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Posted by on Jun 3, 2011 in Politics | 31 comments

Have Republicans Voted To “End Medicare”?

A commercial running in New Hampshire that criticizes Republican Rep. Charlie Bass makes that claim; the National Republican Congressional Committee has demanded the TV commercial be pulled.

The key phrase comes at 0:15: “When Congressman Charlie Bass voted to end Medicare, that was an attack on New Hampshire families just like mine.”

Is it accurate to characterize the budget resolution vote as a vote to “end” Medicare?

The House effort would seriously restructure Medicare for anyone who is, today, younger than 55. (That means I’m exempt but my other half is not.) According to Politifact:

The nonpartisan Congressional Budget Office (CBO) analyzed Ryan’s proposal and found that it will save the government money. But it does so by asking future Medicare beneficiaries to pay more for insurance.


The Republican proposal will end the aspect of Medicare that directly covers specific services, such as hospital coverage. “It’s as if you took the Office of Faith-Based Partnerships and ended the faith-based portion of it, but continued to call it faith-based,” said Jesse Ferguson of the DCCC. “There is no doubt that Medicare — a health insurance program for seniors — would end under the House Republican plan and, according to the independent Congressional Budget Office, health insurance costs would rise for seniors.”

Unquestionably, the Republican budget proposal — should it be codified as enabling legislation — would end Medicare as we know it today. That, however, is not nearly as “punchy” as the claim that Bass voted to “end” Medicare, period. Over-simplification is the enemy of truth and accuracy.

Hyperbole is the stock in trade of political commercials. Viewed in that light, the New Hampshire ad falls into the same category in my mind as Willie Horton*, for example. That doesn’t make it right or OK. It simply means that the Democrats fight just like the Republicans do, with exaggerated FUD. And that’s no way to run a democracy (or elect its leaders).

* Both campaigns — this year’s Medicare and yesteryear’s Horton — were “independent” efforts, not directly affiliated with candidates. As the Washington Post noted in 2004, the Willie Horton ad was short on facts:

It has not mattered much that the facts underlying the commercials were inaccurate, or at least distorted. As Dukakis and his defenders pointed out, the prison furlough program in Massachusetts had been started under a Republican administration and had bipartisan support under Dukakis, who ended the program in early 1988. Moreover, the federal government, under President Ronald Reagan and Vice President Bush, had its own furlough program.

Addendum: Lee Atwater was Bush the elder’s campaign messenger. He’s infamous for this quote: “By the time this election is over, Willie Horton will be a household name.

They succeeded in that goal, though the Horton ad soon became notorious for, in the words of Annenberg School of Communications Dean Kathleen Hall Jamieson, creating “a black face for crime.”

It succeeded, largely by incessant repetition by the television news. And though Federal Election Commission complaints alleging collusion between the Bush campaign and the team responsible for the Horton ad went nowhere, then-President Bush himself defended the spot in July 1991, after then-Sen. Bill Bradley accused the president of using “the Willie Horton ad to divide white and black voters and appeal to fear.”

“The point on Willie Horton was not Willie Horton himself,” Bush said. “The point was, do you believe in a furlough program that releases people from jail so they can go out and rape, pillage and plunder again? That’s what the issue was.” (Salon, Aug 25, 2000

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  • Bob Munck

    So if Hitler had carried through with his plans but started a religion worshiping him and called it “Judaism,” we wouldn’t be able to talk about the Holocaust?

    There is a point where you’re no longer changing the thing, but rather destroying it and building something different in its place. It’s possibly not a bright line, but the Ryan proposal is well over it for Medicare. The GOP wants to fool people with their naming of things, and apparently it’s working for Kathy Gill. Mistaking the name of something for the thing itself is the true enemy of truth and accuracy.

  • DLS

    Ryan’s plan was (and i have used this correct word numerous times before) to transform Medicare from a fake “insurance” that has the federal government pay providers for services rendered, to a program that would supply vouchers, for only a part of costs, to the beneficiaries, who would then have to find (private) insurance. Same name as before, but obviously something else.

  • Note on my Willie Horton reference: MA was the only state that allowed prisoners with life-sentences access to the weekend furlough, something that came about due a court ruling. Of course, providing that context makes it hard to create a snappy 30-second ad.

