MEDICARE MUDDLE: Ezra Klein doesn’t know how to talk!


Continuation—Young star is no Shirley Temple: Bold courageous honest Paul Ryan made some very serious charges in his convention address.

What did the straight-talking truth-teller say? Concerning Obama's raid on the Medicare program, the wonkish straight-shooter said this:
RYAN (8/29/12): You know what? The president has declared that the debate over government controlled health care is over. That will come as news to the millions of American who will elect Mitt Romney so we can repeal Obamacare.


And the biggest, coldest power play of all in Obamacare came at the expense of the elderly. You see, even with all the hidden taxes to pay for the health care takeover, even with the new law and new taxes on nearly a million small businesses, the planners in Washington still didn't have enough money. They needed more. They needed hundreds of billions more. So they just took it all away from Medicare, $716 billion funneled out of Medicare by President Obama.


An obligation we have to our parents and grandparents is being sacrificed, all to pay for a new entitlement we didn't even ask for.


The greatest threat to Medicare is Obamacare and we're going to stop it.


In Congress, when they take out the heavy books and the wall charts about Medicare, my thoughts go back to a house on Garfield Street in Janesville. My wonderful grandma, Janet, had Alzheimer's and she moved in with mom and me. Though she felt lost at times, we did all the little things that made her feel loved. We had help from Medicare and it was there, just like it's there for my mom today. Medicare is a promise and we will honor it. A Romney-Ryan administration will protect and strengthen Medicare for my mom's generation, for my generation and for my kids and yours.


So our opponents can consider themselves on notice. In this election, on this issue, the usual posturing on the left isn't going to work. Mitt Romney and I know the difference between protecting a program and raiding it.
In that passage, Ryan made a series of extremely serious charges. He voiced the Romney campaign’s basic charges about the Medicare program.

As we summarize his claims, we’ll use his actual language:

Obama funneled $716 billion out of Medicare! He did this to pay for a new entitlement!

This was a cold power play by the planners in Washington—a raid on the Medicare program! As Obama takes this money away from Medicare, our parents and grandparents are being sacrificed!

The coldest power-play in Obamacare came at the expense of the elderly!

These are very serious charges; the language is very harsh. As Ryan made these inflammatory charges, the TV cameras lingered on the smiling face of Ryan’s mother, who loves her Medicare.

Just like the candidate's wonderful grandma did!

It’s hard to show sufficient contempt for these charges, although Lawrence O’Donnell managed. And yet, the liberal world has shown little skill at rebutting these inflammatory charges.

The liberal world has shown little skill at telling the public why these charges are bogus. Lacking that skill, we can’t demand that the mainstream press corps offer clear explanations.

Are Ryan’s inflammatory charges accurate? Did Obama “raid” Medicare? Did he really take $716 billion away from the program? Are the nation’s wonderful grandmas being sacrificed in the process?

Is Obamacare being funded at the expense of the elderly?

Ed Schultz and Newt Gingrich have both suggested that these charges are gaining purchase. On Wednesday, Rachel Maddow asked Ezra Klein to clear up all the confusion.

The bright smart young TV star failed.

Long ago, a 3-year-old child emerged on the scene, becoming a major film star. Later in life, she became a skilled spokesperson for the United States, even serving as our representative to the UN!

Ezra Klein is no Shirley Temple. On Wednesday evening, the young TV star’s efforts at clarity utterly failed.

What follows will show you how Democrats lose. Even our millionaire TV stars can’t seem to explain jack shit.

Step one—Excerpting Candidate Ryan: Not long after Ryan’s address, Chris Matthews made an announcement: Help was on the way!

Ryan had made some very strange claims, But the cavalry had been spotted:
MATTHEWS (8/29/12): Ezra Klein has been checking into the veracity of some of what we heard tonight, and we will get to that soon. But that’s when we return. You’re watching MSNBC’s live coverage of the Republican Convention.
Help was on the way! But the children on The One True Channel did a very poor job debunking those Medicare claims.

