Cutting Social Security and Not Taxing Wall Street

Wednesday, 15 May 2013 12:53                              

Traders on the floor of the New York Stock Exchange after New York City Mayor Michael Bloomberg rang the opening bell, Oct. 31, 2012. (Photo: Robert Caplin / The New York Times)

 Traders on the floor of the New York Stock Exchange after New York City Mayor Michael Bloomberg rang the opening bell, Oct. 31, 2012. (Photo: Robert Caplin / The New York Times)

As we move towards the fifth anniversary of the great financial crisis of 2008, people should be outraged that cutting Social Security is now on the national agenda, while taxing Wall Street is not. After all, if we take at face value the claims made back in 2008 by Fed Chairman Ben Bernanke and former Treasury Secretaries Henry Paulson and Timothy Geithner, Wall Street excesses brought the economy to the brink of collapse.

But now the Wall Street behemoths are bigger than ever and President Obama is looking to cut the Social Security benefits of retirees. That will teach the Wall Street boys to be more responsible in the future.

Most people are now familiar with President’s Obama’s proposal to cut Social Security by reducing the annual cost of living adjustment. While the final formula is somewhat convoluted, the net effect is to reduce benefits by an average of roughly 3.0 percent.

Since Social Security benefits account for more than 70 percent of the income of a typical retiree, this cut is more than a 2.0 percent reduction in income. By comparison, a wealthy couple earning $500,000 a year would see a hit to their after-tax income of just 0.6 percent from the tax increase that President Obama put in place last year.

While President Obama is willing to make seniors pay a price for the economic crisis, his administration his unwilling to impose any burdens on Wall Street. Specifically, it has consistently opposed a Wall Street speculation tax: effectively a sales tax on trades of stock and derivatives. The Obama administration has even used its power to try to block efforts by European countries to impose their own taxes on financial speculation.

If the idea of taxing stock trades sounds strange, it shouldn’t. The United States used to impose a tax of 0.04 percent until Wall Street lobbied to eliminate it in the mid-1960s. Many countries, including the United Kingdom, Switzerland, China, and India already impose taxes on stock trades.

The tax in the UK is 0.5 percent on stock trades (0.25 percent for both the buyer and the seller). It dates back more than 3 centuries. The country raises more than 0.2 percent of GDP ($32 billion in the United States) from the tax each year. The tax has not prevented the London stock exchange from being one of the largest in the world.

There are currently two bills in Congress for a similar tax in the United States. A bill by Minnesota Representative Keith Ellison would impose the same tax as the UK on stock trades and would apply a scaled rate to options, futures, credit default swaps and other derivative instruments. It could raise more than $150 billion annually or more than $2 trillion over the ten year budget window.

A second bill has been put forward by Iowa Senator Tom Harkin and Oregon Representative Peter DeFazio. This bill would apply a 0.03 percent tax to trades of stock and a wide range of other financial assets. According to the Joint Tax Committee, the bill would raise close to $40 billion a year or over $400 billion over a ten-year budget window once it is implemented.

Unfortunately the administration has consistently opposed both bills. It claims that it is concerned about the incidence of these taxes – that ordinary investors would see large burdens from the tax. It also claims to be worried that the taxes will disrupt financial markets by making trading more costly.

Neither of these stories passes the laugh test. Ordinary investors don’t trade much, and therefore are not going to feel much impact from the tax. If someone with $100,000 in a 401(k) (this is much larger than the typical 401(k)) turns it over at the rate of 50 percent annually, they would pay $15.00 each year as a result of the Harkin-DeFazio tax.

Furthermore research shows that investors reduce their trading as costs increase. This means that if the tax increases trading costs by 20 percent, then investors will reduce their trading by roughly the same amount (in this example, turnover would fall to 40 percent annually). That means that the net cost of turnover in a 401(k) will barely change for a typical investor as a result of the tax. Wall Street would just see much less business.

So the Obama administration wants us to believe that it is willing to cut the Social Security benefits of retiree living on $15,000 a year in Social Security by $450 but it opposes a Wall Street speculation tax because it is concerned that investors with $100,000 in a 401(k) may pay a few dollars a year in additional trading costs. Only a reporter with the Washington Post would believe a story like that.

The other part of the Obama administration’s story is equally laughable. The cost of financial transactions has plummeted in the last four decades because of computers. Even the Ellison tax rate would just raise costs back to their mid-80s level. The Harkin-DeFazio tax rate would probably still leave costs lower than they were in 2000.

The country certainly had a vibrant capital market and stock exchange in the 1980s, taking costs part of the way back to this level will not prevent Wall Street from serving its proper role of transferring capital from savers to borrowers. It will just clamp down on speculation.

The basic story is very simple. Wall Street bankers have a lot more political power than old and disabled people who depend on Social Security. That is why President Obama is working to protect the former and cut benefits for the latter.

http://www.truth-out.org/opinion/item/16372-cutting-social-security-and-not-taxing-wall-street

 

 

Cutting Social Security Benefits Not the Way to Go


Wednesday, May 8, 2013
By Lois Capps, Santa Barbara

Since President Obama released his budget last month, I’ve heard from constituents throughout the Central Coast with comments and concerns, especially about one specific provision: the President’s inclusion of the Republican proposal to change how Social Security cost of living adjustments are made by using a benefit calculation called “chained CPI.”

The President has said he would only be willing to consider this change in conjunction with a balanced plan of revenue increases and other spending cuts to bring our deficit in line.  While I appreciate his willingness to once again go the extra mile in an effort to find compromise, this proposed change to Social Security is just a bad idea.

First, Social Security is not the cause of our record deficits. In fact, excess Social Security taxes have been used to cover the actual size of the deficit for years.

Second, and most importantly, switching to chained CPI would actually lead to benefit cuts for seniors, persons with disabilities, and veterans on the Central Coast and around the country.  There is no reason to cut benefits in a program that millions depend on when that program—Social Security—is not responsible for our deficit.

Proponents of switching to chained CPI claim that it’s a more accurate way to calculate cost of living because it takes into account consumers’ decisions to substitute similar but cheaper products when prices change.  For example, rising prices of beef may cause consumers to switch to chicken, pork or to forego eating meat altogether to save money.

But there is a huge debate about whether “chained CPI” is more accurate for seniors.  In fact, many economists believe we currently understate seniors’ cost of living because the elderly spend a much higher percentage of their incomes on utilities, housing and, of course, health care. These expenses are much harder, if not impossible, to substitute for than food.  In addition, health care costs, a large share of the average senior’s budget, regularly increase faster than other products and services.

