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Joining a long list of media voices, Time’s Don Von Drehle isn’t happy with the state of the debate over Medicare.
Medicare promises more to future retirees than it is going to be able to deliver. Change is urgently needed. ObamaCare envisions change within the existing structure of the health care industry, while Republican Paul Ryan’s proposal would impose change by having elderly patients buy their own coverage, using government vouchers. Both of these represent huge departures from the status quo. If this election educates voters to make an informed choice between these options, we’ll be a stronger country for it.
But we certainly didn’t see that sort of informative campaign in the special Congressional election in New York’s 26th District last week. Instead, we saw candidates accuse each other of trying to destroy Medicare.
OK, let’s review this again, since, to borrow a phrase, setting the record straight is taking longer than I thought.
The Republican plan really does try to destroy Medicare. That’s not hyperbole. The GOP agenda takes the existing system, eliminates it, and replaces it with a privatized voucher system. They do this while taking money out of the Medicare system, clearing budget room for more tax cuts for the very wealthy. We can certainly debate the merit of such an idea, but that’s what the plan does. When Democrats in New York’s 26th said the Republican candidate endorsed a plan to end Medicare, it’s because the Republican candidate endorsed a plan to end Medicare.
Von Drehle is waiting for the moment when officials “get honest” with the public. That sounds like a good idea — let’s start by being honest about the GOP plan as crafted by Paul Ryan.
The same Time piece argues that Medicare is going to have to change. That’s true, too, and as Jonathan Cohn explains, “[U][nder the terms of the Affordable Care Act, Medicare will change. Specifically, the government (which runs Medicare) will take corporate welfare away from some insurance companies. It will reduce payments to providers while introducing payment reforms that encourage efficiency. It will create a series of budget targets for the program — and then empower an independent commission to enforce those targets, unless super-majorities in Congress overrule it.”
Now, Von Drehle may believe more significant changes to Medicare are needed. And we can certainly debate this. As Paul Krugman recently put it, “[T]hink of Medicare as a footbridge that is deteriorating and will eventually become unsafe. You could propose structural repairs to fix its faults; Ryan doesn’t do that. Instead, he proposes knocking the bridge down and replacing it with trampolines, in the hope that pedestrians can bounce across the stream.”
Pundits are inclined to give Ryan credit for noticing the problem with this footbridge. But that’s not just overly generous, it’s also setting the bar for seriousness way too low.
In the meantime, Democrats are apparently not supposed to mention that the GOP intends to eliminate the footbridge altogether — not because Dems are wrong, but because the truth is intemperate.
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c u n d gulag on June 01, 2011 10:52 AM:
And when we do go to a trampoline based senior health care system, the Republicnas will insist that trampoulines be privatized, and only those seniors in the top 2% can use them.
howard on June 01, 2011 10:55 AM:
and so we are reminded, once again, that a lot of political journalists just aren't very bright and really don't understand policy.
for example, anyone who thinks that the problem is "medicare" rather than "the costs of the american way of providing healthcare" really shouldn't even be opening his or her mouth in the discussion.
Ron Byers on June 01, 2011 10:55 AM:
I am not in favor of doing it alone, but why doesn't anybody, right or left, ever talk about increasing medicare taxes even a little.
Don't get me wrong, increasing taxes is not my first choice, but I just don't understand why it is totally off the table.
bleh on June 01, 2011 10:58 AM:
And by the way, it is very shrill of you to point all this out.
Lifelong Dem on June 01, 2011 10:59 AM:
Your liberal media at work.
Stephen Stralka on June 01, 2011 11:00 AM:
The right does talk about increasing taxes--they talk about how it must never ever ever ever happen because it will cause the sun to explode, which would have a negative impact on the economy. Meanwhile, knowing that any tax increase will never pass the current House of Representatives, the Democrats don't have much incentive to push very hard for this (not to mention most of them are cowards). But there are a lot of people on the left talking about how it's insane that tax increases aren't even part of the conversation.
Jerry Elsea on June 01, 2011 11:00 AM:
Von Drehle's first name is David, not Don
June on June 01, 2011 11:03 AM:
It is discouraging to see a Time article that not only uses the right wing's perjorative word *Obamacare*, but even does it without quotes. I found it hard to take seriously anything the writer had to say after that. And I also have to wonder, are these tepid writers so well-paid, so well off, that the specter of Ryan's plan -- receiving an insufficient voucher to purchase health insurance from insurance companies who will laugh off seniors' applications anyway -- are they all so well taken care of that that scenario doesn't put the fear of God in them in the least?
John Puma on June 01, 2011 11:03 AM:
I'd say the truth is not only intemperate but also inconvenient, unless and until current and future Medicare recipients are stripped of their voting rights.
Of course, the "serious" GOP is working on that, too, without much notice (or is it actual support?) from mainstream media.
Aris on June 01, 2011 11:08 AM:
You mean TIME magazine still publishes? I thought they stopped when their movie critic was given the cover story to ask, "Is yoga, in other words, a science?" and proceeded to think he proved it is indeed. I remember the embarrassment that followed when the rest of the media made fun of TIME's editors as credulous cretins and the magazine in a fit of integrity stopped publishing.
