Obamacare

Paul Ryan vs. Medicare

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Talkin' about policy!

The bowhunting congressman from Wisconsin takes on the flailing entitlement program in today's Washington Post:

The annual analysis of Medicare's financial health released by the program's trustees on Aug. 5 led some Democrats to claim that Medicare's imminent bankruptcy has been delayed, thanks to the creation of their health entitlement program. Only in Washington could the government raid one entitlement program to finance a brand-new one and still claim that deficits have been reduced and entitlements have been reformed.

The trustees' report compares the revenue that supports Medicare's trust funds with the program's planned expenditures. Last year's report revealed a $38 trillion shortfall over the next 75 years. This year the shortfall appears to have decreased, but only after the Democrats' health bill cut $529 billion from Medicare. This apparent improvement was the basis for Democratic celebration—even though the program remains tens of trillions of dollars in the hole.

With the same legislation that cut more than half a trillion dollars in Medicare spending, the Democrats created a nearly $1 trillion health-care entitlement. The Obama administration's own chief actuary has explained that in addition to the dubious assumptions on provider cuts and other claims of savings, the health-care law's Medicare cuts cannot be used to both reduce Medicare's unfunded obligations and pay for a new entitlement. And the Congressional Budget Office said in March that the health-care overhaul's Medicare savings "would be used to pay for other spending and therefore would not enhance the ability of the government to pay for future Medicare benefits."

Put simply, Medicare is on course to collapse. Medicare and interest on the national debt alone will soon overwhelm the federal budget, crowding out all other national priorities.

Politically, Ryan's proposed solution—essentially voucherizing the program—is an extremely tough sell (at best). But it's hard to argue with his diagnosis of the problem. Even under the best possible circumstances, Medicare is set to run out of money soon. As this report by the Committee for a Responsible Federal Budget notes, even if you buy the most optimistic assumptions about Medicare, the program is "likely to permanently exceed its dedicated revenue source by the end of the decade." But it's actually much worse than that, because there's no reason at all to buy those assumptions—not when the entitlement's chief actuary has said flatly that those figures "do not represent a reasonable expectation" of the program's future.

I looked at the Medicare Trustees Report here. More on Paul Ryan here and here.

NEXT: Cable News Switcheroo

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  1. No! No! That’s not true! That’s impossible!

    1. Search your feelings you know it be true.

    2. Good, good! Let the butt-hurt flow through you!

  2. If I’m not wrong, all taxation, both FICA and non-FICA, barely covers Medicare and SS at present. Everything else, from that ag subsidy to Michelle’s paella on the Costa del Sol, is paid for with borrowed swag.

  3. Stop feeding us flimflam sauce! Every serious economist – like myself – agrees that Medicare would be permanently solvent if we only taxed the super-rich at a 90% rate.

  4. Politically, Ryan’s proposed solution?essentially voucherizing the program?is an extremely tough sell (at best). But it’s hard to argue with his diagnosis of the problem.

    How about fiscally? Politically tough sell to a libertarian is really not a problem…99% of the policy we support is a tough sell….as a libertarian reading a libertarian publication written by a libertarian i do not think it is out of line to ask: will it work?

  5. Can we stop with the constant whining from the left that the GOP hasn’t submitted any alternatives to deal with this crisis?

    I suppose this is more of a rhetorical question.

    1. The GOP is not Paul Ryan. The GOP does not back, pay respect to, or even acknowledge the existence of Paul Ryan’s plan.

      Fuck the GOP.

      1. Maybe some in his party are afraid to support him, but judging by this site I would say the GOP as a group supports him.

        http://www.roadmap.republicans.budget.house.gov/

        1. Oh yeah, the budget committee’s website, where Ryan is the ranking GOP member. Yeah, big strong evidence of GOP support there.

          1. It ain’t much, agreed, but there are enough in the GOP who support it.

            1. There’s a big difference between being a Republican in the GOP and being a leader of the GOP political machine. The leaders don’t have a plan. Sure, there are fiscal conservatives, some of them GOPers, who’ll back Ryan, but the GOP (i.e. the national GOP political party) has no interest in offering solutions.

