MEDICARE MUDDLE: Take the Medicare Muddle Challenge!


Ed Schultz says the lies may be working: We were planning to wrap up our award-winning “Medicare Muddle” series.

But after last night’s Big Ed Show, our series is being held over—held over by popular demand!

Schultz began last night’s second segment with a fascinating analysis of the ongoing Medicare fight. Referring to two recent polls, he said the Republican “lies” about Medicare may be working.

Are the Medicare “lies” really working? Without doubt, Schultz could be right. But uh-oh!

As he introduced his segment, Schultz never quite explained what those “lies” actually are. To watch the full segment, click here:
SCHULTZ (8/27/12): What a difference a week can make. It looks like Republican lies about Medicare could be working. Keep in mind, this is a program championed by Democrats since it was signed into law back in 1965 by President Lyndon B. Johnson. And, of course, with President Harry S Truman, the first beneficiary, the Democrats did this despite all of the Republican cries of socialism.

Here’s the famous actor, some guy named Ronald Reagan, back in 1961.

REAGAN (videotape): Now, the American people, if you put it to them about socialized medicine and gave them a chance to choose, would unhesitatingly vote against it.

SCHULTZ: Really? Five decades later, it looks like Republicans are still lying about Medicare. They’ve come up with some brand new lies. Romney’s latest ad repeats the lie about how President Obama is hurting Medicare to the tune of $716 billion.

ROMNEY AD (videotape): Obama has cut $716 billion from Medicare. Why? To pay for Obamacare. So now the money you paid for your guaranteed health care is going to a massive new government program that’s not for you.

SCHULTZ: And the problem is this line of attack appears to be working. On the question of who they trust more to handle Medicare, Romney beats President Obama 45 percent to 42 percent in a Washington Post poll? In another poll, President Obama beats Romney on the Medicare issue but only by one point. And among those 50 years of age and older, President Obama loses on this issue by five points.
According to Schultz, two recent polls suggest that the Medicare lies may be working. As far as we know, that’s entirely possible.

But what are those Medicare lies?

In that segment, Schultz seemed to say the lie is this: “President Obama is hurting Medicare to the tune of $716 billion.” That was his summary of the GOP ad—the ad which more specifically said that “Obama has cut $716 billion from pay for Obamacare.”

Did Obama really do that? Did he pay for Obamacare with a big sack of Medicare money? For ourselves, we’d say the answer is no. But if those Republican “lies” are working—if people believe those GOP claims—should that be a surprise?

In fact, the claims being made in that GOP ad closely resemble the types of claims we liberals have made for the past several years. For one example out of a million, consider Sarah Kliff’s recent post at WonkBlog.

Kliff’s post was quite informative in several ways. As we’ve noted, Paul Krugman specifically recommended it.

But uh-oh! In her headline, Kliff said this: “Romney’s right: Obamacare cuts Medicare by $716 billion.”

That was bad—and matters got worse. Midway through her text, she offered a formulation which very closely resembles the claim in that GOP ad:
KLIFF (8/14/12): As to how the Affordable Care Act actually gets to $716 billion in Medicare savings, that’s a bit more complicated. John McDonough did the best job explaining it in his 2011 book, “Inside National Health Reform.” There, he looked at all the various Medicare cuts Democrats made to pay for the Affordable Care Act.
In Kliff’s own words, Democrats made $716 billion “in Medicare pay for the Affordable Care Act [Obamacare].” That is almost precisely what that GOP ad declares.

But Kliff is (justifiably) a top liberal blogger, and the GOP ad is a lie!

Can we talk? For the past several years, liberals have been offering close approximations of the statement made in that ad. This isn’t something Kliff invented; from the White House on down, we’ve been saying that Obama included various cuts or savings in the health care law “to pay for” the coverage it extends to 30 million new people. For a recent iteration which is less clumsy than Kliff’s, here is the very alert Kevin Drum, correctly pummeling Niall Ferguson for his recent Newsweek nonsense:
DRUM (8/20/12): I'm speechless. How do you even react to something like this? Ferguson is like some clever middle schooler who thinks he's made a terrifically shrewd point by inserting "insurance coverage provisions" into his sentence so that he can later argue that it's technically correct if anyone calls him on it. You can almost hear the adolescent tittering in the background.

For the rest of us, the facts are simple: Covering 30 million people does indeed cost money, and Obamacare includes a number of offsetting savings to pay for that. This is what Obama promised to do: to pay for ACA. And CBO says he did. "Altogether," says their report, the various provisions of PPACA are "estimated to increase direct spending by $604 billion and to increase revenues by $813 billion over the 2012–2021 period." That's a net deficit reduction of $210 billion.
In the passage we have highlighted, Drum used the word “savings,” not the word “cuts.” But from the White House on down, liberals have been saying that Obama “paid for” the health law’s substantial new spending through various “savings” or “cuts.” And plainly, one of the biggest “savings” or “cuts” is that $716 billion in Medicare

If you doubt that, just go back and look at what Kliff wrote.

