Ryan and Bachmann Lied Like Jackals and Medicare Actuary Contradicts Own Report

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Rep. Paul Road Map Ryan((R-WI) delivered the conservative response to President Obama’s SOTU as did Rep. Michele Bachmann (R-MN). First, let’s look at Ryan, who Republicans still refer to as their budget wunderkin, even though they largely ignored his radical economic road map. Ryan made a huge issue out of the deficits, but from 2001 to present he has supported the slash and burn tax and revenue policies of the Bush administration. Ryan ( Bush’s) economic policies have made the deficit about $3 trillion dollars than they would be if Ryan or a cadre of Washington conservatives really cared about fiscal responsibility. Ryan is also supposed to be one of conservatism’s young lions ( he has described himself as such), the future of the Republican Partay. The new Republicans have the same malignant disabilities of the old Republicans, they’d fall on their faces, be exposed as the morally and intellectually vacant husks they are with the Big Lies as a crutch. Fact Checking Rep. Ryan’s State Of The Union Response

RYAN: The facts are clear: Since taking office, President Obama has signed into law spending increases of nearly 25% for domestic government agencies – an 84% increase when you include the failed stimulus. All of this new government spending was sold as ‘investment.’ Yet after two years, the unemployment rate remains above 9% and government has added over $3 trillion to our debt.

“Failed Stimulus?” When President Obama Took Office The Economy Was Shedding Hundreds Of Thousands Of Jobs Per Month…

The Economy Shed Almost 8 Million Jobs Under Republican Policies Before The Recovery Act Could Affect The Economy.

[   ]….PolitiFact: Counting Stimulus Spending In 2010 Is “A Nifty Accounting Maneuver.” In a November 2010 fact check of Rep. Ryan’s “84 percent” claim, PolitiFact.com wrote:

Barely TrueOutside experts that PolitiFact Wisconsin spoke with quibble a bit about the annual budget figures Ryan uses, but the numbers are not really in dispute. And they do show a big jump — from $434 billion in 2008 to $537 billion in 2010.

But that’s a 24 percent increase, not the 84 percent claimed by Ryan and his colleagues.

Where would conservative critters like Ryan be without lying. Either looking for honest work or on the wing-nut welfare circuit spoon-feeding pabulum to the rubes. Despite reports just a couple of years ago that supply-side(voodoo) economics were dead, Ryan is a reminder that conservatives memes are like zombies. America’s economy crashes, largely due to conservative economic policies and it is all the fault of poor people and George Soros. Conservatism is not so much a political movement as a religious cult. Taxes, health care reform, jobs , the deficit… there was nothing in Ryan’s SOTU response that was not informed by incoherent fantasies.

Rep. Michele Bachmann (R-MN) delivered her own response, ostensibly on behalf of the tea baggers. There was some objection to Bachmann delivering her own response. In her defense if she wanted to have a response and a network was willing to carry it than good for her. Too bad that the House’s own Progressive caucus did not take advantage and push CNN for time to reply to her speech. Anyway, Bachmann has never been known for her level of accuracy or honorable behavior. She is a blind ideologue and her fans love her for it. She has no compunctions about lying what so ever, Fact Checking Rep. Bachmann

BACHMANN: Unfortunately, the President’s strategy for recovery was to spend a trillion dollars on a failed stimulus program, fueled by borrowed money.[…] Not only did that plan fail to deliver, but within three months the national jobless rate spiked to 9.4 percent. And sadly, it hasn’t been lower for 20 straight months. While the government grew, we lost more than 2 million jobs. Let me show you a chart. Here are unemployment rates over the past ten years. In October 2001, our national unemployment rate was at 5.3 percent. In 2008 it was at 6.6 percent. But, just eight months after President Obama promised lower unemployment, that rate spiked to a staggering 10.1 percent.