In the beginning was the end! The breakdown began right at the start, when the children returned from commercial to play tape of Ryan’s remarks:
RYAN (videotape): You see, even with all the hidden taxes to pay for the health care takeover, even with the new law and new taxes on nearly a million small businesses, the planners in Washington still didn`t have enough money. They needed more. They needed hundreds of billions more. So they just took it all away from Medicare, $716 billion funneled out of Medicare by President Obama.
That’s the videotape that was shown. It omitted Ryan’s most serious charges, some of his most striking language. It omitted the claim that Obama “raided” the Medicare program. It omitted the claim that “an obligation to our parents and grandparents is being sacrificed” in the process.

It omitted the claim that the money was funneled from Medicare “to pay for a new entitlement.”

The children had edited Ryan’s remarks. In the process, they greatly reduced the outrageousness, and the dishonesty, of the various things he had said.

Step two—Rachel’s attempt at a question: Right there in their edited excerpt, the children had cleaned up Paul Ryan.

Maddow was about to ask Klein to fact-check Ryan’s remarks. But the channel had already removed most of his most flagrant bullshit.

Whatever! The second problem with this fact-check came from Maddow herself. After the tape of Ryan played, she offered this rambling reaction and a non-question question:
MADDOW (continuing directly): And also by Paul Ryan in his proposals. But that doesn’t make him nearly as angry, or make him pause as meaningfully.

The whole ball of wax might come down to one issue ultimately in November. May come down to one policy. The November election might hinge on Medicare.

Part of why the choice of Paul Ryan for vice president was seen in the most favorable light as a bold choice was Paul Ryan’s politically unpopular plan to end the Medicare program the country has known and loved for roughly 50 years.
Because of his plan to end Medicare, the Democrats took the Paul Ryan choice as really good news when it was announced. But tonight Mr. Ryan said again he wants the debate on Medicare because he’s the man who will protect Medicare from the dreaded Democrats, who are really the ones trying to kill it.

For the actual skinny on this much-spun fact, luckily we have Ezra Klein. Ezra!
That was Maddow’s introduction to Klein’s veracity-check. But uh-oh! After making a very dire warning, Maddow asked no actual question. She simply threw to Klein, asking him to provide “the actual skinny on this much-spun fact.”

To which “much-spun fact” did Maddow refer? Her summary and introduction were extremely unclear. In effect, she simply asked Klein to talk for a while. She had provided no focus for his discussion.

Step three—Ezra goes on a ramble: In fairness to bright polite smart Ezra Klein, he wasn’t getting much help here.

Ryan’s most aggressive and inaccurate claims had been edited out of that tape. In her introduction and throw, Maddow provided no focus whatever.

Let’s face it—Maddow didn’t know what to ask about Ryan’s charges. So she simply threw to Ezra.

Ezra started to ramble.

Below, you see the oration which formed Klein's response to Maddow’s non-question. Unless you already understood this topic, his rambling remarks were largely incoherent.

But uh-oh! Like his blog-mate Sarah Kliff, Klein largely repeated Romney’s Medicare charges—restated those charges in his own voice!

We apologize for all the gorilla dust. But this was Klein’s full response:
KLEIN (continuing directly): Hi, Rachel. Right—the Medicare fact. I kind of can’t believe we are actually now running this campaign on Republicans telling Democrats they want to cut Medicare too much, after what Republicans have voted for in recent years.

What those Medicare cuts are, it’s basically two major things. One is that we pay private insurers in the Medicare program about 114 percent what we pay traditional Medicare to cover the exact same group of people. And the other is that hospitals as part of the Affordable Care Act deal agreed to take lower reimbursements.

So, when Romney/Ryan say they want to repeal those cuts, what they are saying very simply put is this: Instead of moving that money from hospitals that have said you can have it, and private insurers that are getting paid more than Medicare, and putting it either towards health care for poor people, as Barack Obama does, or towards deficit reduction, as the House Republican budget does, they should give it back to hospitals and private insurers.

