Last September there was a posting, "Afghanistan: The Chinese Water Torture". It focused on the corruption of the government of President Karzai, corruption partly funded by the U.S., and the general frustration of dealing with the Karzai government at any level on any issue. The Chinese water torture was described as "a slow drop at a time on the forehead until you cry out for mercy or go insane." This ancient form of torture has now been replaced by water boarding.
Dealing with the Republicans on the debt ceiling issue is our domestic version of the slow drip on the forehead. The issue concerns the need to increase the $14.3 trillion limit on federal debt or face financial default which in turn will have negative consequences for the international economy. The Treasury Department has set August 2 as the deadline for avoiding default. There are two basic, interconnected problems in dealing with the GOP on the issue: 1) who speaks for the GOP?; and 2) the Republicans keep moving the goal posts on what they seem to want.
There is a small bipartisan congressional group that has been negotiating for several weeks with Vice President Biden on what would be a mutually agreeable deal for increasing the debt ceiling, an increase opposed most fiercely by tea party members of Congress and other conservative fiscal hawks. The Biden group appeared to be arriving at an agreement on the basics, although not the specifics. The general outline of the package that seemed to be evolving was that the debt limit would be increased, there would be major spending cuts, and a long term set of spending caps would be adopted to keep the lid on deficits in the future. (It should be noted that there is no plan anywhere for paying down the debt and nothing has been said specifically about raising revenues except the budget of President Obama who wants to increase the income tax on upper income earners.) Drip.
Then along came GOP House Speaker Boehner (see previous post) who shifted the goal posts on what the GOP said it wanted in exchange for agreeing to increase the debt ceiling. Boehner said there could be no agreement on the debt ceiling unless it included trillions of dollars in spending cuts, without specifying any time frame for the reduction -- 1 year, 5 years, a decade, or what? Boehner is on record supporting the need to raise the debt ceiling but is under pressure, particularly from the 87 new GOP members of the House, to up the ante on spending cuts as the price for getting the necessary House GOP votes on the debt ceiling increase. There are also some House members who will oppose any increase in the debt ceiling. (In a vote set up by the Republicans to fail, the House Tuesday night voted 318-97 against a bill to increase the debt limit by $2.4 trillion without any spending cuts. That did nothing except to leave the issue on square one where it was before the vote.) Drip, drip.
A few days ago the GOP shifted the goal posts once again when Republican Senate Minority Leader McConnell said that the entire so-called Ryan budget should be considered part of the debt ceiling negotiations. That budget, passed by the House in early spring, calls for about $5 trillion in spending cuts over the next decade and includes restructuring of the two major health care programs, medicare and medicaid. Medicare would be replaced by a voucher system that would subsidize but not cover the full cost of health insurance to be bought from the private sector. Further, the vouchers would cover a decreasing share of the insurance costs over the years. Persons over age 55 would be grandfathered into the existing medicare program. Medicaid would be severly cut in funds and the program converted into a block grant that would basically turn control of health care for the low income over to the states. Both the medicare and medicaid proposals have backfired politically on the Republicans, particularly the abolition of medicare as we know it. Drip, drip,drip.
The Ryan budget plan, which has become the official GOP budget, has caused so much political trouble for the Republicans that the McConnell idea to make it a part of the debt ceiling negotiations is seen as a ploy to force Democrats to show where they stand on the spending cut parts of the Ryan budget now, while also agreeing to longer term changes in medicare and medicaid. So the current picture seems to be three different approaches presented by three different sources. The public is left confounded and confused by the question of whether the GOP members of the Biden group are the official party spear carriers, or does Boehner or McConnell represent the official GOP position? Thus, the beg-for-mercy reference, "Chinese water torture," in this posting's title. Drip, drip, drip, drip.
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To close on a brief note of positive news. In Murfreesboro, TN, a judge has ruled against efforts by some in the community to block the building of a new mosque (see previous post). The religious-based objections were cast aside, although the judge permitted the opponents to continue their case based on a procedural issue about adequate notice of a public hearing. And in Chattanooga, TN, construction is underway on a $2 million Islamic center. Unlike Murfreesboro, the Chattanooga center is proceeding without issue.