Since its inception, Social Security has lifted millions of seniors out of poverty, allowing them to live independently and with dignity.  While Social Security has been a wildly successful anti-poverty program—it’s helped reduce the poverty rate for the elderly to less than 10 percent—its benefits are not especially generous.  In fact, the average Social Security benefit is about $13,000 per year.  And for seniors on the lower half of the economic ladder, Social Security benefits represent 80 percent of their total income.

It is also unsettling that proposals to cut Social Security benefits are happening while most Americans face more uncertainty in planning for retirement. Many financial planners used to talk about retirement savings as a “three-legged stool,” with the legs representing pension benefits, private savings like 401(k)s and IRAs, and Social Security benefits. But the reality today is that two of the three legs on the stool are increasingly less sturdy.

For example, far fewer employers offer defined benefit pension plans today, opting instead to offer 401(k) plans. In 1980, approximately 40 percent of private-sector workers had a guaranteed pension from their employer. But by 2006, that figure had fallen to just 15 percent.

And while 42 percent of American workers today are covered by a 401(k) plan, the average value of a private retirement plan for a person nearing retirement is only $30,000, which experts say is not nearly enough.

In addition, unlike pensions and Social Security, private savings like IRAs and 401(k) plans carry substantial risks.  That includes savers not starting early enough either because they didn’t make enough money or faced other important financial challenges in life.  And IRAs and 401(k) plans are also subject to the vagaries of the stock market, as we have seen during this past half dozen years as financial markets melted down and took retirement savings with it.

This challenge makes Social Security more, not less, essential for retirees and those nearing retirement. And this is especially true for women, who live longer and frequently have fewer savings because they don’t earn as much as men and often move in and out of the workforce to raise and care for their families.

We need to bring our deficit under control, but cutting Social Security benefits is the wrong way to go.  Social Security is a lifeline for millions of seniors at or near retirement. There are better ways to address our deficits than by weakening that lifeline.

Social Security proposal from Obama: How would it affect you?

‘Chained CPI,’ a leading idea for how to keep Social Security solvent for the decades ahead, is part of President Obama’s budget proposal. Here’s what it would mean for benefits.

, Staff writer

Posted April 14, 2013 4:10PM

Nothing else in President Obama’s new budget plan has stirred controversy like this idea: changing the gauge of inflation so that Social Security benefits don’t rise as much each year.
Many fellow Democrats and groups including AARP have been quick to reject this plan.

Mr. Obama himself has only half endorsed it.

“While it’s not my ideal plan to further reduce the deficit, it’s a compromise I’m willing to accept,” he said Saturday in his video address, referring to this and other elements in the budget that are designed to show a good-faith willingness to bargain with Republicans on the thorny issue of entitlement reform.

Maybe this inflation change in benefits will never happen. But it’s also true that the “chained Consumer Price Index,” as the proposed inflation measure is known, is among a handful of leading ideas for keeping Social Security solvent for the decades ahead.

Opponents of the chained CPI can proclaim it “dead on arrival,” but that doesn’t make it so – at least not until some other fixes gain ascendancy.

What if the change happened?

Here’s a glimpse of what it might mean for US retirees.

Lower benefit increases.

The chained CPI, an alternative measure of inflation tracked by the US Labor Department, has generally risen about one-quarter of a percentage point slower than the department’s regular CPI over the past decade.

That fraction of a percentage point makes a difference, over time, in a benefit like Social Security that’s adjusted for the cost of living. Consider the average Social Security benefit, about $14,800 per year in 2012. Stepped up at 2 percent per year, this benefit would grow to $18,000 within 10 years. If boosted by 1.75 percent a year, the payout after 10 years would be about $400 smaller.

Is that really a benefit cut?

Obama’s proposal comes with “protections” designed to cushion the impact. More on that in a moment.

Also, where opponents call this a benefit cut, some finance experts say that’s faulty logic, arguing that the chained CPI is simply a more accurate way of measuring changes in living costs.

“Some commentators portray this proposal as a test of fiscal rectitude,” while others say it should be rejected as imposing “serious hardship on seniors with modest incomes,” policy expert Robert Greenstein said this week in an analysis of the issue. “I’m not comfortable with either position.”

His take, as head of the liberal Center on Budget and Policy Priorities, is that adopting the chained CPI shouldn’t be ruled out but also shouldn’t be viewed as a pain-free reform.

The chained CPI goes up more slowly than the regular CPI partly because it takes consumer buying habits into greater account. In other words, it focuses more on how, when prices rise faster for one item than another, consumers will buy less of the first and more of the second.

“In most analysts’ view, [the chained CPI] more accurately measures inflation for the overall population,” Mr. Greenstein writes. “The elderly population’s market basket isn’t the same, however, as the overall population’s – chiefly because a larger share of elderly people’s spending goes for out-of-pocket health care costs.”

Greenstein argues that the chained CPI is still worth considering, as long as it’s accompanied by companion measures to ease the impact on the very old (who use the most health care) and as long as it’s part of a broad program to control the national debt without shortchanging other priorities like investments that help the economy.

Obama himself has laid out similar conditions. The White House says he’s open to the switch only if it is combined with measures to protect the vulnerable and is part of “a balanced deficit reduction package” that includes fresh tax revenue.

Protections built into Obama’s proposal.

Obama’s budget, released Wednesday, would offer a “benefit enhancement” to older beneficiaries, designed to cushion the adverse impact of the CPI change.

The benefit enhancements would begin in 2020, for those over age 76 or, for disability-insurance beneficiaries, after 15 years on Social Security.

The adjustment would amount to a benefit boost of about 5 percent, phased in over 10 years, from what would otherwise occur. (Even with the enhancement, the federal government saves money because the beneficiaries would have the lower cost-of-living adjustments prior to age 76.)

“Beneficiaries who continued to be on the program for an additional 10 years would be eligible for a second benefit enhancement, starting at age 95,” the White House Office of Management and Budget says.

The White House budget team estimates that the inflation change, coupled with these protections, “would not increase the poverty rate for Social Security beneficiaries.”

Does Social Security really need to be changed?

Whether or not Congress adopts the shift to a chained CPI, Social Security would ultimately require some other adjustments to remain solvent, either in the form of higher tax revenue or downscaled benefits, finance experts say. This is because the revenue from the program’s current payroll tax (along with its trust-fund assets) isn’t enough to match projected costs as the ranks of retirees grow.

