The GOP Gets Some Traction

Rep. Paul Ryan, a Republican deficit hawk, just made a compelling case for how the Senate health reform bill is actually not the cost saver the Congressional Budget Office says it is. His main point was that the Senate bill makes cuts and collects taxes for 10 years, but only includes 6 years of spending. He says the result is a favorable, but misleading, CBO score. There is some truth to what he says. Here’s a story I wrote about one provision in Democratic plan that many experts say at least borders on budget gimmickry.

But instead of addressing Ryan’s points, President Obama tried to pivot away. He asked if Republicans think Medicare Advantage works well. (Medicare Advantage is a program in which the federal government pays private insurers to cover those eligible for Medicare. Every Medicare Advantage recipient costs the federal government 15% more than a standard Medicare recipient, however, and many of the cuts in the Senate bill come from paring this back.) Sen. John McCain, for the second time today, mentioned the special deal that Medicare Advantage recipients in Florida get in the Senate bill. Obama was boxed in and he had not choice but to say McCain has a “good point.” Here’s Politifact’s assessment of McCain’s claim, which has also been made by Karl Rove. The lawmaker tapped to answer Ryan’s charges was Democratic Rep. Xavier Becerra, who did not talk about Ryan’s points either, but simply said CBO is “the referee” and shouldn’t be questioned.

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  • jeriv

    … seriously? That’s the best they have?

  • deconstructiva

    But can Ryan agree on his own CBO #’s, as Becerra asked?
    .
    Fear not since Boehner! brought the R’s back to TP’s full circle. I transcribed the short version for you, Kate (your hands must be tired by now, how will you and KT be able to drink tonight?):
    .
    Boehner! starts …get to the point, already …(finally)… “bill is dangerous experiment that will bankrupt the country. Exchange is evil. I could go on and on and on…. abortion funding (Amy!!!!!) …step by step clink! …clean sheet of paper.”
    So what’s the solution, John?

  • shepherdwong

    Well, when you spend every waking moment throwing sh!t at the wall, you have to be happy when some if it sticks.

  • afguy

    Why, “tax cuts”, “free markets”, and “personal responsibility”, naturally…

  • freeinpa

    The Dems misleading? Impossible!

    It is a Ponzi scheme that will bankrupt this country. I did not see in the CBO report any analysis of the demographics of this country and how the vast percentage of HC costs comes from that age group requiring the most expensive care
    ==
    Maybe Obama will lecture us on how the Baby Boomers will sacrifice thier own needs for the good of his Presidency, I mean country.

    Yeah right!

  • deconstructiva

    Yep, tax cuts cure everything.
    .
    and there’s McCain (though he didn’t mention tax cuts):
    (1.) Start over… clink!
    (2.) AZ hates CA since they stole their water. John, dude, the Colorado River runs thru your state first, how can they steal your water?
    (3.) Worried about recon – uh, John, dude, ask KT if COBRA was done under R’s reconciliation.

  • maverick2k9

    What Paul Ryan may be good at is poking some holes (whether big or small .. is debatable) in the opposition’s plan.
    .
    What he is very bad at is.. coming up with some of his own alternative ideas.

  • diecash1

    afguy — You forgot “hurry up and die already”……

  • diecash1

    “I did not see in the CBO report any analysis of the demographics of this country and how the vast percentage of HC costs comes from that age group requiring the most expensive care”
    ..
    Since seniors are responsible for most of the health care costs in the country, what solution do you propose? Hurry up and die already? High risk pools a la Boehner? What precisely?

  • kevin

    I love Barrasso’s “every hand goes up” routine.
    .
    If what they believe is not true, senator — and it is not — all those hands do is show how effectively the right-wing propaganda machine has been in scaring the sh!t out of them.
    .
    Their beliefs are proof that your lies have worked, not that the bill itself is bad.

  • southernbell49

    I don’t think you can look at cutting costs until all Americans are covered and the insurance industry is regulated.

    Simply looking at the deficit is looking at the issue at the wrong end of the tunnel because if Americans keep paying more for insurance or drop insurance because they can’t afford it, either Americans will have much less money to spend on other things like retirement accounts, cars, home improvement college tuition OR the burden on emergency rooms will get heavier, thus increasing costs.

    Start with universal coverage and go from there.