              1. I disagree, in that Ryan IS part of the leadership of the GOP. He’s the ranking GOP member for the Budget Committee, which counts for something.

                I agree that there should be greater support within the GOP for his plan, but it’s LIGHT YEARS more fiscally responsible than ANYTHING the Dems have suggested.

                Face with the alternative, I’ll take a frightened GOP over a useless democrat.

                1. TMan, it makes the deficit worse. How the hell is that “fiscally responsible”.

                  He just can’t (won’t) get his tax cuts scored.

                  1. YEah, next time say “Polly want a cracker” if you are gonna be Paulie Krugnut’s parrot. That argument has been debunked, dickweed.

              2. Individual Democrats could not get Climate change stuff passed despite having majorities in both houses…

                Does that mean Democrats have no solutions for climate change?

                I think you have a fucked up yard stick.

      2. So, is Paul Ryan’s plan the GOP equivalent of Mission: Impossible?

        “If this plan is captured, the party will deny ever knowing of it’s existence” kind of thing?

        1. I would say that the grown-ups in the GOP support his plan, thus why it’s called the GOP Roadmap, not the Paul Ryan roadmap.

      3. Those two cocksuckers Boehner and McConnell are panting to get their majorities back, so much so that they aren’t about to give the Democrats anything to target. That’s a good tactic, but it omits the fact that people will have voted *against* the Dems without voting *for* you. You’ve been elected, but without a mandate to do shit.

        And we all know they will do just that.

        1. Therein lies the rub, as the Dems will paint this as a plan to “take away medicare from seniors” which will then be parroted via Journolist the major news media around the country.

          I would love to see some backbone, but it is Washington.

          1. You have to wonder. If Chris Christie can walk the talk in Joisie, why can’t these squishes in DC? The federales are at least as fucked at Trenton was. How about some real straight talk?

            1. in jersey people are actually getting pissed about property taxes and theres a bit of a revolt going on. So Christis is able to go to war. There are few seniors who dont mind borrowing their grandkids money in order to keep getting their medicare.

              1. That’s how it has to be presented. I hate the “fuh teh chilluns” rhetoric as much as anyone, but in this case, it’s actually true.

          2. “the Dems will paint this as a plan to “take away medicare from seniors” which will then be parroted via Journolist the major news media around the country.”

            Yeap, it’s always the same bad rerun. They’ll also get plenty of help from the pop “culture”.

          3. Forget it, Man. It’s Washington.

      4. You can’t trust any politician with the name “Paul”.

        1. I knew there was a reason why the one tax-collecting apostle was named Paul!

          1. So close, but no cigar. The tax collecting apostle was named Matthew.

          2. I thought he was tent-maker. You know, small-business owner.

  6. Ryan’s voucher plan for Medicare is downright ridiculous, and betrays his fundamental misunderstanding of what the problem is. If there is one good thing about Medicare, it is the fact that it eliminates the market failures related to adverse selection, by insuring everyone over 65 all the time. Ryan’s plan would re-introduce the market failure! My God! What is he thinking? The last thing we need is for private companies to be doing everything they can to ditch sick seniors.

    And the very idea of my half-blind, slightly senile 86-year-old grandma fighting it out with an insurance company, or trying to comparison shop between complex plans, is just absurd. If you can’t understand this, your partisan blinders are thicker than a brick.

    1. For the love of Pete, will you please stop abusing the phrase “market failure”. FFS, serious. It’s tiresome.

      1. HAHA! Chad? Stop abusing the phrase “market failure”?

        That’s hilarious. He doesn’t HAVE any other arguments.

      2. It’s like a magic talisman that he chants to keep the ghosts of Ricardo, Smith and Friedman away.

        Of course, fixing that “market failure” entails sinking the entire economy, but those are just details.

        1. “market failure” has a very technical economic term, that being when a market delivers goods or services at a level that is not equal to the equilibrium of marginal cost equaling marginal benifit.