This is a bad enough idea, as I mentioned that House Republicans, including Paul Ryan, who wrote the thing, put it in their budget. The broad sort of overarching narrative of that critique, though, the thing that always strikes me about it, is that when Paul Ryan and George W. Bush did a major Medicare prescription drug benefit expansion in the 2000s, they paid for it by putting it all on the deficit.

They didn’t pay for a dime or a dollar of it. Then Democrats came in, they said we’re not going to do that any more, we’re going to be fiscally responsible, and so they said we`re going to pay for all of it. The initial House Democrat proposal would have been a tax on rich people which would have been a lot more politically popular.

But a lot of Republicans said, “That is irresponsible. If you’re going to do health care reform, you pay for it out of the health care system.” Democrats tried to do that, and so they did this cutting of Medicare which they thought was going to help them get Republican support. Instead Republicans then ran against them for cutting Medicare, while simultaneously saying they don’t have a plan to do anything about Medicare spending, and also saying the Affordable Care Act is a fiscally irresponsible plan, which just goes to show that you can't really—the Democrats did not find it very easy to win for compromising or trying to compromise with what Republicans said they wanted on this particular one.
That is a horrible “answer.”

If you already understand the Medicare topic, you may know what Klein is talking about as he wanders the countryside, stringing his reactions together in stream-of-consciousness fashion. But for viewers who lacked that pre-cognition, those remarks were largely incoherent.

Klein toured the countryside, failing to explain the point of his various comments. If you already understood Medicare, you might have guessed what his comments meant.

Others were shit out of luck.

Go ahead—ask yourself this: At any point, does Klein make a clear, concise statement about what Ryan said that was wrong? No such statement ever occurs in this wandering ballad. Instead, Klein throws a bewildering array of figures and claims into a very thick stew.

One example: What exactly does that “114 percent” figure mean in Klein’s second paragraph? We can guess, but even we aren’t entirely clear where it leads.

Was the extra 14 percent taken away as part of the spending reductions? People without prior knowledge were almost surely baffled by now, out in some very deep weeds.

Klein’s oration was very unclear—and that’s the good news about it. Even worse, he kept repeating Romney’s charges about the Medicare program!

Good God! Instantly, Klein was talking about “Medicare cuts,” a dangerous piece of locution. He maintained this language all the way through—and by the second half of his speech, he rather clearly seemed to be saying that the Democrats were using those “Medicare cuts” to “pay for” the expansion of health coverage in Obama’s health law.

Klein seemed to say that Democrats took money from Medicare and “put it towards health care for poor people.” That is precisely what Romney says when he levels his punishing charges!

Let’s be fair: Since nothing Klein says is clear or concise, he doesn’t quite say what the Democrats are “paying for” through their “Medicare cuts.” But it seems it must be that “health care for poor people”—and whatever the Dems are paying for, it’s clear that they aren’t shirking!

When the Democrats came in (whatever that means), “they said we're...going to be fiscally responsible, and so they said we`re going to pay for all of it,” Klein announced to the world. In context, it’s fairly clear what he meant:

According to Klein, the Democrats “pay for” Obamacare through their “Medicare cuts!” More specifically, they cut money from Medicare and put it toward health care for poor people. But that’s exactly what Romney’s ad says—the ad Ed Schultz has been calling a lie! Like his blog-mate Kliff before him, Klein was repeating the basic charges which constitute Romney’s attack:
Current Republican ad: Obama has cut $716 billion from pay for Obamacare.
Sarah Kliff, WonkBlog: McDonough looked at all the various Medicare cuts Democrats made to pay for the Affordable Care Act.
Ezra Klein, MSNBC: The Democrats “pay for” health care for poor people through “the cutting of Medicare”—through their “Medicare cuts.”
Ezra Klein is a nice young man. He’s always polite to Rachel.

But to all appearances, he doesn’t know how to talk about Medicare! It’s hard to call that ad a “lie” when our leading liberal heroes seem to be cutting-and-pasting their own remarks straight from Romney's language.

