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Posted by on Dec 19, 2012 in Breaking News, Economy, Politics | 18 comments

Democrats Dismiss Boehner’s ‘Plan B’ in Fiscal Cliff Talks

Democrats dismiss Boehner’s ‘Plan B’ in fiscal cliff talks (via AFP)

US House Speaker John Boehner unveiled his “Plan B” on Tuesday as Republican lawmakers wrangled with Democratic President Barack Obama over how to steer the economy past the so-called fiscal cliff. Boehner, whose party holds a majority in the lower house, said he was now prepared to countenance a tax…

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  • zephyr

    By all means, let’s cave to the republicans again. What is wrong with Obama???

  • KP

    From the center I have been hoping for tax increases and significant spending cuts. Like new legislation on firearms, there are reasonable and acceptable solutions for most Americans if we mix in a bit of fallibilism.

  • petew

    I think Obama has had much practice negotiating with others, before and after his election in 2008. This means that he is not opposed to moderate positions that represent real compromise.

    Although I see nothing wrong with him keeping the $200,000 lower limit for extending the Bush tax cuts, and although I would prefer that not one single cent be cut from SS, Medicare, and other entitlement programs, the fiscal cliff does represent a real danger, and I would rather see a solution involving some actual and meaningful compromise from Republicans. This being said, is Boehner actually making a practical suggestion?—I would guess that since relatively few tax payers make 1 million in taxable income each year, that the $250,000 level and even the compromise of raising that to $400,000, would represent considerably more revenue than setting the cut off point at $1000,000. So, I think the president should hang-tough on the concessions he has already made. After all, I perceive Democrats as being the only party that has been willing to make any meaningful concessions at all. And, even when it comes to the President’s desire to have the power to automatically raise the debt ceiling, can anyone really blame him?

    Even after quoting Ronald Reagan about the dangers of anyone using the debt ceiling as a form of political grandstanding, it was Republicans who refused to listen and, who brought us close enough to the brink, to do real damage to our credit rating.

    If we want all of this foolishness to end, we’ve got to hope that the President doesn’t give in too much in this negotiation. While his relatively small margin of victory in the popular vote, may not be considered a solid mandate from voters, polls show that more than 2 thirds of voters back the President’s proposals to raise taxes on the wealthy. This means that even if we do go over the cliff, the public is much more apt (and rightly so) to hold the GOP responsible—what does this public opinion represent but a definite mandate concerning the specific issue of taxation?

  • slamfu

    I’ll take the following deals in the following order:

    1) Obama’s offer
    2) Fiscal cliff
    3) Whatever the GOP is offering.

    We’ll survive the fiscal cliff, but I assure you, anything the GOP puts forward will minimize the impact on the wealthiest, shunt almost all of any costs onto the middle class who already don’t have hardly any money above the necessities, and will siphon money out of the consumers of this nation further deepening the recession. Its how they roll. They still think if their top donors have it just a little easier it will fix things. They haven’t been paying attn for the last 12 years. They haven’t ready anything about the 1930’s and how we got out of the depression, or the 1920’s and how we got into it. They are idiots. Far, far bigger idiots than the democrats, which is saying something.

    Obama better not blink.

  • sheknows

    That is indeed the key to a successful negotiation, not to give too much away. Obama has to get tough here. He simply cannot give away too much on SS or Medicare in terms of dollars. Maybe some legislation regarding these entities would be more responsible, such as means testing and caps on medical costs. If private Insurance can place caps on what they will pay for procedures and care, surely the govt. can. Also implement better fraud detection software in the computer systems. They need to SAVE money on these programs, not take money.

    $400k is reasonable to raise revenue, and Boehner should see that. But Obama shouldn’t give him big cuts on those programs that the elderly need so badly. Afterall, THEY cannot increase their income to compensate…they just get poorer.

  • zephyr

    What slamfu said. If Obama caves at all on social security he will forever lose my respect. And btw, cry me a river 400K. Good grief, have these people all lost their minds?

  • KP

    @sheknows “But Obama shouldn’t give him big cuts on those programs that the elderly need so badly.”

    I don’t think he should give up big cuts either. But I don’t know anyone calling for big cuts in a serious way. How about small cuts? We are living into our 80s and 90s. There was a time 65 was old. Not today. For most, there is no reason to stop working at 65. Would you agree to consider moving the age of eligibility to 67? For those who are uninsurable or disabled or unable to work Obamacare should cover them.