Here’s a sense of the magnitude of the changes needed. The Congressional Budget Office estimates that “payroll taxes could be increased immediately by 1.9 percent of taxable payroll and kept at that higher rate, scheduled benefits could be reduced by an equivalent amount,” or some equivalent combination of adjustments could be made to bring the program into balance for the long term.

Some other options for Social Security include having the eligibility age gradually rise, raising payroll taxes on the rich or on all workers, or making benefits less generous for high-income retirees.

www.csmonitor.com/USA/DC-Decoder/201http:/3/0411/Social-Security-proposal-from-Obama-How-would-it-affect-you

 

Obama’s ‘Crossed a Line’ With Social Security Cuts

By Anjuli Sastry

Posted April 12, 2013 3:58PM

WASHINGTON — A crowd of about 100 progressive and liberal activists rallied outside the White House this afternoon to express outrage over the recently released Obama administration budget plan that would cut Medicare and Social Security benefits.

The rally, organized by left-wing organizations including MoveOn.org and the Progressive Change Campaign Committee and attended by lawmakers including Sen. Bernie Sanders, was held in protest over the proposal to create a chained Consumer Price Index — or CPI — included in the White House budget, which could mean lower Social Security benefits for millions of senior citizens and veterans.

The chained CPI proposal could lead to slower growth of Social Security benefits in the next few years because it would determine benefits using a slower inflation rate. The proposal discussed in the past by House Republicans could lead to the average 65-year-old losing out on $130 a year in annual benefits starting in just three years.

Organizers have formed a coalition to deliver petitions with more than 1 million signatures to the president to prevent the bill from making it to Capitol Hill.

“We want to make sure … this is dead on arrival,” Democracy for American chairman Jim Dean told ABC News.

Dean’s organization is one of the many progressive groups that are part of the coalition to deliver the petition to the White House. Dean said that although he and his organization appreciate the president’s “forceful leadership” on issues like gun violence prevention, the CPI proposal is one that has caused them to be extremely disappointed in him.

“People understand that we are not getting everything out of this person,” Dean said. “This was never our way or the highway — even when he was elected in 2008. He’s crossed a line here.”

Sen. Bernie Sanders, I-Vt., urged President Obama to think twice about the budget plan and said it could only lead to devastating consequences in increasing the wealth disparity between the top 1 percent and the rest of America.

“People who have voted with the president … are extremely disappointed with the president,” Sanders told ABC News. “(Americans) are saying do not balance the budget on people who have lost their arms and legs defending this country.”

Rally organizers said Obama was doing a disservice to the senior citizens who rely on social security benefit checks to survive.

“We’ve got to get here now in order to be sure that the voices of people who are going to be impacted by the president’s proposals will be heard by him,” said Brad Wright, a spokesman for the National Committee to Preserve Social Security and Medicare, which is also part of the coalition. “I can’t tell you how disappointed we are — he has said that he would not cut social security … and now they’re doing it. That’s a pretty serious disconnect.”

The budget has yet to take center stage in Washington. Instead, the focus has been on the gun control debate, with some GOP lawmakers threatening a filibuster on gun control legislation.

http://abcnews.go.com/blogs/politics/2013/04/obamas-crossed-a-line-with-social-security-cuts-critics-say/

Medicare Benefit Change News Review Today March 19, 2013: According to the White House Office of Budget Management, reimbursement cuts to Medicare programs appear imminent.

By Stephen Johnson

POSTED 3/19/13 2:55PM

The OMB reports that Medicare providers may see approximately $11 billion in reimbursement cuts during 2013 and even more cuts could affect providers over the next 8 years.  The Congressional Budget Office reports that budgetary reductions that affect Medicare programs will total approximately $123 billion from 2013 to 2021.  Right now, a combination of sequestration cuts, alongside potential Medicare Sustainable Growth rate payment cuts, are raising many eyebrows of concern across the U.S.  The Congressional Budget Office reports that the cuts will be across the board and will negatively affect Medicare Part A, Medicare Part B, Medicare Part C and Medicare Part D programs. As the cost of healthcare continues to rise in the U.S., so too does the cost of Medicare services.  The increase in lifespan also contributes to the cost of Medicare services.  Currently, policy makers in Washington are trying to come to an agreement on how best to balance the budget.  Medicare based cuts are a big part of this discussion.  GOP representative, Paul Ryan, recently released the House Republican Budget which makes changes to Medicare for future beneficiaries.  The changes, according to Ryan, are aimed at eliminating the annual deficit by 2023.

http://www.learningandfinance.com/2013/03/19/medicare-benefit-changes-gop-ryan-reports-medicare-benefit-cuts-part-a-part-b-part-c-part-d-budget-planning-news-today/

 

Obama talking Medicare, Social Security cuts

By GOPUSA.com

POSTED 3/19/13  2:50PM

U.S. President Barack Obama is talking to Democrats and Republicans about cutting Medicare and Social Security entitlements, a White House official said.

“He’s reaching out to Democrats who understand we have to make serious progress on long-term entitlement reform, and Republicans who realize that if we had that type of entitlement reform, they’d be willing to have tax reform that raises revenues to lower the deficit,” Gene Sperling, director of Obama’s National Economic Council, told CNN’s “State of the Union.”

When asked if that means Obama was talking to top congressional leaders, Sperling said, “Well, he just had the leadership in on Friday,” referring to House Speaker John Boehner, R-Ohio, Senate Minority Leader Mitch McConnell, R-Ky., House Minority Leader Nancy Pelosi, D-Calif., and Senate Majority Leader Harry Reid, D-Nev.

Sperling said Obama followed up Friday’s meeting by making phone calls Saturday to rank-and-file senators in both parties who had expressed interest in “the type of grand bargain that Bowles-Simpson have called for, that most budget experts called for, that recognize it’s not cutting defense and domestic spending like education and research we need.”

Erskine Bowles, a former chief of staff to Democratic President Bill Clinton, and Alan Simpson, a former GOP senator from Wyoming, were co-chairmen of a White House bipartisan deficit-reduction panel created in February 2010 to find ways of reducing the mounting federal debt.

The panel’s package of tax and spending changes fell three votes short of the required 14-vote support from its 18 members that would have sent the proposal to Congress for a vote.

Sperling didn’t say who Obama spoke with Saturday.

Boehner said on NBC’s “Meet the Press” that when he met with Obama Friday they discussed the need to avert an end-of-the-month budget showdown that could result in a government shutdown.

