As the Washington Post helpfully points out, the origin of the $716 billion number the Republicans are throwing around is from a letter the nonpartisan Congressional Budget Office sent to John Boehner explaining how expensive it would be to repeal Obama’s health care law. Among the costs of repeal would be an additional $716 billion in Medicare spending over the next ten years.
The Post also supplies a helpful chart that demonstrates that the Medicare savings in ObamaCare come in three roughly-equal parts. About 35% of the savings comes from paying lower reimbursements to hospitals, which accepted this deal because they know they will have a lot more insured customers who will make up for any loss in profits. About 30% of the savings came from tightening up the private insurance known as Medicare Advantage.
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.
And the remaining 35% of savings comes from an assortment of changes, including less compensatory money for hospitals who treat a high level of the uninsured (because there will be a lot fewer uninsured people soon).
In other words, the Affordable Care and Patient Protection Act made Medicare a lot more efficient, but it didn’t do anything to reduce anyone’s Medicare benefits.
So, does it make sense to say that Obama cut Medicare by $716 billion?
But, it gets worse.
When Paul Ryan put his budget proposal together, he didn’t want to have to find another $716 billion in the budget, so he left all those cost savings from ObamaCare in place. And then all but four Republicans voted for those cost savings. But now they want to call those cost savings “cuts” and pretend that they didn’t vote for them. And they want to use these “cuts” that they claim only the Democrats are responsible for as a kind of magic shield to protect them from the charge that they want to take a huge bite out of people’s Medicare benefits.
As I explained in a piece last night and a piece this morning, the Republicans thought they could pass this lie off as the truth until Paul Ryan was placed on the ticket with Mitt Romney. Now they are not so sure. To see that they have a problem, all you have to do is look at how Romney surrogate John Sununu was treated this morning on CNN when he tried to peddle this nonsense.
After CNN host Soledad O’Brien pointed out that Romney is on the record as supporting the Ryan Budget at the time it was debated, and then showed Sununu some information from Romney’s website that demonstrated that his Medicare plan was substantially the same as Ryan’s, Sununu exploded:
“Put an Obama bumper sticker on your forehead when you do this,” he yelled, and charged the president with “taking $717 billion” out of Medicare via the Affordable Care Act, a statistic O’Brien said had been debunked.
“They are assuming, Soledad, stop this!” “All you’re doing is mimicking the stuff that comes out of the White House and gets repeated on the Democratic blog boards out there. If you’re going to mouth what comes out of the White House. …”
Then it was O’Brien’s turn to interrupt, saying that her questioning of Sununu’s assertion was rooted in “independent analysis.”
“Sir, let me finish. Let me finish,” she said. “There’s independent analysis, [Factcheck.org], the CBO, and CNN has also done its own independent analysis and name-calling to me and somehow acting as if by repeating a number of $716 billion, that you can make that stick. … That’s not true. You can’t just repeat it and make it true, sir.”
[the transcript/paraphrasing above is taken with a few edits from Olympia at Daily Kos].
The whole $716 billion or $717 billion argument has been debunked in the sense that saving us hundreds of billions of dollars is in no way similar to destroying the guaranteed benefit of Medicare to line the pockets of filthy rich people like Mitt Romney.
“When Paul Ryan put his budget proposal together, he didn’t want to have to find another $716 billion in the budget, so he left all those cost savings from ObamaCare in place.”
I’m confused. Some of the cost savings of ObamaCare are going to be realized by the fact that there are fewer uninsured people receiving uncompensated care thanks to the exchanges, the individual mandate, subsidies, and so on.
So if Ryan wants to repeal ObamaCare to do away with the individual mandate, how does that square with still taking the savings from Medicare?
Ok, I know I’m trying to apply logic to a clown budget. But wasn’t this thing vetted by the CBO or someone?
Good question.
And I’d go to Ezra Klein to get the definitive answer on it.
But, first, if Ryan’s budget took no affirmative effort to change the provisions of the ACA as they pertain to the overall cost of Medicare, then he’s borrowing the cost savings (fraudulently, if he intends to repeal those provisions).
The reason for this is simple. His budget assumes those cost savings.
However, I can’t say for certain that Ryan’s budget left the ACA untouched. If he made modifications to the law in one area, but not in Medicare, then there is an even stronger case for endorsing the Medicare “cuts.”
Finally, it’s possible to largely repeal ObamaCare while leaving certain provisions in place. But, with hospital reimbursement, for example, to keep those cuts in place without dramatically lowering the number of the uninsured would be reneging on a negotiated deal, and would be seen as being in really bad faith.
Cut costs.
Cut benefits.
They’re both “cuts,” see?
Sununu is the perfect surrogate to challenge because he bases his arguments on how many explosions he can insert between the talking points. He gives anyone who watches him a great ‘tell’ on the whole Party lies.
Give Soledad a hand for standing up to the bully.
Yeah, if only more journalists would actually do this kind of real-time fact-checking. That exchange was very satisfying, all the more so as O’Brien kept her cool the whole time.
Meanwhile, the most important lesson in this mess gets ignored:
IOW, privatization of Medicare insurance cost 17% MORE. That’s a health insurance privatization experiment fail even if there were no differences in the populations insured by Medicare and those in Medicare Advantage. Odds are that Medicare Advantage private insurers cherry picked healthier seniors.
What great real world evidence for giving private health insurers more customers and public dollars. Or a definition of insanity.
Is anyone asking the obvious question,”If seniors like Medicare Advantage, then why doesn’t regular Medicare offer the same benefits (no co-pays or deductibles, free drugs) without involving the private insurance companies?”