          Liberals have taken this term that they heard once in econ 101 and have instead turned into meaning “anything i dont like”

          1. No, I am in fact using it as the very technical term you are describing. Adverse selection is a form of information asymmetry. In particular, the problem stems from healthy people opting out of insurance, or minimally insuring themselves. This drives up costs for the remaining pool, which in turns drives more relatively healthy people out. There is really no end to this, and no “equilibrium” price. Instead, what has been going on in California is the norm. Plans increase in price rapidly, forcing out all but the sickest. They the company starts a new plan with a new enrollment, and starts over again.

            1. you are a dipshit.

              1. Station

            2. Chad, this isn’t a “market failure”. The market is working fine at pricing the risk of the people who are actually in the pool.

              The only “failure” is that, in your own opinion, people should not have to bear the full costs of their own individual health care – that the healthy should subsidize the unhealthy and equalize health care costs across the entire population. Ergo, if the market system we have doesn’t achieve that goal, then you see it as a “market failure.” It’s nothing of the sort. It’s ust the failure of your own utopian vision.

              This is a serious question that’s not at all intended to be rhetorical: What’s wrong with people paying for their own healthcare? Why do you consider this to be a “failure”?

              1. If you can’t see why having the cancer patient being forced to pay $100,000/year for insurance is a problem, your head is so far up your ass that you are beyond hopeless.

                What the hell do you think we are insuring against?

                1. Chad,

                  I work in the insurance industry. You don’t understand insurance at all; it is you who have your head so far up you ass that we can see your nose sticking out of your esophagus.

                  Insurance is purchased to cover the costs of repairing or dealing with an insurable event.

                  Insurable events are occurances that are:
                  1) Unforseeable for an individual
                  2) Happen often enough that they can be predicted statistically over a population.
                  3) Oh, and they must cause a loss.

                  In such circumstances, an insurance company sells policies offering money to people who suffer from these insurable events and collects premiums as the price of the protection (please note the premium is set by customer willingness to pay just like the price of candy bars, hookers and computers).

                  If the total amount of money people are willing to pay covers the expected outlay, you have a viable insurance market.

                  A person who has cancer now, is not suffering from an unforseeable event. Insurance is absofuckinglutely inappropriate for him. Any attempt to force insurance companies to sell policies where the outlay is guaranteed to exceed the income will either destroy their utility as providing insurance or drive them out of business.

                  What you want – people with cancer to be treated regardless of their ability to pay – is charity which is a different thing.

                  For some reason, you assume that people won’t be charitable, and that you ahve to come up with a violent solution to force people to provide charity. You may be rationalizing it as fixing a problem with the insurance market. It’s not, anymore than a law forcing car companies to install wings on automobiles is going to fix the failure of car companies to provide flying cars.

                2. You’re exactly right – that’s what “we are insuring against.” If you have insurance, you’re not paying $100,000.

                  BUT… if you didn’t have the foresight to buy insurance before you got sick and now don’t have the money, why the fuck is that your neighbor’s problem?

                  I agree with Tarran, you are confusing charity with insurance. Sympathy and charity are great, but they’re not the same thing as “insurance”… And it’s that kind of lazy thinking that has fucked our health insurance system up so badly.

                  1. Again, this time to WTB, STATION. (He get’s it cuz he summarized so succinctly, not that dumbfuck Chad will be able to appreciate it or learn ANYTHING from it).

                  2. No, WTB: I understand full well the pre-existing condition problem. What YOU don’t understand is that the market has no solution for it.

                    If you disagree, please explain how your system would work, such that people with cancer didn’t get stuck with $100,000 premiums.

                    1. Jesus, Chony. Even if the pre-existing conditions problem were as onerous as you claim, IT IS NOT MARKET FAILURE. You incorrectly used a technical term you learned in Econ 101, got called on it, and now you’re deflecting.

    2. Well, given that her genes and choice in men produced you, Chad, I too would worry about that women choosing what clothes to wear in the morning, let alone a good health plan.

      1. i lol’d

    3. The seniors in Medicare Advantage seem to do fine.

      1. At spending more that the government would if the government just did the whole thing themselves, perhaps.

        And there are plenty of seniors who have serious problems making these choices. I don’t think most of you guys have dealt with the eldery at all.

        1. you are a dipshit.

