Facts Get in the Way
WASHINGTON — Republicans and Democrats are being equally nasty in their campaign rhetoric, but they’re not being equally truthful. To cite one example, much of what the GOP is saying about Medicare simply isn’t supported by the facts.
Former New Hampshire Gov. John Sununu, one of Mitt Romney’s more pugnacious surrogates, almost had a conniption fit Tuesday when CNN’s Soledad O’Brien pressed him on his assertion that President Obama “gutted Medicare by taking $717 billion out of it.” As Sununu knows but refused to acknowledge, this is not true.
The claim is part of an attempt to shore up a vulnerability Romney created by choosing Paul Ryan as his running mate. The budget that Ryan authored, and convinced House Republicans to pass, would eventually change Medicare into a voucher program: Seniors would be given a certain amount of money each year to buy health insurance.
If that amount isn’t enough to pay for the kind of coverage you want or need — under Ryan’s latest plan, you could buy a policy from a private insurer or buy Medicare from the government — you pay the difference out of pocket. According to the Congressional Budget Office, the average Medicare recipient would pay an extra $6,500 a year.
It doesn’t take a genius to recognize the political problem this causes for Romney, especially in states where older voters are a key voting bloc. The Romney campaign decided to deal with the anticipated Democratic onslaught by striking first with the claim that it is Obama, not Romney, who wants to take away your Medicare.
Like many lies, this one uses a grain of truth as raw material. The Affordable Care Act, otherwise known as Obamacare, slows the rate of growth of payments to Medicare service providers by more than $700 billion over a decade. But no impact is felt by seniors themselves, whose benefits and costs remain the same.
When O’Brien reminded Sununu of these facts, he barked that she should “put an Obama bumper sticker on your forehead.” But the claim that Obama had “gutted Medicare” remained false, and O’Brien told Sununu: “You can’t just repeat it and make it true, sir.”
Sununu knows that. He just wants the focus to be on Romney’s pledge to undo Medicare “cuts” that aren’t really cuts at all. The Romney campaign knows that as long as people are trying to sort out the facts of this specific allegation, they aren’t talking about the real differences between the two parties on the very nature of entitlement programs such as Medicare.
The fact is that Ryan’s plan — which Romney has semi-endorsed and now cannot credibly disown — effectively would “end Medicare as we know it” — the phrase voters will hear a bazillion times between now and Election Day, especially those who live in Florida. This is one piece of campaign rhetoric that happens to be true.
Medicare as we know it is a form of social insurance, a guarantee that citizens over 65 will have adequate medical care regardless of how healthy they are or how much money they have. Medicare, as the GOP wants it to be, is a voucher program that will be adequate for some seniors and inadequate for others.
Ryan prefers the term “premium support” to describe his plan. But as Gertrude Stein surely would have noted, a voucher is a voucher is a voucher.
Everyone agrees that something has to be done about skyrocketing costs for Medicare and also Medicaid, the health care program for the poor. Obama took the first step toward “bending the curve” of cost increases with the Affordable Care Act. Leave aside, for the moment, the fact that Romney now pledges to undo the progress Obama has made. The question is what do we want Medicare to be?
There is no reason why Medicare cannot be reformed as a social insurance program. Other industrialized countries provide universal health coverage for their entire populations for a fraction of what we spend in the United States, and those other countries achieve equal or better health outcomes. Surely we can continue to do so for those of retirement age — if we still want to.
The question to ask Romney is whether he believes in social insurance — whether his objections to the way Obama has begun to reform Medicare are fiscal or ideological. Ask him and Ryan whether they agree that markets are often efficient but seldom compassionate. Ask him whether he sees the free market as our servant or our master.
Eugene Robinson’s email address is eugenerobinson@washpost.com. (c) 2012, Washington Post Writers Group
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What I can appreciate about the Republican party is that they truly understand the ignorance of the American public and use it to their advantage at every possible moment. Obama understands this too, which is why he will not stop the relentless attacks on Romney.