  • freeinpa

    How about the death panels Obama said never existed

  • spob

    “The latest tracking poll from the Kaiser Family Foundation, for instance, showed that 60% believe Democratic health reform would increase the deficit in the next 10 years. The Congressional Budget Office says this is not true.”
    .
    Care to revise that one, Kate. That’s what you wrote earlier. First, I don’t think the CBO guarantees outcomes, so it would never say something’s not true. Second, it’s pretty unfair to claim that ordinary people are misinformed when the no deficit increase prediction is based on some non-real world things, like 10 years of taxes and 6 years of spending.
    .
    I think you ought to retract the above statement, in light of your comment that Ryan’s argument has a lot of truth.

  • http://forgottenlord.livejournal.com forgottenlord

    Who would’ve thought that the people who require the most expensive care cost the system the most amount of dollars. It’s really….like…..not shocking in any way shape or form. It costs more so it’s more expensive. Why do you need the CBO to tell you the bloody obvious?
    .
    Even more WTF worthy, how the heck is this relevant to policy?

  • towandavt

    The Medicare advantage plans aside, older people have more health problems, consequently higher costs. That’s why Medicare costs are high, it’s a high risk pool, duh! The way to lower costs is to broaden the pool. Everyone in the pool, the costs are shared, the system financing works. The Republican plan, not withstanding all their blather about freedom and government cost cutting, will cost us tax payers more. The insurance industry gets all the good risk; the government / high risk pools all the bad risk; The Republicans campaign coffers are filled with the profits of those that they enrich at our expense. WHY DON’T YOU ALL GET THIS? I’m opening the window shout out…not gonna take it any more!

  • pafro

    Barrasso once claimed to Ed Schultz that Canadians are going to Wyoming for medical care because their system is so bad. I have a sister who works at the Wyoming Medical Center in Casper Wyoming where Barrasso used to work, and I asked her if she had ever heard of a Canadian patient traveling their for treatment. She could not think of a single one in the time she had been their.
    I have another (very Republican) sister who works at the large hospital in Cheyenne Wyoming and is in a position where she knows the ins and outs of what goes on there. I also asked her if Barrasso’s claim was correct. She said he is not.
    Barrasso is nothing but a liar.

  • pafro

    Is Ryan the guy who is proposing outlawing Medicare so we can balance the budget by 2050?

  • kevin

    Pfft. I have relatives and friends all over Canada. They come from all across the political spectrum, but they are agreed on one thing — they love their health care and they think we’re insane for having the system we have.

  • http://forgottenlord.livejournal.com forgottenlord

    The Death Panels never existed. They only existed with about 42 different assumptions about motivations and intentions of Doctors, Hospitals, seniors, the adult children of seniors, and the Obama administration and a very, very flawed reading of the bill. In fact, you basically had to assume that Obama, doctors, hospitals, patients and their children all want said patients to “pull the plug”. An actual reading would tell you that, in fact, all Obama wanted was for a higher percentage of patients to have a thing called a “living will” and that patients should be advised of all the options available to them. The choice of Euthanasia was never promoted or mentioned other than being enumerated amongst the many other options that should be provided. The Death Panels themselves – a board that decided whether to pull the plug on Grandma – was never listed anywhere.

  • kevin

    No, Ryan has his own ideas. It’s just that they’re awful ones like privatizing Social Security and putting Medicare recipients on a voucher system.

  • towandavt

    Me too Kevin…Canada, UK, France, Germany, Spain…same deal! They think we are insane. Me thinks they are right!

    Live in a border state and can testify the flow of traffic for health care is to, not from Canada!

    Would someone please remind the folks around the table in the designer threads that their healthcare is at OUR expense….Government provided. Best in the nation! The gall they have! Craven SoBs

  • freeinpa

    “It costs more so it’s more expensive. Why do you need the CBO to tell you the bloody obvious?”

    When you deal with liberals you can’t take anything for granted.

    But I am at a loss as to how costs affect policy- Oh wait it will bankrupt the country!

