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GOP Senators Propose to End Medicare in 2014, Replace with Private Individual Mandate

10:28 am in Uncategorized by Scarecrow

The GOP has a proposal to end Medicare

The stupid[est] wing of the already crazy Republican Party, composed in the Senate of people like Rand Paul (Ill), Jim DeMint (S.C.), Mike Lee (Utah) and others, has predictably come up with this cycle’s most expensive, dishonest, unfair and politically suicidal proposal to end and replace Medicare.

I don’t mean just “end Medicare as we know it,” so pay attention, Politifact.   They mean to flat out kill it, stone cold dead, starting in 2014.   And the craziest part of their proposal is they want to replace it with . . . an individual mandate forcing all Seniors to purchase private health insurance, with government subsidies that become less sufficient over time while health care costs rise.

I can hardly wait for the GOP leadership and Presidential candidates, not to mention President Obama and the Democrats, to figure out how to attack this.

From The Hill:

The “Congressional Health Care for Seniors Act” would allow seniors to choose from the array of plans currently offered to the four million federal employees and their dependents in the Federal Employee Health Benefit program, starting in 2014. It would also gradually increase the eligibility age for Medicare from 65 to 70 over a 20-year period.

The bill was introduced Thursday by Sen. Rand Paul (R-Ky.). South Carolina Sens. Lindsey Graham and Jim DeMint are co-sponsors, along with Sen. Mike Lee (R-Utah).

How did Sen. Lindsey Graham get in on this?  Why, he’s there to lend gravitas and to set the record for most misrepresentations packed into a single statement:

“Our goal is to [1]save Medicare from bankruptcy and ensure seniors have [2] affordable, [3]high-quality health care — a crisis President Obama has [4]only made worse during his time in office,” Graham said. “Allowing seniors access to the Federal Employee Health Benefit (FEHB) program, which members of Congress and federal employees use, will give them [5]more choices and [6]lower their out-of-pocket costs.”

Each of the items marked [ ] is essentially false or misleading, so Lindsey gets six points for dishonesty in just two sentences.   But never mind that.  Think about what they’re proposing and compare that to the structure of the Affordable Care Act.

In essence, every Senior would be required to purchase private health insurance from a list of policies defined and approved by the government, and if they can find the choices on a web page then  . . .voila!  we have an exchange!   The individual mandate would apply to everyone at age 65 (moving to 70 in a few years).  The government wouldn’t ensure you can afford necessary and sufficient health care; it would merely cover, for now, an average of 75% of your premiums for whatever the policy covers.   So as health care costs rose, so would your contributions to the premiums and non-covered care.  And how would anyone control costs?  They wouldn’t, because the Advisory Board set up in the ACA to ferret out lower costs and other means to control provider payments would be gone.  You’re on your own in a dysfunctional market.

But you wouldn’t know this from the talking points the GOP Senators used:

According to a synopsis from Paul’s office, the bill would:

• slash the deficit by $1 trillion over the first 10 years and reduce Medicare’s 75-year unfunded obligation by almost $16 trillion;

• offer seniors “richer benefits, higher quality health care, and better access to doctors and providers” while cutting their premiums to $1,900 per year — less than the $3,500 seniors currently pay for Medicare benefits and supplemental insurance, or Medigap;

• charge seniors the same premium regardless of their health status or pre-existing conditions;

Translation: Since there’s no mechanism by which the proposal could reduce actual health care costs, a $1 trillion reduction in deficits over 10 years means that the proposal shifts $1 trillion actual costs to seniors.   That also means that the claimed cut in premiums is a shell game.  You can’t reduce total premiums while shifting a $1 trillion in costs, let alone $16 trillion.  And the rule that insurers cover all comers regardless of health and pre-existing conditions is a clue we’re dealing with the same mandatory purchase model embedded in the ACA.

The WaPo’s Dana Milbanks captures the wonderful irony:

At Thursday’s news conference, Jonathan Weisman of the New York Times pointed out that the lawmakers were proposing to do with Medicare almost exactly what President Obama’s reforms do for non-retirees: Direct them into private insurance with a subsidy for those who need it most.

Paul was flummoxed. “Uh, anybody want to comment on that?” he asked, producing laughter in the Senate TV studio.