Simple story: Ezra Klein doesn't seem to understand the nature of these transactions. And he doesn't seem to understand the language of Medicare "cuts."

In fact, Ryan’s presentation was full of misstatements and deceptions. A more capable cable climber might have started by saying this in response to Maddow’s flailing attempt at a question:
MADDOW: For the actual skinny on this much-spun fact, luckily we have Ezra Klein. Ezra!

EZRA KLEIN REWRITTEN: We really need to start with one fact: Within the Obama health law, no money is being removed from the Medicare program.

Annual Medicare spending has been reduced, although no health services are affected. The system will simply eliminate overpayments to some health care providers. That's what we should be doing.

That adds up to $716 billion less spending in Medicare over the next ten years. But that money stays in the Medicare system, extending the life of the Medicare trust fund by a full eight years. The money isn’t being siphoned, stolen, raided, robbed or taken away from Medicare. The money isn’t being used to pay for someone else’s health care.

Rachel, if you have time for one more point—Ryan surely understands these points. For crying out loud! He included almost all those spending reductions in his own budget plans! Tonight, he said those spending reductions represent an attack on our parents and our grandparents. I’d have to say that’s very dishonest: As Ryan knows, those spending reductions don’t produce reductions in medical services. And Ryan had those same spending reductions in his own budget plans!
That's well less than half of Ezra's ramble. At this point, Rachel would have had to dream up a question. There’s little chance she could have done so. Despite “earning” millions of dollars per year, Maddow doesn’t seem to know how to talk about Medicare either!

Sorry, Charlie! All across the liberal world, you can see liberal “intellectual leaders” repeating Romney’s basic charges (links below). Ezra Klein is very polite, and he’s making himself rich and famous.

But Ezra Klein is no Shirley Temple. As in the mid-90s Medicare fight, so too in the current battle: Your interests lie in the hands of incompetents. When you watch the TV machine thingy, you’ll often find yourself looking at children who don’t know how to talk!

All together now, let's recite Romney's charges: All over the liberal world, you can see your fiery leaders repeating Romney’s basic charges: Obama took money from Medicare and used it to “pay for” Obamacare!

Ed Schultz calls those charges a lie. But our fiery liberal leaders just keep repeating those charges!

To see Joan Walsh accept Romney’s charges, click here. Also, check out Alex Seitz-Wald, also at Salon:
SEITZ-WALD (8/14/12): The $700 billion figure comes from cost savings created in Medicare to help pay for the Affordable Care Act. Romney is correct in the figure and correct in asserting that the money is being diverted from Medicare to help pay for Obamacare, but he misleads on the mechanism and its effects. First of all, the change affects reimbursements to hospitals, insurance companies and other providers, not benefits for average enrollees. As the Boston Globe’s health policy expert Health Stew noted, “Except for insurers, all the affected groups publicly supported the reductions to help finance the ACA’s expansion in health insurance to about 32 million uninsured Americans.”

Politifact called a similar claim “false” when Romney made it back in December, noting that there “are not actual cuts,” as the savings come from projected future growth in the program, no on-paper budgeting. The Washington Post’s fact checker also rated the claim poorly. ”The Affordable Care Act improves the benefits in Medicare, in terms of prevention, in terms of filling in the donut hole in Medicare Part D for prescription drugs,” explained Jonathan Oberlander, a health policy professor at the University of North Carolina-Chapel Hill.
Seitz-Wald fumbles around, mixing apples with many oranges and making some accurate statements. But let’s return to our chart:
Current Republican ad: Obama has cut $716 billion from Medicare…to pay for Obamacare.
Seitz-Wald: $716 billion is being diverted from Medicare to help pay for Obamacare.
Ed Schultz calls that ad a lie. In the meantime, major liberals are standing in line to repeat the ad’s basic charge: Obama took money from Medicare “to pay for” Obamacare!

That is Romney’s basic charge. Liberals keep repeating it for him! None of them answer an obvious question: If Obama took a big sack of money from Medicare, how did he manage to extend the life of the Medicare trust fund eight years?

