekend telephone interview for his reaction to Ryan’s selection, Collins, the former Erie County executive, would not – even when asked again and again – endorse or even comment on Ryan’s budget, which would partly remake Medicare into a voucher program for future seniors while drastically cutting most domestic spending. [Buffalo News, 8/13/2012]

Republican Chris Collins released this, in response: 

“What we are seeing is a desperate public sector millionaire employ every scare tactic under the sun to distract from the issue that matters most to voters – fixing this economy. Of course, with her record of massive tax increases and job killing regulations, it’s no wonder Kathy Hochul wants to talk about anything other than her failed plan to fix the economy. 

With her whole-hearted embrace of ObamaCare, Kathy Hochul has jeopardized the future of Medicare for current seniors. More incredibly, she turned her backs on the seniors she promised to protect when she voted to cut their Medicare and Medicare Advantage by $700 billion. 

The only way we will solve our budget problems is by adopting pro-growth, pro-small business policies that cut our debt, protect Medicare from going bankrupt, and let small businesses thrive. Kathy Hochul’s plan is to cling to ObamaCare, gut $700 billion from Medicare and watch our economy go down the drain. That’s not a leader – that’s a politician. Our region simply deserves better.”

A few quick observations: 1. Hochul’s release is more effective because it takes Collins’ own words and uses them against him. 2. Anyone else find it odd that Collins, of all people, is using “millionaire” as a pejorative against Kathy Hochul? I thought that was “class warfare” or something. 3. Collins’ statement is so much unsupported pablum about tax & spend liberals. 4. Collins is particularly vulnerable when it comes to being consistent and transparent. Whereas he merely spouts off talking points recycled from his last re-election campaign, Hochul provided hyperlinks to the things Collins has said in the past, and merely hoists him by the petard he so carefully constructed. 

From Zremski’s piece, Collins says, 

All I’m saying is that I’ll never support cuts to Medicare for current seniors or anyone close to retirement age, including Medicare Advantage, which my opponent has actually voted to cut.

But if you’re not “close to retirement age”, yet you’ve been paying into Medicare through your FICA for years and years, relying on the promise of hassle-free Medicare coverage when you retire, you can go pound salt. 

Now – about that $700 billion claim. Collins has been using that for weeks – you should follow his aide Michael Kracker on Twitter, and watch him do battle with Hochul’s campaign manager, Frank Thomas. This claim comes up a lot. 

The claim is that Obamacare rips $700 billion out of Medicare – that it’s a cut, that it steals from Medicare to fund Obamacare, etc. The claim is clumsy, palpably and provably false, and worse – assumes you’re stupid and will accept it as truth. 

Does Obamacare cut $700 billion from Medicare? No. Obamacare saves $700 billion in waste while enhancing and improving seniors’ access to healthcare.  This savings extends Medicare’s solvency by a full eight years. 

A Redditor independently examined the claim and reached the same conclusion – that Chris Collins and other Republicans are criticizing Democrats for saving $700 billion from a socialistic, redistributive, government-run single-payer health care system. 

CBO breaks out the $716 billion that Reibus refers to:

  • Medicare Part A (Hospital Insurance) = $517 billion
  • Medicare Part B (Medical Insurance) = $247 billion
  • * Medicare Part D (offset) = ($48 billion)
 = $716 billion

To make a little more sense of this, I also referred to CBO’s Analysis of the Major Health Care Legislation Enacted in March 2010 – start at page 24 which basically bulleted the reasons, as follows:

  • Changes to Payment Rates in Medicare: “Permanent reductions in the annual updates to Medicare’s payment rates for most services in the fee-for-service sector (other than physicians’ services) and the new mechanism for setting payment rates in the Medicare Advantage Program will reduce Medicare outlays by $507 billion during the 2012-2021 period” I found this very confusing, so I referred to Politifact which states: “The biggest portion of that savings…will come from reducing annual increases in payments to medical providers….The healthcare law does not cut $500 billion from Medicare. It just reduces future growth.” So in essence, it aims to curtail Medicare spending, not outlays to recipients. Ironic how the GOP is attacking Obama for an initiative to save money.