Or maybe we should ask why only 20% of seniors have opted for Medicare Advantage. Probably because while that privatization scheme costs taxpayers more, the beneficiaries also pay more. The “advantage” is that the out-of-pocket hit is more fixed than variable. It’s great for better heeled seniors.
If seniors want health care with no deductibles and co-pays, there is but one rational answer — socialized medicine as exists in the UK. Except for certain populations, prescriptions in Canada are 100% out-of-pocket up to some annual limits. Plus the annual per capita health care costs in Canada are MORE than that in the UK. There’s some good comparative charts in this report. Of particular note is that except for Norway (with its huge oil revenue public treasury) the US is the leader in public dollars spent on health care. In 2008 the US per capita cost of health care covered by public dollars was $3,507. By comparison total per capita health costs in the UK were $3,129 ($2,585 covered by public dollars). And let’s not neglect to note that the percentage of seniors in the UK population is larger than that in the US. So, we already pay through taxation 40% more than what a basic universal health care system can cost.
But aren’t Canadian drugs much cheaper than US? If I didn’t get samples from my doctor, I could never afford Symbicort. Full out of pocket would be higher than my health insurance premiums and even the Blue Cross rate costs 50% of the premium and this is a “Cadillac plan”.
Yes, Canada regulates the price of prescription drugs. But even with that, per capita out-of-pocket costs are almost double that of the UK.
Lot’s of things I don’t like about the UK system, like long waits for non-emergencies (pain not considered an emergency), assigned doctors, denial of expensive care. The two Englishmen I worked for liked it a lot and consider our system “barbaric”. That’s a direct quote. All the Germans that I have met had unqualified support for their system and Germans are not easy to please. According to a survey that I read about, the French have higher support for their system than any other country, but maybe that’s just French nationalism. The one Frenchman that I knew was friendly, urbane, intelligent and witty. He didn’t make negative remarks about anything American except our food (had to agree with him about that), but anything French was superior to anything non-French, even if the non-French was OK. That’s just a sample of one.
The point is, all of these systems are variations on single payer and all have lower costs.
No, they are not all variations of single-payer at all; they are variations of universal health care. They all perform better and at a lower cost than the mess in the US. The additional wait times for NHS services (if that is in fact true) is purely a function of the system being a bit underfunded which is always to be expected in countries with high income/wealth inequality that offer some basic universal government service or good.
I don’t think that’s mentioned enough. While the UK does have slightly longer waits for non-emergencies, they pay significantly less than most countries, with only countries like Singapore paying less. If they increased their funding slightly, their costs would go up per capita, but you’d probably see their wait times reduced significantly (and their costs would more closely resemble the rest of the developed world, rather than a lot lower). And the UK is the most unequal in Europe.
True:
. And it’s the existence of the NHS that minimizes the impact of such inequality on the everyday security and well-being of its populace. Can anyone imagine an Olympic opening ceremony tribute to the US “best health care system in the world?”
The 2012 OECD report for health care costs in 2010 is now out. The trend of health care costs increasing faster than GDP continues. In general the rate of increase reflects the degree of socialization of the delivery of health care services and goods in the system. For example, it increased faster in Germany and Switzerland than in France and Sweden and faster in Canada than the UK. Of course, the US continues to perform worse than all the others.
Finland was a late comer to UHC and appears to have borrowed all the best from the rest. Against enormous odds of beginning with a population that had high rates of diabetes, obesity, and lower life expectancy.
The cuts in the cost of Medicare were mot only used to help fund the ACA, they were put back into strengthening Medicare and adding benefits, i.e. closing the “donut hole”, extending the life of Medicare by 8 years, etc.
Way OT, but Is it just me or is the Romney camp slowly coming more and more unhinged.
I know there has been a article about Obama personally not liking Mittens, but its with good reason, since ending the primary and even during them, Mittens camp lied and still blatantly lying on the stump, in interviews, and in paid advertising and actually boasting that they are indeed “misquoting” Obama.
Although I never notice any real dislike toward Obama on the surface, Obama unlike Romney tends to actually try to keep his supporters civil and tries to keep is comments above the petty, but Romney of course never does the same.
Mittens now apparent disdain for Obama I just don’t understand the root of it even before Obama got into “campaign mode”. I don’t wanna think it’s anything other than Obama being a Dem, but reading what I’ve read about Mormons and African Americans I’m beginning to think it more nefarious.
Anyway, I don’t recall, yet, Obama making any seeminly personal gibes at Mittens, but I don’t think the same can be said of Mittens.
Here’s his latest:
Romney Personally Slams Obama
“Angry and Desperate” hmm interesting choice of words doncha think?
Well, Republicans are masters of projection, eh?
Don’t forget a few things. One, Mormons only officially recognized people like PBO as people in 1978. So Willard was like 30 yrs old at the time. Second, it’s obvious Willard thinks his only path to victory is ramping up the hate. Speaking of unhinged, that’s exactly what the campaign spokesperson referred to Willard as tonight. It’s about time.
The problem is you just needed several hundred words to explain why it’s a lie.
In politics, you’ve lost because the public doesn’t have the attention span to grasp it. Lying works for the GOP.
I wouldn’t expect a windfall from this issue, especially if the Democrats can’t come up with a good commercial people might hear when they get up to go to the fridge during Matlock reruns.
I wrote a stern note on the NPR website yesterday when they repeated the $700 billion lie without noting that it had been debunked. I made a note that even ABC had debunked it.
That evening on an updated and related story NPR embedded a link explaining that it had indeed been debunked.
I think the regular news outlets are noticing some of this. If we just get the thing summarized in under 40 words it could gain some traction with a broader audience.
Raw Story has the smoking clip.