    Thirty years ago age 65 might have been necessary. Things are happening in medicine that are rapidly changing lifespans and the quality of life. In the next ten years stem cells and DNA treatments will see patients replacing organs, treating diseased brains and saving limbs, joints, etc. It looks like we may see 125 years old on a regular basis soon. Certainly between current longevity and Obamacare we can raise age qualifications?

  • KP

    @sheknows “If private Insurance can place caps on what they will pay for procedures and care, surely the govt. can.”

    The government reimbursement schedule is more tightly controlled than private insurance. In many cases the payment schedule is so low and the paperwprk so cumbersome and the limits on treatment so unreasonable that providers are not taking medicare patients any longer. They actually lose money on those patients. This is will worsen as Obamacare is implemented. We are going to have a severe portal entry doctor shortage very soon. If the government keeps putting cost cutting measures on the treating doctors these bright people will find other work that is more desriable.

    These men and women often don’t even begin making a physicians salary until their thirties and graduate school with $250,000 in debt. They sometimes work 60hr weeks and then spend time at night doing paperwork and answering emails. Then there is the risk of malpractice. They don’t have to be wrong to have a patient and attorney throw down on them.

    If you want really good care from a doc that cares about you, he or she needs to work reasonable hours, have a patient load that supports quality care and he shouldn’t feel like he is losing money just because a patient walks in the door.

  • sheknows

    KP… I really don’t see that “low” payment schedule you are talking about. My doc charges $380 for a ROUTINE visit and a few tests equalling another $600. Medicare pays 80% of that and my supplement pays the other 20%. Hardly low.
    Limits on treatment? Haven’t found any yet. They paid for my phys. rehab class to the tune of..get this…$250 an hr without batting an eye. I could have gone to as gym for $40 a month! Then lets discuss my hospital bill…..INSANE charges…but they paid. PULEEZE!!

  • sheknows

    See KP, alot of what you are not taking into account is the bill padding that takes place. The docs and hospitals get their money…believe me. Medicare needs to CAP these prices. They don’t. I know. They actually paid, among other things on my bill $6.00 for a box of tissues!!

  • KP

    I am taking everything into account, that I have access to. I have access to everything you do. I have had a very different experience with Medicare; both as a provider and as the ongoing decision maker (power of attorney and DNR for medical treatment and rehab for my mother following stroke. What you describe should make everybody uncomfortable. It makes me uncomfortable. Likewise, what I describe from personal first hand experience over thirty years should make you uncomfortable. Like most issues, there is truth in both experiences and we probably have some solid common ground. That’s why I like TMV so much. There is a lot to learn here. Thanks, sheknows.

  • KP

    Did you give any consideration to my comments about raising age qualification from 65 to 67?

  • sheknows

    Well, you will have to excuse me if I come off a little militant on this issue. One of my greatest pet peeves is the govts ineptitude at stopping Medicare fraud. That is a whole other discussion, but essentially I see other avenues of reform of Medicare that don’t have to involve cuts to benefits or higher costs. As I have said before, cutting benefits is like throwing passengers off a ship to lighten the load because there is a big gaping hole in it. Why don’t we fix the hole.

  • sheknows

    And yes, for the age raising. I would have no problem with it, but then I am in reasonably good health. Others who might have to wait an extra 2 years, especially if already retired and on SS could not afford private healthcare.
    Hell…unemployed people can’t afford cobra now at $475 a mo. Double that for a private ins. company to insure a 65 yr old.

  • KP

    I am shoulder to shoulder with you on stopping Medicare fraud. That is a HUGE deal to me. No worries about sounding militant. You don’t.

    I’ll bet that you and I could hash out a deal that we agreed on that raises taxes and makes some attempt to cut spending in one afternoon over lunch. That’s how confident I am that Congress doesn’t represent our best interest and is overwhelmingly power oriented rather than results oriented.

  • petew

    Sheknows and KP,

    The two of you seem to be having a private conversation. But, a lot of what you say is true. I especially agree that just about the biggest problem with Medicare is the tremendous amount of fraudulent claims that are filed. I have even heard that they amount to hundreds of Billions of dollars per year. But some lawmakers have already given up, and, consider eliminating fraud to be a foolish and impossible dream—before even trying to end or eliminate big chunks of it. I agree that we should be able to use fraud detecting software more successfully and easily. Perhaps with the exponential rate of digital knowledge that happens each year, this can actually be accomplished sooner than we think.

