Aaron Carroll gives voice to my frustration with the GOP ticket and Medicare plans**.
This time around, we’ve got a ton of proposals that contradict each other. There’s Paul Ryan’s 2012 budget (now abandoned). There’s Ryan-Wyden. There’s Paul Ryan’s 2013 budget (which Wyden doesn’t support). There’s Mitt Romney’s “plan“. And now there’s the Republican party platform.
So Medicare will both stay a defined benefit program and be saved by no longer being a defined benefit program. We will eliminate the $700+ billion in savings to the trust fund, yet extend its life. We will not cut any benefits, but will reduce Medicare spending dramatically. We will increase Medicare spending, but somehow not seniors’ premiums.
All of this could, of course, be explained by a few questions and some direct answers. In this election, though, I suspect neither are forthcoming.
Carroll is being more generous than the GOP deserves. I think it pretty clear that the abandoned 2012 plan is the plan actually preferred by Ryan, and those who support him. It was abandoned when they decided to compromise. If the support existed in Congress, it would become our new Medicare plan. Beyond that quibble, I am in agreement with Carroll. The plans not only contradict each other, they also, sometimes, have internal conflicts. As Carroll notes, this could all be cleared up with a few questions being answered. I do not think that will happen soon. Campaigning against Medicare cuts was a major factor in the GOP domination of the 2010 election. So, while everyone knows that Medicare spending must be cut, we can expect more attacks on the Medicare cuts in the ACA, while claiming that the GOP plan(s) will save Medicare by doing something. We just aren’t sure about what that something will be, or how it will work.
**Carroll has links to each of the plans on his post.
There are a limited number of ways in which to lower costs of Medicare
– Cut benefits
– Cut payments for providers
– Cut coverage of many prescription drugs
– Implement an aggressive managed care program with an effective and trusted primary care access portal
The only one of these that would both cut costs and improve care is the fourth. Sadly, it is not likely to come about for several reasons. JMK has commented a number of times about the health care system in Hong Kong and that stimulated my interest in what is happening there. I am working on a piece about that program and how it got to where it is as well as where it may be going. I will try to finish this in the next several days.
No, there’s no way one approach will keep Medicare viable.
Obama care “saves”/CUTS some $700 BILLION/year in Medicare expenditures (without effective oversight, nor even a cogent explanation of HOW).
CUTS (and substantial ones) seem inevitable. Cutting benefits, payments for providers and some prescription drugs coverage, as well, seem to be in order.
Like Steve, I bristle at the very idea of more well-off taxpayers being shortchanged – delivered equal care to lower income beneficiaries. . .I believe that makes our objection more clear then previously stated by either of us. People who earn more income have earned a higher quality of life. There’s nothing either mysterious, nor unfair about that.
Steve has certainly acknowledged that higher income earners have earned better housing, better food, better cars, better access to legal and medical care, so ANY plan that would attempt to “equalize” any of that is anti–individualist, and anti-American (that is it runs counter to the principles of private property & individualism America is based upon).
Would ANYONE think that a couple earning $34,000/year with 5 children in upstate NY should live in a subsidized 5 BR, 4 bth home, while a couple earning $370,000 with no children, living in NYC should be burdened with the costs of such subsidies to the point (perhaps a 55% federal tax rate & another 10% combined City & State income taxes) forcing them to abandon their comfortable 3BR/2bth $800,000 Upper East Side Co-Op and effectively live “below their means” merely to subsidize the “useless eaters” who produce far less?
I know I tend to skim Steve’s posts, but from what I’ve read I gather he’s an even more fierce Libertarian (a supporter of the economic free-for-all and the idea that “fairness is allowing everyone, from the HS drop out to the Harvard PhD to compete freely – letting the best competitor win”) than even I am (I tend to have somewhat stronger Corporatist leanings, though I fight them).
ONLY a complete idiot (that’s NOT a gratuitous insult, people can be bright in one area, like being extremely creative entrepreneur, and be completely idiotic and lacking in any common sense on any number of other issues) would think that low-wage earners are “being treated unfairly” and deserve to be subsidized at the expense of those who produce the most.
Today, the top 10% of income earners in the USA produce 34% of ALL the work/productivity in the country. It’s naive to think that people (because they dropped out of HS, or simply don’t like competition) have been “barred from producing.” On the contrary there’s been continuing and aggressive outreach to get these folks producing for the past 50 years!
Obviously there’s a massive disparity in wealth creation in the USA!
Simplistic, naive, “emotional thinkers” reflexively seek top “equalize incomes,” BUT that merely rewards sloth, indolence and non-productivity at the expense of productivity.
No, the ONLY logical way to approach such a dilemma is to further reward the productive and make being non-productive as miserable as humanly possible – purely to incentivize productivity, nothing more than that.