Your typical Dem thinks they can talk in nuance and the American people will somehow get it. They wont, American Idol is on.
The “root cause” of the Democrats’ wild allegations against Republicans, their fear of change, their slogans and insane metaphors, are all explained by mass psychology, diagnosed more than a century ago by the French psychologist Gustave Le Bon.
Le Bon’s 1896 book, “The Crowd: A Study of the Popular Mind,” was carefully read by Adolf Hitler and Benito Mussolini in order to learn how to incite mobs. Our liberals could have been Le Bon’s study subjects.
With the country drowning in debt and Medicare and Social Security on high-speed bullet trains to bankruptcy, the entire Democratic Party refuses to acknowledge mathematical facts. Instead, they incite the Democratic mob to hate Republicans by accusing them of wanting to kill old people.
According to a 2009 report — before Obama added another $5 trillion to the national debt — Obama’s own treasury secretary, Tim Geithner, stated that in less than 10 years, spending on major entitlement programs, plus interest payments on the national debt, would consume 92 cents of every dollar in federal revenue.
That means no money for an army, a navy, rockets, national parks, food inspectors, air traffic controllers, highways, and so on. Basically, the entire federal budget will be required just to pay for Medicare, Medicaid and Social Security — and the cost of borrowing money to pay for these programs.
When Social Security was enacted in 1935, the average lifespan was 61.7 years. Today, it’s almost 79 and rising. But liberals believe the age at which people can begin collecting Social Security must never, ever be changed, even to save Social Security itself.
Mobs, according to Le Bon, have a “fetish-like respect” for tradition, except moral traditions because crowds are too impulsive to be moral. That’s why liberals say our Constitution is a “living, breathing” document that sprouts rights to gay marriage and abortion, but the age at which Social Security and Medicare benefits kick in is written in stone.
Le Bon says that it is lucky “for the progress of civilization that the power of crowds only began to exist when the great discoveries of science and industry had already been effected.” If “democracies possessed the power they wield today at the time of the invention of mechanical looms or of the introduction of steam-power and of railways, the realization of these inventions would have been impossible.”
Liberals exhibit this exact group-think fear of science not only toward light bulbs and nuclear power, but also toward medical inventions. Thus, when a majority of the country objected to Obamacare on the grounds that — among many other reasons — a government takeover of health care would destroy medical innovation, liberals stared in blank incomprehension.
They believe every drug, every diagnosis, every therapy, every cure that will ever be invented, has already been invented. Their job is to spread all the existing cures, while demonizing and stymieing pharmaceutical companies that make money by inventing new drugs.
Democrats haven’t the slightest concern about who will formulate new remedies because they are enraged at profit-making and suspicious of scientific advancement.
Apart from cures that will never be invented, liberal elites will be mostly untouched by the rotten medical care to which they are consigning the rest of us. Note how Democrats’ friends, such as government unions, immediately received waivers from Obamacare. Rich or connected liberals, such as George Soros, Warren Buffett, Nancy Pelosi and Barack Obama, will always have access to the best doctors, just as Fidel Castro and Hugo Chavez do.
Republicans and Democrats are being equally nasty in their campaign rhetoric, but they’re not being equally truthful.
Until the SGR gets fixed the ACA is one big lie. As usual, Democrats and Republicans are lying pretty equally.
Ah yes, the old equal fallback. Works every time!
And this is why dems finally started getting down in the mud with the republicans. Too bad, but it isn’t like they had a choice. What will break the cycle when voters aren’t smart enough to looks at details, facts, and the record?
The ugly tone deconstructed:
http://www.balloon-juice.com/2012/08/16/the-new-ugly-tone/
Yup, they’re masters at the big lie and manipulation. Thanks for pointing out the facts
I admit I was at first soothed with the information that if anyone could still choose Medicare. Turns out Medicare will be paid for with vouchers as well.
Sen. Wyden has since withdrawn from support of the Ryan/Wyden plan in part because of Ryan’s limit of growth of overall spending as a percentage of GDP is 1/2 of Wyden’s (.5% vs 1%), in part because of the Medicaid block grant proposal and raising the age to start Medicare to 67.