  • Disproportionate Share Hospitals: CBO states that “Both Medicare and Medicaid provide additional payments to hospitals that serve a disproportionate number of low income patients. PPACA…modified the formulas use to calculate such payments under Medicare. Projected to reduce direct spending by $57 billion over the 2012-2021 period.” The Urban Institute explains that ” the loss of federal disproportionate share hospital payments and potentially high uncompensated care costs borne by state and local governments on behalf of the uninsured will also motivate states to expand Medicaid under the ACA. On balance, states would experience net budget gains from implementing the Medicaid expansion.” So they are basically phasing out a federal program (disproportionate share hospitals) to expand another (Medicaid) and States would have a net budget gain!

  • Thus far we have accounted for $650 billion of the $716 billion and NONE of these “steal money from Medicare.” They simply attempt to save money, reprogram funding.

As for the remaining $65 billion, CBO says “many of those provisions will reduce spending, whereas others will increase it. The provisions that will reduce spending make a variety of changes to prior law, including establishing a mechanism to reduce the growth rate of Medicare spending if projected growth exceeds a given target, initiating a number of programs intended to modify the health care delivery system, and adjusting payments for prescription drugs in Medicaid….PPACA and the Reconciliation Act include numerous provisions intended to identify opportunities and create incentives for providers to make changes to the health care delivery system that will reduce costs and improve the quality of care.”

So, there you have it. Chris Collins and the Republicans are lying to you about Obamacare, about how it affects Medicare, and about myriad other things. Collins isn’t talking about the Ryan budget and how it effects Medicare because he saw what it did to Jane Corwin. Instead, he’s trying to pivot the debate (by the way, has he agreed to any debates? Will he be releasing any tax information at all?) to lies about how Obamacare is stealing money from Medicare. Are we going to re-litigate the Corwin vs. Hochul debacle of  May 2011? Looks like it, and even with a re-worked district geography and demographic, it’s still got a lot of seniors who don’t appreciate being lied to, and don’t like that Collins supports the partial privatization, decimation, and increased user cost the right wing is proposing for Medicare. 

Chris Collins: Repeal Consumer Protections

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This morning, on my way to work, I caught a WBFO interview with Republican candidate for Congress, Chris Collins. The lies and misinformation reveal that Collins is either misinformed, trying to dupe his prospective constituents, or both. 

Collins suggested that the Affordable Care Act, or Obamacare, is exactly like the Canadian single-payer Medicare system. While Obamacare is many things, many of which are open to debate and criticism, one thing it decidedly is not is anything resembling what Canadians enjoy*. 

*Yes, enjoy. 82.5% of Canadians in a recent poll indicated that they were “very satisfied” or “somewhat satisfied” with their health care system. 86% of them wanted the current system strengthened through public initiative, rather than privatized. American politicians can denigrate a Canadian system that is wildly popular with Canadians.  By contrast, a 2007 Gallup poll found that only 57% of Americans were satisfied with whatever private or public insurance they had.  By contrast, our own domestic single-payer Medicare plan, available only to seniors,  Whereas in 2007 45% of people with expensive private coverage reported problems with access to care, and 35% reported problems with billing, only 18% of Medicare recipients reported access problems, and only 14% reported any billing issues.  A 2010 Suffolk University poll revealed that 94% of American Medicare recipients are satisfied with their socialist, Canadian-style, single-payer plan. 

He went on to say that he hopes that Romney becomes President, and that that Republicans maintain their House majority, and add three Senate seats so that they can “completely” dismantle and repeal Obamacare. In its place, Collins suggested insurer competition across state lines, and minimizing injured patients’ access to the courts to seek redress for medical malpractice. Both of these “solutions” would hardly put a ding in the overwhelming cost of health care in this country, and would do absolutely nothing to guarantee universal coverage, or to shut the emergency room-as-primary care payment budget hole that our taxes fill. 

But the question that wasn’t asked is, what would result from an immediate repeal of Obamacare? Here are the provisions that have already become active: 

  • Expand the FDA’s ability to approve more generic drugs (making for more competition in the market to drive down prices) ( Citation: An entire section of the bill, called Title VII, is devoted to this, starting on page 766 )

  • An increase in the rebates on drugs people get through Medicare (so drugs cost less) ( Citation: Page 235, sec. 2501 )

  • Established a non-profit group, that the government doesn’t directly control, PCORI, to study different kinds of treatments to see what works better and is the best use of money. ( Citation: Page 684, sec. 1181)

  • Requires chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. ( Citation: Page 518, sec. 4205 )

  • Creates a “high-risk pool” for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of “pre-existing conditions” altogether. For now, people who already have health issues that would be considered “pre-existing conditions” can still get insurance, but at different rates than people without them. ( Citation: Page 49, sec. 1101, Page 64, sec. 2704, and Page 65, sec. 2702 )

  • Forbids insurance companies from discriminating based on a disability, or because they were the victim of domestic abuse in the past (yes, insurers really did deny coverage for that) ( Citation: Page 66, sec. 2705 )

  • Renews some old policies, and calls for the appointment of various positions.