    Another thing is that, as Obama says, we are learning from cities and municipalities that have already taken steps to think outside the box, and, are successful at doing so. Certainly we have the resources and helpful knowledge to work out all the bugs in our healthcare system so that we will not have to return to pre-recession era, when the private healthcare system, was rapidly becoming more costly and less successful at every days turn!

    A few months ago, our PBS station aired a documentary concerning the many areas that have learned how to lower the costs of healthcare, and mentioned some interesting discoveries—one being that more Doctors than we might guess, are willing to earn fixed salaries rather than be paid for treatments they administer and tests they run which may not even be necessary, and they are also pointing to the fact that more focus should be placed on preventative medicine that can become financially unchained as well, and, can effectively deal with illnesses once they have really developed

    The critics will always cry IMPOSSIBLE, and doubt that such changes can be made, but Obama has never claimed that this is all a done deal, and regarding the ACA legislation, he has always said that it is going to need many tweaks and, the input of every member of Congress can help, provided that we really continue to honor such needed revisions. And, no one should consider compromise, promising not give up, before trying them. Romney’s Massachusetts focused first on getting people covered and then, and on making the system less costly! we have then, and now, the rest of the country can too! YES WE CAN!

  • ShannonLeee

    400k is reasonable. Obama should not budge from it….. he probably should have offered 350k…and then could move to 400k in the final deal.

    As for cuts to SS or Medicare. Solvency is not the reason Reps want to cut the programs. They want people to believe that they can no longer rely on the programs. It is part of a long term plan to dissolve the programs.

  • KP

    Good stuff, petew, thanks for jumping in.

    As I was sharing with sheknows, beyond fraud, Medicare has a large issue with providers. Their reimbursement schedule has doctors running the other direction. Last year Obama has praised the Mayo Clinic as a “classic example” of how a health-care provider can offer “better outcomes” at lower cost. But the Clinic is removing coverage of Medicare patients.

    Specifically, Mayo has said it will no longer accept Medicare patients at one of its primary care clinics in Arizona. It will decide on whether to drop Medicare patients in Florida and Minnesota, which serve more than 500,000 seniors, soon.

    Mayo says it lost $840 million last year treating Medicare patients, the result of the program’s low reimbursement rates. Its hospital and four clinics in Arizona—including the Glendale facility—lost $120 million. Only governments can lose that much money and pretend they don’t have to change.

    ***** As I mentioned to sheknows: “Mayo Clinic loses a substantial amount of money every year due to the reimbursement schedule under Medicare,” the institution said. “Decades of underfunding and paying for volume rather than value in Medicare have led us to this decision.”

    Mayo is probably a leading indicator of where other hospitals and doctors are headed. Physicians on average earn 20% to 30% less from Medicare than they do from private patients, and many are dropping out of the program.

    In some specialties—neurology, oncology, gynecology—in places like Manhattan and Washington, patients can struggle to find any doctor who’ll accept Medicare.
    “The $500 billion in Medicare cuts planned as part of ObamaCare won’t help this trend. The hospital industry agreed earlier this year to chip in $100 billion over the next decade in lower annual payment increases for Medicare. The chief Medicare actuary estimates that up to 20% of hospitals could become unprofitable as a result of the scheme.”

    “The irony is that the Obama Administration has repeatedly praised Mayo as an example of the efficiency and lower cost.”

    As far as salaried physicians; at Kaiser in California physicians are also salaried. That is my insurer. Mayo’s doctors are salaried and work in teams. Mayo would prefer to receive a bundled payment for an episode of illness, rather than the Medicare practice of reimbursing for individual procedures. As it is now under Medicare, Mayo’s less-is-more model means it can’t make up its true costs on volume.

    The new exchanges will essentially import Medicare’s rules. The real Mayo story is that troubled Medicare is preventing the growth of more hospitals and clinic like Mayos and Kaiser of California, and that ObamaCare is paving the way for all of health care to operate like Medicare. That is not helpful is we want to see cost savings. And it is driving doctors away from treating Medicare patients. Finding providers is going to be a _huge_ issue.

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