Weekly Audit: Republicans' Budget Declares War on Medicare

By Lindsay Beyerstein, Media Consortium blogger

The Republicans are poised to unveil a model budget on Tuesday that would effectively end Medicare by privatizing it, Steve Benen reports in the Washington Monthly. House Budget Committee Chair Paul Ryan (R-WI) is touting the budget as a strategy to reduce the national debt.

Ryan’s plan would turn Medicare from a single-payer system to a “premium support” system. “Premium support” is a euphemism for the government giving up to $15,000 per person, per year, to insurance companies to defray the cost of a health insurance policy.

As Benen points out, privatizing Medicare does nothing to contain health care costs. On the contrary, as insurance customers weary of double-digit premium increases can attest, private insurers have a miserable track record of containing costs. They excel at denying care and coverage, but that’s not the same thing.

The only way the government would save money under Ryan’s proposal is by paying a flat rate in vouchers. Medicare covers the full cost of medical treatments, but private insurers are typically much less generous. So, after paying into Medicare all their working lives, Americans currently 55 and younger would get vouchers for part of their health insurance and still have to pay out-of-pocket to approach the level of benefits that Medicare currently provides.

Taking aim at Medicaid

The poor are easy targets for Republican budget-slashing, Jamelle Bouie writes on TAPPED. Ryan’s proposal would also cut $1 trillion over the next 10 years from Medicaid, the joint federal-state health insurance program for the poor, by eliminating federal matching and providing all state funding through block grants. Most of this money would come from repealing the Affordable Care Act’s Medicaid expansion, which is slated to add 15 million people to Medicaid.

Block grants are cuts in disguise. Currently, Medicaid is an entitlement program, which means that states have to enroll everyone who is eligible, regardless of the state’s ability to pay. In return, the states get federal matching funds for each person in the program. Ryan and the Republicans want to change Medicaid into a block grant program where the federal government simply gives each state a lump sum to spend on Medicaid. The states want to use this new found “flexibility” to cut benefits, narrow eligibility criteria, and generally gut the program.

This is incredibly short-sighted. The current structure of Medicaid ensures extra federal funding for every new patient. So when unemployment rises and large numbers of new patients become eligible for Medicaid, the states get extra federal money for each of them. But with a block grant, the states would just have to stretch the existing block grants or find money from somewhere else in their budgets. Medicaid rolls surge during bad economic times, so a block grant system could make state budget crises even worse.

Ryan’s proposal has no chance of becoming law as long as Democrats control the Senate. The main purpose of the document is to lay out a platform for the 2012 elections.

Fake debt crisis

In The Nation, sociologist and activist Frances Fox Piven argues that the Republicans are hyping the debt threat to justify cuts to social programs:

Corporate America’s unprovoked assault on working people has been carried out by manufacturing a need for fiscal austerity. We are told that there is no more money for essential human services, for the care of children, or better public schools, or to help lower the cost of a college education. The fact is that big banks and large corporations are hoarding trillions in cash and using tax loopholes to bankrupt our communities.

She notes that Republican-backed tax cuts for the wealthy are a major contributor to the debt.

Jesus was a non-union carpenter?

Josh Harkinson of Mother Jones reports on the religious right’s crusade against unions. He notes that James Dobson of the socially conservative Family Research Council tweeted: “Pro-family voters should celebrate WI victory b/c public & private sector union bosses have marched lock-step w/liberal social agenda.”

Harkinson reports that the Family Research Council is backing the Republican incumbent, David Prosser, in today’s Wisconsin Supreme Court election–a battle that has become a proxy fight over Gov. Scott Walker’s anti-collective bargaining bill:

The FRC’s new political action committee, the Faith, Family, Freedom Fund, is airing ads on 34 Wisconsin radio stations in an effort to influence the April 5 judicial election that could ultimately decide the fate of the law. The ads target Wisconsin Assistant Attorney General JoAnne Kloppenburg, who’s running against a conservative incumbent, David Prosser, for a seat on the state Supreme Court. If elected, Kloppenburg wouldalter the balance on the court in favor of Democrats, giving them the ability to invalidate the recently enacted ban on public-employee collective bargaining. “Liberals see her as their best hope to advance their political agenda and strike down laws passed by a legislature and governor elected by the people,” say the ads. “A vote for Prosser is a vote to keep politics out of the Supreme Court.”

