President Obama and his allies are predictably in full-out attack over the House Republicans’ deficit reduction plans. But they are on shaky ground for two reasons: The American people are frightened and more aware than ever about the dangers of massive deficits — driven largely by open-ended entitlement spending. And the president has no standing to criticize Republicans for proposals that are part of the very health law he worked so hard to pass.
This is true whether we are talking about premium support for Medicare, vouchers for health insurance, or ratcheting down payments to doctors through the Independent Payment Advisory Board.
Let’s start with premium support: Jim Capretta of the Ethics and Public Policy Center has taken on the president on the hypocrisy of his charges that Republicans are trying to end Medicare as we know it with “vouchers.” In a piece for National Review Online called “Obamacare?s Cruel and Inhumane Inflation-Indexed Vouchers,” Capretta writes about the tactics the president used against Republican presidential nominee John McCain:
“Indeed, in October 2008, when the race moved from a dead heat to Obama’s advantage, no issue was featured more prominently in TV attack ads than McCain’s supposed plan to ‘tax health benefits.’
“Then, after assuming office, President Obama had a very sudden and inexplicable change of heart. Taxing benefits for the first time in history really didn’t seem like such a bad idea after all. The change of heart was so thorough that Obama went from chief opponent to chief proponent of the idea in a matter of months. As Obamacare wound its way through Congress, the administration gave the concept a new name — the ‘high-cost-insurance tax,’ or ‘Cadillac tax’ — and insisted that it be included in the final version of the legislation, to the great consternation of organized labor. Now that’s shameless.”
The same attack tactics were revived in the president’s criticism of the Ryan Medicare plan. Lest anyone be deceived, Medicare is $30 trillion in the red and cannot possibly pay the benefits promised to the next generation of seniors without toppling the economy with crushing taxes.
Ryan wants to change the program starting in 2022 to give seniors a benefit that looks a lot more like the coverage that people would have had during their working years through a new system of “premium support.” The allocation would be adjusted so that older, sicker, and poorer seniors would get larger payments, and it keeps Medicare the same for everyone on Medicare today and for those who are 55 and over now. If we don’t reform this program, Medicare won’t be there for anyone.
Again to quote Jim’s piece:
“The government will oversee this new Medicare marketplace, organize the information and choices for the beneficiaries, and ensure that all of the plans meet minimum standards…
“By the Democrats’ reaction, you’d think this idea was the beginning of the end of Western civilization.
“‘Cruel.’ ‘Inhumane.’ ‘The end of Medicare as we know it.’ From the president on down, liberals everywhere have jumped on the Ryan Medicare plan as the worst idea ever conceived.”
Problem is, that the president has proposed just the same thing with his vouchers for private health insurance in the exchanges.
“But, wait a second, there’s something vaguely familiar about how the Ryan Medicare plan is supposed to work. Inflation-indexed credits. Competing private insurance plans. Government oversight of the marketplace. Oh yeah: That’s the description of Obamacare that advocates have been peddling for months.” [i.e., vouchers for subsidized health insurance in the exchanges.]
“Even by Washington standards, the cynicism at work here is stunning. Liberals everywhere are practically giddy at the thought of running against the way the Medicare credits are indexed in the Ryan plan. Only problem is, it’s in their plan too.”
IPAB Exposed. It doesn’t end there. White House Deputy Chief of Staff Nancy-Ann DeParle posted a blog on the White House website on Wednesday called: “The Facts About the Independent Payment Advisory Board.”
DeParle writes: “The President’s framework instead builds on the improvements made by the Affordable Care Act.”
Among those “improvements” would be taking half a trillion dollars out of Medicare to create two new budget-busting entitlement programs and creating a rationing board — the Independent Payment Advisory Board or IPAB — to enforce lower payments. This will give unelected, unaccountable government appointees the power to make decisions about payment policy in Medicare that will ultimately determine whether millions of seniors have access to the care they need.
The president wants to double-down on their powers, giving them the authority to “sequester” congressional appropriations and to reduce payments to an even lower rate than called for in ObamaCare.
So that means the president’s creative solution to deficit reduction is to pay doctors and hospitals less and to turn those decisions over to people unreachable by the voters. Medicare actuaries already have said that Medicare is on track to pay providers even less than Medicaid, and the president apparently believes those payments would still be too high.
It gets worse.
DeParle writes: “Under their [the Republican] proposal, a typical 65-year-old who becomes eligible for Medicare would pay an extra $6,400 for health care, more than doubling what he or she would pay if the plan were not adopted.”
We answered this charge last week and also in a piece for National Review summarized below:
“Since the president offered a speech, not a detailed 73-page plan like Ryan’s, we have to try to figure out what the White House really means. Here’s the best assessment: The Ryan plan, when it begins in the year 2022, would provide an age-adjusted payment so that seniors can pick the best health plan to meet their needs. The older they are, the bigger the payment they would get. The average payment for insurance for all seniors is expected to be about $15,000 a year. But it will be less for seniors when they turn 65 because their health costs will be lower and the expected payment of $8,000 would cover most or all of their premiums.
“The White House apparently did simple subtraction between the expected payment for 65-year-olds and the average premium for all seniors and came up with a number that has no relation to reality.”