    Kathy’s rule of thumb: it takes at least five times as much “stuff” (sentences, minutes) to refute claims like these … which is why consultants use them. We’re a nation of fast-food for the brain, too. “Don’t make me think!” is the (unstated) American approach to policy matters and politics.

  • casualobserver

    Not only is the hyperbole an issue, but the brainpower of the spokesperson. Persons already qualifying for Medicare are not affected by the proposed changes.

  • davidpsummers

    “Hyperbole is the stock in trade of political commercials.”

    Heck, I would say it is probably fair (ie not hyperbole 🙂 ) to say that it is close to being stock in trade almost any political commentary these days. (So I would say that the quote is an understatement 🙂 )

  • To Bob:
    It’s a budget resolution. It’s not enabling legislation. There is a world of difference between the two.

    Even Obama (reportedly) calls the Republican proposal an end to Medicare “as we know it.” (I used the phrase before I saw that it had been attributed to him.)

    EDIT: And bravo — we’ve proceded straight to Hitler with the very first comment. That’s got to be a Godwin’s Law record –'s_law

  • From the CBO analysis –

    Among other changes, the proposal would:

    * Convert the current Medicare program to a system under which beneficiaries would be entitled to premium support payments to help them purchase private health insurance. Those payments would grow over time with overall consumer prices. The change would apply to people turning 65 beginning in 2022; beneficiaries who turn 65 before then would remain in the traditional Medicare program, with the option of converting to the new system.

    * Convert the matching payments that the federal government makes to states for Medicaid costs under current law into block grants of fixed dollar amounts beginning in 2013. Those amounts would grow over time with overall consumer prices and the population.

    * Repeal the key provisions of the major 2010 health care legislation that deal with insurance coverage and certain other provisions.

    From the LA Times analysis of the CBO analysis:

    “But the CBO report says the money won’t be enough. The cost to buy private insurance, plus the projected out-of-pocket spending that the 65-year-old would have to pay for medical care in 2022, would total about $20,510 per year, according to the CBO, which both Republicans and Democrats rely on to independently evaluate the effects of proposed legislation.”

  • @CasualObserver is spot on — the choice of spokesperson seems to lend another layer of deception to the ad (ie, she appears to be >55 which means she isn’t affected by the proposal).

    Another problem with the ad, IMO, is that it implies that there was a vote on Medicare, which there was not. There was a vote on the budget resolution.

  • DLS

    Kathy, “Godwin’s Law” is complete silliness. Logically those who want to enforce it also must be compelled to remove a huge amount of 1930s and 1940s (especially) history. (Also, to remove all thoughts about Hitler, his associates, Nazi Germany, etc.)

    It’s a silly game or fad played by some (usually lefties) on the Net — it’s nothing more substantial or respectable.

  • Godwin’s Law is simply an indicator of defeat. It’s not something that’s “enforced”. By the time things roll around to Hitler comparisons, you’ve probably lost your point.

    More interesting to me, is the budget that comes out from behind closed doors. Everything else has gone down in flames.

  • TheMagicalSkyFather

    Here is the problem with the 55 cutoff line. Why on earth will the rest of the nation pay for the gold plated version that the largest and most expensive part of the market will get when they know when they retire they get the shaft? How long will that work? See that will shift the “the workers are paying for the lazy” argument from the right to the left since the GOP will remain defending their base, the boomers that are largely unaffected by this change AND are part of why the program is going belly up(we will change lazy to old). What the Ryan plan does is make younger supporters of medicare/caid like me turn their back on the program and want it to die a quick death because we are in this together or we are not. If we are only looking out for me and mine then I need that extra money to do so.

    This is why over 55 should be scared because a large enough monkey wrench in the gears and we are closer to an end of the entire concept. Also any amount we give for seniors to pay into the already proven failure of the insurance system will only result in that amount magically becoming the basement price for a plan. Much like college subsidies and loans this will only make what we laughingly call a free market system worse and all because we lack the guts to move to single payer or a true free market model, in health care the mixed model is a proven failure.