Roger Bybee of Working In These Times argues that recalling Republican state senators in Wisconsin is not enough to defend workers’ rights from Gov. Scott Walker’s anti-union onslaught.

This post features links to the best independent, progressive reporting about the economy bymembers of The Media Consortium. It is free to reprint. Visit the Audit for a complete list of articles on economic issues, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The MulchThe Pulse and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

 

 

Weekly Audit: Wolf in Sheep's Clothing--The Myth of Fiscal Conservatism

By Lindsay Beyerstein, Media Consortium blogger

Fashionable pundits like to say that the Republican Party has shifted its focus from “social conservatism” (e.g., banning abortion, shoving gays back in the closet, teaching school children that humans and dinosaurs once walked the earth hand-in-claw) to fiscal conservatism (e.g., tax cuts for the rich, slashing social programs). But is that really true? Tim Murphy ofMother Jones argues that the old culture war issues never really went away. Rather, the Republicans have simply rephrased their social agenda in fiscal terms.

For example, Rep. Mike Pence (R-IN) is quite upfront about the fact that he hates Planned Parenthood because the group is the nation’s leading abortion provider. Yet, he seeks to de-fund the Planned Parenthood and the entire Title X Family Planning Program in the name of balancing the budget. Never mind that the federal money only goes toward birth control, not abortion, and research shows that every dollar spent on birth control saves $4 in Medicaid costs alone.

Steve Benen of the Washington Monthly surveys the current crop of GOP presidential hopefuls in Iowa and agrees that reports of the death of the culture war have been greatly exaggerated.

But the key takeaway here is that fiscal issues have largely been relegated to afterthought status. That’s just not what these right-wing activists — the ones who’ll largely dictate the outcome of the caucuses — are focused on. Indeed, even Ron Paul, after pandering to a home-school crowd last week, conceded, “I haven’t been asked too much about fiscal issues.”

Budget cuts

Sarah Babbage writes in TAPPED that Obama and the Democratic leadership in Congress seem poised to grant an additional $20 billion in spending cuts for FY 2011, in addition to the $10 billion in cuts they’ve already pledged for this fiscal year. Babbage notes that, after weeks of negotiations, we’re right back to the $30 billion in cuts the GOP initially demanded. She warns that these cuts will have a trivial impact on the $1.6 trillion deficit, but they could have a devastating effect on the fragile economy.

Taxes for thee, but not GE

General Electric raked in $14.2 billion in profits last year, $5.1 billion of which came from the United States, yet the company paid $0 in U.S. income tax, Tara Lohan notes in AlterNet. Despite its healthy bottom line, and its sweet tax situation, GE is asking 15,000 unionized U.S. workers to make major concessions at the bargaining table. GE wants union members to give up defined benefit pension programs in exchange for defined contribution programs.

As we discussed last week in The Audit, defined benefit plans guarantee that a retiree will get a set percentage of her working salary for the rest of her life; defined contribution plans pay the worker a share of the revenue from a pool of investments. As the fine print always says, investments can decrease in value. So, if the stock market crashes the day before you retire, you’re out of luck.

Generation Debt

Higher education is supposed to be a stepping stone to a better standard of living, but with unemployment hovering around 10%, many college graduates are struggling to find jobs to pay their student loans. Aliya Karim argues in Campus Progress that the government should compel colleges and universities to be more transparent about the realities of student loan debt:

The government should require colleges to provide information about graduation rates, college costs, and financial aid packages on college websites, enrollment forms, and guidebooks. This information should be easy to find and understand. Without such information available to them, students may not be aware that their future college has a graduation rate lower than 20 percent or that its graduates face close to $30,000 in debt.

The government has a lot of leverage over public and private schools because so much student debt is guaranteed by taxpayers. Greater transparency will enable students to make more informed choices, and give colleges with low graduation rates a greater incentive to clean up their act.