Aris
P.S. Sorry, I was thinking of a different universe...
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JS on June 01, 2011 11:09 AM:
Maybe part of the problem is just about everyone (and that includes many pundits on the left, much less the MSM/Village) describes the issue as "we have to fix Medicare" to solve the government budget problem.
In my view, the problem is medical inflation, not that Medicare is a government budget problem. Medicare is a delivery system that is efficient because (a) it has the scale to demand/negotiate cost controls and (b) low overhead/lack of profit motive. The problem is medical inflation, which will cause major problems regardless of whether you kill Medicare under the Ryan budget, or just continue Medicare without addressing skyrocketing medical inflation.
This has been going on at least since the 90s with medical plans through businesses - one year the rates go up 8-10%, the next year benefits are cut back because workers would cry bloody murder if there was another huge rate hike. (cycle repeats ad infinitum) Again, the problem is medical inflation - not the delivery system.
The Democrats made at least a swipe at the underlying problem with the ACA. They are still trying to set up the medical expert panel that would recommend best practices, and further improve Medicare cost-effectiveness. (And there are other ideas in the bill which didn't get credit from the CBO, but may help further on costs.) Of course the GOP demagogued this as 'death panels'.
But until you start talking about how we have to fight medical inflation, the wingnut argument about the Ryan budget is just a different way to "fix Medicare" as a way to solve the government budget problem. It's the wrong argument to be having.
T2 on June 01, 2011 11:20 AM:
it's tough when you are a Right-leaning "journalist" that is not pure TeaParty mental.
You know the facts, the truth about policies, but you hate to just say "sorry, these GOP plans, which I'd love to espouse, are actually terrible pieces of legislation". So you go the "each side complained" route despite the fact that one side is wrong and the other right. The fact that today's Media settles for this type of "reporting" or articles indicates they are wrestling with the same problem: truth hurts.
Stephen Stralka on June 01, 2011 11:24 AM:
Another thing just occurred to me. As has been pointed out numerous times, the amounts of these vouchers would not keep up with rising healthcare costs. What occurred to me is that there's no guarantee that the vouchers themselves won't be whittled away over time. After all, as has also been pointed out numerous times, the Ryan plan does nothing to fix the deficit, since all the savings are almost exactly canceled out by tax cuts (curious coincidence, that). Even if the Republicans get everything they want here, the next logical step for them would be to push for even more tax cuts, and it's not like they'd be looking to cut defense spending to pay for them.
chi res on June 01, 2011 11:40 AM:
Actually, the semantical arguments on both sides as to what is or isn't "Medicare" are getting tiresome.
Please argue on the merits of whether or not the plan provides adequate medical care to seniors (which Ryan's obviously does not), not on your definition of the word versus their definition of the word.
Doctor Whom on June 01, 2011 11:50 AM:
Bottom line -- the elites have decided that there just aren't enough goodies to share any more, and since the goodies are righfully their's and not yours, they're just going to go ahead and take them all for themselves. The rest of you rubes -- well, that's what you get for not having the common sense to go to Choate and Princeton.
David V. on June 01, 2011 11:52 AM:
I think Ron Buyers has a great point...it's off the table because it's a thoughtful, logical suggestion which would actually help people.
Joe Friday on June 01, 2011 11:52 AM:
You can add Evan Thomas of NEWSWEEK to the list. Every week, as part of the panel on Inside Washington, Thomas repeats that politicians are not being honest with the American people because:
* Entitlements are the drivers of our deficits and debt (THEY'RE NOT)
* Medicare and Social Security are bankrupt (THEY'RE NOT)
* Paul Ryan is "brave" and "courageous" for addressing the deficit problem (HE WOULD MAKE IT WORSE)
* The Democrats are "demagoguing" the Medicare issue (THEY'RE NOT)
Just how does a supposedly semi-intelligent 'editor-at-large' spew this claptrap ?
SYSPROG on June 01, 2011 12:29 PM:
How about we start holding the MEDIA responsible for the 'lies' they spread? Not just FAUX news but 'journalists' that are too lazy to do the research and just flap their lips?
Vince on June 01, 2011 12:39 PM:
As an often negative voice on this blog, I'd like to take this opportunity to voice something positive about the ACA. Specifically, the provision whereby Medicare will track which hospitals actually do a good job of providing care and which do not, and funnel more money to the good ones. This is one of several concrete ways that Obama and the Democrats have ushered in ways to save money in Medicare spending. Real ways, not fake ones. The fact that hospital management doesn't like this provision is a good sign. In fact, a rule of thumb should be that if hospital management and/or insurance companies are against a provision in the ACA, it must be a good one.
There are signs that doctors' interests and the interests of insurance and hospitals are diverging over some of the provisions in ACA, with the doctors increasingly on the side of positive reform (the Rand Paul doctor types notwithstanding). If this trend continues, it bodes well for any future health care reform debate, as I think the voice of doctors will carry much more weight with the public than either insurance or hospital executives. Not sure if this divergence was part of the ACA strategy, but it is looking like a good outcome of ACA nonetheless.