Your fiery leaders don’t know how to talk! Ain’t life in the liberal world grand?


  1. Hmmm. Money being saved in Medicare costs being redirected to other purposes although people are still paying the same amount in Medicare withholdings? Same old bait-and-switch, it seems to me.

    Remember when people were outraged to learn the Red Cross was funneling their contributions to 9/11 victims families to other places in need, say, floods in OokaTookah? People wanted the satisfaction of knowing their money went to 9/11 victims and nobody else, even if that meant making 9/11 victims millionaires.

    Medicare should be allowed to keep its surplus,, by jingo. Republicans are playing this wrong. Bill O'Reilly should be having a field day lookin' out for the folks on this one.

  2. I agree 100% with this you Bob.

    How can we fix this problem?

    1. Probably, in arguing that hospitals and providers are going to be okey dokey with cuts in payments because they now have a plethora of new patients in all their unknown, aging, and price-fixed glory.

      If the media will ever clue folks in enough to get that far into the issues, that is.

    2. There's that word "cuts" again...

    3. I suppose that the word is germane depending upon whether you are equivalent of Ikea or a college student in the years ahead.

  3. A reduction in payments is a "cut" in any sense I can think of.

    1. Well, you're either a fool, or trying to fool other people then.

      Because, it isn't "Medicare" that's being cut.

      Medicare getting cut, means, to the ordinary people who hear it, that the benefits available are being reduced.

      That is something that a Plan could do. A Plan could reduce the benefits available to Medicare recipients. Presumably, such a Plan would save money. THAT Plan would match ordinary folks' idea of what "Medicare cuts" means.

      But that's not what's going on in Obama's Plan.

      His Plan doesn't "cut Medicare." ALL of the promised benefits are still promised. Instead of cutting Medicare, Obama's Plan has promised to reduce the cost of Medicare, to save money -- WHILE STILL MAINTAINING ALL OF ITS BENEFITS.

      Now, you may say -- Obama won't be able to keep his promise. That's an argument you can make.

      You can say, well, if we save any money on medical expenses, we'll eventually just *have* *to* cut the benefits! Of course, if you say that, you're basically saying WE CAN NEVER REDUCE OUR MEDICAL COSTS & WE CAN NEVER GET MORE EFFICIENT.

      But you can't say -- he's cutting Medicare. If you say that, you're just a liar.

    2. Again, I'm a liar unless I'm paying more for food, gas, specimen cups, rent, taxes, automobiles, college education, and liability insurance.

    3. No, a reduction in services is a cut. I paid less for gas yesterday than I had two,weeks before. But I got just as much gas. I don`t know why this concept is so hard to understand.

    4. Oh, I agree. If I stop selling gas that's a cut to my customers who bought it.

    5. When you stop providing services and no one else steps in to provide them, you`ll have a point. Given the profits in the healthcare sector, I don`t advise you hold your breath.

    6. Good!

      Just so we know know that you're basing your prognostications on people stepping in who will (across the board) offer only regular unleaded instead of high-test.

    7. Does any of 2:57 PM through 4:52 PM comments contradict what's in the 2:51 PM comment?


      There are NO benefit reductions. That's the ordinary, plain-folk meaning of "cuts." And there aren't any.

      If there were, you'd point to them rather than bullshit about gasoline.

      All the benefits are still three. None are cut.

      The Medicare trust fund (if anyone cares!) is stronger, more solvent (if anyone cares), under Obama's Plan.

      There's nothing but bullshit in Ryan's presentation. And nothing but bullshit in these defenses.

      Show us the "cuts," liars!

    8. That's like arguing that there would be no cuts to food stamps if those benefits stayed at the level of 1992.

    9. Cecelia, food stamps and health care are like apples and watermelons.

      Reducing spending on food stamps would almost certainly reduce the amount of food that people could buy. The same can't be said about health care.