  • SteveinCH

    I hope you aren’t serious MSF. As someone under 55, I know I’m getting the shaft on Medicare and SS anyway. Honesty is better than pretending it won’t happen.

  • Bob Munck

    @KATHY GILL 4:19 PM

    Godwin’s Law is about comparisons to Hitler; I used an analogy involving Hitler.

    I don’t understand your point about a budget resolution not being the same thing as enabling legislation. Are you saying that in its current form it doesn’t actually do anything, but only calls for things to be done in the future? I’m quite sure that the plan is to enact the changes described in his budget resolution as enabling legislation. So what difference does that make?

    Or is your point just about the vote being on the budget resolution, not Medicare per se?

    The problem with having to say “Medicare as we know it” is a red herring; simply call Medicare “Medicare” and Ryan’s proposal “Ryancare.” He wants to eliminate Medicare in favor of Ryancare. Explain both; summarize the differences; make some tables and graphs.

    (Btw, I’ve been on the net since 1972; I’ve violated Godwin’s Law so many times that HE compares ME to Hitler.)

  • DLS

    MSF wrote:

    Here is the problem with the 55 cutoff line. Why on earth will the rest of the nation pay for the gold plated version that the largest and most expensive part of the market will get when they know when they retire they get the shaft? How long will that work?

    I’ve written about this before, taking what amounts to a “devil’s advocate” stance joining farther-left people who understand already that the reason for universality with entitlements, and for resisting any change from this, is that when universality ends, so will general popular support for what then becomes a stigmatized program directed primarily at the poor. I’ve taken some grief from those who dispute it, but I remain convinced it’s true.

    In this case, too, the answer about under-55s getting angry is that like it or not, despite the basic problems with entitlement growth and unsustainability, the likely trend for health care is for more and more of it to be provided by (the federal) government (or paid for, anyway) — as I’ve said, within ten years and possibly in as few as five, Medicare for All will no longer be radical. Even people in the health care field are coming around to this, not only the providers I talked to about it before 2005 when I was in St. Louis, but as recently as a few days ago in the New York Times.

    (notably blue New England)

    The quick answer to MSF’s questions is, everyone else will someday be 55 or older and they’re not optimistic about their prospects with health insurance as it is (largely private) now.

    I’ll also add that this will add to the “generational divide” coming big conflict between increasing numbers and fraction of the population that is elderly and receiving SS and Medicare, and the younger people who already are somewhat resentful taxpayers.

  • Hi, Bob — both.

    (1) A budget resolution sets out a budget for THIS fiscal year. It is not binding on future fiscal years.

    (2) A budget resolution is not a bill; bills are what make legislation.

    A bill is the form used for most legislation, whether permanent or temporary, general or special, public or private.

    The form of a House bill is as follows:

    A BILL

    For the establishment, etc. [as the title may be].

    Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That, etc.
    The enacting clause was prescribed by law in 1871 and is identical in all bills, whether they originate in the House of Representatives or in the Senate.

    A Budget Resolution binds Congress (for one budget cycle) but it is NOT LAW.

    You cannot “repeal” a law through a budget resolution.

    (3) No one has voted on a bill (a law) to repeal (or redefine) Medicare.

    This is SLOPPY rhetoric.

    Americans are clueless enough about their government; it makes matters worse that political operatives deliberately add to the confusion.

  • JSpencer

    Of course hyperbole is the stock and trade of politics, but to the extent it’s been ramped up by D’s it’s been a mostly delayed reaction to R’s having thrown honesty and accuracy out the window long ago. This doesn’t make it right of course, but the “chickens coming home to roost” component shouldn’t be overlooked. In any case, it’s hardly any secret that today’s GOP would happily ditch any and all social programs (not to be confused with corporate sycophancy) if they though it was possible to do without committing political suicide.