This post features links to the best independent, progressive reporting about the economy bymembers of The Media Consortium. It is free to reprint. Visit the Audit for a complete list of articles on economic issues, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The MulchThe Pulse and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

GOP to Workers: "Why Should They Get What We Took Away From You?"

Was recently listening to the journalists on Slate's Political Gabfest pondering why union density is so much higher amongst public sector workers than the private sector. None of them mentioned the most important difference: It's harder for a government to get away with running a terror campaign against the union. There's more oversight and accountability to restrain public sector management from threatening workers for union activity, implying benefits to keeping out the union or danger with it, holding captive audience meetings against the union, or just firing union leaders. Only some of these tactics are even illegal. And bosses get away with those all the time. (Check out this reportfrom Human Rights Watch, or this one from Prof. Kate Bronfenbrenner). Consultants get very wealthy guiding companies on how to run fear campaigns against employees trying to organize. It's a lot harder for the TSA to cut anti-union consultants a check than it is for Wal-Mart. When it comes to organizing, the fundamental difference between public sector and private sector workers is that public sector workers have a better chance at organizing free from fear. So lots and lots of public sector workers do.

Right-wingers' desire to crush workers' freedom to organize and bargain collectively, whether public sector or private, is old news. But the zeal with which newly elected right-wing politicians are going after public employees is based in a sense of opportunity - one that comes not just from high unemployment or the media's deficit hysteria or GOP electoral gains but from the continuing decline in private sector union density. Republicans are emboldened to go after public sector workers organizing rights because so few private sector workers are organized.

(Resentment towards public sector workers can take on a gendered angle as well, as in some European countries where the public sector is significantly more female than the private sector, giving politicians an easy subtext to wield against public workers.)

If more private sector workers had the right to bargain for pensions, affordable healthcare, and a living wage, conservatives would see less purchase in high-profile fights to shred their rights and benefits for the janitors, firefighters, and teachers who work for us.

You see this in anecdotes like the one in a recent NYT piece where a woman says "I don’t get to bargain in my job, either." This is the chutzpah of the Right: They erode the right for private sector workers to organize for a voice in the conditions of their work and their benefits on the job. They go after all the programs that help people to get jobs or provide protections that don't depend on a job. They attack public education, deny us public healthcare, and deride public infrastructure. They push corporate-dominated "globalization" that privileges the flexibility of capital and further denies people around the world a voice in the conditions of their lives. They throw up barriers to the political participation of the non-rich. They enshrine the rights of bosses to fire without cause, outsource with impunity, escape taxes without consequence, punish pregnancy and lock workers inside buildings. Then, looking out across the wreckage they've created, they tell workers: "Why should that janitor be above the poverty line when your job sucks? Who do you know that has a pension these days?"

In other words, the push on those of us who reject the right-wing future, besides exposing their shell game, is to organize. We need to defend the human right to organize across industries, sectors and countries. And we need to strengthen it and exercise it. Goes without saying that Republican politicians have shown far more zeal about being part of the problem than Democratic ones have shown about being part of the solution.

There's not much future for the American labor movement without turning around the decline in private sector union density. And there's not much democracy if you spend half your waking life under dictatorship.

Weekly Pulse: End-of-Life Counseling Returns, But Death Panels Still Nonsense

by Lindsay Beyerstein, Media Consortium blogger

A proposed program to cover counseling sessions for seniors on end-of-life care has risen from the ashes of health care reform and found a new life in Medicare regulations, Jason Hancock of the American Independent reports.

In August, former Alaska governor Sarah Palin started a rumor via her Facebook page that the the Obama administration was backing “death panels” that would vote on whether the elderly and infirm had a right to live. In reality, the goal was to have Medicare reimburse doctors for teaching patients how to set up their own advance directives that reflect their wishes on end-of-life care.

Patients can use their advance directives to stipulate their wishes for treatment in the event that they are too sick to make decisions for themselves. They can also use those directives to demand the most aggressive lifesaving interventions.

