From the category archives: Medicare
If you had any doubt about just how stark the differences are between the Republican and Democratic approach to fixing our economy, these dueling letters between Treasury Secretary Jack Lew and GOP Senator Orrin Hatch should clear that up for you quickly. At issue is the idea of “economic patriotism.”
First, some background...
There’s currently a loophole in our tax code that allows American companies to dodge paying taxes by renouncing their corporate citizenship, leaving operations here but claiming an overseas address. This legal tax dodge costs our nation billions of dollars each year.
“The practice has become known as “inversion.” But what it really amounts to is desertion. And it could cost Americans tens of billions of dollars. There are 47 firms in the last decade that have exploited this loophole, according to new data compiled by the nonpartisan Congressional Research Service. But it’s a hot topic again because at least a dozen U.S. firms are currently considering taking advantage of it.”...Center for American Progress
The President’s 2015 budget would make it harder for firms to reap the benefits of being an American company while simultaneously dodging their tax obligations by requiring a minimum 50% foreign ownership to avoid U.S. taxes (it’s currently only 20%). This week, Lew sent a letter to Congress urging quick action (okay, try not to laugh...) to pass inversion legislation.
“Congress should enact legislation immediately...to shut down this abuse of our tax system. What we need as a nation is a new sense of economic patriotism, where we all rise and fall together. We know that the American economy grows best when the middle class participates fully and when the economy grows from the middle out. We should not be providing support for corporations that seek to shift their profits overseas to avoid paying their fair share of taxes.”
Sounds reasonable, right? Not according to the ranking GOP member of the Senate Finance Committee who penned a testy letter in reply. Not only does Senator Hatch reject the legislative fix offered by Senate Democrats to recoup the billions lost to corporate scofflaws he also redefines the idea of “economic patriotism” by shifting the target from known corporate tax dodgers to American families who depend on Social Security, Medicare, Medicaid and the Children’s Health Insurance Program:
“I must disagree with the administration's position that we should, in the short term, enact punitive, retroactive policies designed to force companies to remain domiciled in the United States.”
“My hope is that your definition of "economic patriotism" is not so narrow as to only include a particular business practice ... I hope that you share my view that "economic patriotism" includes a desire to fix the problems that are truly ailing our country and threatening the livelihoods of future generations. Non-partisan watchdogs and rating agencies have been issuing warnings about our ballooning national debt and runaway entitlements for years now. These issues represent the greatest threat to our fiscal and economic security...”
Welcome to Washington, where you’re an “economic patriot” if you turn a blind eye to corporate tax dodgers who owe this nation billions of dollars and instead take it from middle-class benefits paid for by average Americans , the truest patriots of all, who worked a lifetime building the economy that fuels those corporate profits to begin with.
USA Today has a must-read editorial supporting our position that Medicare should be allowed to negotiate with drug-makers for lower prescription drugs, just as the Veterans Affairs department currently does.
“Part D already costs about $80 billion a year and is on track to double by 2022 as benefits improve and Baby Boomers retire. For two reasons, a significant chunk of that money is wasted on overpayments to drug companies: When Part D began, millions of patients were shifted over from Medicaid, the state-federal program for low-income people that gets far lower drug prices than Medicare. Suddenly, the cost of providing drugs to the same people shot up. Congress barred Medicare from negotiating the way Medicaid and the Department of Veterans Affairs do with drug makers to get lower prices. Instead, lawmakers insisted the job be done by private insurance companies.”
The fact that Medicare is forbidden in the law that created Medicare Part D to negotiate lower prices is no accident. The drug lobby worked hard to ensure Medicare wouldn’t be allowed to cut into the profits which would flow to big Pharma thanks to millions of new customers delivered to them by Part D. Even some Republican House members (this was a GOP sponsored bill), including Rep. Walter Jones from North Carolina and Rep. Dan Burton from Indiana, were aghast at the whole process:
"The pharmaceutical lobbyists wrote the bill," says Jones. "The bill was over 1,000 pages. And it got to the members of the House that morning, and we voted for it at about 3 a.m. in the morning," remembers Jones.
Why did the vote finally take place at 3 a.m.?
"Well, I think a lot of the shenanigans that were going on that night, they didn't want on national television in primetime," according to Burton.
Unfortunately not much has changed since 2003. Roll Call has this wrap-up of what drug companies spent during the last quarter alone on lobbying Congress:
Five pharmaceutical companies have reported million-dollar increases in their spending on lobbying the federal government during the first quarter of 2014. Pfizer Inc., Novartis, Johnson & Johnson Services, Bayer Corporation, and Merck & Company have each boosted their lobbying of the executive and legislative branches.