We’re not trying to single out Kliff or Drum; they happened to do their (informative) posts at a time when we were discussing this point with an e-mailing friend. We’re not trying to single out Schultz, although last night’s segment wasn’t especially helpful. After his rather fuzzy opening, Schultz threw to his guest, Howard Dean, who basically said that older white voters believe the claims in that GOP ad because they don’t like Obama’s race. (Dean also repeated his analogy from a few weeks back, in which he said the GOP is using the Big Lie technique, just like the Soviets did.)

Let’s hope few voters were watching. It doesn’t occur to someone like Dean that older white voters (and others) may believe these GOP claims because they’ve heard very similar claims from the White House itself; or because he and Schultz did a very poor job explaining what is wrong with the claim; or because we’ve all been swamped in disinformation about the federal government’s “trust funds” for the past forty years, with zero attempt at clarification from our liberal leaders.

Zero; nada, none.

For the past forty years, conservative disinformation machines have spread a massive amount of confusion about the Social Security trust fund. The current muddle about Medicare’s trust fund is, in part, one fruit of that larger effort.

For decades, disinformation machines on the right have spread this type of confusion. As they’ve done so, liberal leaders like Dean and Schultz haven’t lifted a finger to address the resulting confusion. “The money isn’t there—we’ve already spent it?” “The Social Security trust fund is just a pile of worthless IOUs?” For decades, liberal intellectual leaders have fiddled and diddled as this type of confusion has spread all through the land.

Today, we’re unable to discuss topics like this—just as the limited Walpiri can’t count past one and two.

Last night, Schultz said that GOP ad is a lie. But he and Dean made little attempt to explain what the lie consists in. Instead, they spread a form of political poison, insisting that people believe this claim because Obama is black.

That was the best our leaders could do. But go ahead! One more time, read the claim in the GOP ad, then read what Kliff wrote:
Republican ad: Obama has cut $716 billion from Medicare…to pay for Obamacare.
Sarah Kliff: McDonough looked at all the various Medicare cuts Democrats made to pay for the Affordable Care Act.
The Walpiri can’t count past one and two—and we liberals have a very hard time discussing topics like this. With that in mind, are you willing to take the Medicare Muddle Challenge?

Over the weekend, Drum said that Obama hasn’t taken any money out of the Medicare trust fund. We assume that statement is true.

Here’s what that statement means:

Every dollar of payroll taxes submitted for Medicare is going to be spent on Medicare! Due to Obama’s future spending reductions, those dollars will be spent more slowly. But they will be spent on Medicare; they’ll be spent on nothing else.

If that’s true, it’s obvious that the $716 billion in question will not be used to pay for those 30 million new insurance policies. If so, then who will pay for those new policies?

If you gave them a million years, Dean and Schultz couldn’t tell you. In fairness, they did know what liberal leaders must say—that American voters are racists.

(Good lord, it’s easy to be a leader if that’s all you have to come up with!)

People! Disinformation machines have been pushing these conceptual scams over the past forty years. They pushed these (effective) conceptual scams when Carter and Clinton were in the White House, when Gore went ahead in the polls.

All through those forty years, the liberal world slept in the woods, sometimes rousing itself to call people racists. Today, you can’t pass the Muddle Challenge. And no, it isn’t your fault!

Due to their lack of counting skills, the Walpiri are easy to scam in a deal. So is our extremely lazy and self-impressed liberal world.


  1. Question: The doc-fix is passed each year by Congress to prevent the reduction of prices paid to doctors for providing care to Medicare patients.

    The fix is passed each year because people recognize that if payments to providers are reduced, Medicare patients will have reduced services, even if their guaranteed benefits have not been changed.

    Now, with that insight, why should we not expect reduced or delayed services for Medicare patients as a result of the $716 billion of planned reductions in future Medicare spending? (The largest component of the proposed $716 billion reduction is hospital reimbursement rates.)

  2. What I'm waiting for is an explanation of why Bob thinks Romney's Medicare claim is a "lie". In every post on this subject we are treated to his smug assertion that it is, but he offers no basis for HIS claim.

    We know the ACA extends healthcare services to many not previously covered. While the bill contains numerous new taxes, they fail to completely pay for the new services. The ACA, as proposed, was supposed to reduce the deficit (HA!), so no other taxpayer money was budgeted for the bill. So where, oh where, are these additional funds derived? Bob apparently has the answer to this conundrum, but falls victim to the same behavior he so often derides: He doesn't tell us!

    1. From the savings that are supposed to come from the cuts in future Medicare spending ala price fixes.

    2. Earlier changes to the reimbursement formula reduced the fees doctors would be paid for Medicare procedures in order to cut costs. Seeing as many doctors would be forced to offer services below cost, we faced the prospect of doctors refusing any new Medicare patients or of older doctors just leaving the profession entirely, so we are treated to the annual ritual of Congress restoring those cut funds via "doc fix" legislation. Is there any assurance that these price fixes won't face the same fate and the "savings" prove just as illusional?