  • http://forgottenlord.livejournal.com forgottenlord

    Freep, the CBO can still calculate the average cost of health insurance. It doesn’t matter what is the most expensive and what is the least expensive. What matters is what the trend is and the general trend of costs can be extrapolated. Sure, the general trend has continuously increased costs for the elderly while there’s been a more moderate increase for everyone else (due to the ability to keep people alive on the very expensive care just a wee bit longer), but the average still accounts for that. That’s simple mathematics and therefore, the CBO doesn’t have to go out of its way to mention it.
    .
    In fact, the only reason for anyone to bother mentioning it as a problem is because they don’t think the government should be spending money on said people. But, don’t you think that when it comes to the elderly – the second least capable group (after young children) of making money for themselves and the group that has next to no increase in income (and often gets its money through the government run Social Security program) and (particularly those that are on the most expensive health care treatments) absolutely need to be provided health care or they will not live to see the next sunrise, don’t you think that cutting government funding for their health care is far closer to “death panels” than anything Obama proposed?
    .
    Your arguments are intellectually deficient.

  • stuartzechman

    older people have more health problems, consequently higher costs. That’s why Medicare costs are high, it’s a high risk pool, duh!
    .
    (sigh)
    .
    No, that’s not true at all.
    .
    Please, please, please try to follow this, because what you’ve said sounds intuitive and reasonable (like many conservative and centrist talking points do), but is completely false:
    .
    ( link to CBO’s “Sources of Growth in Projected Spending on Medicare and Medicaid” WARNING PDF PDF )

    Illustration of the Effects of Aging and Cost Growth on Spending
    .
    How aging, cost growth, and the interaction between
    those two factors affect spending can be illustrated
    using a simple example in which there is one elderly
    person and nine nonelderly people (see the accompanying
    table). Spending in the first year is $1,000 for a
    nonelderly person and $2,000 for an elderly person.
    Total spending is $11,000 ($9,000 for the nine nonelderly
    people and $2,000 for the elderly person).
    In the second year, the situation changes as follows:
    .
    Aging Only
    .
    If another person becomes elderly but costs do not
    rise, spending in the second year totals $12,000
    ($8,000 for the eight nonelderly people plus $4,000
    for the two elderly people). The increase of $1,000 is
    attributable solely to aging.

    .
    Cost Growth Only

    If the population does not age but costs rise 10 percent,
    spending in the second year totals $12,100
    ($9,900 for the nine nonelderly people plus $2,200
    for the elderly person). The increase of $1,100 is
    attributable solely to cost growth.

    .
    Aging and Cost Growth
    .
    If another person becomes elderly and costs rise
    10 percent, spending in the second year totals
    $13,200 ($8,800 for the eight nonelderly people plus
    $4,400 for the two elderly people). The resulting
    increase of $2,200 exceeds the sum of the pure
    “aging” effect ($1,000) and the pure “cost growth”
    effect ($1,100) because of the interaction between the
    two
    (an extra $100 arising because the cost of the
    additional elderly person is magnified by the increase
    in per capita costs)

    So you see (or at least I hope you see) that aging is not the largest factor in cost growth in Medicare and Medicaid, increased “Excess cost growth,” as the CBO puts it, (inflationary health care prices) are.
    .
    Medicare costs aren’t actually high compared to private sector health care costs, either, but let’s just take one problem with your arguments at a time, OK?
    .
    Did that make sense? Did you look at the chart on page 6 of the CBO report?

  • tjoyce994

    “An actual reading would tell you that, in fact, all Obama wanted was for a higher percentage of patients to have a thing called a “living will” and that patients should be advised of all the options available to them.”
    -
    And the idea was originally proposed by a republican. It’s another one of those ideas the republicans claim were never considered.

  • diecash1

    free
    ..
    Death panels? That’s your answer? Typical BS from you. You know (or should know) that they only exist inside of insurance companies. There is not now and never has been any “death panel” in either bill.
    ..
    Again, you complain and attack but you are unable to offer any solutions…..typical Repub, you fit right in with the entire party of “NO.”

  • towandavt

    StuartZ I believe we ae actually on the same side of this debate. Note that the report says that aging is not “the MAJOR” reason for growth in costs. You are right. I understand what the report is saying, but it is a factor if not a major factor. My point was really that a market designed to dump all the high costs into the government pool without spreading the risks across a broader population is not a fair way to do the business. The larger the pool and more diverse the population in it, the better the numbers work. Reducing the administrative costs to something that looks like the Medicare program and dealing with healthcare services inflation are also a factor. Don’t get too wonky on me!

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