  • TheMagicalSkyFather

    Actually I am serious as a heart attack. Why should Gen X or Y pay for the Boomers, that largely voted for constant tax cuts without gov cuts AND that were the last generation to do better than their parents, to have gold plated coverage? After all they are the only gen group that comes close to being able to afford it. They are the problem, they are too large a group hitting the system all at once while the lower generations salaries continue to fall. How is that not a nightmarish situation. You are talking about the group that voted for pols that ballooned the deficit pushing it off on Gen X, Y and those to follow to pay for their tax cuts and programs and weapons they refused to pay for themselves and now they want to pull up the ladder of healthcare and likely in the end SS after they are done benefiting from it. Yea, screw that. If under 55’s get the shaft I want it all burned to the ground I am rather sure I will not be alone in that sentiment.

  • SteveinCH

    LOL. You are going to get screwed if the programs aren’t changed anyway. Maybe you don’t realize that.

  • TheMagicalSkyFather

    Oh I do, what I dont accept is the best option is to throw them into a market that is #1 not free and #2 largely created the mess we are in with the entire health care industry. Saying “it will not be there for me” is only true if you decide you refuse to fix it any way that doesnt amount to gutting it, at which point *shock* it wont be. Why would I support #1 getting the shaft in my retirement and yet pay for those that created this mess to keep all the bene’s they havent paid for and #2 shift them into the market with a 15k base payment for healthcare which will only distort the market even MORE. I am sorry but the way I see it everyone under 55 will get screwed twice and the only people benefiting will be on Wall Street, well and those burn it down that will have the luxury of living off the taxpayers while sitting on the money and property they accumulated while not paying taxes and shifting jobs overseas. I think we already have more than enough of that as it is. Any other false binary choices you would like me to bat down?

  • SteveinCH

    Except of course that the alternative solutions, at least the ones I’ve heard you propose, are completely infeasible.

    I’m not arguing for the Ryan plan but if the choice is between Ryan and the Democrat bury your head in the sand and hope the problem goes away, it’s a pretty easy choice.

    Of course, I also believe that, as a matter of government solvency, a defined benefit pension at public expense is fiscally irresponsible but that’s a far broader discussion.

  • SteveK

    Except of course for the alternative solutions used in:

    • Canada,
    • India,
    • Israel,
    • Denmark,
    • Finland,
    • France,
    • Germany,
    • Ireland,
    • Italy,
    • Netherlands,
    • Russia,
    • Sweden,
    • Switzerland,
    • United Kingdom,
    • Australia,
    • New Zealand,
    • etc.
    • etc.
    • etc.

    Ya, gotta love the, “Everybody is out of step except US” argument, it’s so…

  • SteveinCH

    Who made that argument, certainly not I.

    SteveK, please help me understand why costs are lower in those other markets is it,

    1. A healthier population
    2. A willingness to provide less end of life care
    3. Higher utilization of capacity via rationing
    4. Lower wages for doctors and other HCPs
    5. Lower costs for pharmaceuticals
    6. Lack of a strong practice of defensive medicine
    7. The payments system.

    If you think the answer is 7, you’re nuts. So please tell me, other than number 5, which of the cost drivers you think the government of the United States should implement as part of its cost savings program under single payor.

    Single payor is either code for some portion of 1-6 or it has no impact. Pick away. I’ll be waiting ; )

  • SteveK

    Waits over!

    Single payer (Universal) Health Care works and is providing ALL other ‘first world’ nations with more services, lower costs, and, longer life expectancies.

    You seem to think if you change a word or two you’re asking a new question… You’re not, it’s the same question that you keep asking over and over again.

    It’s been answered… and the answer is that you are wrong. This “show me AGAIN” game you want to play is a waste of time.

    If you want to see how the Health Care World is working (and not working) you’ll just have to backtrack and find the National Geographic Graph that compares “cost”, “services”, “satisfaction”, “life expectancy”, No. of doctor visits / year between the U.S. and all those other countries you seem to think have it all wrong.

  • SteveinCH

    What a surprise that you chose not to answer.

    The biggest difference in cost is what is paid for services. As soon as you say…yes, we need to cut HCP salaries by 50%, we’ll have a discussion to have. Until then, well, you can keep spewing irrelevant comparisons.

    Total cost is unit cost times number of units…pure and simple. Both unit cost and number of units is lower. If that’s what you want, just say so.

  • SteveK

    SinCH, Your comment was read.