Waste not, want not

Though end-of-life counseling was ultimately gutted from the Affordable Care Act (ACA), the legislation will eventually ensure health coverage for 32 million more Americans. However, Joanne Kenen in The American Prospect argues it will do comparatively less to curb the high costs of health care. The architects of the ACA had an opportunity to include serious cost-containment measures like a robust public health insurance option to compete with private insurers, but they declined to do so.

Kenen argues that the government should more aggressively target waste within the health care delivery system, especially Medicare and Medicaid. Unchecked and rising health care costs through Medicare and Medicaid are a significantly greater driver of the deficit than Social Security or discretionary spending:

“The waste is enormous,” says Harvard health care economist David Cutler. “You can easily convince yourself that there is 40 to 50 percent to be saved.” Squeezing out every single bit of that inefficient or unnecessary care may not be realistic. But it also isn’t necessary; eliminating even a small fraction of the current waste each year over the next decade would make a huge difference, he added. Health care would finally start acting like “a normal industry.” Productivity would grow, in the one area of the economy where it has not, and with productivity gains, prices could be expected to fall.

The new end-of-life counseling program will help reduce waste in the system, not by pressuring people to forgo treatments they want, but by giving them the tools to refuse treatments they don’t want.

Teen births down, but why?

The teen birth rate has dropped again, according to the latest CDC statistics. Births to women under the age of 20 declined by 6% in 2009 compared to 2008. One hypothesis is that the reduction is an unexpected consequence of the recession, an argument we pointed to in last week’s edition of the Pulse. John Tomasic of the Colorado Independent is skeptical of the recession hypothesis. He writes:

Emily Bridges, director of public information services at Advocates for Youth, agrees with other observers in pointing out that teens aren’t likely to include national economics as a significant factor in pondering whether or not to have unprotected sex. Peer pressure, badly mixed booze, general awkwardness, for example, are much more likely than the jobless recovery to play on the minds of horny high schoolers.

Some states with weak economies actually saw a rise in teen birth rates, Tomasic notes. However, this year’s sharp downturn in teen births parallels a drop in fertility for U.S. women of all ages, which seems best explained by economic uncertainty.

It’s true that prospective teen moms are less likely to have jobs in the first place, and so a bad job market might be less likely to sway their decisions. However, young women who aren’t working are unlikely to have significant resources of their own to draw on, which means that they are heavily dependent upon others for support. If their families and partners are already struggling to make ends meet, then the prospect of another mouth to feed may seem even less appealing than usual.

Abortion is the elephant in the room in this discussion. The CDC numbers only count live births. Logically, fewer live births must be the result of fewer conceptions and/or more terminations. Some skeptics doubt that economic factors have much to do with teens’ decisions about contraception. However, it seems plausible that decisions about abortion would be heavily influenced by the economic health of the whole extended family.

Last year’s decrease was notably sharp, but teen birth rates have been declining steadily for the last 20 years. The Guttmacher Institute, a New York-based non-profit that specializes in research on reproductive choice and health, suggests that successive generations of teens are simply getting savvier about contraception. Births to mothers between the ages of 15 and 17 are down 48% from 1991 levels, and births to mothers ages 18 to 19 are down 30%.

Stupid drug dealer tricks

Martha Rosenberg of AlterNet describes 15 classic dirty tricks deployed by Big Pharma to push drugs. These include phony grassroots patient groups organized by the drug companies to lobby for approval of dubious remedies. Another favorite money-making strategy is to overcharge Medicare and Medicaid. Pharmaceutical companies have paid nearly $15 billion in wrongdoing settlements related to Medicare and Medicaid chicanery over the last five years.

This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

Weekly Audit: Curbing the Deficit, Cat Food, and You

by Lindsay Beyerstein, Media Consortium blogger

The deficit commission released its much anticipated list of helpful money-saving tips for the federal government last week. These tips include tax cuts for the rich, reducing unnecessary printing costs, and cutting the jobs of federal contractors.

The recommendations are more like a menu than a program. As Mark Schmitt of The American Prospect notes, there’s no coherent vision, just a list of possible tax increases and program cuts with projected savings attached.

The commission was dubbed the Cat Food Commission by critics who see the project as an attempt by the Obama administration to provide political cover to gut Social Security, thereby forcing the elderly to subsist on cat food.