    10. CeceliaMc @ August 31, 2012 5:09 PM

      >>>>>That's like arguing that there would be no cuts to food stamps if those benefits stayed at the level of 1992.<<<<<

      But that's just it, Medicare expenditures are going to continue to increase on a per beneficiary basis in inflation adjusted terms. All the PPACA does is bend the [rising] cost curve in the future. The target is to try to keep benefits growing at a 0.5% greater than inflation rate instead of the more rapid rate of growth that has been going on in Medicare for years. Oh, and the annual rate of cost growth in the private health care sector has been even faster than that in Medicare and Medicaid for decades.

      >>>>>...the economic benefits of Social Security, Medicare, and Medicaid are absolutely enormous. They provide a service (insurance against risk, and people value insurance quite highly) much more efficiently than do private-sector providers. In the case of Social Security, this efficiency is mainly in low administrative costs and the government’s ability to provide actuarially fair insurance without needing the compensation that private-sector insurance providers would demand.

      For the health programs, these benefits are supplemented by the federal government’s demonstrated success in containing health costs more effectively than private providers. To take just the most obvious example, since 1979, Medicare costs per beneficiary have grown cumulatively 40 percent more slowly than equivalent benefits provided by private insurers. To make this concrete, the average family insurance plan provided by employers today costs $15,000. If the private sector had managed to constrain costs as effectively as Medicare over this time, it would only cost $9,100—giving workers with family health insurance plans a potential boost to wages of just under $6,000.


    11. ...continued

      Veterans Administration medical care is probably the most efficiently run of all the major systems in the United States, public and private.

      >>>>>...A little farther down the hall, patient Scott Kneen flips a switch on his high-tech wheelchair.

      Hydraulics in his wheelchair lifts and straightens his body so that Kneen is almost standing. He's been using this position to help heal severe sores on his backside. Goldish said this type of wheelchair has been popular among a number of veterans....

      Kneen could go to just about any hospital for his care. Besides his VA medical benefits, he also has Medicare and Medicaid insurance.

      "You know they're trained to handle stuff like this," Kneen said. "And they're better at wound care and treating it. So no question I would choose the VA."

      ...It's a challenge, but [Dr. John] Drucker[, Chief of Staff at the Minneapolis VA] said the VA has figured out a way to do things economically. Like doctors at the Mayo Clinic, most VA doctors receive a salary, so they have no incentive to order unnecessary tests and procedures to make more money. That saves the VA huge sums of money that can be reinvested in necessary care.

      Also, the VA has an electronic medical record system that's the envy of many. Drucker said doctors can get detailed information about patients even if they were treated at a VA clinic across the country.

      "Staff do not have to transport records," he said. "They don't have to look for them; they're just available on the computer screen in front of the provider who can use that information immediately to make a medical decision about a patient."

      The electronic records have allowed them to improve patient quality and eliminate a lot of wasteful spending.

      Compared to the average Medicare patient in the private market, the VA spent substantially less on its patients in 2004. That year, Medicare paid an average of $6,800 dollars per patient, while the VA was able to deliver care for approximately $5,000 per patient. That's 35 percent less than Medicare, which is the baseline widely used in measuring the cost of health care. [CMike -- granted, a bit of an apples to orange comparison.]

      Measuring for quality care

      The VA measures everything it does. Its doctors examine the case records of every person who dies in the medical center to see whether there were quality issues that contributed to death. They also review cases when a patient returns to the hospital with a medical problem within a week of being discharged.

      They even measure access to the VA. Doctors must see 95 percent of their patients within 30 days of that patient's initial request for an appointment. Mental health patients must be seen within 14 days; and if it's a crisis, they need to be seen immediately....

      Let's face it, there's been a tremendous return on investment for the 0.1% from the dollars they've invested brainwashing the American public about the wonders of the free-market. Sure the oligarchs were reeling for a while there, in the thirties, but then they returned to the Long March and, ever since Ronald Reagan was elected, they've been sprinting Forward.