So, given that no reasonable person would seek to “equalize” housing conditions (as I outlined above) between high income earners and lower income earners, why would ANY right-thinking person think that “equalizing access to medical care” isn’t fraught with the SAME disastrous outcomes!
These online discussions are great, because I’m a lot like Andy Jackson (only a little bigger, a little tougher and yes, a mathemagician. . .did I note that there’ve only been 17 others in the entire world and throughout mankind’s history to date?…Damn I really AM a jerk sometimes). . .I wouldn’t countenance a “coward” as Old Hickory (Andrew Jackson) would call them, who’d utter ridiculous things like, “pitting the best educated and those born well-off against everyone else just isn’t fair,” OR “people’s incomes shouldn’t rise beyond a relatively narrow relative/nominal range.”
That’s not just “crazy talk,” that’s Marxist talk and Old Hickory would’ve almost certainly have beaten the hapless and witless Karl Marx literally to death for daring to utter such anti-individualistic madness.
Look, my heart literally bleeds for the non-producers, BUT the issue MUST BE incentivizing that guy to produce, NOT seeking to reward people for “just being the lovable screw-ups that they are,” regardless of how “lovable” they may be as screw-ups.
You EARN relative to what you produce. Given that Americans naturally tend to LOVE hard work, I don’t see incentivizing work/productivity as at all onerous.
So, given that no reasonable person would seek to “equalize” housing conditions (as I outlined above) between high income earners and lower income earners, …
I strongly support the equalization of housing conditions. One example that hits close to home for me is my sister and her husband. They live in a house appraised at $400,000 in the Knoxville area. This would be the equivalent to a $800,000 house in a larger city, such as Cincinnati. Their lot backs up to a golf course. They have a three car garage plus 2,800 sq. ft. of living area. And, NO KIDS.
Due to their hard work in starting a software company from which they’ve made a shit load of money, they live better than any other member of my family, despite him being a college flunk-out (literally) and her taking nearly 20 years to complete her degree. Their money could be much better spent providing better living conditions for their 7 nieces and nephews, (plus a 1 or 2 on his side, I think) 4 of which are my kids.
Better clothes to bolster their self-esteem, college educations, doctor bills, decent and stylish cars, plus and especially, better housing with all the upper middle class amenities could much more easily be afforded should greedy, rich leeches, such as my sister and her husband, pay their fair share. Besides, if it hadn’t been of the rest of us needing and using products and services they produced, they’d be nothings but broke has beens. Without us, they wouldn’t have built that business.
“Their money could be much better spent providing better living conditions for their 7 nieces and nephews. . .should greedy, rich leeches, such as my sister and her husband, pay their fair share. Besides, if it hadn’t been of the rest of us needing and using products and services they produced, they’d be nothings but broke has beens. Without us, they wouldn’t have built that business.” (DaD)
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There actually are a few people in places like NYC who really do believe that sort of thing.
There really IS a “wealth creation gap” in this country, but the answer isn’t divvying up the proceeds of those who produce the most, it lies in getting others to get into producing more wealth themselves and the ONLY way to do that is to incentivize productivity by making non-productivity as painful as possible.
So in places and times where the penalty for non-productivity was starvation and death, starvation and death never actually happened?
Steve
“So in places and times where the penalty for non-productivity was starvation and death, starvation and death never actually happened?” (Steve)
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What kind of non sequitor is that? “Starvation and death” haven’t been the result of non-production since the industrialization of the world. TODAY, in FACT, in places like NYC welfare, food stamps, section-8 housing allowances, etc. add up to more than $30,000/year in value, which creates a HUGE disincentive to work. People on “the dole,” are pretty adept at seeing how jobs that pay the same or even slightly more than their benefits already total simply and quite literally “don’t pay.”
Consider that that person garnering $32,000/year in benefits only sees an $8,000/year increase for working a 40hr/week job at $40,000/year!
It’s not at all hard to see how dysgenic such policies are.
I’m sure they do. And, Steve’s still concerned that someone starved during the Middle Ages.
Talk with relatives who lived through the Great Depression. Travel around the rest of the world.
Steve
“Talk with relatives who lived through the Great Depression. Travel around the rest of the world.” (Steve)
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Here’s what’s set America apart from places like Rhodesia (now Zimbabwe), which I’ve seen….I wouldn’t put Northern Italy, Corsica or Chile in the same league as that place….work has been incentivized here in the U.S., as has wealth creation – investing in industries, etc, BUT primarily in the industries that most people WANT to work at – mines – Americans LOVE mining, they LOVE trucking. Americans tend to have very strong backs and LOVE hard, demanding, even dangerous work, so investors could never go wrong investing in mines, smoke stack industries, factories, etc., because, as Elijah Pickens used to say, “Americans love them hard work, even more than they like fried chicken”…and he’s right – we do like both!