  • TheMagicalSkyFather

    SteveinCH-Infeasible could have a bit to do with the fact that we refuse as a nation to grow up and accept that we do not have anything approaching a free market. Yet you prefer this option although you have stated many many times your main issue with entitlement and gov welfare programs is not that they help the poor but that they help the well off and old that do not need it. So what programs were you speaking of when saying that?

    How will giving the biggest generation gold plated care and short changing everyone that follows help avoid what you disliked not to mention how will that fix our fiscal house in the first place. This is akin to saying since I want a second BMW now everyone after me is stuck with a toyota but it is fixed because they get to buy toyotas see, lol. Start the program now, do not cut taxes, or extend them, until our fiscal house is in order OR come up with an idea that does not create open generational political warfare which is precisely what this does.

    Thing is I am pretty sure you know this. This is after all the best and possibly only way to shift the younger generations to the GOP when the GOP actually begins to go after those that are over 55 now. The ACA is a slow road to gov healthcare just like the Ryan plan is the slow road to the end of the program. Both things are 100% true and both sides deny the one in their camp because it would make them look as manipulative as they are. One last thing, a free market or a single payer system are not infeasible. I find it odd that you view a free market that way but if you prefer tilted closed markets that means you really dont trust the free market, you trust markets that are stacked in your desired way which is actually rather the opposite of a free market. They are not popular options but they are valid and 100% better and more financially sound than what we have. What we have and the Ryan plan are fairy dust and you know it. It is not a fix, it is a doubling down on what got us here, an irrational mixed market that ensures corporate profits and continually worse service for increased costs.

  • SteveinCH


    Infeasible politically is all I meant.

    As to the merits, I was comparing Ryan’s plan to head in the sand. By now, you should know I prefer means testing now to either approach.

  • Dr. J

    Single payer (Universal) Health Care works and is providing ALL other ‘first world’ nations with more services, lower costs, and, longer life expectancies.

    Yeah! We can fix Medicare by making it a single payer system! Can’t think of any flaw in that plan.

  • SteveinCH:

    All of those countries have a longer life expectancy than the U.S.

    Maybe they all just eat better and exercise more. (I doubt it, but it’s possible.) In any event, health care costs less — as a percent of GDP — there.

    You can see more at this CIA page — the US ranks 50th, BTW, in life expectancy. But we spend more per capita than anyone else on health care. Go figure. Money can’t buy happiness or health?

  • Dr. J

    Yes, Kathy. Most everyone agrees there’s a big cost and outcome disparity between us and other countries. The question is where specifically they manage to spend less, and how much we might hope to save in those areas by following their example?

    SteveK (and many other people on the left) keep answering “the payment system”, but it’s a non-answer in that it doesn’t identify any specific areas where the payment system saves money. And it’s an egregious non-answer when discussing Medicare, which is already a single payer.

    SteveinCH gives a good list of possible answers. Lower overhead and better preventive care are worth considering too.

  • SteveinCH


    Here’s the thing. Yes, other countries have different systems and yes, those systems are lower cost and produce (by many measures) better outcomes.

    The problem here is correlation versus causality. To understand why the differences exist, one needs to look at the root causes for cost and outcome differences. The payments system is not a root cause in either case. It has a small, one time, effect on cost and no discernible effect on quality.

    The actual root causes are things that are far harder to change or far more politically sensitive. Here’s my point, if single payor advocates wanted to say, “We favor single payor because doctors are paid too much as are pharma cos and there is too much money spent on end of life care and unnecessary testing. We are going to use single payor to correct those things and thereby dramatically reduce costs.”; I would think that a very logical argument. It’s not a policy that I would support but it’s a very logical argument.

    But single payor advocates (many) simply say the words single payor, point to the cross-country comparisons and think magic fairy dust is going to make costs come down.

    As I said at the top, the cost of healthcare in this country is usage*rate. The only way to reduce costs is to reduce usage or reduce rate. Reducing usage is rationing. Reducing rate is price controls. Both have consequences. It may well be that other countries have accepted those consequences as in the public good. It equally may well be that they are free riding on the US (particularly in innovation).

    But that’s beside the point. One needs to look at the root causes of cost and explain how one proposes to change them. This is doable but one needs to be realistic about what one is doing.

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