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From the monthly archives: February 2010

We are pleased to present below all posts archived in 'February 2010'. If you still can't find what you are looking for, try using the search box.

“No” is NOT an Option for Seniors in Medicare

NOWhile “just say no” is a popular political slogan and now even a Congressional strategy for some in Washington, the effects of saying no to health care reform will be felt much sooner than later for millions of American seniors.  Starting Monday, doctors serving patients in Medicare will face a 21% pay cut because the so-called “doc fix” was just one of many reforms lost when healthcare reform was shelved.    Current law says reimbursement rates for doctors must be based on a formula tied to the economy’s health.  A “doc fix” was included in health care reform legislation to provide a longer-term solution rather than the annual rite of temporary fixes. However, no health care reform has meant no doc fix of any kind.  Now physicians have to decide, take the 21% pay cut or close their practices to Medicare patients.  CNN reports on the American Medical Association’s response to what this “just say no” approach in health care reform will mean for seniors:  
 "To our physicians, we are providing information on their Medicare participation options, including how to remove themselves from the Medicare program," said James Rohack, president of the American Medical Association.
and according to Dr. Edward Kornel, a New York neurosurgeon: 
Kornel said consumers should prepare for some difficult days ahead. "If doctors drop Medicare patients, these people will be forced to go to clinics where it's hard to get appointments, the waits are long and you get far less attention than you would otherwise get," said Kornel. "I think this situation is headed for disaster."
Democratic leaders in the Senate attached a temporary doc fix to the unemployment legislation due for a vote yesterday.  However, Republican lame-duck Senator Jim Bunning, is blocking that vote from happening.   Modern Healthcare  described it this way: 
Senate Majority Leader Harry Reid (D-Nev.) had fast-tracked legislation meant to temporarily extend a number of expiring provisions, part of which includes the so-called “doc fix,” as well as an extension to COBRA subsidies, unemployment insurance and a host of smaller Medicare items.  Most of those provisions are set to expire at the end of the month. The Democrat-backed bill would allow those provisions to carry on for at least one month at a cost of $9.2 billion. But according to several sources, Republican leaders want to see that the package is fully paid for first. An attempt late last year to pass a longer-term bill that would have effectively scrapped the sustainable growth-rate formula, or SGR, also failed to pass the Senate.
“Just Say No”, “Starve the Beast”, “Keep the government out of my Medicare”... catchy slogans with serious repercussions for America’s seniors.    Pay cuts for doctors and reduced physician access, a growing doughnut hole in Medicare Part D, escalating premiums and cost sharing and ultimately insolvency for a program burdened with the same skyrocketing health care costs seen system wide.  These are the real-world implications of this “just say no” approach and America’s seniors may pay the biggest price for inaction...and soon.

Cutting Social Security Isn't the Answer

The President signed an Executive Order creating a Commission on Fiscal Responsibility and Reform.  There will be 18 members: 6 appointed by the President-2 we already know Co-Chairs former GOP Senator Alan Simpson (Wyoming) and former Clinton chief of staff Erskine Bowles. The Leadership of both parties will also appoint 6 Senators and 6 House members - equally divided between Democrats and Republicans.  Although, the GOP wants taxes taken off the table of any discussion and are threatening to not name anyone. The National Committee has long opposed creation of a commission targeting Social Security and Medicare for cuts to balance the federal books.  Our President/CEO, Barbara Kennelly, issued this statement today:
“President Obama inherited an economic nightmare.  It’s a nightmare America’s seniors are living each and every day thanks to skyrocketing health care costs, no COLA, shrinking home values, decimated savings and a shaky economy.  Seniors and their families want fiscal sanity returned to Washington; however, we should not be considering cuts to the very programs keeping millions afloat during this recovery. Social Security is not to blame for the nation’s fiscal problems and has not contributed one dime to our nation’s bleak debt and deficit picture.  To the contrary, Social Security’s trust fund surplus has been used for years to help balance the federal books.   Our hope is that this Presidential Commission will rise above the political rhetoric, do the right thing, and ensure Social Security does not become a piggy bank to pay for the fiscal failures of the past. The future of generations of Americans depends on it.”