The people in places like Zimbabwe can’t even imagine aspiring to become a miner or a trucker. Such options simply aren’t available to them.
When I was there (for 7 months and 17 days in 1978) Rhodesia was called “the breadbasket of Africa,” because it produced over 90% of the food stuffs for sub-Saharan Africa! Can you believe that over 96% of Rhodesia’s food stuffs were grown on white-owned farms, consisting of (at that time) about 10% to 12% of the farmland there?
I weaponized a cocktail of snake venom in that fetid place (and tried it out with some limited success). Pete (my fellow American business partner) would later rejoin the core of that group, which would come to form the base of a private security force called Executive Outcomes. We were abruptly pulled out of there after I suggested to our financial backers (that group’s major funding came from South Africa and Israel, but a lot of money also came in from the USA, Switzerland, Italy and Germany, as the U.S. & Israel and their partners were looking to “cock-block” the former USSR from getting to the extensive mineral reserves there) that “the quickest and most efficient way to deal with the problem there was to eliminate the white farmers.” They apparently mistook my meaning. I meant “remove,” not exterminate, that is, to buy them out and “repatriate” them to places like Australia, New Zealand, Canada or even the USA.
By my estimations, within two generations sub-Saharan Africa would’ve returned to what it had been traditionally for centuries – a land on which a band of no more than 200,000 hunter/gatherers roamed the savannahs and rain forests.
Communication problems like that have been the bane of my existence.
At any rate, what I’m saying is that prosperity is NOT built from the ground up – by a government helping the poorest and most limited “buy more stuff,” and thereby stimulating demand, but by incentivizing hard work and drudgery on the part of the people AND investment in the types of industries most people want to work in – mines, smelting plants, factories, etc.
We’ve bone-headedly embarked on a series of dysgenic policies that serve to DIS-incentivize work and thus work to eradicate prosperity.
It’s sad but true that TODAY, in places like NYC (and elsewhere around the U.S.), welfare, food stamps, section-8 housing allowances, etc. add up to more than $30,000/year in value, which creates a HUGE DIS-incentive to work. People on “the dole,” are pretty adept at seeing how jobs that pay the same or even slightly more than their benefits already total simply and quite literally “don’t pay.” At least they “Don’t pay ENOUGH!”
Consider that that person garnering $32,000/year in benefits only sees an $8,000/year increase for working a 40hr/week job at $40,000/year! Seriously, how many excellent miners and factory workers have had their love of hard, back-breaking work culled out of them by such incompetent and misguided policies, that seem almost designed to keep such people from “being all they can be?”
When hard work is rewarded….you get MORE of it AND more prosperity as a result.
When sloth and indolence are rewarded…you get MORE of that, AND, of course, more misery is the inevitable result of that!
Kim, a short fence can work if the devils can neither see nor smell what is on the other side. We have the electric fence and nothing that they wish to eat is within about ten or fifteen feet of it. On the other hand, a lot of our friends have had fences up to eight feet fail. Even worse, the stupid deer seemingly cannot figure how to get back out so do a lot of damage while “trapped” inside. I think the entire country would be well served with a 80 to 90 percent deer cull.
I know this is OT, but I never understood the attraction of one’s house backing up to a golf course. They have them out here, and they have almost as much of a premium as an equivalent lakefront lot. Go figure.
I don’t get the equivalence to lakefrontage either, but apparently lots of duffers like to play golf. There are a number of very nice homes around the Silver Lakes Golf Course on Staten Island, separated from the course by a 30′ maybe 40′ chain link fence….THAT seems to amount to paying a premium for ugliness.
You mean like 30-40 feet HIGH? Ewww.
Well, the lake is down about 42″ right now, and some of the lakefront property owners can’t use their docks. I have a slip at the marina, so I have the last laugh for now. I’m wondering what the hell they’re going to do in October when they have to get their boats out for shore maintenance.
“You mean like 30-40 feet HIGH? Ewww.” KM)
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Yeah, like having a prison fence in your backyard.
I guess it keeps the errant golf balls out….
I suppose it’s nice knowing that the area behind your house won’t be over-developed, BUT I’d never compare those properties to any decent lakefront.
I’m guessing that our deer could get over it even at that height. Rats with hooves is how I think of them. On the other hand, ten feet generally keeps them out. My electrified fence works fairly well with an assist from our dog.
Ed, I put up a four foot fence using 4×8 lattice boards. It works, as the deer can’t see the other side well.
Thanks Ed. If you can, ferret out how it could work in the US, especially with our geographic differences. I have read up a bit on Singapore, and they benefit from having everything so close together. You can really specialize services much better.
Steve