  • Creates a new 10% tax on indoor tanning booths. ( Citation: Page 942, sec. 5000B )

  • Forbids health insurance companies from telling customers that they won’t get any more coverage because they have hit a “lifetime limit”. Basically, if someone has paid for health insurance, that company can’t tell that person that he’s used that insurance too much throughout his life so they won’t cover him any more. They can’t do this for lifetime spending, and they’re limited in how much they can do this for yearly spending. ( Citation: Page 33, sec. 2711 )

  • Allows children to continue to be covered by their parents’ health insurance until they’re 26. ( Citation: Page 34, sec. 2714 )

  • Eliminates “pre-existing conditions” exclusions for kids under the age of 19. ( Citation: Page 64, sec. 2704 and Page 76, sec. 1255 )

  • Limits insurers’ ability to change the amount customers have to pay for their plans. ( Citation: Page 66, sec. 2794 )

  • Helps close the “Medicare Gap” by paying rebates to make up for the extra money they would otherwise have to spend. ( Citation: Page 398, sec. 3301 )

  • Prohibits insurers from dropping customers once they get sick. ( Citation: Page 33, sec. 2712 )

  • Requires insurers to be transparent about fees. (Instead of just “administrative fee”, they have to be more specific).

  • Requires insurers to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they’re turned down. ( Citation: Page 42, sec. 2719 )

  • Increases anti-fraud funding, and new ways to stop fraud are created. ( Citation: Page 718, sec. 6402 )

  • Medicare extends to smaller hospitals. ( Citation: Starting on page 363, the entire section “Part II” seems to deal with this )

  • Medicare patients with chronic illnesses must be monitored more thoroughly.

  • Reduces the costs for some companies that handle benefits for the elderly. ( Citation: Page 511, sec. 4202 )

  • A new website is made to give people insurance and health information. (http://www.healthcare.gov/ ). ( Citation: Page 55, sec. 1103 )

  • A credit program is made that will make it easier for business to invest in new ways to treat illness by paying half the cost of the investment. (Note – this program was temporary. It already ended) ( Citation: Page 849, sec. 9023 )

  • A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they’re not price-gouging customers. (Citation: Page 41, sec. 1101 )

  • A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn’t paying for the Aspirin you bought for that hangover. ( Citation: Page 819, sec. 9003 )

  • Employers need to list the benefits they provided to employees on their tax forms. ( Citation: Page 819, sec. 9002 )

  • Any new health plans must provide preventive care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge. ( Citation: Page 33, sec. 2713 )

What the ACA really amounts to is a consumer protection act. While Collins and his ilk will call this a job-killing tax on the middle class, or something, it really amounts to a prohibition against insurance companies from engaging in predatory practices against its ratepayers. It provides better protections for consumers.  

The question is – why does Chris Collins want to repeal all of the consumer protections that have gone into effect? 

Collins also suggested that an extension of the Bush-era tax cuts should be extended to all Americans, including him and those like him with millions in income. The Obama plan would extend those tax cuts only to the middle class, and revert back to Clinton-era, pre-9/11 rates for those making more than $250,000 per year. 

Under Bill Clinton, unemployment dropped steadily from over 7% in 1993 to 4.4% by the late 90s. To suggest, therefore, that reverting tax rates to what we had in the 90s would stymie employment growth versus the situation we have now – with anemic jobs growth and the Bush tax cuts in place – strains credulity. 

Collins suggested that reverting to the Clinton-era tax rates for those making over $250,000 per year would be a “wet blanket” on job growth. However, only 3.5% of small businesses – mostly professionals like doctors and lawyers – would be affected by this change. An op/ed in the Washington Post goes into more detail here. 

Chris Collins opens his mouth and finds himself wrong again. Almost like it’s a pattern or something.