Here are the top pharmaceutical spenders in the first quarter of 2014:
Pharmaceutical Research & Manufacturers (PhRMA) $4,680,000 – up from $4,050,000 in 2013 Q4.
Pfizer Inc. $3,190,000 – up from $2,090,000.
Novartis $2,580,000 – up from $920,000.
Amgen USA Inc. $2,560,000 – up from $2,330,000.
Eli Lilly & Co. $2,086,000 – down from $2,430,000.
Johnson & Johnson Services $2,110,000 – up from $860,000.
Bayer – $2,040,000, up from $1,000,000.
Merck & Co. $2,000,000 – up from $820,000
These are the same companies which claim any attempts to rein in their overpayments in Medicare will kill their research and development of new drugs:
“The drug companies say they must impose higher prices in the U.S. to pay for research that enables them to innovate and develop new drugs that save our lives. But that’s not true. Half of the scientifically innovative drugs approved in the U.S. from 1998 to 2007 resulted from research at universities and biotech firms, not big drug companies, research shows. And despite their rhetoric, drug companies spend 19 times more on marketing than on research and development.” Healthcare for America Now
Meanwhile, in their opposing USA Today editorial big Pharma also argues that people like Part D so it shouldn’t be changed and, by the way, prescription drugs help people stay healthy.
“Surveys show 90% or more of Part D enrollees are satisfied with their coverage and say it works well. The use of medicines under Part D also helps to reduce spending on other health care services in Medicare, a fact that was recently acknowledged by CBO.”
Of course, access to prescription drugs helps people stay healthy but what does that have to do with whether or not Medicare should be forced to overpay for those drugs? Naturally, seniors like Part D. Why wouldn’t they when before its passage they had absolutely no drug coverage? That doesn’t mean Americans support paying more than they, or the government, should in order to pad drug makers’ pockets.
For the second year in a row, America’s massive health insurance industry lobby launched a Washington lobbying and advertising blitz hoping to scare seniors into believing they’ll lose their Medicare and politicians will lose their seats if the industry’s government overpayments aren’t protected. Mission accomplished. Rather than trimming rates, the Obama administration raised them:
“Private Medicare plans would see a 0.4 percent boost in their payment rates for 2015 under a final rate announcement made by Centers for Medicare and Medicaid Services officials Monday.
Officials with Medicare said the better-than-expected news for insurers came about in part as a result of healthier enrollees signed up for both Medicare Advantage and traditional fee-for-service plans, which means less of a cost burden on the health insurance system for the aged.” Congressional Quarterly
When CMS says “in part” what they aren’t mentioning is the part where the administration basically caved (for the second year in a row) to the insurance industry’s million dollar lobbying blitz to keep its billions of dollars of federal overpayments intact.
“Today’s announcement by CMS to, once again, preserve government overpayments to private insurers in Medicare Advantage is bad policy and bad economics for the Medicare program. These subsidies were supposed to be gradually trimmed in order to expand benefits and improve the quality of care for all seniors in Medicare. However, each year the insurance lobby threatens to cancel coverage or charge more to seniors in MA plans rather than accept a reduction in their overpayments or reimbursement rates.
For many years, private insurance companies have claimed they can provide better coverage to seniors at a lower cost. The reality proves otherwise. Since 2003, all seniors in Medicare (including those not even enrolled in Medicare Advantage) have paid higher premiums to help fund the billions in government overpayments to private Medicare Advantage insurance companies. Over the years, as much as 14% more per beneficiary has been paid to MA plans than is paid to cover individuals enrolled in traditional Medicare. It’s a wasteful federal boondoggle that was rightfully corrected by passage of the Affordable Care Act (ACA) in 2010. Additionally, thanks to the ACA, growth in health care costs have been decreasing which means that reimbursement rates also go down. As reimbursement rates have decreased, MA plan enrollment has increased.
Let’s be clear, contrary to the health insurance industry’s massive lobbying campaign claims, Medicare doesn’t make the decision about cuts to seniors’ MA coverage, including increasing premiums or reducing access to doctors. That decision rests squarely in the board rooms of the nation’s private insurance industry, which is unwilling to give up a penny of their government giveaway in favor of continued threats of diminished coverage and higher premiums for seniors.