        2. Medicare Advantage plans provide a lot better coverage than traditional medicare. Even if you have traditional medicare, you’re at very significant financial risk unless you have supplemental policy. The Medicare Advantage plans limit your risk significantly since they have out-of-pocket maximums (which traditional medicare does not have for a lot of services). The Medicare Advantage plans also usually provide for some services that traditional medicare, even with a supplement, wouldn’t cover. So the government is spending more, but the beneficiary is getting more.

    4. What market failure?

    5. Chad, I can assure than my 93 year-old grandmother had a nice little benefit from medicare when she needed it in her last year of life. But her private pension and personal savings covered about 2/3 her medical care – which required some assisted living but no surgery of any kind.

      But I’m sure an 86-year old blind woman will not notice the rodents and the feces on the floor and unwashed sheets on the beds of the nursing home that gets all of its funds from medicare rather than only a third. Scenes like that make you hate the 72-year old fart who got a medicare-paid knee replacement so he could continue to golf twice every goddamned week.

      1. That’s nice, Invisible. And what portion of workers nowadays have lifetime medical benefits from a private employer? Virtually none.

        Btw, many members of my family work in nursing homes. The place is clean as a whistle and the folks that work there do more for less than just about any job I can think of.

        1. Chad-

          That’s nice, Invisible. And what portion of workers nowadays have lifetime medical benefits from a private employer? Virtually none.

          I know of one… Meet Mr. Donald Berwick— (Director of Rationing- Medicare 2010).

          1. Check AND MATE, Sad Chad….

            1. lol….Medicare is private, eh?

              I just hope the gub’ment keeps its damned hands off MY Medicare.

              *facepalm*

        2. That’s nice, Invisible. And what portion of workers nowadays have lifetime medical benefits from a private employer? Virtually none.

          And your point is… what? That people are still entitled to someone else paying for their healthcare and if a private company won’t do it, the government therefore must?

          BTW – that’s a rhetorical question, because I know that’s exactly the point you’re making.

        3. And the phasing out of private pensions and lifetime benefits happened in a vacuum, right Chad? We’re not allowed to point out the thousands (millions?) of ways that state and federal governments have tried to “improve” insurance, medical care and pensions, and formed dozens (hundreds?) of agencies to regulate these areas, in addition to the thousands of tax laws that direct people and businesses to make decisions in these areas. All of these rules and regulations take place in the arena of politics and are undertaken by both parties with often opposing criteria. How do you expect such a system to give good results?

    6. “And the very idea of my half-blind, slightly senile 86-year-old grandma … trying to comparison shop between complex plans, is just absurd.”

      Why?

      1. She’s old, not retarded (presumably). You go to the insurance agent, have him print out a sheet with the relevant numbers, ask questions, and pick one.

        1. What planet do you live on, Atanarjuat?

          1. My grandparents both grew up on a farm in very small towns in Texas and Kansas in the early 1900s. They have many health problems today. But they don’t have any problems with day to day transactions like this. Granted, they do have adult children they could ask for help.

            1. There are plenty of old people out there who neither have responsible or capable children to take care of them, nor the mental and physical abilities to take care of themselves.

              And the last thing I want to do is spend my time protecting my grandma from predacious insurance companies. I’d rather just pay the damned taxes. WAAAAYYYY easier.

              1. Because a monopolistic government that takes money out of your pocket under duress is much more preferable to having the opportunity to enter into a multitude of different relationships with private companies, some of which may or may not be “predacious” but at least require you to do due diligence to figure out which is which.

                Yeah, it’s just easier not to think and close your eyes. I agree.

              2. So, 320 million other Americans should be forced to do things the way you want to do them, under threat of imprisonment, because you are too lazy to take care of your own shit, but you still can’t figure out why people think you’re a fucking tool? Got it.

    7. Thats definitely a flaw in Ryan’s plan since the vouchers are a flat amount, regardless of risk. But I think it could be solved while still getting the advantages of vouchers. You could index voucher amounts to acturial risk and require insurance companies to take all-comers. This approach could be applied to everyone as well. It would eliminate the need for the individual mandate too. I think this is close to what Germany does.