Officially, the commission is charged with making suggestions to balance the budget by 2015. Kevin Drum of Mother Jones is surprised at the hype the presentation has attracted, considering that it’s not a piece of legislation, or even proposed legislation, or even the actual report by the deficit commission, but rather a draft presentation by “two guys in a room” (co-chairs former Sen. Alan Simpson (R-WY) and Erskine Bowles).

Hope is not a plan

Drum has trouble taking the draft seriously because its main focus is cutting discretionary spending, which according to the Congressional Budget Office, only accounts for about 10% of our projected deficit. The secondary focus of the report is Social Security, which only accounts for a small share of the projected deficit, and moreover, is easily fixable with very small tax increases and tiny decreases in benefits phased in over a long period of time.

Rising health care costs account for the lion’s share of our projected deficit, but as Drum notes, the draft doesn’t get into detail about how to contain those costs, the authors simply stress that someone had better get on that. No kidding. The authors assert that that the government should never take in more than 21% of GDP in total taxes. Drum dismisses this suggestion as completely unrealistic seeing as the authors have no plan to slow the growth of health care costs.

Note to workers: “Drop dead”

Roger Bybee of Working In These Times takes aim at the presentation’s suggestion to cut taxes on the rich. The deficit chairmen urge legislators to cut the top tax rate from 35% to 23%, which as Bybee notes, would actually add to the deficit. The presentation also favors cutting corporate taxes and taxes on American expatriates. Hardly deficit-friendly stuff. Bybee argues that the real goal of this commission is to deflate public expectations about the role of government:

This draft report was thus not about slicing the deficit, but shrinking those portions of the government on which the poor and working class depend and shoveling new benefits to corporations and wealthy, at a time when the richest 1% already rakes in 23.5% of all U.S. income.

According to AFL-CIO head Richard Trumka, whom Bybee quotes, the message to the American worker is: “Drop dead.”

Gawker vs. the Cat Food Commission

Astute commenters at the media gossip blog Gawker discovered, via a New York Times interactive feature, that the entire problem could be solved by rolling back the Bush tax cuts and ending foreign wars. John Tomasic of the Colorado Independent explains how they did it:

The Gawkers simply let the non-job-making Bush tax cuts expire (because they were never meant to be permanent and because most Americans don’t want them extended) and they ended Bush’s (now Obama’s) overseas military adventures, which cost more money every week ($2 billion!) than the Rolling Stones have made in the last forty years, our contemporary version of the Cold War space race taking place not in space but in Afghanistan and Iraq, where the United States is racing only against itself to borrow and spend as much money as possible every single day– almost none of that money spent on the troops who come home wounded and sad and totally screwed up.

Nine out of ten grandmas prefer the fiscal policies of the Clinton administration to Meow Mix.

Extending unemployment = Jobs

Ed Brayton of the Michigan Messenger argues that extending long term unemployment insurance benefits would benefit the economy to the tune of half a million jobs. The unemployed still have to eat. Their children still need shoes. If unemployment benefits are extended, the unemployed will spend their benefits quickly in order to live, which is exactly what an economic stimulus is designed to do. Grocery stores and shoe stores employ people. Checkers and shoe salesmen also spend their wages in their communities, thereby sustaining the jobs of still more people.

Pension plan bets green on green

Investing in green jobs is sound economic policy, but governments can’t do it alone. The private sector has to help finance the greening of our economy, too. One California pension plan is stepping up and betting big, investing $500 million on green projects, according to Mikhail Zinshteyn of Campus Progress. The California Public Employees’ Retirement System (CalPERS) has a green portfolio worth $2.5 billion, which it has amassed since 2006. CalPERS is betting that low carbon energy programs and other clean energy initiatives will be a lucrative place to park their members’ money.

Hopefully, these investments will also benefit the economy in the short term by creating jobs, including jobs for some California public employees. However, some analysts are skeptical that these investments will yield the handsome dividends that CalPERS analysts are projecting.

This post features links to the best independent, progressive reporting about the economy by members of The Media Consortium. It is free to reprint. Visit the Audit for a complete list of articles on economic issues, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Mulch, The Pulse and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.

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