Rate of Job Growth - Bush/Republican Years Versus Obama

Not only devoid of any fact, but a blatant hypocrisy. Republicans cut taxes and spent like mad men for eight years. They put that debt on the Chinese credit card. V.P. Cheney famously said deficits don’t matter. Suddenly deficits, much of which are a result of policies Bachmann supported, are a threat. In addition to lying and the hypocrisy is the utter lack of any genuine core convictions. If we assume that Bachmann and Ryan honestly believe the bull they shovel out for mass consumption they don’t have mental acuity of a tree stump.

Right-wing conservative bloggers have seized on this news, Medicare official doubts health care law savings

Two of the central promises of President Barack Obama’s health care overhaul law are unlikely to be fulfilled, Medicare’s independent economic expert told Congress on Wednesday.

The landmark legislation probably won’t hold costs down, and it won’t let everybody keep their current health insurance if they like it, Chief Actuary Richard Foster told the House Budget Committee. His office is responsible for independent long-range cost estimates.

Foster’s assessment came a day after Obama in his State of the Union message told lawmakers that he’s open to improvements in the law, but unwilling to rehash the health care debate of the past two years. Republicans want to repeal the landmark legislation that provides coverage to more than 30 million people now uninsured, but lack the votes.

Foster was asked by Rep. Tom McClintock, R-Calif., for a simple true or false response on two of the main assertions made by supporters of the law: that it will bring down unsustainable medical costs and will let people keep their current health insurance if they like it.

On the costs issue, “I would say false, more so than true,” Foster responded.

As for people getting to keep their coverage, “not true in all cases.”

Writing at the Washington Post – a paper conservatives still claim is a ho bed of liberal bias – Jennifer Rubins cites this actuary’s testimony and Road map Ryan as the smoking gun that the entire Affordable Care Act is a shame. Jen, as is the habit of those afflicted with conservatism does not do details or research,

Rep. Paul Ryan 1, ObamaCare 0
By Jennifer Rubin

House Budget Committee Chairman Paul Ryan (R-Wisc.) held an important hearing on ObamaCare, showing just how important is the process for educating the public, and thereby setting defenders of ObamaCare back on their heels.

Rubin also throws in some testimony from someone at the Ethics and Public Policy Center. Which happens to be a right-wing front group who thinks Paul Ryan walks on water. Since Jen likes to keep score, lets add that up. Two right-wing conservatives testifying to a Committee chaired by right-wing ideologues, plus one actuary equals the Right 1, Obama O. Republicans cannot get even single digit arithmetic right without spinning it. The Medicare actuary may have some points to make about Medicare and cost containment, but as is usually the case it is not as simple as the Right would like everyone to believe. First, Foster ( the actuary) say that costs for some Medicare recipients will go up because we’re doing away with Medicare Advantage. Medicare Advantage was supplemental insurance the government was subsidizing. It costs hundreds of millions of dollars. Is it now the Ryan and Republican position that the government should rescue this costly government entitlement? We all know that it is not. So complaints about Medicare Advantage are solely for the sake of scoring political points and slices away a large part of Foster’s “concern” that medicare recipient benefits are going down. Those on Medicare who want supplemental insurance can still buy it in what Republicans should be passingly familiar with – the open market. Foster’s larger point about savings is debatable. Why would I say that. Because a report by his office in September of last year – well after the Affordable care Act was passed said so, The Office of the Actuary in the Centers for Medicare & Medicaid Services – National Health Expenditure Projections 2009-2019 (September 2010)(pdf)

Provisions of the Affordable Care Act are projected to result in a lower average annual Medicare spending growth rate for 2012 through 2019 (6.2 percent), 1.3 percentage points lower than pre-reform estimates. The relatively lower projected Medicare expenditure growth rate reflects reduced annual payment updates for most Medicare services, substantial reductions to managed care plan payments, and the creation of the Independent Payment Advisory Board.

