Democratic Convention 2012

What Kathleen Sebelius Gets Wrong About the Romney/Ryan Medicare Plan: Almost Everything


You might expect the administration's top health official to be able to launch an accurate attack on her opponent's health care plans. But in a short speech at last night's Democratic National Convention, Obama administration Health and Human Services Secretary Kathleen Sebelius attacked the Medicare reforms put forth by President Obama's GOP — and managed to get just about everything wrong.

Here's the key paragraph from her speech

What's missing from the Romney-Ryan plan for Medicare is Medicare. Instead of the Medicare guarantee, Republicans would give seniors a voucher that limits what is covered, costing seniors as much as $6,400 more a year. President Obama extended the program's life by eight years while improving seniors' benefits, and strengthened the Medicare guarantee. (The president agrees with you: no vouchers!) 

Let's take these lines one at a time.

"What's missing from the Romney-Ryan plan for Medicare is Medicare."

This is wrong, or, at the very least, extremely misleading. Romney's Medicare reform is frustratingly opaque on many of its specifics. But one thing he's made clear is that it would leave a traditional, government-run Medicare fee-for-service option in place. The most recent version of Ryan's plan, which was cosponsored by Democratic Senator Ron Wyden, would also leave a government-run, fee-for-service Medicare option in place. 

"Instead of the Medicare guarantee, Republicans would give seniors a voucher that limits what is covered, costing seniors as much as $6,400 more a year."

Also wrong. As The Washington Post's Sarah Kliff points out, that figure, touted by numerous Democrats last night, is based on an independent estimate of an older version of the Ryan plan that didn't retain fee-for-service Medicare as an option. It's not based on the current incarnation of the Ryan plan, and it's certainly not based on anything that the Romney campaign has proposed. (Indeed, Romney's plan is evasive enough that it would probably be difficult to make similar estimates reliably.)

"President Obama extended the program's life by eight years while improving seniors' benefits, and strengthened the Medicare guarantee."

Sebelius has made this claim several times before. But it's dubious at best. As both the Congressional Budget Office and Medicare's own chief actuary, Richard Foster, have explained, the only way that ObamaCare's Medicare payment reductions will extend the life of the trust fund is if the savings produced by those reductions are not used to pay for new insurance subsidies. To say otherwise would be double counting. Yet the administration claims that the law both funds new insurance subsidies and improves the trust fund. As Foster has explained, that essentially amounts to a claim that the administration plans to spend dollars twice

As a side note, it's also interesting that Sebelius chose to say that the administration "extended the program's life by eight years," which suggests that the program is headed for death by 2024, when the Trust Fund is currently projected to expire. If the life of Medicare is truly set to end in 2024, shouldn't that be a pretty big deal? Regardless, a program with that short a lease on life doesn't sound like it provides much of a "guarantee." 

"The president agrees with you: no vouchers!"

Conveniently, so does the Romney-Ryan campaign.

Neither Ryan-Wyden nor the Romney campaign would overhaul Medicare via a voucher system, which would give seniors a fixed voucher to offset health insurance costs. Instead, both the Ryan-Wyden plan and the Romney campaign are proposing premium support systems that use competitive bidding to help set payment levels equal to the second least-expensive plan that above a government-defined floor for coverage. Those payments are made directly to insurers who operate through regulated exchanges — much like both ObamaCare and RomneyCare. There are similarities between vouchers and premium support systems, in other words, but crucial differences as well.  

But maybe it's not so surprising that Sebelius would mix up vouchers and premium support. She's been confused about the difference before. Asked to explain the difference between the two in a congressional hearing last year, she declined to go into much detail, saying she's "not as familiar" with premium support systems. Apparently not. 

NEXT: Actresses to Speak at DNC

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  1. Jeez, guys. Did the Meth Fairy drop by the reason offices? I’m not even pretending to work and I can’t keep up today.

    1. And the HitandRunPublicans still think they’re being unfair and not criticizing the Democrats enough.

    2. They all got into Cavanaugh’s Adderall prescription and then pounded some dextromethorphan. He was told to lock it up, but I guess he didn’t heed the warning.

      1. Ain’t no party like a robo party!

      2. I need to go get one of those. I am told Adderall is a wonder drug.

        1. What? All drugs bad! Oh wait, a pharmacy that both teams are in bed with is making big money off of it. Never mind, it’s great then.