  7. You’ve been elected, but without a mandate to do shit.

    That doesn’t seem to have been much of an impediment to the Demos.

    1. Nuh-uh! The American people elected the Democrats to carry out a progressive mandate, and create the public option, and destroy the banks, and tax the living hell out of carbon! It’s just that the evil, mean, Democrats won’t do it because they’re scared of the Republicans!

      Most of the American people are progressive. I have polls to prove it to, but I can’t show them to you unless you know the super secret password!

  8. I like it when people keep saying my social security benefits are “safe” when

    1) They aren’t benefits – they are simply returning my money

    2) Medicare is already not paying doctors to the point where some docs won’t take more medicare patients – which means I paid in to medicare and in theory would be paid back in doctor services but doctors are already NOT perform service for new Medicare patients

    and

    3) Social Security and Medicare are funded from basically the source and the one that DOES NOT HAVE a contribution limit is already FUBAR.

    And yet somehow I’m supposed to believe in stories and sales pitches rather than mathematical facts.

    1. Wrong. You SS benefits are your childrens’ and grandchildrens’ generations’ money. Your money went to your parents and grandparents generation. It’s all fair, and completely sustainable.

      As for the doctors, ask yourself a question: Is Medicare paying to little, or is our private insurance industry overpaying? Given how much doctors earn, the answer is almost certainly the latter. Our medical professionals are strongly overpaid relative to their international peers, even after factoring in loans and insurance. And given how hard other competing professions have been hit in this recession, it is almost certain they are beating lawyers, MBAs, professors, scientists, etc as well. You can thank the AMA cartel for that.

      1. It’s only sustainable because the decrease in birth rates, and therefore SS taxes, was compensated for by immigration. Why should the government be involved in retirement savings at all? Don’t give me the “cat food” answer. If you survive to your mid-60s without resorting to cat food, you can survive old age.

        1. No one survives old age…. No one.

      2. You can thank the AMA cartel for that.

        Damn, you almost sounded like Milton Friedman there, Chad.

        Tell us, how was this cartel set up and how is it maintained?

      3. And everyone gets a 8% rate of return, right Chad? Oh right that’s bullshit as well….

      4. —“Given how much doctors earn, the answer is almost certainly the latter”—

        Yes, the wise government (aided by Chad) can determine the proper amount that Doctors, hell anybody, should make.

        It’s all so easy. The government sets everybody’s pay and tells business how much profit is fair and sets the selling price for all goods and services. All problems solved.

        I should have thought of it.

        1. Somebody or something should determine the “proper” amount for them to make, and a non-competitive market is clearly not the correct answer.

      5. Nice definition of a Ponzi scheme. Why is Madoff in prison?

        1. Most Ponzi schemes don’t have the mechanism whereby the people at the top of the pyramid kick the bucket regularly, making room for people farther down the pyramid to move up…

      6. And Chad, once again (as I seem to say every time you pipe up about health care):

        When you address people, try harder not to sound so damn ignorant. You just have no clue what you’re talking about. None.

      7. So how are Unions any different than the AMA Chad? The AMA limits entry, it limits demand, and rasies wages.

        BTW: If the supply of physicians INCREASE in a certain area, COST RISE. Why is this? Becasue more people have access to care, therefore expenditures increase. Canada learned this a long time ago. When costs increase, they decrease med school enrollment. Becasue the minions need direction from their benevolent Philosopher Kings……….Go fuck yourself you fucking race baiting, class envious Socialist. I have read yours posts for some time now and find you to be a petulant prick. Now be off with you, or get me some more coffee; I have patients to see……

        1. Where have I ever supported unions, AMAB?

      8. General practitioner MDs and DOs don’t make as much as you might think, and small-time independent family practitioners don’t make the kind of Beverly Hills money that seems to be associated with the medical profession. Sure, they do pretty good compared to someone who didn’t go to college or who holds a bachelor’s degree, but they’re hardly super-rich.

        Specialists can make quite a bit of money, that is true. What’s the problem with that? Becoming a competent heart surgeon is a tremendous feat, requiring years of expensive, grueling schooling and training. I’m not saying they’re in it for the money, but for the kind of personal investment required to pursue such a career, a large salary doesn’t seem unreasonable to me.