Yes, the clowns are always hilarious, as long as no one takes them seriously.  But this isn’t the circus and these people are Senators. It won’t take much more craziness for the clowns to be in charge of running the place, as they already do in the GOP-controlled House and the GOP side of the Senate.

So once again, Obama/Democrats, how are you going to explain why this is nuts?   Don’t say we didn’t warn you.

Rand Paul Is Not the Stupidest Tea-GOP Senator. However . . .

6:42 pm in Uncategorized by Scarecrow

St. Stupid's Day Parade 2009

St. Stupid's Day Parade 2009 by Laughing Squid, on Flickr


US Senator Rand Paul (Tea-GOP, Ky.) told America on Wednesday that if we decide as a nation that everyone has a right to decent health care, and set up community health centers to help further that goal, that would effectively turn doctors into slaves. Via Politico’s Kate Nocera:

“With regard to the idea whether or not you have a right to health care you have to realize what that implies. I am a physician. You have a right to come to my house and conscript me. It means you believe in slavery. You are going to enslave not only me but the janitor at my hospital, the person who cleans my office, the assistants, the nurses. … You are basically saying you believe in slavery,” said Paul (R-Ky.), who is an ophthalmologist.

I had never realized this similarity between being a doctor and being a slave. So I listed all the features I could think off, and sure enough, they look about the same:

A. What most people associate with being a slave:

1. Get forcefully taken from your home and family, while watching members of your family be killed or raped.
2. Be bound and shackled, kept in cells and holding pens.
3. Sold to slave traders who transport you to slave markets, shackled, possibly killed or maimed during shipment
4. Deprived of most medical attention, malnourished, beaten with no reccourse
5. Sold to slave owners, still shackled, taken to owner’s destination
6. Forced to perform manual labor every day, sun up to sun down, as ordered by slave owner; subject to sexual assualt
7. Receive minimal medical treatment; have no rights, no comforts, no government or laws accountable to you
8. Treated as property. Can be traded, sold, disposed of at will of owner; marriage not recognized; children not yours but belong to owner to dispose of at will.
9. Continuously subject to being physically beaten, injured, killed by owner with no recourse

B. What most people associate with being a doctor:

1. You choose to study the profession, get degrees, become qualified.
2. You choose to work or not in that profession
3. You accept patients for whom you provide care
4. You receive compensation that puts you in upper class; gain high community respect.
5. You decide whether to run for US Senator

Who knew there was so much slavery in other developed countries? I learn something every day.

Rand Paul: I Can Be A Spoiled Child, Because Adults Will Stop Me

12:50 pm in Economy, Legislature by Scarecrow

Apparently, Rand Paul thinks being a U.S. Senator means he gets to stomp his feet and throw a temper tantrum whenever he wants to “send a message.” And the reason it’s okay is because he’s assuming enough adults in Congress will be responsible enough not to give him what he wants.

Let’s be clear, we know why he’s throwing his mock temper tantrum. Congress periodically sets — and raises — the cumulative limit on how much debt the U.S. can hold. But since we’re in a period of unavoidable budget deficits — the near depression helped push it to $1.3 trillion this fiscal year and almost that much in President Bush’s last budget — and will be for many years to come, the cumulative debt is steadily increasing, even though the annual deficits will be declining. That’s not necessarily a problem in itself, but Very Serious Persons think it should be brought down over time.

If Congress doesn’t raise the cumulative debt ceiling, the U.S. cannot fund its budget beyond the still depressed levels of incoming revenues without shutting down and/or defaulting on its debt payments. A government shutdown or debt default would be catastrophic for government financing and public services.

Since there’s no plausible scenario in which a “balanced budget” can be accomplished in the foreseeable future — and no coherent economic theory that justifies doing so — the newly elected senator from the State of Kentucky is saying he’s willing to vote for a governmental collapse and destruction of its credit.

But it’s okay, the child-senator explains, because there aren’t enough other senators as idiotic as he is. So the country is safe and it’s okay for him to behave irresponsibly. Good luck, America: Rand Paul is coming to take back your government.

