I'm cranking up Lennon's Imagine from iTunes as I write this--great idea. I  also really like "Let it Be" by the Beatles and "Hey Jude" by Paul McCartney.

I want to show the myth in the GOP Talking Point that makes it an absolute boldfaced lie, because what is being attributed to Obama is really about the "Doc Fix" and comes from Congress and CMS who is made to do it. They're told to cut X Percent because Congress wants to blame them for it, and they make the cut so drastic for docs that Congress always avoids it's actually happening.  The Ryan budget does the exact same thing but it cuts patients' funds not docs' payments.  

"Vouchers" aka the new GOP cutesy term "Premium Support" which are different letters of the alphabet for "Vouchers" Damn listening to "Imagine" helps me see right through that.

And the Voucher plan that Ryan /Romney are pushing is a whole different animal--it would gut Medicare for Vouchers only now they call it a new name "Premium Support."  You don't need med school or residency to know that is just a cutesy term for vouchers.

How would a voucher work? Simple.  Someone who is friend or family or maybe you have had surgery for cancer or a coronary bypass graft (CABG).  They are expensive operations.  A CABG depending on variables can cost $150 grand to $200 grand not to mention follow up cardiology visits, followup echoes, five default meds the patient gets put on including a Ca Channel  Blocker, an Ace Inhibitor, and a Beta Blocker, and a host of other possibilties. Nowing this, picture taking away Medicare and handing your friend or family a 15 grand voucher and telling them the rest comes out of their pocket, or if they have a good enough Medigap or ancillary insurance they still pay the decuctible and it's sizable particularly with the donut still in play for several years although  Obamacare aka ACA eliminates it eventually.


The ACA Saves $200 Billion for Taxpayers through 2016 and Nearly $60 Billion for CMS Beneficiaries
http://www.cms.gov/apps/files/ACA-savings-report-2012.pdf

The Republican ticket’s big Medicare myth August 13, 2012 Ezra Klien in the Washington Post

http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/08/13/the-white-houses-medicare-plan-isnt-that-hard-to-find/


All weekend, I have seen talking heads jump on the tube and make one of their centerpieces a $750 billion cut from "Obama" to Medicare, and I think we'd all agree Medicare will be a focus as the campaign for WH and Congress gets into it's final push in September.

I watched National Review editor Rich Lowry make an absolute fool of himself due to his ignorance of Medicare because essentially Andrea Saul, Romney's Deputy had emailed all the talking heads for Sunday shows and Surrogates the stupidly ignorant Medicare Obama Cut point to shout out.  He literally wouldn't let Maddow respond by talking through her and I'm watching the DVR of that now.  And equally ignorant David Gregory cut their argument off.  But she has a TV show and Lowry doesn't so she'll address this tonight with Ezra Klien who wrote a killer article showing Lowery is totally ignorant of what is going  on with  Medicare right now.

I just want to explain the reality of this "cut" and it's origins and to make the most important points that both Paul Ryan and the Obama administration propose the exact same cut literally which has not actually been enacted in any law, not to mention that there are other gynormous savings in Medicare in all kinds of ways when Obamacare kicks in and gets fleshed out in 2014.

But I want to look at this so-called "Obama cut" that isn't an "Obama cut" and has nothing whatsoever to do with Obama anyway.  In medicine we get bombarded with this thing every year since the late 1990's and it has a wonkyname SGR (Sustained Growth Rate).  The current one is SGR 2012 and it has been hanging over docs' heads as it does every year from two directions.  
This thing is about a $340 billion dollar deficit for Medicare that we've had since the  late 1990's. Congress suprise surprise has never wanted to deal with it although to their credit there are some docs in Congress (none from Ga. who has the largest # MDs in  Congress) who do.

One of the leading docs trying to hammer out a final solution is a  Michael C. Burgess, M.D. a Rep. from the Texas District 26, and the AMA has a decent plan.  This proposal is being laid at Obama's feet but he has next to nothing to do with it directly at all.  Congress doesn't want to deal with it; hasn't since late '90's so they have passed a law that they continue to pitch it to Medicare's lap.  Specifically, the #2 guy at Medicare and his team, Jon Blum, an attorney who has been in that position for years, knows it isn't their job so they have a way of putting it back in Congress' lap.  Every year they propose a drastic cut in physician fees--this year SGR 2012 has been set by Blum and his liberal arts majors (not knocking them--I did English and Chemistry) at 31.2%.  And the Sequester would peg it about the exact same. So that cut hurts docs dramatically, many of whom run  on very tight profit margins because of office staffs and equipment costs (or there are easier ways to make money but most  docs really find the material interesting).  Right now, Medicare pays docs roughly 60-65% of what a premium Medigap or other traditional private insurance policy from Aetna, or Humana, or Wellpoint or United Health would pay them.

So what's being attributed to Obama really comes from  Congress, and it has every year for literally 15 or so years ago in 1997 when Obama was in his 2nd year in the Illinois Senate. It comes from something called the Balanced Budget Act of 1997 passed by Congress
and signed by Bill Clinton. Every year at the last possible moment literally, Congress stops the Medicare cuts TO DOCTORS NOT PATIENTS with something the media calls the "Doc Fix." Princeton healthcare economist Uwi Reinhardt explains it here:

The Annual Drama of the ‘Doc Fix’
http://economix.blogs.nytimes.com/2010/12/17/the-annual-drama-of-the-doc-fix/?src=tptw

The current situation is covered by AMA News here:
http://www.ama-assn.org/amednews/2012/07/30/gvsa0730.htm

Medicare pay: Budget sequester adds to annual payment rate woes

Now to my point:  Congress for 15 years, and Paul Ryan both have the exact same "cut to  Medicare which is .05% of GDP as Ezra Klien eloquently explains in the column linked below.  The difference is that what Ryan and Romney and their surrogates like confused and hapless Rence Preibus and National Review Editor on Gregory are saying that Obama "cut Medicare" is total fiction.  Congress proposed back in 1997 and now with the  Sequester to cut Medicare payments to physicians 31.2%.  It has since and they doc fix it away or kick it down the road every single year as they did a few months ago. Except at the end of 2012 it rears it's head again with the Sequester in the budget agreement which will become a big deal right after the electionl

Now along comes Paul Ryan who has always proposed this exact same cut for the exact same amount as Klien shows, but Ryan gets it done a different way. Ryan doesn't touch the payment amount to docs.  Instead the Ryan budget in the pretty blue  binder he holds up cuts patients' funds to pay their docs $750 billion or 31.2%.  Ryan's budget fixes are directed at poor and middle class people so the rich can get a $250 grand tax break.  I'm assuming that all the GOP here are in the bracket or rich enough that they'll profit from the break for the rich that Romney and Ryan propose just as Romney will.

The Republican ticket’s big Medicare myth

http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/08/13/the-white-houses-medicare-plan-isnt-that-hard-to-find/


-- Modified on 8/13/2012 2:57:15 PM

-- Modified on 8/13/2012 3:15:20 PM