          1. I no puritan. Drugs are generally quite good. I just sorry so many degenerates use them and give them a bad name.

            1. I’m more sorry that our barbaric government throws people in jail for smoking a plant.

              1. They are only able to do that because people have this idea that drugs are always bad even if they are not abused.

                1. The right attitude is, ok sometimes drugs are bad, so does that make it the governments business what someone puts into their own body? To which the answer is ‘HELL NO!’

        2. It’s just an amphetamine. Now, Ritalin…that’s supposed to feel just like cocaine. But I’ve also heard reports that that’s not true.

          I guess I’d better try it and find out.

          1. I heard it was some kind of wonder concentration drug. Hell, I am hyper enough. I really don’t know that speed would do me much good besides put me in a better mood.

          2. Ritalin did not feel like cocaine to me. It worked okay. Adderall was something that I could sit down with 6 hours of homework and not move from my seat until it was finished. It sucked (sucked!) to use on slow work days. Also, not very euphoric. I guess I’m just not the type to develop a meth habit. I found out that despite what I tell myself, I’m about as productive as I want to be.

            1. I’ve heard some reports that cocaine addicts can’t tell the difference between Ritalin and good coke, and then I hear stories like yours. It’s probably different person to person, which is why I need to try it.

              Adderall, in my experience, is utterly non-euphoric and therefore of little to no interest to me. Like you, my productivity comes from whether I decide to actually do some work. If I do, it gets done, no matter how tired I am.

              1. “Ask Her For Adderall”

                If she happens to suggest
                A love based on trust and respect,
                Tell her I’ve been wasted since last week.

                1. By a band from MN. Possible GOP theme tune?

          3. Methylphenidate (Ritalin) is chemically similar to cocaine and works on basically same mechanisms in the brain. The biggest difference is duration.

            1. Ok, you dope fiends, the DEA is on it’s way to Reason HQ as we speak, before you H and R radicals are out on the playgrounds of our nation, sticking needles into little tykes to get them hooked on your vile substances and turn them into radicals.

              1. Shit. I was working full time and trying to keep up with kids who hadn’t spent a decade punishing their brain with liquor. As a non-traditional student in engineering school, I was simply returning my brain to what it was like when I was 19.

          4. I took Ritalin for years as as a child and Adderal as an adult. I found Adderal vastly superior; Ritalin almost did nothing.

            This is one of those things that’s going to vary quite a lot person to person, though.

            1. Did you have to go to a shrink to get it or did your doctor or PA write you the script?

              1. Depends on your doc, but your primary care physician can write that script.

                1. My doctor comments here and prescribed the spice, melange. I sleep better, but I also now have the memories of all of my ancestors.

                  1. I prefer sapho juice.

                    It is by will alone I set my mind in motion. It is by the juice of sapho that thoughts acquire speed, the lips acquire stains, the stains become a warning. It is by will alone I set my mind in motion.

                    1. You quote the movie instead of the books again, and I’ll send over an old crone with a gom jabbar.

          5. I like Ritalin better than adderall/amphetamines. I’ve never been a big fan of speed and I am fairly ambivalent about cocaine, but I think that Ritalin combines the best aspects of both. Both Ritalin and Adderall do work quite well for what they are supposed to do, whether or not you have ADHD. My wife just got a prescription for Adderall and it really helps when I occasionally need a little help staying on task and getting things done.

  2. What Kathleen Sebelius Gets Wrong About the Romney/Ryan Medicare Plan: Almost Everything

    She also seems pretty shaky on the proper use of moisturizer as well.

    1. At least the Simpsons can now solve the mystery of the monkey paw.

      1. “Have you ever gotten a squeezer from a mummy? Well, get ready…”

      2. Oh, foul accursed thing! What demon from the depths of Hell created thee?

        1. The King of Hell, Barakus Obaminus.

    2. *gasp* How insensitive of you, SF. You know she’s molting!

      1. I hope she picks this as her new shell.

  3. Jesus Christ, all this convention shit is boring. Here, Alison Brie instead.

    1. Odd out of context. What’s that from?

      1. Not a political convention, I’ll tell you that much.

        1. Are you sure? It has an LP look to me, somehow.

          1. Dear Zod. I didn’t think I could desire her any more than I already do.

      2. Does it matter?

        1. I’m voting for Alison Brie. please sent my absentee ballot to my bunk.

        2. Here, Alison represents the American voter, going back and forth between the two political parties, having trouble distinguishing one from another.

