Advice for Living in an Autocracy
INTERESTING STUFF – 19 November 2016

Medicare in Peril


Republican House Speaker Paul Ryan has wanted to privatize Medicare ever since he first went to Congress 18 years ago. Now, with a new president on deck, he sees his chance.

And just in case that “privatize” word feels a bit toxic, he has renamed the effort to kill the program, Medicare Phase Out. Don't be fooled; it is the same thing as privatization.

But something else may come up in Congress before Medicare Phase Out legislation that will make the first inroads into killing Medicare. Let me explain.

The president-elect appears to have backed off somewhat his campaign promise to repeal and replace the Affordable Care Act, also known as Obamacare.

Now he says he wants to keep the pre-existing conditions provision along with one other that allows parents to keep their children on their coverage until the kids are age 26.

As we have learned in the past 19 months, it is impossible to know if what * says has any relationship to what he will do about anything. But until we know differently, we can only work with his statements.

So, in regard to repealing and replacing Obamacare (except for those two provisions), let us remind ourselves what Obamacare has done for Medicare beneficiaries:

Thanks to Obamacare, the donut hole in Part D, the prescription drug plan, has been gradually closing and will be gone by the year 2020. This has already saved elders billions of dollars and will continue to do so.

Also thanks to Obamacare, there are no copays for wellness visits to physicians and certain preventive services, among them annual flu shots, mammograms and colonoscopies.

And a big one, Obamacare extended Medicare's solvency by more than a decade, until 2029, giving more time to figure out how to make the program permanently solvent.

If Obamacare is repealed and replaced, these benefits will disappear and more important for Ryan, he will have already made a major inroad into killing Medicare without even needing to make a targeted effort.

And, he is willing to lie to make Medicare Phase Out happen.

Here is an interview with Ryan from last week with host Brent Baier on Fox News - transcript and commentary from Talking Points Memo:

”What people don't realize,” Ryan told Baier, “is because of Obamacare, Medicare is going broke, medicare is going to have price controls because of Obamacare, Medicaid is in fiscal straits.

“You have to deal with those issues if you are going to repeal and replace Obamacare. Medicare has serious problems [because of] Obamacare.”

Now, here is editor of Talking Points Memo, Josh Marshall, who has saved me hours of research in his ongoing attention to and coverage of Medicare's peril for which I am enormously grateful:

”First, Ryan claims that Obamacare has put Medicare under deeper financial stress.” writes Marshall. “Precisely the opposite is true. And it's so straightforward Ryan unquestionably knows this. The Affordable Care Act actually extended Medicare's solvency by more than a decade. Ryan's claim is flat out false.

“Second, I've heard a few people say that it's not 100% clear here that Ryan is calling for Medicare phase out. It IS 100% clear. Ryan has a standard, openly enunciated position in favor of Medicare Phase Out. It's on his website. It's explained explicitly right there.”

As the new administration prepares to take power in January, both health programs are in trouble and those who want to kill them will continue to lie. It is up to us to stem that tide and when the time comes to take action.

Meanwhile, keep your eye on Talking Points Memo, also known as TPM. Josh Marshall and his crew are doing a sensational job tracking this issue.

The bright spot in this scenario to trash both Obamacare and Medicare is that in addition to the 22 million people with Obamacare who like that pre-existing condition provision and 26-year-old children's coverage provision, there are an additional 56 million insured with Medicare who like that program – even love it.

With all those people, I suspect we, the American people, may have some leverage over this health coverage threat.

There is much more to know about it and plans to make but geez, this has been a hard week for most of us, working out how we feel and what to do about our new world order.

And I haven't made it any easier – the posts this week have been dense to wade through, including this one.

So let's give ourselves a break. There is a holiday coming up next week, time to relax a little – not that I won't be here on the usual days, I just won't ask as much of you or me for a few days.

OH, WAIT A MINUTE: I woke this morning to a pertinent Op-Ed from economist Paul Krugman in The New York Times. It is titled "The Medicare Killers" and you should read it. Here is the link.

If you don't subscribe to The Times or you have used up your monthly allotment of stories, email me (Contact link above) and I'll send the text to you. Well, I'll be out of the house today until mid-afternoon west coast time but after that I can do it.


I don't belong to AARP, but hope those that do put their corporate feet to the fire in demanding they use their full force on keeping Medicare as is. On unsubscribe en masse.
Hard to tell what they'll do since, I believe, they're part of the massive insurance conglomerate and might benefit from a change.

Have a good holiday, everyone.

Thankful for this place of sanity and good vibes!

Be well.

Doesn't Paul Ryan have any over 65 people in the people who vote for him? Everything that has privatized is more expensive, services are fewer and any alternatives are not always better.

I had splints put in a couple of years ago. My doctor offered to do it for half price if I didn't use my insurance. I can only conclude private insurance is a major reason why health care is so expensive.

As Wikipedia and many other trusted sources note, Paul Ryan received Social Security survivor benefits at age 16 when his father died. The monthly checks, which were put away to pay for his college education, continued until he was 18.

Can anyone spell hypocrite?

There are many residents here at the ALF that are very worried about this.
If it were not for Medicare many of us here would be a lot sicker and a lot poorer than we already are.
I only wish that both candidates would have spent more time explaining their positions on the subject.
Unfortunately, the question of Social Security, and Medicare was not brought up in any of the encounters until the very last question of the very last debate.
I figure I've got another 15 - 20 years left and I'll be damned if I am going to spend them eating dog food and wearing rags living in a refrigerator box just so I can pay for my blood pressure and other meds.