Rand Paul Exposes His Moral and Intellectual Hypocrisy

7:03 am in Uncategorized by Scarecrow

I’ve been thinking more about the insulting remarks Rand Paul made in Kentucky when he suggested that skilled, unemployed folks should just suck it up and settle for whatever lower-paying job they can get. What I wrote here doesn’t fully expose his moral and intellectual poverty.

It’s bad enough that Paul doesn’t seem to know that with 15-20 million people under- and unemployed, hundreds of people will be lining up for a handful of jobs. His condescending "tough love" lecturing is oblivious to the enormity of the jobless problem. It’s even more insulting that he assumes folks at the ends of their hopes are not already doing everything they can to stay afloat.

It is a favorite theme of Republicans of varying stripes that the unemployed and poor are there because they deserve to be; their status proves they’re undeserving. Lecturing them on moral virtues is what conservative Republicans have always done.

But the worst part is the cynical hypocrisy illustrated in the same Blue Grass Politics article, in which Rand Paul was also asked how he felt about taking government Medicaid/Medicare payments for his medical practice.

To understand the full hypocrisy of this common Republican belief, recall that because of obstruction by Republicans and DINOs (Lieberman, Bad Nelson) who think just as Paul does, the Congress has failed to pass a modest jobs bill that would fund youth summer jobs and prevent states from having to lay off hundreds of thousands of teachers and cut Medicaid services, while extending unemployment and COBRA health insurance benefits. Yet our can’t-get-its-priorities-straight Congress and dysfunctional Senate have agreed on a measure to keep Medicare from cutting fees to doctors.

Even though he rants against government spending, Rand Paul hasn’t said boo against Congressional efforts to shield doctors from taking less pay for what they do. Instead, he told the interviewers this:

In another radio interview, with a Bowling Green station on Wednesday, Paul defended his acceptance of Medicare and Medicaid payments as an eye surgeon for the last 17 years. Paul said he wants sweeping cuts in federal spending, but as a doctor, he has little choice but to serve patients covered by the massive federal health-care programs.

“I work hard and I don’t see any other person in this country who’s gonna work hard and not be paid for it,” Paul said.

What Paul is saying is that a doctor works hard and is highly skilled, so it’s only fair that persons performing an essential public service be fairly compensated. I think most would agree with the principle. But when Paul speaks to an unemployed teacher with a Masters Degree in Education, even though the country’s educational system is crying out for skilled, energetic teachers anxious to teach, she should suck it up and consider flipping burgers. It’s tough love for her; subsidies for him.

But in Rand Paul’s world, we shouldn’t apply "tough love" to him, because he’s not one of the undeserving:

Paul declined to say how much money he gets from the programs, but he said approximately 50 percent of his income is Medicare and 5 percent is Medicaid. According to the Kentucky Cabinet for Health and Family Services, Paul has been paid $130,461 over the last five years through Medicaid. If that represents 5 percent of his income, then Paul’s Medicare payments over the same period would be more than $1.3 million or about $260,000 a year.

Rand Paul: tough love is only for the undeserving but not for his privileged class.


One more point
: I’d have thought a true libertarian would offer his services, and if he can’t sell them at what people can afford to pay, he would accept the market’s verdict and try another job. But what he essentially says here is he’s entitled to a comfortable living as a doctor. He has "little choice" because he can’t prosper as well as he believes a doctor is entitled to, unless he accepts Medicare/Medicaid patients and government payments. And his patients in turn can only afford his services if government pays him the fees he assumes he’s entitled to.

I think that’s a classic illustration of an entitlement system for doctors. Some libertarian.

Tough Love from Weak Minds: Rand Paul Tells Skilled Unemployed to Work for Less

2:48 pm in Uncategorized by Scarecrow

The folks at Kentucky’s BlueGrass Politics catch Rand Paul lecturing the unemployed in his state that they just need a dose of tough love. His original idea: take a job for lower wages.

Republican U.S. Senate candidate Rand Paul on Friday urged Americans who have been unemployed for many months to consider returning to the workforce in less desirable jobs rather than continue relying on government unemployment assistance.

“In Europe, they give about a year of unemployment. We’re up to two years now in America,” Paul said on Sue Wylie’s WVLK-AM 590 radio program.