    3. Economists like Dean Baker wonder why, given that we have the highest paid doctors in the world here in the States, we don't start opening the spigots on visas, making them available to any and all med school grads and doctors from around the world who can pass competency exams in medicine and in English, and who are willing to intern here until they demonstrate a satisfactory level of proficiency. (BTW, are we to assume that doctors elsewhere must have to pay their patients if the doctors here are offering their services at below cost yet are the best compensated in the world?)

      Baker also wonders why, if globalization is such a great thing for the manufacturing sector, Medicare and private insurance are not jumping on the band wagon and providing for patients to receive incentives to agree to have certain expensive procedures preformed abroad and for any of these willing patients to have their lengthy recoveries requiring hospitalization to take place there, too. This "free-trade" fetish that's been all the rage among conservatives for decades doesn't have a class component to it, does it?

      I, myself, wonder why Medicare and private insurance companies don't work for more Med school slots to be available to train doctors in this country each year and why Medicare doesn't come to terms with aspiring doctors and subsidize their Med school expenses in order to increase the supply of doctors and, thereby, drive down the earnings expectations for those in the profession so that the problem of doctors "refusing any new Medicare patients" will disappear in a generation.

      Also, it's interesting to hear the claim that after being underpaid for years, "older doctors" (in, what, their mid-fifties?) are mad as hell so they're going Galt and giving up the profession entirely. What are they going to do, stock shelves at Home Depot or do they have some other game plan? Certainly from what we've been told, these doctors, or those of them without an inheritance anyway, don't have enough money to retire.

    4. I have been under the impression that Medicare does pay for physician training.

    5. Medicare and the NIH do subsidize Medical Schools and teaching hospitals but apparently whatever they're doing the U.S. still has a poor physician to population ratio compared with most other countries with developed economies. (Actually, I think Canada's ratio is still worse than ours because the government there withdrew subsidies for med school students back around 1990 - a decision they reversed several years ago.)

      Medicare subsidies to teaching institutions benefit the students through some sort of trickle down and there are stipends for actual residents.

      I'm suggesting that as long as the U.S. has a doctor shortage that is leading to Medicare patients being under-served, students who are able to meet rigorous benchmarks during their years of medical training should be subsidized sufficiently so that they are not discouraged from the pursuit of M.D.'s and D.O.'s by the debts they might have to incur on the way, provided they agree to devote some amount of their professional practices to Medicare and Medicaid beneficiaries.

      (And, there should be more slots available to reasonably qualified applicants begin the study of medicine in the U.S each year.)

    6. There is such a program already. The govt subsidies physician training to some degree, on the condition that these docs work in areas where there is great need and hardship.

    7. If I'm not mistaken I believe that, in the 1990s, Uwe Reinhardt opposed subsidizing med school education. Not anymore apparently, the times, they are a-changin.

  3. I had assumed that this would be because in the case of non-Medicare clients, the govt is picking up most of the tab there as well,making providers captive in the sense of having to depend on individuals to pay the tab for more services and higher rates.

  4. From what I understand, one reason is that hospitals expect an influx of paying patients now that insurance coverage has been expanded under the ACA. That's why providers agreed to the deal.

    1. I don't get what "agreed to the deal" means? They endorsed the legislation? They decided not to lobby against it?

      What options did they have?

    2. Don't forget Obama's secret deal with Big Pharma to protect their profits by refusing to aggressively negotiate for lower drug prices à la Medicare Part D, while simultaneously increasing the market for taxpayer funded medications.

  5. The Wikipedia article on the Walpiri, an Australian aboriginal people, explains at length that the Walpiri "divide their relatives, and by extension the entire population, into eight named groups or subsections." This casts serious doubt on the unserious (but also unfunny) claim that they cannot count past two.

    I'll believe that "the limited Walpiri can’t count past one and two" when I hear the fact explained by a credible anthropologist or linguist.

    Until then, I'll stand by my belief that the only supposedly intelligent beings that can count no higher than two are computers.

  6. Obama is taking the middle class honkies' money and "redistributing" it, just like he told super patriot Joe the Plumber. Alinsky Ayers Dohrn Lenin Stalin Rev. Wright Mau Mau Kenya Kenyatta Krushchev you-know-who Goebbels Black Panthers Willie Horton Rev. Wright Al Sharpton beer summit looks like he could be my son Mau Mau Alinsky foreigner Soviet socialist moocher hate business hate small business no experience TelePrompTer Solyndra Alinsky Rev. Wright Jesse Jackson Mau Mau Kenya Jimmy Carter.

  7. On the question of who they trust more to handle Medicare, Romney beats President Obama 45 percent to 42 percent in a Washington Post poll

    Republicans point out that Medicare is unsustainable and have a plan to change it into something sustainable. Democrats ignore Medicare's unsustainability. I think that's why plurality trust Romney more than Obama to handle Medicare.