    12. Alternatively CeceliaMc, here's a Kaiser Family Foundation report (24 page pdf) [my emphasis]:

      The 2010 health reform law (the Patient Protection and Affordable Care Act, also referred to as the ACA) establishes a new Independent Payment Advisory Board (IPAB) with authority to issue recommendations to reduce the growth in Medicare spending, and provides for the Board’s recommendations to be considered by Congress and implemented by the Administration on a fast-track basis.

      IPAB has been heralded by some as a cornerstone of efforts to slow the growth in health care spending, beginning with enforceable savings targets for Medicare to help limit the growth in program spending. Some, including the President’s National Commission on Fiscal Responsibility and Reform, have advocated strengthening the role of IPAB.

      Yet others, including some in Congress, representatives of some aging organizations, and various health industry stakeholders, are opposed to IPAB and are pressing to block its implementation.

      As authorized by the health reform law, IPAB is an independent board housed in the executive branch and composed of 15 full-time members appointed by the President and confirmed by the Senate. IPAB is directed to recommend savings for Medicare if the per capita growth in Medicare spending exceeds defined target growth rates. Prior to 2020, the growth target is based on a measure of inflation, and in subsequent years, it is based on the per capita growth in the economy (gross domestic product (GDP) plus one percentage point). The recommendations made by IPAB move to the Congress for fast-track consideration.

      If Congress does not act in the required timeframe, the Secretary is required to implement the Board's recommendations, also on a fast-track basis. The Board is prohibited from recommending changes that would reduce payments to certain providers before 2020, and is also prohibited from recommending changes in premiums, benefits, eligibility and taxes, or other changes that would result in rationing.

    13. In my comment @ September 1, 2012 2:25 AM I see I posted, "The target is to try to keep benefits growing at a 0.5% greater than inflation rate..." That should have read "try to keep costs growing at a 0.5% greater than inflation rate..."

    14. The way to look like a fool is to pretend that $716 billion taken out of reimbursements is not a cut in reimbursements. It's not a cut in benefits, but it is a cut in reimbursements. It's also not a cut in benefits only to the extent that insurance companies, hospitals and providers don't try to recoup lost income from consumers.

  4. It's heartening to know Americans think so highly of the dedication of our doctors.

    They seem convinced that our healers are so Hippocratically challenged they will provide shoddy medical care rather than cut their own expenses or sacrifice a penny of income.

    Doctors in Europe live in big houses, and drive BMWs, and take their families out to dinner, and earn less than half what American doctors do.

    One example of useless waste.
    A small percentage of American doctors are repeat offenders in malpractice suits.

    Doctors wail about their insurance premiums, but when they review the repeat offenders, they can't bring themselves to take away their licenses, or force them to take more training, the SOP in European countries, most of which do not have malpractice suits or malpractice insurance.

    Isn't it possible that doctors might revolt against the broken system we have, and demand reform, rather than knuckle under to the insurance companies?

    Sure, a lot of doctors are staunch Republicans. A lot of doctors are mature white men, the backbone of the Republican party.

    But a lot of their customers are not.

    1. Well, we have accomplished more here than we will ever see in the national media.

      We've managed to go from profit-driven providers being glad to accept price fixes due to a higher (and iffy demographic) client load, to their being glad to do it out of the goodness of their hearts.

    2. CeliaMc - I'm not sure what your point is - you tend to be a little cryptic.

      It seems to be that the $719 billion savings will indirectly adversely affect Medicare beneficiaries, because providers will withdraw from the program due to getting $719 billion less money. Apparently, the $719 billion largely comes from (1) reducing payments to rpivate insurers in an alternative Medicare program who are paid 14% more than the government pays to the same typeof patients on regular Medicare, which seems an obvious way for the government to save money; and (2) hospitals will be reimbursed less, and hospitals are said to be ok with this because more patients will be insured which will make up for it. I am sure you must realize that people without insurance do get treated in hospitals. Very, very often they can't afford to pay the bills, and the costs get passed on to other patients with insurance. (Also, inability to pay uninsured medical bills is aleading cause of personal bankruptcies).

      Also, even Ryan and the Republicans' plan called for the same $719 billion savings. Does their hypocrisy concern you?