“As bad as it sounds, ultimately we do have to sometimes accept a wage that’s less than we had at our previous job in order to get back to work and allow the economy to get started again,” Paul said. “Nobody likes that, but it may be one of the tough love things that has to happen.”

Gosh what a clever, helpful and original idea.

I just had a conversation with a woman who is just completing her Masters Degree in Education. She’s been looking for a teaching job for months, but unfortunately she’s finding that states and local communities are laying off teachers, not hiring them. She’s sent resumes/references and inquiries to dozens of schools all over the country, public and private, and all she’s got so far is a part time position for part of this summer but nothing beyond that.

So I’m sure she’ll be thrilled to hear this new idea and just run over to the local McDonald’s and get on their waiting list for trainees or join the 500 people waiting in line for the next Walmart opening.

I’m surprised the jobless haven’t thought of this sooner, but the undeserving never think of these things. So they’re fortunate that Rand Paul has the imagination to realize that America is just overflowing with minimum wage jobs for trained teachers and skilled workers trying to support their families.

Or maybe he’s just an idiot.

"There is no good reason for anyone to vote for a Republican." — Brad DeLong


More on Rand Paul’s Moral and Intellectual Poverty

Rand Paul Proposes to Tank Economy and Increase Unemployment During Recession

6:03 pm in Uncategorized by Scarecrow

Rand Paul can’t seem to avoid proving not only his economic ignorance but his apparent indifference to the harm his policies would cause. He told the folks in Kentucky that in the middle of the worst recession since the 1930s and with 15 million people unemployed, he’d insist on eliminating the US budget deficit, which would tank the economy and put even more millions out of work.

From Bluegrass Politics:

FRANKFORT — Republican U.S. Senate nominee Rand Paul vowed Monday to introduce his own balanced budget for the nation if he is elected.

“If filibuster be necessary to make them pay attention to the debate over a balanced budget, I think a good week’s time would be well spent to have the whole country talk about what’s going to happen to us if we become (financially troubled) Greece,” Paul said.

Paul, appearing on the Rush Limbaugh radio show with guest host Walter Williams, stressed his call for a federal balanced budget by law.

He noted that Kentucky requires a balanced budget.

Kentucky “is suffering through a recession like every other state but we are nothing like California because we are forced to balance our budget,” Paul said.

“We don’t spend money we don’t have.”

Earth to Rand Paul:

1. California’s state constitution requires it balance the budget, every year. That, along with crippling voting requirements (which Rand would likely approve) to pass a budget or raise revenues, makes it extremely difficult time getting a budget out, year after year.

2. Neither California nor Kentucky can help solve this because states can’t print their own currency. Only the US/Fed can do this. That’s partly why we have/need a federal government and national currency.

3. The US is not Greece. But Kentucky and California, like Greece, do not have their own currency. Unlike Kentucky and California, the US can "spend money it doesn’t have."

4. And unlike Kentucky/California, the US can expand money and increase spending without a balanced budget. The fact the US has increased spending during the recession means that Kentucky’s economy is significantly better off than it would have been if Rand Paul’s proposals had been imposed.

5. If Rand Paul’s fiscal and economic recommendations were followed, it would tank Kentucky’s and the US economy and put millions of people out of work across the US.

I should add that since states are having to contract their budgets during the recession, the effect, as Matthew Yglesias points out, more than offsets the federal stimulus effects.

Looked at comprehensively, what the country has been implementing is a mild version of the conservative policy prescription for boosting growth—fire bureaucrats and trim spending. And it’s not working very well. And with continuing economic weakness, state and local governments are set for further trimming even as federal stimulus winds down. This is going to be a disaster. Nothing about having economically pressed jurisdictions lay off huge quantities of teachers is going to improve the situation.

And not just teachers, but critical safety net measures like health care.

Governors and state lawmakers, already facing some of the toughest budgets since the Great Depression, said the repercussions would extend far beyond health care, forcing them to make deep cuts to education, social services and public safety.

Good luck, Kentucky. Hope you can sort this out before Rand Paul’s misguided thinking tanks the whole economy and puts you out of work.

John Chandley

This would blow Rand’s mind: HuffPost/Warren Mosler, G20 Says Expansionary Policy Not Sustainable
And this is heresy: Paul Krugman, Madmen in Authority
Another synapse too far for Paulites: Brad DeLong, We Need Bigger Deficits Now!