Obama “agreed that we should not have any talk of a government shutdown,” Boehner said. “So I’m hopeful that the House and Senate will be able to work through this.”

The House is scheduled to vote Thursday on a spending measure that would keep the government running after its current stop-gap funding mechanism elapses March 27.

The House measure would provide funding through the end of the fiscal year, Sept. 30, and give new flexibility to the Pentagon to manage $40 billion in cuts it took Friday in the sequester.

The sequester is the Washington term for $85 billion in across-the-board federal domestic and military spending cuts triggered when the White House and congressional Republicans failed to reach a compromise on an alternative.

The cuts were included in the 2011 deal to raise the federal debt limit. They are projected to run through Sept. 30 and are the first of a decade-long plan to cut spending $1.2 trillion for nearly every federal program, except for military personnel and entitlement programs such as Medicare and Social Security.

This year’s cuts represent 2.4 percent of the federal government’s annual $3.55 trillion budget.

Sperling, who also appeared on “Meet the Press,” said Obama would work to undo the sequester cuts as part of a broader discussion about deficit reduction.

“We will still be committed to trying to find Republicans and Democrats that will work on a bipartisan compromise to get rid of the sequester,” Sperling said.

“That’s why the president was calling the leadership on Friday, that’s why he spent his Saturday afternoon calling Republican and Democratic senators who he thinks could be part of a caucus of common sense to help move our country forward,” he said.

http://www.gopusa.com/news/2013/03/04/obama-talking-medicare-social-security-cuts/

FOR IMMEDIATE RELEASE: DIRECTOR’S REPORT

Posted 2/21/13 3:34 PM

On March 27, 2013 Civic Council Executive Director, Louis Ambrose will travel to Capitol Hill and deliver petitions to Congress.  Speaker of the House John Boehner and Senate Minority Leader Mitch McConnell and other key Congressional leaders are scheduled to receive  thousands of petitions signed by our constituents.

ObamaCare Cuts $716 BILLION From Medicare

Posted 2/19/13

Though Democrats denied it during the 2012 campaign, Obamacare cut Medicare by $716 billion in order to partially fund $1.9 trillion in new entitlement spending over the next ten years. A big chunk of those Medicare cuts came from the market-oriented Medicare Advantage program. Cleverly, the Obama administration postponed the Medicare Advantage cuts until after the election, so as to persuade seniors that everything would be just fine. But the election is over. On Friday, the administration announced that it would be significantly reducing funding for the popular program. Obama’s proposal, according to one analyst, “would turn almost every plan in the industry unprofitable.”

Democrats have long been hostile to the Medicare Advantage program, which allows seniors to get their Medicare coverage through plans administered by private insurers. Today, more than a quarter of retirees get their coverage through Medicare Advantage, and the program has experienced rapid growth over the past decade. Richard Foster, the recently-retired chief actuary of the Medicare program, has projected that Obamacare’s cuts to Medicare Advantage would force half of its current enrollees to switch back to the old, 1965-vintage Medicare program. Robert Book and James Capretta estimate that this will cost enrollees an average of $3,714 in 2017 alone.

New rates to be ‘enormously disruptive’

Because the typical for-profit managed care plan targets profit margins of only 5 percent, and non-profits even less, the net consequence would “turn almost every plan in the industry unprofitable,” according to McDonald, unless CMS changes its proposal. “If implemented, these rates and the program changes CMS is suggesting would be enormously disruptive to Medicare Advantage, likely forcing a number of smaller plans out of the business and creating disarray for many seniors.”

Could CMS bend the rules again?

CMS didn’t issue these rates because they’re mean. Obamacare requires these rate cuts; indeed, as I noted above, they were supposed to have been implemented before the election. “We appreciate that plans are facing several legislatively mandated changes affecting payment for 2014,” CMS’ Jonathan Blum and Paul Spitalnic write in their 199-page report. “We solicit comment on suggestions to address these challenges within the parameters of current law.” The final rates are to be issued on April 1.

CMS is likely to come under pressure to once again postpone the cuts, by engaging in rule-bending or accounting gimmicks. If CMS assumes that Congress passes a “doc fix” by the end of the year, in order to avoid a 25 percent reduction in physician reimbursement rates, plans could benefit from a 4 percent increase in government reimbursements. Understandably, CMS normally doesn’t incorporate the “doc fix” into its calculations unless one has been actually passed by Congress. CMS could also decline to implement a recalibration of its risk adjustment formula, something that would ease the pressure on insurers.

2014 will be the year when reality hits

It’s important to reduce the amount that the government spends on Medicare, and to do so in a way that minimally affects the care that seniors receive. The simplest way to do this is to gradually raise Medicare’s eligibility age by three months each year. Now that we have Obamacare’s insurance exchanges to support lower- to middle-income seniors, it’s not necessary to force Americans to pay taxes in order to subsidize health insurance for wealthy seniors like Warren Buffett and Mitt Romney.

But Obamacare chose a different path, one that will force more Americans into creaky, out-of-date programs like Medicaid and Sixties-era fee-for-service Medicare. The law will dramatically increase the cost of privately-purchased health insurance, something that Obamacare supporters are only now starting to admit.

There will be much more to talk about as the Obama administration issues the rates, regulations, and mandates that the “Affordable Care Act” requires. Stay tuned.

http://www.forbes.com/sites/aroy/2013/02/19/here-comes-the-boom-cms-slashes-medicare-advantage-disarray-for-many-seniors/?commentId=comment_blogAndPostId/blog/comment/1314-10214-4942

Obamacare’s Medicare Cuts in the New Year

By Jeffrey H. Anderson

Posted 2/19/13 2:40 PM
 
With the flipping of the calendar to January, we’ve now moved into the first year in which Obamacare will cut funding for the popular Medicare Advantage program. The Congressional Budget Office (CBO) projects that, in 2011, Obamacare will cut Medicare Advantage by $2 billion. According to the CBO, that $2 billion is the first part of the $638 billion that Obamacare, if not repealed, is poised to cut from Medicare and related federal programs over the next decade.

As everyone except for the Obama administration and its congressional allies seems to recognize, Medicare is already going broke and is therefore not the place to look for loot to spend elsewhere. The $638 billion in cuts, followed by more than $1.5 trillion in cuts in the seven years to follow (according to the CBO) — for a total of $2.2 trillion in cuts to Medicare and related federal programs by that point (according to the CBO) — would have real-world effects on the quality of care. Even CBS News reports that “perhaps the biggest worry” under Obamacare is the disturbing prospect of “long waits to see the doctor.”