      Romney himself when he was in Israel recently praised the Israeli system for having lower costs than we do. Their costs are way lower. This was noted in passing in the MSM, but has passed by completely now. In Israel, like in all advanced countries except the US, the cost for medical care is far less; everyone is covered and the care is as good or better. The subject is so tabu in the US that Republicans, Orwellianly, can castigate Obama for allegedly wanting the US to adopt a European type system, as if there was something wrong with that. These $719 billion reduced expenses seem to be a step in the direction of the desparately needed efficiencies to bring down the costs of medical care in the U.S.

      I'm not sure what your solution is.

      AC in Mass.


    3. words in capital letters at end of above post are typo, should have been deleted.


  5. I have often been critical of The Howler lately, but this one is dead-on. Rachel, Ezra and company should be deeply ashamed of themselves for this shoddy performance. The White House and Obama campaigns should also be ashamed of themselves for, once again, not adequately circulating the correct version that makes clear these are not "cuts." It really does not take a lot of words to undermine the Romney version.

    1. Yeah I don't share his politics, but you can certainly thank him for having a clarity and a willingness to discuss things that will never be delved into by our national media.

    2. It doesn't take a lot of words to undermine the Romney version, but they have to be carefully chosen.

      Otherwise people will tune out (Medicare is boring to the average person) or get confused. And conservatives are skillful at twisting things to their advantage when liberals don't communicate effectively.

      In this case, the conservatives have already convinced some middle- and working-class voters that "they" (read by many whites as "black people") are taking "your" money.

      Unfortunately, the liberals who get what's happening can't convince the liberals in charge that this might be very damaging come November. It's like the veteran who warned John Kerry in the summer of 2004 that these Swift Boat charges had to be taken very seriously. Kerry just blew off the warning.

  6. Bob, you're right that Ezra did a lousy job of explaining. I stopped reading about a quarter of the way through the second paragraph (presumably TV viewers would have paid attention longer before zoning out).

    But even your Ezra Klein Rewritten would confuse viewers. Let's face it, Medicare is a complicated issue.

    That's all the more reason why liberals need to communicate better. It's easier to tear things down than to build them up, and conservatives have taken great advantage of this fact.

    Thanks for doing your part to make things clearer.

    1. Bob's response wasn't complicated at all.

      Obama did not cut $716 billion from Medicare to give it to Obamacare and destroy people's benefits. Paul Ryan's GOP plan to voucherize Medicare will destroy it and end it as we know it.

      Obama is saving Medicare by dealing with waste, fraud and overpayments, extending its life, and putting $716 billion in savings back into the program.

      Is that simple enough for you? It's not that hard to grasp. Really.

    2. Obama did not find $716 billion in waste fraud and overpayments. You're fantasizing.

    3. ABL, you liar, what benefits have Medicare beneficiaries lost under Obama's plan?

      What? Yeah, that's right -- NOTHING!

      You've got vague bullshit about, "well, something will have to be cut if the providers get less cash" -- but that's the real fantasizing.

      In the real world, we know that there's HUGE waste, fraud and overpayment in the US system -- so much so in fact that $716 billion is peanuts.

      You can't point to any real lost benefit to recipients because there isn't any. Everything covered before is still covered.

      The people really responsible with doing the math have said eliminating this wasteful spending EXTENDS the life of Medicare, quite the opposite of the bullshit you're trying to spread.

      Sell it somewhere else, liar.

    4. Finnegan, I can understand the issue easily enough. But I've also seen plenty of people who don't follow along so well when it comes to politics... and a lot of them would be confused by Bob's version.

      Your version is also hard to follow.

      If it's so easy to explain Medicare, why isn't it being done already?

  7. tl;dr

    To reduce expenses and keep Medicare more solvent:

    You CAN cut benefits -- and that's what real people would call cutting Medicare.

    Or you can keep benefits constrained and save money in our wasteful system -- that's what real people call good sense, and liars call cutting Medicare.

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