Here is a synopsis of the original Ryan/Wyden plan, which even then had problems. It resembles Newt Gingrich’s 1995 plan which he declared would make Medicare “wither on the vine”. This explains why.
[Ryan and Wyden claim that their proposal guarantees that traditional Medicare “will always be offered as a viable and robust choice.” Unfortunately, that’s not the case. Under premium support, traditional Medicare would tend to attract a less healthy pool of enrollees, while private plans would attract healthier enrollees (as occurs today with Medicare and private Medicare Advantage plans). Although the proposal calls for “risk adjusting” payments to health plans — that is, adjusting them to reflect the average health status of their enrollees — the risk adjustment process is highly imperfect and captures only part of the differences in costs across plans that stem from differences in the health of enrollees.
Inadequate risk adjustment would mean that traditional Medicare would be only partially compensated for its higher-cost enrollees, which would force Medicare to raise beneficiary premiums to make up the difference. The higher premiums would lead more of Medicare’s healthier enrollees to abandon it for private plans, very possibly setting off a spiral of rising premium costs and falling enrollment for traditional Medicare. Over time, traditional Medicare would become less financially viable and could unravel — not because it was less efficient than the private plans, but because it was competing on an unlevel playing field in which private plans captured the healthier beneficiaries and incurred lower costs as a consequence. Ryan-Wyden also would allow private plans to tailor their benefit packages to attract healthier beneficiaries and deter sicker ones, which only makes this outcome more likely.]
http://www.cbpp.org/cms/index.cfm?fa=view&id=3704
The problem with the 700 billion is not that we found savings (I’m all for that), but that we didn’t put them back into Medicare, where it is desperately needed to make the program solvent, and instead spent it on a separate program. In that sense, I’d say it’s true that Obama took “717 billion out of it.”
As for whether or not it will affect beneficiaries, you don’t think insurers getting paid less to cover Medicare beneficiaries will result in fewer insurers willing to cover them? You don’t think hospitals and doctors getting paid less will result in fewer hospitals accepting Medicare patients?
As for whether a decrease in an increase is considered a “cut”, a “cut” has not actually meant “decreased spending” for some time now, a trend perpetuated mostly by Democrats. I believe the last politician I’ve heard actually talk about actual cuts is Ron Paul.
As for whether Democrats or Republicans are less truthful, there’s more than one way to mislead. One is to lie, the other is to withhold key facts, such as:
* Under the latest Ryan plan, the value of the voucher depends on the cost of the competing plans (which include traditional Medicare, as you noted), and those competing plans are required to meet the same standards as Medicare. (This, I understand, is the technical difference between “premium support” and “voucher”, but I don’t very much care what you call it.)
* The 6,500 figure you cite is not from an analysis of his latest plan, which would probably cost nothing or little extra due to the fact above. The only way it would cost extra to get traditional Medicare is if the private plans cost less, and if Democrats are right that the private sector can’t do it as efficiently as the government, then they won’t.
That’s not to say there aren’t things to criticize about Ryan’s plan. Here, I think, is a reasonable analysis:
http://www.cnn.com/2012/08/14/opinion/carroll-medicaid-medicare-ryan/index.html
TO,
That criticism is one I agree with, and the cnn article also points it out.
I’d tweak Ryan’s plan to specify that the private plans must not only be actuarial equivalent, but must cover the same things (and optionally more). From what I can reason, that should solve the selection problem. If a private insurer can charge less for the same coverage, what’s the downside? And if they can’t, then Medicare will be the cheaper option and the voucher will cover it.
How would private insurers charge less for the same thing and still make a profit? It’s a good question. It’s questionable whether they’d be able, but the only mechanism they could use is to find ways to keep their population healthy, perhaps by covering certain things to help keep people healthy, or by negotiating different payment structures to providers to move away from pay-for-service. I think we all agree that’s exactly what we need to happen to reduce costs in health care overall.