        1. At a minimum:
          (this does not include the 4 years of undergraduate college)
          General Practice Internal Medicine: 4 years of medical school + 3 years of residency = 7 years of training

          Then on the longer end,
          Pediatric Heart Surgeon: 4 years of medical school + 7 years of general surgery residency + 2 years of cardiothoracic fellowship + 1-2 years of pediatric CT fellowship = 14 years

          Doctors become understandably annoyed when liberal know-it-alls start saying that they make too much money, and also understandably turn to lobbying groups like the AMA to protect themselves from regulations.

          1. The AMA is no better than the AFL-CIO. It would be hard to say that doctors are overpaid if the AMA weren’t unnaturally limiting the potential supply of doctors through med school seats. They also limit the procedures that can be done by non-physicians to cut out the competition. How anyone could claim to be a libertarian and support a guild like the AMA is baffling to me.

            1. You’re ascribing powers to the AMA that do not exist. The AMA is a lobbying group that less than 20% of doctors are members of. They lobby congress. It’s not a union because it has no collective bargaining power and it can’t call a strike.

              Med school seats are determined by individual programs and state licensing boards. The AMA can lobby congress to limit these spots, but as the current increase in the number of these spots shows, they don’t dictate the policy.

              You need to find a new boogeyman.

              1. Not to go all Gunnels on you, but I recommend you read Capitalism and Freedom. Friedman documents how the AMA restricts med school slots to keep doctor pay high. The AMA approves med schools and their slots, so they’re able to keep them low. There are fewer med schools today than there were 100 years ago. And who do you think has significant say and control over those state boards.

                I never said that they were a union, however, they’re worse than one when it comes to restricting competition. I can start a car company and there’s fuck all the UAW can do about it. Try opening up a hospital without AMA approval.

          2. Marklok, I have pointed out many times here before that the best comparison group for doctors is PhD scientists, who also have a post-graduate training period of seven years (5 years for the PhD, 2 for the all-but-mandatory post-doc). New PhDs in the physical and biological sciences are making around $75000 nowadays. A quick look at any mortgage calculator would indicate that a young doctor would need an additional $40000 per year or so of before-tax income to cover the additional debts (science grad school is paid for, both residency and post-doc pay, but pay poorly), and about another $10000 for each year the doctors spend training for their speciality. So, roughly, your pediatric heart surgeon should be earning $185000….maybe a bit more because they probably, on average, come from the top of the medical pool. A regular internist should probably be starting around $115000.

            That’s not even close to the reality.

            http://www.cejkasearch.com/com…..survey.htm

            What could explain the difference in salary? Surely not talent (I have dragged enough pre-meds through orgo and p-chem to be absolutely certain about that!). Indeed, a good portion of doctors could have been scientists, and vice versa….surely enough to ensure fungibility and equivalent salaries on long time scales.

            The difference, of course, lies in competition: one profession is protected by a guild that limits access at multiple points. The other is in direct competition with cheap-ass labor from India and China.
            Who would have guess that that would make a difference?

            1. “What could explain the difference in salary?”

              Supply and demand.
              As for the AMA “guild” see my above post.

            2. While it’s pretty easy for a big corporation to do R&D in India or China, it’s quite a bit harder to do your heart surgery there. Sure, medical tourism is up and coming, but it’s a small portion of the market.

  9. So what if the voucher program is a “tough sell”? The question is is it a viable alternative. It is. And it is the kind of thing Libertarians should support. But rather than admit that Sudderman dismisses it as a “tough sell” like that means anything.

    1. What the FUCK!?!?!

      I totally made the same argument and you JOHN!! you just ignore it and post anyway!!

      Damn you John. Damn you to hell!

      joshua corning|8.13.10 @ 5:25PM|#

      Politically, Ryan’s proposed solution?essentially voucherizing the program?is an extremely tough sell (at best). But it’s hard to argue with his diagnosis of the problem.

      How about fiscally? Politically tough sell to a libertarian is really not a problem…99% of the policy we support is a tough sell….as a libertarian reading a libertarian publication written by a libertarian i do not think it is out of line to ask: will it work?

