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July 05, 2011

Democrats: We Are Going to Cut, Slash, and Chop MediCare, But We Want Seniors Everywhere to Know We're Going to Keep the Name Intact

That is the true headline here.

Senator Charles E. Schumer of New York, the No. 3 Senate Democrat, said: “We are very willing to entertain savings in Medicare. Medicare gives very good health care very inefficiently.”

In return, Mr. Schumer said, Republicans should be willing to consider some additional revenue.

Negotiators said they were seriously considering cuts in Medicare payments to hospitals for uncollectible patient debt and the training of doctors; steps to eliminate Medicare “overpayments” to nursing homes; a reduction in the federal share of some Medicaid spending; and new restrictions on states’ ability to finance Medicaid by imposing taxes on hospitals and other health care providers.

Medicare and Medicaid insure more than 100 million people, account for 23 percent of all federal spending and are likely to be an important part of any budget deal. Military spending, which accounts for about 20 percent of federal expenditures, is likely to be included as well.

Obama and the Democrats already swiped $500 billion from Medicare, and their non-plan plans for reducing spending call for cutting a trillion plus more. And they repeat that here, looking to cut "waste" and such from Medicare, but to the tune of hundreds of billions.

They also wish to run on the plank of "saving Medicare."

But in what way? It seems to me they are eager to cut the program. They just want to keep the name, and tell seniors that by saving the name they saved the program.

Note that the Democrats intend to cut, cut, cut Medicare without any plausible plan for delivering the same levels of service for less money. They want to keep Medicare as the overspending government program it is, with no discipline imposed on pricing through consumer choice; they just want to spend less on it.

Well, if the system remains as it is -- as the Democrats insist it ought to -- but you're simply cutting trillions from it, obviously, then, the system will deliver less in actual benefits. If the dollar input is reduced, and there is no reform imposed that could deliver more value for fewer dollars, then dollar output in terms of services rendered must be reduced.

The Paul Ryan Plan calls for a fundamental reform of Medicare, to take it out of the realm of a perpetually growing, wasteful, inappropriately-incentivized government program and something that responds to, and exerts, market pressures to keep costs down. So at least there is the possibility with even fewer dollars being spent on the program, the same (or nearly the same) level of benefits will be delivered.

So note the Democrats and Paul Ryan do not disagree that Medicare must be, will be slashed.

The only debate is whether or not we're going to retain the same inefficient delivery vehicle and thereby guarantee that those cuts will result, as a mathematical certainty, in actual cuts in deliverables, or whether we're also going to undertake an effort in reform such that those fewer dollars result in the same level of service seniors have come to depend on.

Both parties are agreed to slash Medicare. But one party wants to keep the bureaucratic structure and strange incentive systems that have brought it to the brink of bankruptcy.

And they are insistent that if they slash as much as Republicans but retain the wasteful bureaucratic system that brought us to this pass, they should be credited as somehow being "pro-senior."


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posted by Ace at 01:44 PM

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