Dionne's column in the Washington Post notes that Ryan's take on healthcare reform relies on the belief "that there are some magical things the free market can do in the United States that it hasn’t done anywhere else in the world." (See http://www.washingtonpost.com/opinions/why-paul-ryan-is-losing-the-medicare-argument/2011/06/01/AGqThkGH_story.html?hpid=z3). The problem for the Republicans is that most Americans can see the plan puts people who can't afford adequate healthcare even more at the mercy of the insurers.
ReplyDeleteCosmo
ReplyDeleteCan't disagree with Ryan that there are some "magical things" the free market can do in the U.S. Look at the great recession that the free market gave us -- very black magic.
And even for people who can afford adequate health care, it will cost them more and more each year since the voucher increases will lag the growth in health care costs and insurance. Eventually some of them will shift into the category of those who can't afford adequate health care.
And now I see the House is ready to take up an Agriculture Appropriations bill designed to make deep cuts in food assistance programs. Once again, radical Republicans seek to balance the budget on the backs of the poorest Americans while fighting for the richest to continue to enjoy their tax assistance programs. I guess starving out of work people to death is the answer to reducing unemployment.
ReplyDeleteCosmo
ReplyDeleteThe Republicans are ready to do anything but increase revenues, particularly from upper income earners or the corporate world. It's a "Read my lips . . . " all over again but we know what happened to George I on that one.
The farm built has often used food stamps as a trading gimmick for votes on farm subsidies. But this time it may just be another case of to hell with the poor.
Looks like we'll need a bucket. We really do need to cut spending and reduce the huge deficit we have amassed but we can't hold the debt ceiling hostage. The repercussions would be devastating. As long as the Biden group was making some progress they should be left alone to continue without interruption.
ReplyDeleteIt is hard to imagine how the states could take any more of the burden of responsibility for health care when they are so overburdened already and in deep trouble with debt. I do agree with another comment I've read that at least Ryan is proposing something. I don't think it can be disputed that medicare will run out of money and then nobody is going to have any coverage at all.
Carole
ReplyDeleteThe Republicans simply cannot stop playing to their base which includes the fiscal hawks who think only in terms of spending cuts. To them everything is hostage to spending cuts. Increased revenues through higher taxes, even on the wealthy, are taboo. Instead of keeping the issue to the budget process where it belongs, they are using the debt ceiling as the vehicle.
The medicaid program for the low income is the health care program that hits the states since they have to pay their share of the program. Medicaid is a matching program with the states paying anywhere from 25 to 50 percent of the cost. The stimulus program included $100 billion plus to help the states out with the medicaid cost because of the recession which was making more people eligible, but the stimulus money is running out. Ryan wants to reduce federal spending on medicAID from the top and turn control over to the states in the form of a block grant. Much of the analysis on this has concluded that this will end up costing the states more money.
You are correct that medicare needs a fix because it is indeed a costly and getting-costlier program. Before the last election the Republicans were screaming that Obama was destroying medicare because he proposed to cut out the special bonus going to insurance companies through the medicare advantage program. The advantage program was enacted during the Bush administration to try to entice the elderly out of medicare into private insurance; advantage adds some extra services that don't normally go with medicare and many elderly did shift. But the advantage program costs the feds about an extra 20 percent per person which goes to the private insurance companies. Obama proposed to cut out this bonus. There are a number of things that can be done to the medicare program to cut costs but I don't believe the Democrats have put them into a single package as a counter to Ryan.
Maybe cracking down on medicare fraud would help. A change in existing policies that would not enable false claims to be filed. The current policy to file claims quickly has lead to millions of dollars of false claims being filed as there is no time to look into them. The medicare program needs to be restructured to save it for future generations.
ReplyDeleteCarole
ReplyDeleteThere is no question that fraud adds to the cost of medicare and medicaid.
I believe it is required that doctors and hospitals be reimbursed within 30 days of submitting their claims. That certainly is too quick to permit any personal examination of the millions of individual claims pouring into the system. There is a coding process that takes place when a claim for reimbursement is made; that process including the code for the medical procedure used, the social security number of the patient, the doctor/hospital id number, as well as other items. The computers are programmed to sound the alarm if certain aberrant patterns appear for a doctor or hospital and this leads to some of the fraud charges we read about in the newspaper. But I'm sure there are ways of gaming such a system to prevent detection of all but the most egregious cases of fraud.
Every administration has faced this problem and fraud detection methods are being improved over time but the system is too massive to permit individual scrutiny of all claims within the 30 day period. So fraud, like shop lifting at Walmart, is factored in as the cost of doing business.