Dr. Herbert Pardes, president and CEO of New York-Presbyterian Hospital, one of the best hospitals in the world (ranked 6th in the United States by U.S. News and World Report), warns, “I think there’s a very real concern about having adequate numbers of Medicare doctors.” Dr. Pardes says, “I think they [patients] will see delays in the timing of their appointments. I think a number of doctors who’ve been frustrated because of the Medicare fee level will actually stop taking Medicare [patients].  So that’s a real worry for all of us.”

No wonder 60 percent of Americans, including 66 percent of independents, want Obamacare to be repealed.

http://www.weeklystandard.com/print/blogs/obamacares-medicare-cuts-new-year_525931.html

Nancy Pelosi’s False Claim That GOP Would Raid MediCare

Glenn Kessler

Posted January 16, 2013

Jacquelyn Martin/AP “We already have an Affordable Care Act. We found savings of over $700 billion by slowing the increase and the rate of reimbursement to certain providers. We used that $700 billion to increase benefits to seniors and the Republicans took the same money and used it for a tax cut at the high end and said that we were cutting benefits, which we weren’t.” — House Democratic Leader Nancy Pelosi (Calif.), on CBS’s “Face the Nation,” Jan. 6, 2013.

We are reluctant to re-litigate the rhetoric of the 2012 presidential campaign, but this comment by Rep. Nancy Pelosi about the House GOP budget jumped out at us. We had frequently written during the campaign about the misleading claim by Mitt Romney that President Obama had gutted more than $700 billion from Medicare to fund Obamacare.

And yet here was Pelosi claiming Republicans had used the “same money” to fund a tax cut, compared to Democrats, who she said had used the $700 billion to “increase benefits to seniors.” To alter a common expression, what’s good for the gander is good for the goose. Is Pelosi playing the same kind of rhetorical games?

The Facts: First of all, the $700 billion figure comes from the difference over 10 years (2013-2022) between anticipated Medicare spending (what is known as “the baseline”) and the changes that the Obama health-care law makes to reduce spending. Thus it is not really money in bank — and the Medicare actuary has raised concerns about whether the cuts to providers were sustainable. The Obama health-care law also raised Medicare payroll taxes by $318 billion over the new 10-year time frame, but only a third of that money is credited to the trust fund; the rest goes to general revenues.

Pelosi is correct that the House Republican budget plan crafted by Romney’s running mate, Rep. Paul Ryan (R-Wis.), retained virtually all of the Medicare “cuts” contained in the health-care law. But then we get into a philosophical dispute about what happens next. Ryan, who is chairman of the House Budget Committee, says he devotes the Medicare savings to extending Medicare solvency (as does Obama). But his budget also includes cuts in tax rates that he says would be funded through the elimination of deductions, tax loopholes and the like.

During the campaign, budget analysts cast serious doubt on whether eliminating such tax provisions would raise enough money to fund the rate cuts. So Pelosi assumes that the GOP budget numbers don’t add up, and thus Ryan is funding tax cuts with Medicare cuts. This line was an especially effective attack by President Bill Clinton during his budget wars in the mid-1990s with then-Speaker Newt Gingrich (R-Ga.), which is why it rang a bell. (The Fact Checker covered the Clinton-Gingrich conflict in an earlier life.) But the Ryan budget is merely a blueprint; no detailed legislation has been crafted. The vagueness of a budget blueprint allows opponents to make many assumptions about it, but there is no one-for-one match that one can find in the document. Moreover, Pelosi also asserts that Democrats used “that $700 billion to increase benefits to seniors,” referring to the elimination of a gap in Medicare prescription-drug coverage known as the “donut hole,” and some other benefits. But the Congressional Budget Office says that such changes amount to just $48 billion over 10 years. The Medicare savings in the health-care law, however, in theory, do extend the solvency of the trust fund for hospital insurance, but that is not the same thing as a benefit increase.

The Pinocchio Test

We realize that politicians often must speak in short hand on television, but Pelosi went too far here. In the GOP budget, there is no direct line between the tax cuts and Medicare cut. Pelosi could have offered the opinion that Ryan’s tax cuts were accompanied by cuts in programs for the less fortunate, but she was wrong to put a price tag on it. Moreover, she made it appear as if all of the Medicare savings in the health-care law was used to bolster benefits for seniors. That is not correct either. The increased benefits are just a small portion of that amount. Moreover, under the concept of the unified budget, money that is collected by the federal government for whatever purpose (such as Medicare payroll taxes) is spent on whatever bills are coming due at that time. During the campaign, Democrats had vehemently complained about the GOP’s claims about this $700 billion figure. There is no reason to play the same game.

Two Pinocchios

http://failover.washingtonpost.com/blogs/fact-checker/post/nancy-pelosis-claim-that-the-gop-would-raid-medicare-for-tax-cuts/2013/01/09/1147b9be-5ad2-11e2-9fa9-5fbdc9530eb9_print.html

Congress has failed to reform the Medicare payment system

January 15, 2013

Today 47 million seniors depend on Medicare to ensure they have access to doctors they know and trust, to help them make the best decisions for themselves and their families. Unfortunately, seniors’ access to doctors has been continually put at risk because Congress has failed to reform a flawed Medicare payment system implemented in 1998.

This year the system threatened Medicare doctors with a pay cut of nearly 27 percent. Fortunately, the recent “fiscal cliff” agreement stops the cut from going into effect this year (a remedy known as the “doc fix”). But unless Washington finds a permanent solution, Medicare doctors could face an even bigger cut next year. For over a decade, when doctors have faced these cuts, Congress has put a Band-Aid on the problem but left the same broken payment system in place. These temporary fixes not only have undermined seniors’ access to their doctors but also have driven up the cost of a long-term solution that will ensure seniors can keep access to their doctors and get better value for their health care dollar. This cycle of threats to seniors’ health care has gone on far too long. After contributing to Medicare through a lifetime of hard work, Americans shouldn’t have to worry about being turned away by the doctors they know and trust. Washington must permanently replace this system and create a fiscally responsible, stable payment system that ensures affordable, quality care for seniors. This is especially important given that the typical Medicare beneficiary has an annual income of roughly $20,000 and spends nearly 20 percent of that on health care. The solution should focus on reducing overall health care costs and not merely shifting the cost to beneficiaries.

Entitlement benefit cuts on the table in talks with GOP on ‘fiscal cliff’

By Mike Lillis – 12/04/12 12:46 PM ET

Entitlement cuts should remain on the table as party leaders seek to hash out an end-of-the-year budget deal, Rep. Steny Hoyer (D-Md.) said Tuesday.