This annual drama with private insurers in Medicare proves, once again, that when private MA plans are unwilling to compete on a level playing field with traditional Medicare, seniors will ultimately pay the price. So much for providing better coverage for less.”...Max Richtman, NCPSSM President/CEO
Attempts to reignite the intergenerational warfare campaign against Social Security -- led by the billion dollar austerity lobby -- seem to have hit a new high. Alternet highlights just a few of the recent instances:
A string of recent examples—rants  from MSNBC’s wealthy young commentator, a notorious elderly-attacking  House candidate, think tanks promoted  on NPR—generational warfare cheerleaders are proclaiming that America is heading toward an epic and immoral conflict as better-off seniors are robbing millennials of shrinking federal dollars because retirement programs cost too much. That’s simply false, as Social Security is solvent  through 2033, and spending on all mandatory programs as a percentage of GDP is close to  where it’s been since 1975, at 21 percent.
This line of attack isn’t in a political vacuum. It comes as some Democrats are reframing  the debate on Social Security and campaigning  for increased benefits. Nor is it a new argument, as a right-wing club of libertarians, Wall Street bankers and deficit hawks have tried for decades to undermine and privatize the program.
For MSNBC’s, Abby Hunstman, this is the second time in as many weeks that she’s taken to the airwaves with a monologue chock-full of errors and political rhetoric heavy of drama and light on the facts. NCPSSM’s Equal Time, joined the Los Angeles Times and others in pointing out just a few of those errors in her first attempt to “educate” millennials:
Millennials Face Big Problems – Abby Hunstman, MSNBC
“Here’s the reality, at the rate we’re spending, the system (Social Security) will be bankrupt by the time you and I are actually eligible to get these benefits.”
“We can’t afford it.”
“While we’re living two decades longer we haven’t made any changes.”
MSNBC anchor Abby Huntsman (daughter of GOP Presidential Candidate Jon Huntsman) clearly misunderstands Social Security’s funding and twists both life expectancy data and worker ratios to the breaking point to build a false case for cutting Social Security benefits for millennials. Contrary to Huntsman’s claims, there is not a single scenario or economic projection in which Social Security goes bankrupt, most Americans aren’t living 20 years longer and there have been numerous reforms to Social Security in the past, including raising the retirement age.
If Washington does nothing at all by the time the Trust Fund is depleted in 2033, millennials and generations after them will receive a 25% benefit cut. Huntsman urges raising the retirement age to 70-75 on top of that which means an even larger benefit cut for our children and grandchildren. Unfortunately, rather than educating her fellow millennials with the facts, her “fix” for Social Security comes straight from the multi-billion dollar anti-entitlement lobby’s talking points. There are ways to fill the funding gap without hitting future generations with huge benefit cuts. Rather than gutting Social Security under the guise of “fixing it”, Congress should lift the payroll tax cap and enact other meaningful reforms to strengthen the program for future generations.
Inexplicably, rather than address her mistakes Huntsman then chose to double-down on them with a second error-laden missive. Michael Hiltzik with the Los Angeles Times tried, a second time, to help her with the “basic math” she claims to understand:
Huntsman complained that I called her out for asking how we're going to pay the rising costs of the health and social insurance programs, as though "even raising the question means you're automatically anti-Social Security or against the elderly."
No. I called her out for raising the question using bogus numbers, such as life-expectancy rates from birth, which have risen sharply since the '30s but aren't relevant to Social Security's fiscal health. Instead, the key figure is life expectancy from age 65, which hasn't risen very sharply. (Huntsman appears to accept this point.)
Huntsman offered several possible remedies for rising costs in these programs -- means-testing benefits, increasing the retirement age, raising the Medicare eligibility age to 67 from 65 -- and complained that we're not even debating these options.
That's where she really goes off the rails. We have been debating those options, for years. They've all been studied, measured, calculated and scored. The reason they haven't been implemented is that none of them is simple. None of those she listed would have an appreciable positive effect on the fiscal health of the programs, and some, such as raising the Medicare eligibility age, might make the overall federal budget picture worse.
Economist Dean Baker also gave it a try:
“The far greater risk to the living standards to the people of Huntsman's generation is the risk that we will continue to see the upward redistribution of income over the next three decades that we have seen over the last three decades. As a result of this upward redistribution of income, people like Ms. Huntsman's father have benefited enormously, while most workers have seen little or none of the gains from economic growth. If this pattern continues then most people in Ms. Huntsman's cohort will not fare well financially even if we eliminated their Social Security taxes altogether.”
So Huntsman continues to take her cues directly from the billion dollar Wall Street campaign to paint Social Security & Medicare as the biggest threat to future generations while ignoring the income inequality which will curse millennials for a lifetime.
The Kaiser Family Foundation has produced a wonderful new video, Old and Poor: America’s Forgotten. It was debuted at this week’s Senate Special Committee on Aging hearing examining the war on poverty and seniors. We consider this a must-watch, must-share video.
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