          1. That’s not what I see, ProL.

            1. I’m open to alternative explanations.

              1. Is “pig on a spit” too crass?

  4. Merits aside. Who out there is dumb enough to believe that any plan cosponsored by Ron Wyden is some kind of nihilist Libertarian apocalypse?

    1. According to my facebook feed, most of the smartest kids (STEM-wise) from my high school.

      It’s fucking depressing.

      1. Is it just me or is Wyden a non retarded Democrat? I always look for reasons to hate the guy. But it seems like any time a Democrat is doing something sensible, said Democrat is Wyden.

        1. It’s probably by comparison.

          1. Yes. He’s more of a turd if you’re familiar with him.

            Here’s Bill Keller fellating Wyden in his (Wyden’s) hometown paper:

        2. non retarded Democrat


      2. Just remind those kiddies, that when they turn 26 and move out of moms basement, they need to suck it up and start paying for this old coots health care, bwahhahhaaaa

  5. Sibelius never referred to the “Ryan/Wyden” plan. She named another one. Why does Suderman assume she is discussing that one?

    And if the option for old Medicare is there why bother at all? Any D or R knows the government will pay more benefits than a private insurer will.

  6. I think this has been asked before… but is it just me or is the left chock full of wretched old hags?

    1. What you don’t find Sabilius, Elizabeth Warren and Janet Napalitano attractive? Sexist!!

      1. When I see Napolibutchy, what immediately comes to mind is:

        “That’s not a woman, that’s a man baby!”

        1. You should see her in person. That feeling is even stronger.

          1. I never want that to happen. Hearing her voice on the DC metro is as close as I ever want to come to seeing that nasty hag.

            1. I have been at the very back of a few meetings with her and heard her speak. She is just incredibly unimpressive. Usually politicians are not very bright but have a charisma about them. She has no charisma. Chertoff was not charismatic but you always had the feeling he was Vulcan level smart. She isn’t that either. Mediocrity is really the word that sums her up. I have no idea how she got to where she is. It wasn’t looks, intelligence or charisma that is for sure.

    2. Seriously, it is kind of a cast from a Sugar Free produced porn film.

  7. “Those payments are made directly to insurers who operate through regulated exchanges ? much like both ObamaCare and RomneyCare.”

    Why does Mitt Romney’s web site say this:

    “Medicare is reformed as a premium support system, meaning that existing spending is repackaged as a fixed-amount benefit to each senior that he or she can use to purchase an insurance plan”

    So…which is wrong, the candidates web site or Peter Suderman?

    1. I think they are both right. The fixed amount benefit is the form of a voucher, which means the money is paid to the insurance companies.

      1. “How will seniors be affected by the costs of different options?
        Future seniors will be able to enjoy the savings from selecting less expensive plans, or choose to pay more for costlier options. When the insurance premium costs less than the support provided, the balance will be available in an HSA-like account to pay for other out-of-pocket health expenses.”

        Insurance companies are going to manage these HSA-like accounts? Don’t see the words exchange or insurance companies in the published plan.

        1. Then maybe Sudderman is wrong.

    2. “If seniors choose more expensive plans, they will have to pay the difference between the support amount and the premium price; if they choose less expensive plans, they can use any leftover support to pay other medical expenses like co-pays and deductibles”

      This doesn’t look like payments to insurance companies to me

  8. Jesus Christ, what the hell is wrong with people?

    A South Florida woman who is accused of injecting people with Fix-a-Flat and other substances in a black market buttock-enhancing business was released on bond Friday.…..-jail?lite

    1. I guess the fix-a-flat folks will be changing their advertising soon:


    2. Squats are hard man. Take the easy way out.

  9. Yo, fuck medicare in to a fucking abyss. Fucking fucking fuck.

  10. Michelle Obama asks donors to skip pizza night to give to Obama.…..aying.html

    1. Ye gods. Please, those of you who have budgets that are limited to the point that you have to skip eating out in order to donate, give us your fucking money before we kill you.

    2. I’m having a little trouble processing the incredibly presumptuously arrogant yet strangely, deeply pathetic begging that the Obama campaign is engaging in. I’ve just never seen anything like it, and it creeps me the fuck out.

  11. Of all the creepy apparatchiks in this present gang running the protection racket, I always considered sebelius the most unpleasantly fascistic.

  12. Alright Suderman, don’t worry about insulting us by dummying it down. What would you say are the most important differences between a premium support system and a voucher system? Also, outside the context of insurance, what would you call a system that provides non-voucher support for purchases?

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