Target: Social Security

Commission targetThere are a number of important blog posts and articles to recommend to anyone who's rightfully concerned about ongoing efforts to reduce our debt & deficits on the back of Social Security.  First, news from Congressional Quarterly on what President Obama's Commission is beginning to look like.  White House staff  "briefed" concerned organizations yesterday but CQ learned more than we did.
"President Obama plans to name former Wyoming Republican Sen. Alan K. Simpson and former Clinton White House Chief of Staff Erskine Bowles as co-chairmen of his deficit commission, according to sources on and off Capitol Hill. The announcement could come as early as Thursday. The White House did not immediately return e-mail messages or phone calls seeking comment.A Democratic congressional aide said the White House has told congressional leaders that Bowles and Simpson have accepted the offer."
Dean Baker offers just one glimpse into Senator Simpson's history with Social Security, namely supporting privatization and COLA cuts:
"It is not good news that President Obama picked former Senator Alan Simpson as one of the co-chairs of his deficit commission. Simpson is not just your run of the mill Republican. He is an extreme foe of Social Security. The plan was to cut the size of the annual COLA to 1 percentage point less than the CPI. This may sound trivial, but it would add up over time. Someone who was retired 5 years would see their benefits cut by roughly 5 percent, 10 years by 10 percent, and 20 years by 20 percent. This is real money."
Over at Daily Kos, New Deal Democrat, offers a lengthy record of candidate Obama and President Obama's comments on Social Security.  While we don't necessarily agree with all of his conclusions, this post does offer a detailed compilation of comments that help provide some context for why we're even having this conversation now. Which is the bottom line question--Why with staggering unemployment facing us for some time to come, investment and savings income still reeling from the market collapse, home values decimated and skyrocketing health care costs eating seniors alive are we looking at cutting the very programs which are keeping millions from poverty?  Especially when, contrary to a billion dollar campaign to persuade us otherwise,  Social Security is not responsible for our debt/deficits. We highly recommend you read the Center for Economic and Policy Research's latest paper, The Budget Deficit Scare Story and the Great Recession , for some perspective on this debate and its potential impact on millions of Americans, young and old alike. **Just in:  please also check out the Center on Budget and Policy Priorities' new deficit analysis, Where Today's Large Deficits Come From.   They say:
"Some critics charge that the new policies pursued by President Obama and the 111th Congress caused the huge federal budget deficits that the nation now faces. In fact, the tax cuts enacted under President George W. Bush, the wars in Afghanistan and Iraq, and the economic downturn together explain virtually the entire deficit over the next ten years."

The Roadmap to Privatization

GOPRoadMapIt appears the GOP Budget philosophy is...if at first you don’t succeed with a failed idea try, try again (and again, and again.)   This week the ranking Republican on the House Budget Committee, Paul Ryan,  reintroduced his “Roadmap for America’s Future”.  In short, it is a budget plan which decimates Social Security and Medicare in the name of deficit reduction.  The only thing new about this strategy, is the fact that Rep. Ryan isn’t shy about acknowledging that he believes seniors should foot the bill for our current economic nightmare.   Ezra Klein described the plan this way: 
To move us to surpluses, Ryan's budget proposes reforms that are nothing short of violent. Medicare is privatized. Seniors get a voucher to buy private insurance, and the voucher's growth is far slower than the expected growth of health-care costs. Medicaid is also privatized. The employer tax exclusion is fully eliminated, replaced by a tax credit that grows more slowly than medical costs. And beyond health care, Social Security gets guaranteed, private accounts that CBO says will actually cost more than the present arrangement, further underscoring how ancillary the program is to our budget problem.
Let’s see, seniors have to find private insurers who will accept their vouchers which will by definition cover less and less of what health care actually costs.  In other words, let’s ignore any effort to reign in the skyrocketing costs of health care nationwide in favor of shifting all of those skyrocketing costs directly to seniors.  This is a roadmap for disaster.   The CBO  said this about the Ryan plan: 
Both the level of expected federal spending on Medicare and the uncertainty surrounding that spending would decline, but enrollees’ spending for health care and the uncertainty surrounding that spending would increase. Under the Roadmap, the value of the voucher would be less than expected Medicare spending per enrollee in 2021, when the voucher program would begin. In addition, Medicare’s current payment rates for providers are lower than those paid by commercial insurers, and the program’s administrative costs are lower than those for individually purchased insurance. Beneficiaries would therefore face higher premiums in the private market for a package of benefits similar to that currently provided by Medicare.   Moreover, the value of the voucher would grow significantly more slowly than CBO expects that Medicare spending per enrollee would grow under current law. Beneficiaries would therefore be likely to purchase less comprehensive health plans or plans more heavily managed than traditional Medicare, resulting in some combination of less use of health care services and less use of technologically advanced treatments than under current law. Beneficiaries would also bear the financial risk for the cost of buying insurance policies or the cost of obtaining health care services beyond what would be covered by their insurance.
As for Social Security, the GOP Roadmap leads to the same privatization dead-end for seniors, who are already reeling from Wall Street excesses and collapse which have decimated their nest-eggs.  Once again, just as we saw in President Bush’s failed privatization plan, long-term solvency isn’t the goal.  The goal is to turn Social Security over to Wall Street through the creation of Social Security private accounts.   Texas Rep. Jeb Hensarling describes it as a little “re-engineering” of the social contract. 

