Posts tagged Medicare

The Deal with the Deal

79
5 months ago
by Michael Weiss in

We went right up to the edge of the cliff, peered into the abyss, and turned back. For now. But what exactly came out of the cliff-​​averting bill? Let’s take a look at the details, as well as their poten­tial ramifications.

First, because so many peo­ple want to keep score, who “won” this bat­tle? Nobody. Seri­ously. There are no win­ners here. Pres­i­dent Obama, who had the trump cards (though not Trump’s endorse­ment), gave an aston­ish­ing amount of ground. Again. Repub­li­cans didn’t get a lot of what they wanted, either. And all of us lost because this deal kicked most of the prob­lems down the road a few months.

Any­way, on to the details. 

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The Fiscal Games

18
6 months ago
by dcpetterson in

I’ve writ­ten about the upcom­ing Con­gres­sional fis­cal chal­lenges sev­eral times before. It’s sort of a tra­di­tion by now. I feel oblig­ated to doc­u­ment the play-​​by-​​play for the cur­rent games so as to keep the story mov­ing along.

Games

Games

We are rapidly approach­ing the Fis­cal Pot­hole. Much has hap­pened in the last two weeks. We’ve got less than four weeks until the dead­line hits. Come the New Year, the Bush-​​era tax cuts expire, the 2011 Debt Ceil­ing cut­throat sequester goes into effect, unem­ploy­ment insur­ance pay­ments run out, the FICA Tax Hol­i­day once comes to another end, the Medicare Doc Fix needs to be fixed again, and the Alter­na­tive Min­i­mum Tax needs its annual goos­ing. To top it off, Amer­ica runs back up against the debt ceil­ing shortly thereafter.

Will we sur­vive this cat­a­stro­phe? Can dis­as­ter be averted? What have the play­ers been doing? Activ­ity comes fast and furi­ous. Who will survive?

Pres­i­dent Obama sub­mit­ted to Con­gress a plan that tack­les all of these issues, quite an ambi­tious achieve­ment. It includes a four tril­lion dol­lar deficit reduc­tion over ten years, extends the Bush tax cuts for every­one in Amer­ica on the first $250,000 of income, extends the pay­roll tax credit and bonus depre­ci­a­tion for busi­ness invest­ment, makes per­ma­nent the Alter­na­tive Min­i­mum Tax and Medicare Doc Fixes, along with another pack­age of rou­tinely expir­ing tax pro­vi­sions — mostly for busi­nesses — known col­lo­qui­ally as tax exten­ders. That’s just the begin­ning. (more…)

Ryan’s Lost Hope

124
10 months ago
by Monotreme in

I’m feel­ing an increas­ing frus­tra­tion with the inabil­ity of pol­i­cy­mak­ers — and the vot­ers who act as their enablers — to put for­ward a rea­son­able and fis­cally respon­si­ble plan for dig­ging this coun­try out of the ditch we’re in.

The prob­lem is pretty easy to grasp, even if the solu­tions escape us. As we’ve dis­cussed else­where, the data are clear and unequiv­o­cal. The world econ­omy is headed for the crapper.

There’s some good news to be had. It’s not too late for this nation to reverse its fis­cal course and set the Ship of State on the right eco­nomic course. In my opin­ion — an opin­ion our read­ers are wel­come to chal­lenge in the com­ments sec­tion below — there will likely be a flight of cap­i­tal from Europe to the United States as the Euro Zone slides deeper into the Slough of Despond. That poten­tial for invest­ment in our econ­omy only exists if we seize the moment and develop the polit­i­cal will to act. So far in the cur­rent finan­cial cri­sis, investors have indi­cated that they have more faith in the United States than in any other coun­try to do the right thing. As a patriot, so do I.

Fis­cal reform could be a major fac­tor in fill­ing the hole we’ve dug. We. Both polit­i­cal par­ties. Me and you. All Amer­i­cans.
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A Radical Proposal

22
11 months ago
by dcpetterson in

Employ­ment hasn’t been recov­er­ing at a high enough rate sat­isfy any­one. Return to full employ­ment will likely take more than a few years. Many have been com­plain­ing about this, so here are a few rad­i­cal ideas to cre­ate jobs. I don’t think there’s any ques­tion they’d work for that pur­pose. But I can antic­i­pate a lot of opposition.

  1. Require that busi­nesses shorten their aver­age work week by a min­i­mum of five hours, set­ting the Amer­i­can “stan­dard” work week to 35 hours. Pro­vide tax incen­tives for going beyond that, by as much as an addi­tional five hours, low­er­ing the work week to 30 hours.
  2. Remove the age require­ment for Medicare, to allow all Amer­i­cans to get on a single-​​payer health care sys­tem, and allow employ­ers to drop all insur­ance coverage.
  3. Lower the retire­ment age for Social Secu­rity to 60. Encour­age Amer­i­cans to retire earlier.

It may not be obvi­ous how these mea­sures could cre­ate jobs. They could lead to full employ­ment, vir­tu­ally overnight, give a jolt to the econ­omy such as Amer­ica has never seen, make us all health­ier, and give us a lot more free time. Let me explain. (more…)

Living with Death Panels

31
1 year ago
by Monotreme in

Two years ago, as Con­gress was engaged in heated debate over the leg­is­la­tion that would even­tu­ally become the Patient Pro­tec­tion and Afford­able Care Act (PPACA, also called, dis­parag­ingly, “Oba­macare”), ex-​​half-​​Governor and failed Vice Pres­i­den­tial can­di­date Sarah Palin weighed in with her view: the leg­is­la­tion would include, in her famous phrase, “death panels”.

Of course, it’s not just this one pro­vi­sion that presents a prob­lem. My orig­i­nal com­ments con­cerned state­ments made by Dr. Ezekiel Emanuel, a health pol­icy advi­sor to Pres­i­dent Obama and the brother of the President’s chief of staff [cur­rent Chicago mayor Rahm Emanuel]. Dr. Emanuel has writ­ten that some med­ical ser­vices should not be guar­an­teed to those ‘who are irre­versibly pre­vented from being or becom­ing par­tic­i­pat­ing citizens…An obvi­ous exam­ple is not guar­an­tee­ing health ser­vices to patients with demen­tia.’ Dr. Emanuel has also advo­cated bas­ing med­ical deci­sions on a sys­tem which ‘pro­duces a pri­or­ity curve on which indi­vid­u­als aged between roughly 15 and 40 years get the most chance, whereas the youngest and old­est peo­ple get chances that are attenuated.’

Unfor­tu­nately, the ensu­ing debate over end-​​of-​​life issues and the financ­ing of health care for all Amer­i­cans was char­ac­ter­ized by an increas­ing amount of heat (“You Lie!”) and very lit­tle light from that point forward.

Was Sarah Palin right? (more…)

Where Have All the Dollars Gone?

48
1 year ago
by Michael Weiss in

A few weeks ago I noted that we’re spend­ing more per capita, even adjust­ing for infla­tion, than we ever have been, and yet we keep hear­ing about how we have to cut back on every­thing. It seemed to me a con­tra­dic­tion, and I couldn’t help but wonder…where have all the dol­lars gone?

After get­ting no real spe­cific answer from the fray (though a few ideas of where to look for answers), I turned to a com­bi­na­tion of the Inter­net and Excel. In one sense, the answer didn’t sur­prise me, but in some ways it really did.

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