Ryan must have a mighty grudge against poor, old, white people. Otherwise why pick one of his first targets as something on which even his own backers might oppose him?

Oh yeah, this is dominance politics again, like Trump looming over HRC in the debate. They want to be see if we'll cower. Will we?

Good sources and terrific explanation here Ronni.

To call Paul Ryan a weasel is an insult to weasels. Anything and everything goes in the quest for privatization and profit.

Due to ill health, I won't have as many years left as Bruce, but I am not looking forward to dying under a bridge.

If a politician told me the sun came up this morning, I'd go outside to see for myself if it was true. And then I'd go out two more times, just to be sure I got it right the first time.

I hate that we're all in a position that we have to fight to keep these programs. Nothing good will come from privatizing Medicare, Obamacare and Social Security. Thanks for helping to keep us informed.

If Congress approves the nominees that * - rump is proposing we are in for a very rough ride indeed. Jeff Sessions for Attorney General? My god, the man is an avowed racist of the lowest order.

I want to fight it all with every fiber of my being, but my energy wanes at the enormity of the battle. That said, I will write, call, and e-mail protesting the privatizing Medicare and Social Security.

I will donate what I can to the programs under threat.

We have the numbers needed to fight and if every elder takes the time to contact his/her congressperson and protest and urge their friends to do so, the representatives will listen in fear not being elected.

Join Bernie in Our Revolution.

I think Trump won with a lot of help from being on Twitter and Facebook. As much as letters to our Congressman, blogs, emails, phone calls are important, I think it will be essential to get this message out via social media, and with short factual posts that refute exactly what Ryan and his troops are falsely alleging. There are a lot of people who only access the Internet via phone these days - so it's important to get the message out in short formats. Even young people, when informed that Trump is going against what he promised in a way that could hurt their grandparents, will pay attention if it's done right.

I am seriously skeptical that "market forces"/competition would produce the results Ryan seems to think they would, while preserving access to and quality of care. Vouchers undoubtedly would be insufficient to provide for the medical needs of many older people.

A huge group of now middle aged Baby Boomers are potential Medicare enrollees. This group includes a significant percentage of the less-educated white working class voters who elected *. I think they're in for many unpleasant surprises under * and might want to consider this: if Medicare is dismantled, who will pay the future uncovered medical costs of parents whose fixed incomes cannot cover these costs? Hmmm. . maybe Ayn Rand-acolyte Ryan's ultimate strategy for bending the curve on elder healthcare will be the return of Sarah Palin's death panels. (If she gets the appointment as *'s Sec'ty. of the Interior, wave b'bye to the AWLP and our national parks; say hello to drill-baby-drill and police reports from Alaska!)

My husband and I belong to an HMO and have been very satisfied with our Medicare Advantage plan. My primary concern is that our HMO was acquired recently by a larger HMO, and I worry a LOT that it may elect to cancel the plan in the next year or two. It would be highly problematic for us to find a comparable new plan in our 80s. I have no desire to spend big chunks of the time I have left trying to comprehend the fine print and lengthy lists of "Exclusions" in private healthcare plans!

Ryan's proposals to dismantle Obamacare has shaken me...I live in a country which has universal health care (Canada), and sincerely wish everyone could have our level of security and care. However the forces of populism and right-wing thinking are everywhere these days, and I know that my country is not immune to having our health care compromised. Heaven help us all!

Thank you for the story about Paul Ryan and the Social Security survivor benefits and what a difference they made to his life. I spelled hypocrite earlier today in a comment I left on a FB post by our local daily newspaper. I provided an explanation of why, after more than 40 years of being a subscriber, I ended that relationship yesterday. I did it because yesterday morning that paper published an opinion piece by the editorial board, advising readers to "It’s time to give * a chance" (they used his name, but I'm using your preferred moniker for him, Ronni). In their plea for their readers to straighten up and fly right, they included referrals to those who were not doing so as "having grudges," being "mopers," “sore losers,” and not "moving on." It went on in that vein, and was very patronizing and, I felt, particularly hypocritical, in light of the fact that, just a few days ago, the paper had been responsible for the launching of a yearlong campaign for the discussion of racism in the community. Apparently, they didn’t see the irony of beginning that work by urging the public to get behind the person who. for the past year or more, has done more to undermine unity and sow the seeds of bigotry than possibly any other person in recent history. Sheesh.

I think we need to point out to the late baby boomers and the younger generation that they have benefited from both Social Security and Medicare. Since these programs are in place which allow their parents to be (or become) financially independent as they age it has allowed the younger group to more easily leave home and move away in search of jobs and careers. Imagine what will happen to them if these are reduced or eliminated. Who do they think will be responsible for helping and caring for their parents as they age and need care/medical care. They may think they do not have any responsibility to provide care or assistance but when the time comes will they be able to sit by and watch their parents suffer? I think not. All the generations need to fight to keep these programs.

Bob, that's exactly my point although you stated it more clearly perhaps. Younger people have a very personal stake in this issue. Not only may they need to step up financially for their aging parents if Medicare is "reformed" as envisioned by Paul Ryan & Co., but they--and their children--will need to budget for elder care earlier in their careers. The alternative would be elder abandonment. Perhaps optimistically, I agree that most adult children would be unable to do that--which would further imperil their own financial security in old age.

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