Friday, November 27, 2009

Threat To The Elderly

Health care guru Jonathan Cohn thinks it's just dandy that President Obama likes the recent article on health care costs published in The Atlantic by Ron Brownstein.

Of course he would. Brownstein lauds the bill crafted by Senate Majority Leader Harry Reid and concludes

The attempt in all these ideas to nudge the medical system away from fee-for-service medicine toward an approach that ties compensation more closely to results captures how much the health care debate has shifted toward cost-control. So far, the rise in health care spending has proven almost invulnerable to every previous attempt to tame it, like the managed care revolution in the 1990s. Even if Obama signs into law a final bill embodying all these reform proposals, many skeptics wonder if they can bend, much less break, the seemingly inexorable increase in health care spending. Reischauer understands that skepticism, but isn't able to entirely suppress a kernel of optimism that this latest reform agenda may prove more effective than its predecessors. "One never knows whether we're turning the corner or if this is just playing the same old game for another inning," he says. "But I sense there's something different out there. I think the medical profession and its leaders have read the handwriting on the wall and are trying to evolve." If so, the ideas the Senate will begin voting on tonight could mark a milestone in that journey.

In addition to the cost-containment provisions in the bill, Brownstein commends proposals of the New America Foundation, including

mechanisms to more quickly diffuse into the private insurance system reforms that show promise in Medicare. Democratic sources say a group of centrist Democrats led by Virginia Senator Mark Warner is trying to devise a package designed to do just that, perhaps by expanding the role of the independent Medicare advisory commission.

The President may like that idea of "an independent Medicare advisory commission." On February 14 The Wall Street Journal reported

The president met with 44 fiscally conservative "Blue Dog" Democrats this week and gave a nod to legislation that would set up commissions to deal with long-term deficit strains. The commissions would then present plans to Congress for an up-or-down vote.

"We feel like we've found a partner in the White House," said Rep. Charlie Melancon (D., La.), a Blue Dog co-chairman.

Now, The Hill notes of Democratic Senators Conrad (N.D.), Bayh (Indiana), Feinstein (Ca.), Warner (Va.), and Lieberman (Ct.) and Republican Senators Gregg (N.H.), Voinovich (Ohio), and Sessions (Alabama)

Seven members of the Senate Budget Committee threatened during a Tuesday hearing to withhold their support for critical legislation to raise the debt ceiling if the bill calling for the creation of a bipartisan fiscal reform commission were not attached. Six others had previously made such threats, bringing the total to 13 senators drawing a hard line on the committee legislation.

“You rarely do have the leverage to make a fundamental change,” said Senate Budget Committee Chairman Kent Conrad (D-N.D.), who said he hasn’t ruled out offering the independent commission legislation as an amendment to the healthcare reform bill.

The panel, which has been championed by Conrad and ranking member Judd Gregg (R-N.H), would be tasked with stemming the unsustainable rise in debt.

Among its chief responsibilities would be closing the gap between tax revenue coming in and the larger cost of paying for Social Security, Medicare and Medicaid benefits. The Government Accountability Office recently reported the gap is on pace to reach an “unsustainable” $63 trillion in 2083.

The panel would also have the power to craft legislation that would change the tax code and set limits on government spending.

The legislation would then be subject to an up-or-down vote; it could not be amended

The stakes are extraordinarily high because

If the debt ceiling is not raised above its current $12.1 trillion mark by then, the government will exceed its borrowing limits and will be forced to default on the debt. Economists have warned that the inevitable result would be a lowering of the U.S. credit rating, triggering substantial increases in the interest rates the government is already paying.

Chris Bowers at Open Left explains why Senate leadership must just say 'no:'

Let's review the threat that these five Democrats are making:

They will allow the United States to default on its debt, which will vastly increase the overall amount we have to pay on our debt

Speaker Nancy Pelosi turns over Congressional power on Social Security and Medicare to an unelected commission that will almost certainly propose deep cuts in Social Security and Medicare entitlements. Keep in mind that if deep cuts to Social Security and Medicare pass under a Democratic trifecta, the party would be doomed at the ballot box for years to come.
This is completely insane, and there is no choice but to call this bluff.

Let's see these five Democratic Senators explain to the entire nation why they allowed the country to default on its debt. No matter how safe their seats appear to be, no Senator is going to win reelection after making the entire country default on its debt Their rationale does not matter. Being blamed for making the country default on its debt-especially after all five of these Democrats voted in favor of the Wall Street bailout and are demanding that Social Security and Medicare be cut-will be the effective end of their political careers.

Commissions established to recommend cuts to programs such as Medicare and Social Security are not created to consider whether cuts should be made, but rather to recommend them. If they are enacted, it would not only be a devastating blow to the elderly but virtual political suicide for the Democratic Party. Digby points out (11/25/09, "Bad Bargain")

The lesson is clear. Democrats don't get rewarded for "righteous" bipartisan gestures. They get impeached. And to dream that the American people will somehow reward the president for putting in place mechanisms for lowering the deficit is delusional. People don't even know what the deficit is, they just think it's a symbol of bad governance. Putting us on the road to "entitlement" destruction won't change their opinion if they still see signs of .... bad governance. It has no real meaning to real people. Personally hurting financially and believing that their futures are in jeopardy does have real meaning --- and the Republicans will make sure they know who to blame for it.

This should be clear to the Democrats who are trying to blackmail Speaker of the House Pelosi (in whose chamber the ceiling would be raised first). And it should be clear to Barack Obama, who routinely has demonstrated extraordinary political prescience- and perhaps it is. Certainly, though, the Republicans behind the idea understand the implications.

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