Rachel Maddow On Why Rand Paul Doesn’t Get It

9:14 pm in Uncategorized by Scarecrow

In 1964, the United States enacted the Civil Rights Act outlawing discrimination in all public facilities, whether privately owned or public. Kudos to MSNBC’s Rachel Maddow for displaying the language of Title II, which establishes as the law of this land, enforceable by injunction, the following fundamental human rights:

All persons shall be entitled to the full and equal enjoyment of the goods, services, facilities and privileges, advantages and accommodations of any place of public accommodation, as defined in this section, without discrimination or segregation on the ground of race, color, religion or national origin.

Notwithstanding the members of the Texas School Board and the sensibilities of libertarians, every American should read, understand and cherish these words. They establish the basic democratic principle — still not complete — that America will demand our businesses and government institutions treat all of us fairly. I don’t know how you can have a democracy worth defending without that principle.

Despite claims of principle, Rand Paul does not appear to accept this core American value. His opposition is not principled, though he would have you believe so. When pushed to explain his real beliefs, whether with local press, CNN, or Maddow’s show, or even in politically dictated clarifying statements, he has repeatedly evaded the central question, changed the subject or distracted the questioner with some irrelevant point that just so happened to be more dog whistles to his fanatical supporters.

Paul has been asked at least a dozen times whether he agrees with the core principle that America’s businesses should not be allowed to discriminate. But instead of saying "yes," he’s told us he’s not racist himself, though no interviewer has made that charge. He’s said he doesn’t approve of discrimination and wouldn’t join a private club that discriminated, but that was never the issue. He’s said we should worry about gun rights, though no interviewer made any connection between the 2nd Amendment and the core principle of non-discrimination. And he’s tried to go off on free speech, when that has nothing to do with whether or not he supports using government to end discrimination in accommodations.

It’s appalling enough that Rand and his supporters would reopen an issue whose history of violence and inhuman treatment remains an indelible stain on who we’ve been, and who some would remain. But Paul’s views are not merely unAmerican and dangerous for that reason.

I don’t know and don’t care whether Rand Paul thinks of himself as racist or favors discrimination. The danger he represents is that in legitimizing governance views that should have been buried with Jim Crow, he’s trying to fool everyone about who he is. He apparently doesn’t have the integrity to explain clearly what he believes. Perhaps he only wants to keep signaling to his Tea Party fans that he’s one of them, while hiding the implications from everyone else.

As others have noted, there is more here than the philosophical libertarian view that government should not impose even a collective American value about non-discrimination upon private businesses, which after all, are created — licensed — by the state, not handed down from the gods. The larger principle is whether American government can insist privately owned businesses meet standards of acceptable conduct, deemed reasonable and necessary for the public welfare, as we the people define it through our chosen governments. That’s as American as apple pie.

So if Rand believes the answer is "no," then let him stand before the voters of Kentucky, with his Republican Party behind him, and explain to them why not just the corner drug store but major pharmaceutical and chemical corporations should be set free to harm people and damage the environment merely because they’re private businesses.

Because that’s the de facto operating principle we’re seeing on our Gulf and in our coal mines and on Wall Street and the executive suites of our health insurance companies and mega-media monopolies. It’s the belief that government should minimize its interference in how businesses behave even where their activities can cause great harm.

That view is strangling America, though don’t expect Paul to explain that to his Tea Party followers or Paul’s critics to apply that to their ongoing tolerance of corporate America’s capture of too much of our government.

Added/edits Friday a.m.

Update: More wisdom from Dr. Paul:

"What I don’t like from the president’s administration is this sort of, ‘I’ll put my boot heel on the throat of BP,’" Rand said in an interview with ABC’s "Good Morning America." ”I think that sounds really un-American in his criticism of business."

Other views:
Salon/Joan Walsh, Rachel Maddow demolishes Rand Paul
Digby, Who’s his daddy?
IVB/Chad Peace: Rand Paul toasted by even-handed Maddow
Ezra Klein: Rand Paul may not be a racist, but he is an extremist
Crooks & Liars/Dave Neiwert, Paul hurriedly tries to back away . . .