“How would private insurers charge less for the same thing and still make a profit? It’s a good question”
which is solved with non profit public health care… like I have in Germany.
The problem is that out entire system is in trouble. A medical degree costs too much… requiring future doctors to take loans… requiring them to charge serious prices to pay off those loans.
Getting a medical degree in Germany is FREE. Doctors do not make nearly the same money as US doctors, but they do very well and do not have to pay off 100k in loans.
this alone seriously drops the cost of health care…and the doctors also stay in Germany as opposed to going to the US for a big pay day.
we have a lot of fundamental problems that make health care too expensive…and all of the solutions that work over here are called “socialism” in the US.
Another article that claims “the other side is worse” and tries to support it with an single example (you can’t prove a generality with examples). Rather than sound like a broken record about how even this approach is misguided, I’ll just point out, while the author has indeed found a claim that is, at the least, simplistic, he calls them lies while his own article contains similar flaws.
For example, he claims that the GOP will “end medicare as we know it”. But he also admits that Ryan’s plan would allow people to continue to choose medicare. Now I’m sure people will make arguments, perhaps quite good ones, about how the _net_effect_ will be to “end medicare as we know it”. Of course conservatives will argue that squeezing providers by 700 million has to end up cutting services someplace. In the end, what the “net effect” will be is a matter of opinion.
Now before people jump into arguing who’s opinion is “right”, lets step back and note that opinions aren’t facts. And while arguing over who’s opinions are correct is the basis for debate, they aren’t a basis for saying someone is “lying”. In fact, the term “lie” has become almost meaningless in our current partisan system, having been reduced to “giving an opinions I don’t agree with”.
The idea that people are lying seems, in the partisan atmosphere, to be based on the assumptions that not only is our side “right”, but that the other side must know they are wrong and so be lying when they claim to have opinions one disagrees with. Since both of these are taken as a given by partisans, it is no wonder that the term “lie” gets thrown around as a matter of course.
Let’s all break it down to the nitty gritty for a moment:
What has the GOP attitude been toward entitlements for decades now? Why would anyone imagine their intent has suddenly become innocuous? Let’s be honest.
Well sure this can be called a fact, David. Medicare as we know it is a runaway entitlement program that’s on course to bankrupt the government. Any fix necessarily ends it “as we know it,” so that claim can be said to be true.
On the other hand, Mr. Robinson’s complaint is that Ryan’s version of Medicare won’t pay for all the care that future recipients are expecting. In that sense it’s exactly the same as the existing plan, which won’t be able to pay for them either. One could argue the most worrisome threats of Ryan’s plan are already with us.
Two ‘nutters’ agree and it’s a ‘fact.’
Cool… What’s new?
@adelinesdad: The saving were indeed “put back into Medicare,” or, more precisely, were never taken out in the first place. If you won’t take Gene Robinson’s word for it, you can check this out for yourself. The Medicare Trustee’s reports can be found at the following URL:
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/index.html?redirect=/ReportsTrustFunds/
In the 2010 report, there is a detailed discussion of the affects of the Affordable Care Act on Medicare. Specifically note paragraph 3 on page 8, which states that the projected date when the HI trust fund is depleted has been moved forward by 12 years as a result of the changes made by the Affordable Care Act. In the 2011 and 2012 reports, the thing to look at is the first table in section II.B. This shows that Medicare funds are used for two purposes only: to pay Medicare benefits and to pay administrative expenses. No money was taken out of Medicare for any other purpose.
Today’s New York Times Editorial on “THE ALLEGED “RAID ON MEDICARE” (The Times’ emphasis)
Some will say, “consider the source.” Oh Well, let’s have your sources…
“A Republican attack ad says that the reform law has “cut” $716 billion from Medicare, with the money used to expand coverage to low-income people who are currently uninsured. “So now the money you paid for your guaranteed health care is going to a massive new government program that’s not for you,” the ad warns.
What the Republicans fail to say is that the budget resolutions crafted by Paul Ryan and approved by the Republican-controlled House retained virtually the same cut in Medicare.
