[Vision2020] Warning to the GOP: Don't Mess with Medicare

[nickgier at adelphia.net]

Hi Kai:

You certainly do not advance the discussion with your mention of "spittle" and "rants."  I would expect better from a professional journalist.  This is trash talk, Kai, and you know it.

I also expect that my students would not commit the fallacy of irrelevance, which requires those who want to argue correctly to focus on the content and form of the argument rather than its source in Congress or on campus, which is irrelevant to the argument.  Sound arguments carry the day regardless of their source.

You claim that you want common sense, and the argument of those who support Medicare is one of eminent common sense.  You don't fix a popular and successful program with low administrative costs by taking billions of dollars away from it and giving it to private insurers with high administrative costs, who have skimmed off the best customers and left the rest with less coverage.

As far as Senator Crapo's response, he does not advance the argument either.  (I respond to his column below.) Many of America's children are going without health care because Republicans such as Crapo played the phony "socialized medicine" card opposing proper funding for the CHIP program.  

Socialized medicine is defined as system where doctors are government employees, which is the case in Cuba and North Korea, but virtually no where else in the world.  Many countries with universal coverage, such as Japan, Taiwan, the Netherlands, and German used private insurers but make sure that everyone is covered, not just a select few that companies can make a big profit from. Indeed, German health insurance companies are prevented by law from making a profit.  A basic principle should be that one does not subject essential human services, such as health, education, and security to the profit motive.  In these areas the common good should be the motive.

Yours for no more trash talking,

Nick

Here's Kai's trash talk: In the interest of fairness, I am posting Crapo's opinion on the same subject. Somewhere between the two is the truth, in the meantime they cover the rest us of with the spittle of their partisan rants. Common sense is a rare commodity on Capitol Hill and college campuses. 

I will indicate my response to Crapo with the initials "NG."

POLITICAL MANIPULATION IN THE EXTREME
Guest opinion submitted by Idaho Senator Mike Crapo

Millions rely on Medicare to access our healthcare system.  They should have exceptional care and cutting edge treatments available to them. Reimbursing doctors so that they can serve these patients is critical-for this reason, I have consistently advocated for timely and adequate physician compensation.  Systemic reform is also crucial.  The Medicare system needs the strengths inherent in the market-healthy competition that provides choice, flexibility and affordability.   The Medicare Modernization Act of 2003 introduced market forces into the
system that have benefited millions of seniors since.

NG:  It is now clear that the 2003 act was a boon to insurance companies but a disaster for ordinary recipients.  The companies received a handsome 13 percent in overpayments, but didn't manage care and didn't control costs.  The 2003 act benefited 9 million seniors on private plans but shortchanged many millions more.  If H.R. 6331 had not passed, the AMA predicted that the number of doctors who would be forced to deny Medicare patients would have increased from 25 to 60 percent.  Why, by the way, Sen. Crapo, why was the AMA hopping mad at the GOP for opposing this bill?  Why did they run ads against 10 GOP senators in 6 states?  The only people eager to kill this bill were the insurance companies.

MG: Unfortunately, in early July, the Senate voted to compromise positive gains we've made in instituting market-oriented reforms to Medicare over the past four years.  The vote on H.R. 6331, the Medicare Improvements for Patients and Providers Act, wasn't about physician compensation.  It was about whether or not this country would reject market-oriented
reforms and move, instead, toward a strictly government-run healthcare system.  As Paul Krugman, an editorial writer for the New York Times said in an article the day after the vote occurred: "Ostensibly, Wednesday's vote was about restoring cuts in Medicare payments to
doctors. What it was really about, however, was the fight against creeping privatization...If the Democrats can win victories like this now, they should be able to put a definitive end to the privatization of Medicare next year. "  Krugman concludes his article by stating, " A lot
can still go wrong with this vision.  But the odds of achieving universal health care, soon, look a lot higher than they did just a couple of weeks ago."  Krugman has it exactly right.  Contrary to
Krugman, though, I don't support socialized medicine and don't view last week's vote on Medicare with jubilation.

NG: There's that hobgoblin "socialized medicine" again, the two words that has killed any attempt to offer the comprehensive health care that all other industrialized nation has been able to achieve.  And yes, Krugman, is correct: we should fight privatization of Medicare and we should move to universal coverage for all Americans by means of Sen. Kennedy's plan called "Medicare for All." Can Sen. Crapo show any positive gains with Medicare Advantage except some Cadillac programs for select seniors and big profits for private insurers?

MG: There are those who want to move this country backward, toward failed healthcare policies that reduce choice, incentives for good service and access while increasing systemic and individual costs.  They created a bill with controversial offsets, eroding provisions that have made Medicare more responsive to recipients.  That's what the vote on H.R. 6331 was about, plain and simple.  Physicians still would have received their unreduced Medicare compensation; there was virtually universal support for that fix and it will be made under every proposal on the
table.  But, linking the physician compensation fix to removing market-oriented reforms in Medicare was political manipulation in the extreme.

NG: The only political manipulation here is a blatant attempt to privatize a popular and successful government program and cave into the health insurance lobby. Medicare Disadvantage is the failed policy in this instance.

MG: Those who want to reverse our move toward a more market-oriented Medicare system tried to turn my nay vote into an appalling misportrayal of my priorities.  My priorities are and always have been patients, physicians and our entire health care system.  Time and again, I've
championed adequate and timely Medicare reimbursement for physicians. I've been a leader in the Finance Committee in fighting for this for years, as my voting record testifies.

Let me repeat:

*  Support for stopping impending cuts in physician Medicare compensation is virtually universal and bipartisan; physicians would have received updated compensation, regardless of the outcome of H.R. 6331.
*  This vote and legislative battle were not about physician's compensation.  They were about rejecting market-oriented reforms and moving toward socialized medicine. 
*  I have been and will remain a leader in fighting for proper physician compensation.  In fact, although I consistently support annual fixes, I continue to advocate for a permanent fix rather than the temporary fixes Congress continues to enact.

NG: Bush and a GOP Congress had plenty of time to pass a permanent fix, but all they did was make the problem worse with Medicare "Disadvantage."  The reason why the 10.6 percent cut was so high is that a GOP Congress kept putting off a solution for compensating doctors and that is why the AMA is so angry and frustrated.