National Review Online also has an interview with former Sen. Phil Gramm of Texas, an economist, who calls the House budget “one of the most remarkable economic documents in the modern history of the country. The fact that it passed the House of Representatives shows that the American government in a crisis is capable of making hard decisions,” Gramm assures NRO, before adding, “or at least the House is.” And Ryan, he thinks, is a remarkable man: “He’s sincere, which I think is the highest praise you can have for a politician.”
The Pulitzer! And warmest congratulations to Joe Rago, the lead health care editorial writer for The Wall Street Journal who received the Pulitzer Prize this week for his outstanding body of work exposing the truth about ObamaCare. Here is the link to the list of editorials for which he received the award, virtually all of which we have brought to your attention in Health Policy Matters, on the Health Reform Hub over the last year.
Joe deserves the award and so does the whole WSJ editorial page for the amazing work they are doing in continuing to explain the damage the law will do to our health sector, our economy, and to future generations.
CLIP OF THE WEEK
In this video, Rep. Tom Price, MD, gives opening remarks at the Galen Institute/Docs4PatientCare event entitled “The New Health Law: Bad for Doctors, Awful for Patients.” Other videos from the event are available on our YouTube channel.
Watch now >>
GALEN IN THE NEWS
Doubling Down on Obamacare Rationing
National Review Online: Critical Condition, 04/15/11
Seniors, beware. Buried in the president’s deficit speech last week was a plan to give even more powers to the Medicare rationing board created in his health overhaul law. President Obama proposes giving the unelected, unaccountable Independent Payment Advisory Board (IPAB) new authority to tighten the screws on payments. He clearly sees rationing as the tool to control costs by setting “a more ambitious target” for the IPAB ax. According to a House Budget Committee estimate, the president’s IPAB goals would lead to benefit cuts of $9,600 for seniors over the coming decade. Medicare actuaries have said that the payment cuts already built into Obamacare make it so that Medicare will eventually pay less than Medicaid does today, making it extremely difficult for patients to find doctors who will see them.
Are seniors prepared for this?
Read More »
The New Health Law: Bad for Doctors, Awful for Patients
Jason Fodeman, M.D.
The health overhaul law will strip away physician autonomy, drown doctors in bureaucracy, and drain job satisfaction. As the profession deteriorates, older doctors will retire while younger doctors will look to switch careers. Many young people considering a career in medicine will pursue other opportunities. The supply of providers will dwindle as demand for services reaches an all-time high. Ultimately, the consequences of the health overhaul law will be passed along to patients through restricted access, long wait for appointments, and rationed care. The time has come for a long-overdue, honest discussion on not just the impact that government will have on patients, doctors, and the practice of medicine, but the impact it already has had over the past 45 years. The importance cannot be undersold as the Patient Protection and Affordable Care Act is indeed bad for doctors, but it is always the patient that suffers the most.
Read More »
Why Accountable Care Organizations Won’t Deliver Better Health Care — and Market Innovation Will
Rita Numerof, Ph.D., The Heritage Foundation, 04/18/11
ACO Fairy Tale Faces a Rumpelstiltskin Moment
Michael L. Millenson, Kaiser Health News, 04/19/11
Obamacare rules belie compassion, care
Donald P. Condit, M.D., The Detroit News, 04/19/11
New Efficiencies in Health Care? Not Likely
Theodore Dalrymple, The Wall Street Journal, 04/16/11
Piping Up: Medical Innovation Critical To Bringing Down Health Care Costs
Sally C. Pipes, Forbes.com, 04/18/11
Premium Support Can Save Medicare, But Only If Congress Can Just Say No
Joseph Antos, The American Square, 04/19/11
Obama Panel to Curb Medicare Finds Foes in Both Parties
Robert Pear, The New York Times, 04/19/11
Transforming Medicare into a Modern Premium Support System: What Americans Should Know
Robert Moffit, Ph.D. and Kathryn Nix, The Heritage Foundation, 04/15/11
Building a Market-Based Health-Insurance Exchange in New York
Paul Howard, Manhattan Institute, 04/11
Wisconsin Opens Office of Free Market Health Reform
Jennifer Haberkorn and Kate Nocera, Politico Pulse, 04/22/11
Arizona’s Health Care Freedom
Katie Pavlich, Townhall.com, 04/19/11
INTERNATIONAL HEALTH SYSTEMS
Canada’s Medicare Bubble: Is Government Health Spending Sustainable without User-Based Funding?
Mark Rovere and Brett J. Skinner, Fraser Institute, 04/18/11
Public Reporting of Quality Outcomes: What’s the Best Path Forward?
Alliance for Health Reform Briefing
Wednesday, April 27, 2011
12:15pm – 2:00pm
A Hard Look at Criticism of Physician-Industry Collaboration
Benjamin Rush Society Event
Wednesday, April 27, 2011
12:00pm – 1:00pm
2011 Spring Task Force Summit
April 28-29, 2011
Grace-Marie Turner will speak about Why ObamaCare Is Wrong for America on Friday, April 29.
Why ObamaCare Is Wrong for America Bloggers Briefing
The Heritage Foundation Event
Tuesday, May 3, 2011
The authors of Why ObamaCare Is Wrong for America, including Galen’s president Grace-Marie Turner, will discuss the book with bloggers and online journalists.
Health Care 2011: Advancing Health Care by Facilitating Innovation
Galen Institute Conference
Thursday, May 5, 2011
8:30am – 1:30pm