      1. Dude, you can’t expect people to actually read threads.

        1. Other people excluding me?

          YES!!

          Anyway back to John:

          How do we get Peter to actually address this?

          And do you think he is the new Weigel or simply being lazy?

          1. I think he is the new Weigel. One of Weigel’s favorite games was to always say something bad about Republicans, no matter how lame, even in the odd hapenstance that the Republican was right. That is what is happening here. Ryan is making a good proposal and Suderman can’t say anything bad about so he makes up the lame “tough sell” shot.

            1. 3 years from now I wonder what will be his “hug” moment.

              The good news though is, if his time line follows Weigel’s, he will not be here to cover the 2012 elections.

  10. The first thing to do with Medicare is to drastically means test and asset test it and make seniors with high incomes or significant assets pay something closer to a real market rate for their insurance.

    Vouchers shuffle the money around, but don’t change the fact that handing out a subsidy based on nothing more than age indiscriminately subsidizes everyone, including multi-millionaires.

    Why are we taxing people who make minimum wage and saddling future generations with huge debts in order to provide subsidized health insurance for multimillionaires?*

    *Insert standard libertarian disclaimer wherever you want to put it.

    1. The problem is that old people are a bad risk and no one will insure them. How does an 80 year old get health insurance on the market? And when they get sick who then pays for their treatment? Only the most super wealthy could afford that. So I really don’t see how you means test it without just totally fucking old people.

      And don’t give me the old “they are just sucking at the government tit” line. The government forfeited the right to saw that when they made every old person go on medicare by law. This prevented them from paying in big when they were young to gaurentee coverage when they were old. Also, it allowed insurance companies to sluff a huge burden onto the government.

      1. Pretty simple really. young people are going to have to pay big not only for themselves but for their grandparents as well. Similar to the Social Security proposals floated around when Bush was in office.

        I don’t know how or if Ryan’s proposal addresses this….for my ignorance I blame Peter’s crack reporting.

      2. John-

        How does an 80 year old get health insurance on the market?

        They pay for it out of their own pocket.

        And when they get sick who then pays for their treatment?

        Their inheritors.

        So I really don’t see how you means test it without just totally fucking old people.

        I am quite willing to “Fuck” old people. They’ve fucked me my entire life.

        And when they get sick who then pays for their treatment?

        You. (If you want to bitch, you can pay…)

      3. John-

        How does an 80 year old get health insurance on the market?

        They pay for it out of their own pocket- just like the rest of us.

        And when they get sick who then pays for their treatment?

        Their inheritors.

        So I really don’t see how you means test it without just totally fucking old people.

        I am quite willing to “Fuck” old people. They’ve completely fucked me my entire life. (These same old people since my birth in 1964 have voted for Medi(s)care, Medicaid, Welfare, Affirmative Action, trillion dollar defense budgets, the DOE, the EPA, HUD, and have increased the SS tax by 600%.

        Old people suck!

        And when they get sick who then pays for their treatment?

        You. (If you want to bitch about this issue, you can pay for it yourself…)

        So I really don’t see how you means test it without just totally fucking old people.

        Old people die… Absolutlely, positively, 100% of the time.

        They are “pre-fucked” before anyone ever gets to make a “decision”. Why do you need Other People’s money to merely prolong the drama?

        The government forfeited the right to saw that when they made every old person go on medicare by law.

        And the only people who reflexively obey the gov’t are merely ‘sheep’- who deserve every bit of the “shearing” they receive.

        1. Those that refuse to die get taken out in accidents beyond their control. Ted Stevens was taken out that way. Perhaps a little too late. Fuck karma.

        2. Dirty little secret about Medicare. It has no actuarial basis. The average person pays in approx $50 K in their lifeteimes. And they expect an insurance policy that costs $25 K per year from age 65 to death. What a great deal that was promised to us by LBJ. What happens to the Ponzi scheme when it runs out of money? Ask Madoff….