In reality, the $716 billion is not a “cut” in benefits but rather the savings in costs that the Congressional Budget Office projects over the next decade from wholly reasonable provisions in the reform law.
One big chunk of money will be saved by reducing unjustifiably high subsidies to private Medicare Advantage plans that enroll many beneficiaries at a higher average cost than traditional Medicare. Another will come from reducing the annual increases in federal reimbursements to health care providers — like hospitals, nursing homes and home health agencies — to force the notoriously inefficient system to find ways to improve productivity.
And a further chunk will come from fees or taxes imposed on drug makers, device makers and insurers — fees that they can surely afford since expanded coverage for the uninsured will increase their markets and their revenues.
NO HARM TO SENIORS The Republicans imply that the $716 billion in cuts will harm older Americans, but almost none of the savings come from reducing the benefits available for people already on Medicare. But if Mr. Romney and Mr. Ryan were able to repeal the reform law, as they have pledged to do, that would drive up costs for many seniors — namely those with high prescription drug costs, who are already receiving subsidies under the reform law, and those who are receiving preventive services, like colonoscopies, mammograms and immunizations, with no cost sharing.
Mr. Romney argued on Friday that the $716 billion in cuts will harm beneficiaries because those who get discounts or extra benefits in the heavily subsidized Medicare Advantage plans will lose them and because reduced payments to hospitals and other providers could cause some providers to stop accepting Medicare patients.
If he thinks that will be a major problem, Mr. Romney should leave the reform law in place: it has many provisions designed to make the delivery of health care more efficient and cheaper, so that hospitals and others will be better able to survive on smaller payments.”
This is one fact-check. Would be interested in seeing a “fact check” that disproves these claims.
Read more here:
http://www.nytimes.com/2012/08/19/opinion/sunday/truth-and-lies-about-medicare.html?_r=1&nl=todaysheadlines&emc=edit_th_20120819
(I’ve been on vacation and disconnected for a few days, so I may or may not get around to responding to some of the other points raised since my last comment, but I’ll start with this one.)
Kenneth,
The double-counting of the savings as both extending the life of Medicare and also paying for the new programs created by the ACA is a problem that has been much discussed. Based on the accounting rules, my understanding is that the Medicare trustees are bound to consider those savings as going back into Medicare, extending its life. One the other hand, the CBO is bound to consider the over-all effect of the ACA, which means that they offset those savings with additional, non-Medicare spending in the ACA. In response to the dilemma, the CBO issued a report indicating that this obviously doesn’t add up:
http://www.cbo.gov/publication/25017
“The key point is that the savings to the HI trust fund under the PPACA would be received by the government only once, so they cannot be set aside to pay for future Medicare spending and, at the same time, pay for current spending on other parts of the legislation or on other programs. Trust fund accounting shows the magnitude of the savings within the trust fund, and those savings indeed improve the solvency of that fund; however, that accounting ignores the burden that would be faced by the rest of the government later in redeeming the bonds held by the trust fund. Unified budget accounting shows that the majority of the HI trust fund savings would be used to pay for other spending under the PPACA and would not enhance the ability of the government to redeem the bonds credited to the trust fund to pay for future Medicare benefits. To describe the full amount of HI trust fund savings as both improving the governments ability to pay future Medicare benefits and financing new spending outside of Medicare would essentially double-count a large share of those savings and thus overstate the improvement in the governments fiscal position.”
See also, from the Public Trustee for Social Security and Medicare and co-author of the Medicare report you cited: http://mercatus.org/publication/fiscal-consequences-affordable-care-act
Dorian, quoting the NYT:
A fair point, except that the emphasis in the ad appears to be “that’s not for you.” Retaining the cuts themselves isn’t a problem, as I’ve said, as long as they are put back into Medicare, which appears to be what Ryan would do and I would approve of. Everyone wants Medicare to cost less, and it’s obvious that it must. The issue is what do we spend (or not) the savings on?
“Reasonable provisions” is a matter of opinion. I question whether reducing payments to doctors and hospitals from already low levels is going to promote efficiency or cause access problems. Also, those savings are uncertain, but the spending is not.