A number of Democratic leaders — including Reps. Nancy Pelosi (Calif.), John Larson (Conn.) and Xavier Becerra (Calif.) — have said they would support some spending reductions in Medicare, but that cuts to direct benefits should not be a part of the negotiations. Along with Senate Majority Leader Harry Reid (D-Nev.), they also maintain that Social Security reform has no place at all in the “fiscal cliff” talks.

Hoyer said GOP proposals to raise the Medicare eligibility age, make wealthier seniors pay higher Medicare rates and limit the cost-of-living increases for some federal programs are legitimate ones, even as he warned he might not support them.

“They clearly are on the table,” Hoyer said of the Medicare changes during his weekly press briefing in the Capitol. “They were on the table in the Boehner-Obama talks. They’ve been on the table for some period of time. That does not mean that I’d be prepared to adopt them now, but they’re clearly, I think, on the table.”

Hoyer said the GOP’s proposal to reduce the cost-of-living increases to certain federal programs – the so-called chained consumer price index (CPI) – should also be considered as part of the fiscal cliff talks.

“We have many Republicans say ‘absolutely not’ … on [higher] rates or revenues,” he said. “There are Democrats on our side who say ‘absolutely not’ if they do A or they do B or they do C. … You’ve got to put everything on the table.”

CPI, a measure of inflation that attempts to gauge cost-of-living fluctuations, is used to index a number of government programs – including food stamps, federal pensions and determining tax brackets. But in the current deficit-reduction fight it’s most often used in reference to Social Security payments.

Indeed, Senate Minority Leader Mitch McConnell (R-Ky.) last week urged that Social Security adopt the chained CPI formula.

“Those are the kinds of things that would get Republicans interested in new revenue,” McConnell told The Wall Street Journal.

Many Democrats have rejected the chained CPI for Social Security because it would reduce the cost-of-living increases under the popular seniors’ program.

Hoyer’s office said Tuesday that Hoyer’s support for having chained CPI on the table was not a reference to Social Security, which they say he wants on “a separate track.”

Party leaders are seeking a deal to prevent a host of automatic tax hikes and spending cuts from taking effect next month. The White House last week introduced a proposal that includes $1.6 trillion in new revenues and $400 billion in new entitlement cuts — though not benefit cuts — over the next decade.

GOP leaders unveiled a counteroffer Monday, featuring $800 billion in new tax revenues and $2.2 trillion in cuts to discretionary and entitlement programs.

Both sides have rejected the other’s proposal, with GOP leaders dismissing Obama’s plan as “unserious” and the White House calling on GOP leaders to come up with more specifics on their proposal.

The central sticking points continue to be tax rates and entitlement benefits. Republicans say they want to close tax loopholes and cap deductions, but they’ve rejected Obama’s plan to allow income taxes on the highest earners to go up next year, as scheduled.

Many Democratic leaders, meanwhile, have rejected the GOP plan to scale back Medicare and Social Security benefits, including proposals floated recently by McConnell to raise Medicare’s eligibility age and reduce future inflation-indexed hikes in Social Security payments.

“Social Security is not part of the problem,” Reid said last month. “We want to make sure that in the outer years people are protected also, but it’s not going to be part of the budget talks, as far as I’m concerned.”

Becerra delivered a message recently warning that Democrats will consider anything — except entitlement benefit cuts.

“We’re willing to talk and to put everything on the table for discussion — at least, this Democrat is,” Becerra added. “But the moment you want to privatize Social Security, or voucherize Medicare, or block-grant Medicaid — that’s where you lose us. Because we want to strengthen those programs, not let them die on the vine.”

Hoyer on Tuesday said negotiators should take those warnings seriously, but he also emphasized that a bipartisan deal will inevitably — and necessarily — include provisions that one side or the other doesn’t like.

“Very frankly, if we don’t say, ‘Look, we have to take into consideration what people say they won’t do, but we also have to take into consideration what the majority think we can do to get us to the objective, to get America on a fiscally sustainable, credible path,” Hoyer said.

“You’ve got to have everything on the table, not withstanding the fact that I don’t like some things that may be on the table.”

This story was updated at 4:06 p.m.

 

HANDS OFF MEDICARE

By Annysa Johnson of the Journal Sentinel

Posted December 12,2012

Dozens of protesters gathered outside Sen. Herb Kohl’s and Sen. Ron Johnson’s downtown Milwaukee offices Monday, calling on them to tax the wealthiest Americans and preserve programs for the poor and middle class as the nation nears the so-called fiscal cliff.

“We don’t need any cuts to our Medicare and Medicaid,” said Edward Jude of Milwaukee, a Vietnam veteran whose 29-year-old daughter relies on state-funded health care for her sickle cell anemia treatments.

“With these here cuts, what am I supposed to do, watch my daughter pass away?”

The protests, organized by Citizen Action, Wisconsin Jobs and others, was one of 100 planned across the state and the country Monday. They come as the nation nears the year-end “fiscal cliff” when higher taxes and cuts to numerous programs are automatically set to kick in.

Organizers are asking Kohl, a Democrat, and Johnson, a Republican, to support a solution that emphasizes jobs; higher taxes on the wealthiest Americans; and the preservation of Medicare, Medicaid and Social Security, among other measures.

“The elections are over,” said the Rev. Willie Brisco of the Milwaukee Inner-City Congregations Allied for Hope, who led about 100 protesters in a prayer outside Kohl’s offices at the Reuss Federal Plaza downtown.

“It’s time for our leaders to come together to get these problems solved. It’s time to stop the rhetoric,” he said.

The protesters wielded white carnations and signs saying “No Cuts to Medicare and Medicaid” and “I am Working America” as they chanted, “No cuts, no compromise!” and “Tax, tax, tax the rich!”

A smaller group marched from the Reuss Plaza to the federal courthouse, where security officers stood guard along the front of the building and two Milwaukee police officers watched from across the street.

Speakers included activists and health care workers who spoke to the hardships of people on the margins and the difficult choices ahead for them.

“If we have these cuts, I’m going to have to choose between taking care of my aunt and my children,” said Jamecca Cohee, a home health care worker who earns about $9 an hour caring for two disabled relatives.

“Or I’ll have to get rid of my kids so they’ll have a better life,” she said.

Small groups of protesters were blocked from hand-delivering letters to Kohl’s and Johnson’s offices, though a Johnson aide met protesters in the lobby of the federal building to accept the letter there.