I have not had time to study this entire report also put out by the Medicare actuary’s office, but it does contain this paragraph in the reading I’ve gotten to –2010 ANNUAL REPORT OF THE BOARDS OF TRUSTEES OF THE FEDERAL HOSPITAL INSURANCE AND FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUNDS(pdf)

The financial projections shown for the Medicare program in this report represent a substantial, but very uncertain, improvement over those in recent years as a result of the far-reaching provisions of the Patient Protection and Affordable Care Act (as amended by the Health Care and Education Reconciliation Act of 2010). Compared to the projections in last year’s annual report, projected Medicare costs as a percentage of GDP are 12 percent lower in 2019, 20 percent lower in 2030, and 43 percent lower in 2080. The legislation postpones the estimated date of exhaustion for the HI trust fund from 2017 in last year’s report to 2029. At 0.66 percent of taxable payroll, the long-range actuarial deficit for HI is only one-sixth of its prior level. Projected long-range expenditures for SMI Part B are also substantially lower than before, while Part D expenditures are slightly lower.

It is important to note, however, that the substantially improved results for HI and SMI Part B depend in part on the long-range feasibility of lower increases in Medicare payment rates to most categories of health care providers, as mandated by the Affordable Care Act. Moreover, in the context of today’s health care system, these adjustments would probably not be viable indefinitely into the future.

WaPo’s right-wing columnist sees slam-dunk, ObamaCare will never work. Cooler heads might read this report and conclude there is likely some necessary tweaking ahead. That is kind of subtle thinking. Thinking not blinded by Obama Derangement Syndrome. No surprise that progressive thinkers took up this very issue almost two years ago. Lin Nichols makes the kind of obvious observation that flies over the head of the right-wing dogmatists. COSTS: The Price of Pessimism — What the CMS Actuaries Missed

Small growth in National Health Expenditures is a good deal.  The CMS actuaries estimate that after all is said and done, national health spending will claim 0.3 percent more of GDP in 2019 than under current baseline trajectories.  They come to this conclusion despite being pessimistic about behavioral responses to delivery system reforms and despite assuming we will be covering 34 million more Americans by that time.  In other words, even analysts who are pessimistic about savings assert that we can just about pay for covering most of the uninsured out of savings from elsewhere in the health system.  Even a little more success than they project (far less than the percentage they were wrong about the Medicare Drug Benefit) and we will be covering the uninsured at lower cost than we would have spent without reform.

In sum, there are some fine analysts at OACT, and Rick Foster and his team serve our nation well as actuaries of the Medicare program.  When it comes to knowledge of the delivery system and the under-65 population, however, they are perhaps less up to speed than McKinsey or CBO.  People should not get hung up on their judgments about the potential for delivery system change.  People should notice, however, that they estimate the savings provisions in the House legislation will generate $20 billion more over 10 years than CBO estimates.  This is their area of relative expertise.  Predicting behavioral responses, of hospital CEOs or of uninsured individuals, is not.

All future costs should be in the context of where we were headed without some kind of reform – something conservatives had plenty of opportunity to do during the Bush era and during the health care reform debate. As the generally conservative and often times overly cautious Kaiser Foundation noted,

Health care costs have been rising for several years. Expenditures in the United States on health care surpassed $2.3 trillion in 2008, more than three times the $714 billion spent in 1990, and over eight times the $253 billion spent in 1980. Stemming this growth has become a major policy priority, as the government, employers, and consumers increasingly struggle to keep up with health care costs. [1]

In 2008, U.S. health care spending was about $7,681 per resident and accounted for 16.2% of the nation’s Gross Domestic Product (GDP); this is among the highest of all industrialized countries. Total health care expenditures grew at an annual rate of 4.4 percent in 2008, a slower rate than recent years, yet still outpacing inflation and the growth in national income. Absent reform, there is general agreement that health costs are likely to continue to rise in the foreseeable future.

What has been and continues to be the conservative answer to millions of uninsured Americans and spiraling health care costs, to act like Jennifer Rubin and throw peanuts from the gallery. They have no ideas and no solutions, so spin and hysteria is their standard response.

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