          1. What happens? Easy! Legislators deny that it is a Ponzi scheme and kick it down the road. When “experts” point out through simple math that the funding is unequal to the payout and the whole thing must soon crash, you accuse them of being Teabaggers and move on to the more compelling story of the Jet Blue steward who told the world to take his job and shove it! Yeehaaaaw!

        3. And when you are old and sick you will be the first one to whine for an handout.

          You are just being a troll.

      4. “The problem is that old people are a bad risk and no one will insure them. How does an 80 year old get health insurance on the market? ”

        If we severed the link between health insurance and one’s employers, than 80 year olds could keep their insurance, even after they retire. They would have the same health insurance they’ve been paying into their entire lives. Kinda like they pay into SS their entire lives now, and then reap the (decreasing) benefits now.

    2. I think “because old people consistently vote” would be the answer.

      And most old folks think they have some account with the government that covers healthcare with what they’ve payed in over the time they worked. Reality could make them electorally vindictive (and they will vote in someone who will keep up the wealth transfers).

      1. Problem is, they (and me and you) have been taxed every payday to support the system. Taxpayers have a reasonable expectation to receive services in return for their forced contributions to the system. The elderly, who have paid into the system longer than anyone, will naturally be the most tenacious in demanding that their government make good on its promises. It has taken decades for Medicare to reach the crisis stage and it will take decades to phase it out, if it isn’t already too late. But simply ending it is unrealistic and politically impossible. The only thing that could do that would be a cataclysmic economic event of such magnitude that (scary voiceover): the living would envy the dead.

        1. Ryan’s plan takes this into account. The seniors who have already paid in do get their money back, just not in the way that they currently do.

          1. A rational and ethical phaseout of Medicare (and SS for that matter) would be relatively painless if done over several decades. The only thing standing in the way of it is naked power grubbing by two branches of government. I heard on NPR this morning (so it must be true) that President Obama said that Republicans want to privatize Social Security (if only!) and that it would (somehow) raise the “deficit” by trillions! So once again (and every two years) SS and Medicare become untouchable. Those in power fear that the very mention of it will get their asses fired, and those wanting power think they can’t win if they even hint about addressing the problem. They think we voters are too stupid to comprehend and deal with the looming crisis. And can anyone blame them?

        2. When SS was created it was to push older Americans out of the job market and make way for the young workers of the G.I. generation. SS benefits didn’t keep up with inflation, and the elderly were still the poorest group in the country, until the G.I. generation reached retirement age in the 60s, and the elderly became the richest and children (Gen X-ers), became the poorest.

          From Birth to Death the G.I.s have received government bounty, in what they believe to be proportionate to their accomplishments.

          The Lost generation had been used to getting the shaft from the government, and were the most against the New Deal, and later were reliably fiscally conservative, and didn’t vote for SS benefit increases. Similarly, Gen-Xers have been bearing the brunt of taxation and garnering the least government protection. We grew up with shitty public schools and had to overcome terrible educations, in order to compete with smug Boomers for jobs. Now we are bearing the brunt of this economic downturn, with our prime earning years being those of serious economic decline (like the Lost during the Depression), and the actuarial implosion of the Entitlement Programs is set for OUR retirement. We Gen-Xers, having been used to the short end of the stick, and having a generally libertarian view of things, will give up our public benefits because we have to, and we, having seen this sacrifice coming our entire lives, will be resigned to it.

          1. That’s the spirit!

            1. I used to be an optimistic person. But I live in the DC area.

              1. Get out there while you still can.

  11. I’d love to see a guy with a 1920s haircut finally bring down the New Deal.

    1. FDR had a 20’s haircut right?

      Even if Ryan does not do it the New Deal was doomed from its inception. So no matter if he does it or if it kills itself from its own debt it will be brought down by a guy with a 20s hair cut.

      1. I appreciate the sentiment but that’s a stretch.

  12. Can somebody please explain to me how Medicare is the guv’ments fault? Stupid libertardians.

    1. It’s not. It’s a market failure. I don’t know WHY we waste time with these ‘tarditarians.

      One day they will learn that every single past government screw up is the exception, and future government successes will become the rule.

      Until then, we are resigned to having to try to explain it to them. One day they will thank us.

    2. I don’t know, it’s a guv’ment program, maybe?

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