A spokeswoman for Kohl said it is his policy to allow protesters to come up to his office and attributed the prohibition to miscommunication with the federal protective services.

Mike Wilder of Citizen Action of Wisconsin and the African-American Round Table called the lack of direct access “very concerning.”

“When you have taxpayers who want to have access to their elected representatives, they should be allowed to do so,” he said.

http://www.jsonline.com/news/wisconsin/marchers-demand-social-services-funding-amid-fiscal-cliff-cuts-0l7vmlm-182873181.html

AARP uses its power to oppose Social Security, Medicare benefit cuts for retirees

By Michael A. Fletcher and

Posted: November 18

AARP, the lobbying powerhouse for older Americans, last year made a dramatic concession. Amid a national debate over whether to overhaul Social Security, the group said for the first time it was open to cuts in benefits.

The backlash from AARP members and liberal groups that oppose changes in the program was enormous — and this time around, as Washington debates how to tame the ballooning federal debt, AARP is flatly opposed to any benefit reductions for the nation’s retirees.

AARP’s rejection of any significant changes to the nation’s safety net could be a major factor as policymakers seek a deal to put the government’s finances in order through raising taxes and cutting spending on federal programs, possibly including popular entitlements such as Medicare and Social Security.

Republicans say scaling back Social Security and Medicare, the largest drivers of future government deficits, is necessary. President Obama has previously been open to benefit cuts.

But for lawmakers who would have to vote for such changes, AARP’s 37 million members and $1.3 billion budget are a force to be reckoned with. In the past eight months, AARP has sponsored a series of candidate debates, run television ads, circulated questionnaires and held more than 4,000 meetings around the country to mobilize its legion of supporters to oppose any cuts.

Under the slogan “You’ve earned a say,” the group has been building opposition to entitlement changes. A recent poll by the organization found that 70 percent of Americans 50 and older think Medicare and Social Security shouldn’t be part of the upcoming fiscal debate.

“We’re fighting to stop cuts to Medicare and Medicaid that will hurt beneficiaries,” said AARP’s top lobbyist, Nancy LeaMond. “We want to ensure that Social Security is not part of this deficit discussion.”

Leading bipartisan proposals to reduce the federal debt have proposed changes to entitlement programs, including raising the Medicare eligibility age from 65 to 67 and adopting a stingier formula to determine Social Security payments. Both proposals were discussed during secret negotiations between Obama and House Speaker John A. Boehner (R-Ohio) in summer 2011 during efforts to resolve the country’s debt ceiling crisis. Those talks collapsed without a final agreement. But many political observers expect the proposals to resurface as Democrats and Republicans try to reach a deal to avert the “fiscal cliff” — the government spending cuts and tax increases set to kick in at the beginning of next year.

AARP opposes raising the age for Medicare eligibility on the grounds that it would increase costs for younger seniors while driving up premium costs for older ones. The group opposes efforts to shrink Social Security cost-of-living increases, which it says would cost older seniors thousands of dollars in benefits.

AARP’s critics say it is looking out for current retirees at the expense of future generations.

“We’ve been stealing money from our children, and one of the main reasons that we’ve been unable to stop is that AARP is so opposed to any change to the entitlement programs and they’re politically powerful,” said Kevin A. Hassett, an economist at the American Enterprise Institute.

But AARP argues that it is protecting benefits vital to both current retirees and younger Americans. With the demise of guaranteed pensions in the workplace and the inability of many workers to save enough for retirement, Social Security and Medicare are increasingly indispensable.

“You have people in their 40s and 50s who are cascading toward a terrible retirement,” said Eric Kingson, a Syracuse University professor who co-chairs Strengthen Social Security, a coalition that has joined AARP, organized labor and others in opposing any benefit cuts in the program.

AARP and others say the recent economic downturn has made it even more urgent to protect entitlements. Households with adults approaching retirement have median retirement savings of $120,000, about the same as 2007, according to the Center for Retirement Research at Boston College. But balances for younger workers have shrunk, meaning that more that half of all Americans could see their standard of living decline once they retire, the center said.

A recent issue of the AARP Bulletin — the largest circulation magazine in the world, sent to all its members — warned seniors that the proposed change to Social Security previously embraced by Obama and Republicans could cost “a potential cumulative loss of thousands of dollars.” The organization followed that with a letter to all members of Congress cautioning against Social Security changes.

Dozens of Democratic senators are vowing to protect Social Security — including Sen. Majority Leader Harry M. Reid (D-Nev.), who has said any changes to the program should not be considered as part of the upcoming debate over the fiscal cliff.

This would not be the first time that AARP has applied its political muscle with decisive effect.

The group’s backing was influential in passing what liberals called a flawed Medicare prescription drug plan in 2004. Then, AARP’s opposition doomed President George W. Bush’s proposal to partially privatize Social Security. And its support was instrumental in helping to enact Obama’s health-care overhaul, which reshaped parts of Medicare.

“It is the 900-pound gorilla,” said Frederick R. Lynch, a Claremont McKenna College professor who wrote a book about the organization. “All AARP has to do is whisper.”

But as Medicare and Social Security have come to account for about a third of the federal budget, some former AARP officials say it is increasingly risky for the group to try to wall off the programs from cuts.

Aware of growing political support for entitlement changes, even among traditional Democratic allies, AARP signaled a shift in thinking last year. John Rother, then AARP’s top lobbyist, said at the time that the organization was open to benefit cuts for Social Security recipients. This was widely viewed as a major departure for the group and welcomed by some as refreshingly realistic. But the statement caused a furor among the many interest groups opposed to such a change.

Soon afterward, Rother left AARP. He says it’s important for AARP to advocate for its position but also to be flexible.

“You want to be perceived as being a strong advocate, but at the same time your long -term interest is in solving a problem,” he said in an interview. “The art, if you will, is to make sure that you are operating and messaging in such a way as to get the best possible results for your members within the context of solving the problem.”

Rep. Nan A.S. Hayworth (R-N.Y.), who has spoken with AARP officials about their policy, said she wishes the organization would do more to talk to its members about the financial challenges facing entitlement programs rather than simply opposing cuts.

“I think it’s important to have a mature conversation so we understand the challenges we face going forward,” she said.

In 25 years, spending on Medicare and Medicaid is projected by the Congressional Budget Office to equal 10 percent of the economy — double the current percentage. In the same period, Social Security spending is expected to rise from 5 percent of the size of the economy to 6 percent, mainly as a result of the retirement of baby boomers.