Dorian: “This is one fact-check. Would be interested in seeing a “fact check” that disproves these claims.”
I don’t know how to disprove an opinion, but here’s a start: http://www.politifact.com/florida/statements/2012/aug/20/mitt-romney/romney-says-obama-cuts-716-medicare-pay-obamacare/
They rate Romney’s statement as “half true”. The reasons for the “half” are:
1) His use of the word “cut” to mean “reduction in projected growth.” Yes, I agree, but the word “cut” is used with this meaning frequently by both parties, to the extent that it’s arguable whether the word really means what it used to mean. A few years ago Republicans used to get worked up about Democrats using the word to describe their proposals to cut spending, but I rarely hear the objection anymore. I think the political class has more-or-less accepted the new definition. In any case, it’s a semantic argument and I’m concerned more about the substance.
2) His assertion could use more explanation. Sure, it’s a complicated argument that takes some explanation, as I’ve tried to do supplemented by the links. That doesn’t make what he said wrong, though.
Notably, though, the fact check does not dispute that the money is effectively taken out of Medicare to pay for other programs.
ShannonLeee, I agree that doctor’s pay is a part of what makes healthcare in the US more expensive, and that may be made worse by certain policies. However, it’s also true that high-skill labor in general pays more in the US than elsewhere, so this is part of a problem that is not limited to health care. To avoid repeating myself, I’ll refer to you to what I wrote on my own blog about it: http://sovereignmind.wordpress.com/2009/11/23/why-does-health-care-cost-so-much-in-the-us/
AD,
Thanks for your comments.
In the end, perhaps with the exception of the CBO reports and hopefully the politifact.com fact check and a couple of other non-partisan fact checking organizations, we are all expressing opinions, or opinions on opinions (as I have done myself and as you do, for example, your opinions that “the emphasis in the ad appears to be ‘that’s not for you’” and that “’Reasonable provisions’ is a matter of opinion.”)
As to my “I would be interested in seeing a ‘fact check’ that disproves these claims,” you correctly state, “I don’t know how to disprove an opinion, but here’s a start:” and you link to politifact.com where we read their “ruling” as:
The problem is that, then, you start stating your opinions (the use of the word “cut,” and, more importantly that “the money is effectively taken out of Medicare to pay for other programs”) on even this fact-check, we have come full circle.
I could “opinionate” about your use of the word “effectively” and, for example quote parts of politifact’s “verdict” and lift phrases and sentences and entire paragraphs to support my opinions, as I have done in bold, below:
Good place to leave it at.
I respect your efforts and your opinions, but I will continue to disagree with them and I hope you’ll respect such.
I believe the facts support my opinion that the ACA does, in effect, take money out of Medicare in order to fund non-Medicare spending. However, I recognize that you think the facts support a different opinion. Nevertheless, I’m happy that we can agree, it seems, that whether or not the substance of what Romney and others have said regarding the ACA and Medicare funding is true is a matter of opinion. It’s a matter of how the facts are interpreted.
The original post says that Romney and other Republicans and being dishonest about the issue. It’s not necessary for me to prove that your opinion and interpretation of facts on the matter is wrong in order to counter the assertion that they are being dishonest. It is only necessary that I present facts and reasonable interpretation of facts that back up an alternate opinion, as I believe (in my opinion) I have done*. You are still free to disagree with that opinion, but it then becomes more difficult to argue the opinion is dishonest.
*To recap:
A “cut” and a “decrease in growth of spending” are terms that are different but in political rhetoric have come to mean the same thing and are commonly used interchangeably by politicians of both sides. I believe this to be a fact, but if you dispute it I can find examples.
Using the accounting mechanism of the CBO, which is heavily relied upon by Democrats to claim that the ACA does not raise the deficit, the savings from Medicare are used to fund non-Medicare spending. This is also a fact. The reasonable interpretation of this fact that I’ve put forth is that the phrase “taking money out of Medicare” is, in effect, true.