LeaMond, AARP’s top lobbyist now, said that Medicare savings can be found by slowing the growth in health-care costs and that Social Security can be strengthened without cutting benefits, though she did not say how.

She said AARP members care deeply about the long-term solvency of the programs even if they don’t want to bear the brunt of the cost of fixing them.

“If the critics spend anytime with our members, you cannot help but be struck by their powerful sense of legacy,” she said. “They want to leave Medicare and Social Security as strong for their kids and grandkids as for them.”

http://www.washingtonpost.com/business/economy/aarp-uses-its-power-to-oppose-social-security-medicare-benefit-cuts-for-retirees/2012/11/17/affb5874-2aa6-11e2-bab2-eda299503684

 

Social Security Benefit Changes 2013; Social Security and Payroll Tax Cut Extensions; Benefit Program Solvency at Risk

Posted on | November 17, 2012

Fiscal Cliff Fears Linger: The primary stock composites in the U.S. finished the last week of trading lower overall as fears of the fast approaching “fiscal cliff” gripped tighter.

President Obama met with congressional leaders this week to discuss ways to avoid the financial pitfalls associated with the end of year changes.  Spending cuts and tax increases are scheduled to initiate as of this calendar year’s end and many Americans will be affected.

Many tax changes are scheduled to become reality as of January 1, 2013.  Bush era tax cuts are set to expire as this year comes to a close.  One of the current payroll tax cuts works against Social Security solvency.

Neither the Democrats or the Republicans have interest in extending a tax cut that could minimize the foundation which supports social security.  It is no secret that the current state of social security longevity is in question.  For this reason, it is very likely that the payroll tax cut will be allowed to expire as 2012 closes.  The payroll tax cut reduced employee contribution to social security from 6.2 percent to 4.2 percent.  It has been in effect since 2011.  The long-term stability of Social Security benefits will be at risk if the tax cut is extended once again.

Stephen Johnson

http://www.learningandfinance.com/2012/11/17/social-security-benefit-changes-2013-social-security-and-payroll-tax-cut-extensions-benefit-program-solvency-at-risk/

Smallest COLA increase since ’75

by Stephen Ohlemacher -Associated Press

Posted 10/15/12
 

WASHINGTON — Social Security recipients shouldn’t expect a big increase in monthly benefits come January. Preliminary figures show the annual benefit boost will be between 1 percent and 2 percent, which would be among the lowest since automatic adjustments were adopted in 1975. Monthly benefits for retired workers now average $1,237, meaning the typical retiree can expect a raise of between $12 and $24 a month. The size of the increase will be made official Tuesday, when the government releases inflation figures for September. The announcement is unlikely to please a big group of voters — 56 million people get benefits — just three weeks before elections for president and Congress. The cost-of-living adjustment, or COLA, is tied to a government measure of inflation adopted by Congress in the 1970s. It shows that consumer prices have gone up by less than 2 percent in the past year. “Basically, for the past 12 months, prices did not go up as rapidly as they did the year before,” said Polina Vlasenko, an economist at the American Institute for Economic Research, based in Great Barrington, Mass. This year, Social Security recipients received a 3.6 percent increase in benefits after getting no increase the previous two years. Some of next year’s raise could be wiped out by higher Medicare premiums, which are deducted from Social Security payments. The Medicare Part B premium, which covers doctor visits, is expected to rise by about $7 per month for 2013, according to government projections. The premium is currently $99.90 a month for most seniors. Medicare is expected to announce the premium for 2013 in the coming weeks. “The COLA continues to be very critical to people in keeping them from falling behind,” said David Certner, AARP’s legislative policy director. “We certainly heard in those couple of years when there was no COLA at all how important it was.”

Is Government-Run Health Care Really More Affordable?

Jeffrey H. Anderson

Posted October 12, 2012

During last Wednesday’s presidential debate, President Obama claimed that the private sector just can’t match the leanness and efficiency of the federal government. He was speaking specifically about privately covered health care versus government-run health care. Obama said, “Jim, if I — if I can just respond very quickly, first of all, every study has shown that Medicare has lower administrative costs than private insurance does, which is why seniors are generally pretty happy with it. And private insurers have to make a profit. Nothing wrong with that. That’s what they do. And so you’ve got higher administrative costs, plus profit on top of that.”

But the facts don’t back up Obama. Last year, the Government Accountability Office (GAO) estimated that Medicare loses a staggering $48 billion a year simply because of fraudulent or improper payments. In comparison, the profits of the nation’s ten largest health insurance companies last year were a combined $13.7 billion. In other words, Medicare loses three-and-a-half times what the ten largest private health insurers make.

Moreover, that $48-billion figure doesn’t even represent the full tally on the government side, since, in the GAO’s words, it “did not include improper payments in [Medicare’s] Part D prescription drug benefit, for which the agency has not yet estimated a total amount.” (As an aside, one wonders: Does Obama think the Medicare Part D prescription drug program — the popular program after which the proposed Romney-Ryan Medicare reforms are modeled — is “a voucher program”?) Both 60 Minutes and the Washington Post have previously estimated annual Medicare fraud at $60 billion.

With roughly 40 years of evidence to draw upon, the verdict is in. We can see that government-run health costs have risen far more, per patient, than the costs of privately covered health care. As a study I authored for the Pacific Research Institute shows, since 1970, the costs of Medicare and Medicaid have each risen one-third more, per patient, than the combined cost of all other health care in America.

Why do the costs of government-run health care rise more, even though Medicare and Medicaid pay health care providers less?  (And under Obamacare, Medicare providers would be paid even worse — worse than Medicaid providers by the end of this decade — with such “savings” going to fund Obamacare.) I’ve previously offered a few answers in these pages:

“Because [government-run health care] is as devoid of healthy competition as it is replete with wasteful inefficiency.  In Medicare, if providers get it right the first time, they get paid once.  If it takes four or five times — at seniors’ inconvenience and sometimes at their peril — they get paid four or five times as much.

“…Medicare’s notoriously low payment rates don’t keep providers from making up the difference (and then some) by prescribing more care — which Medicare almost always pays for, no questions asked.  [In comparison] most private administrative costs are money well spent — in establishing networks of accountable doctors, combating fraud, and so on.”

In sum — and Obama’s views notwithstanding — nothing gets cheaper by being funneled through the massive bureaucratic apparatus of the federal government.

A wise and frugal government, which shall leave men free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned - this is the sum of good government. - Thomas Jefferson

US Capitol Building