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That “re-engineering” would put your Social Security in the hands of the same Wall Street money managers the federal government just bailed out.  What would your Social Security look like now, if we had privatized the system two years ago? Here’s what CAP  reported back in 2008, before the worst of the economic collapse... 
As a Center for American Progress Action Fund report found, under a Bush-style privatization plan, a October 2008 retiree would have lost $26,000 in the market plunge. If the U.S. stock market had behaved like the Japanese market during the duration of that retiree’s work life, “a private account would have experienced sharp negative returns, losing $70,000 — an effective -3.3 percent net annual rate of return.” And this doesn’t take into account the full plunge of the stock market, which dipped below 7,000 in March 2009. As the Cunning Realist pointed out, failed investment banks Bear Stearns and Lehman Brothers were both “blue chips, the sort of companies that proponents of private accounts insisted any new system would be limited to.” Can you imagine the mess that would have occurred — and the leverage those companies would have held — had not only the financial system’s health, but the retirement accounts of untold seniors, been tied up in them? The Center for Economic and Policy Research found that, “as a result of the collapse of the housing bubble, the vast majority of baby boomers will be approaching retirement with little wealth outside of Social Security.” Privatization opponents would have had seniors sacrifice that safety net as well.
Destroying Social Security and Medicare, under the guise of deficit reduction, isn’t about creating sound economic policy it’s just more of the same old privatization politics, rewrapped, repackaged and rejected by the American people just two years ago.  Are our collective memories really so short?  Because the truth is...this roadmap puts America's seniors on a highway to hell.

Budget Breakdown for Seniors

Policy analysts all over town are pouring over the President’s budget searching for answers about funding levels for their issues and programs.  What’s up, what down?  The President summed up the budget challenges this morning...                            Of course, seniors want to know about Social Security and Medicare. Here is what the White House has to say in it’s Fact Sheet for Seniors:
To support our Nation’s seniors, the Budget will: Protect Social Security.  The President recognizes that Social Security is indispensable to workers, people with disabilities, seniors, and survivors and is probably the most important and most successful program that our country has ever established. Based on current forecasts, Social Security can pay full benefits until 2037.  The President is committed to making sure that Social Security is solvent and viable for the American people, now and in the future.  He is strongly opposed to privatizing Social Security and looks forward to working in a bipartisan way to preserve it for future generations. Protect  and Improve Medicare. The President recognizes that Medicare is a sacred trust with America’s seniors and supports policies that will strengthen the Medicare program and extend the life of the Medicare trust fund. The Budget includes new Medicare and Medicaid demonstration projects that evaluate reforms to provide higher quality care at lower costs, improve beneficiary education and understanding of benefits offered, and better align provider payments with costs and outcomes.  Special emphasis will be placed on demonstrations that improve care coordination for beneficiaries with chronic conditions, that better integrate Medicare and Medicaid benefits for beneficiaries enrolled in both programs, and that provide higher value for dollars spent.  Reduce Social Security Backlogs, Improve Customer Service, and Cut Waste.  The Budget proposes $12.5 billion for the Social Security Administration (SSA), an increase of $925 million, or 8 percent, above the 2010 enacted level of $11.6 billion. This amount includes resources to increase staffing in 2011 and will allow SSA to provide services faster with a focus on key service delivery areas, such as processing initial retirement and disability claims, and disability appeals. It will enable SSA to lower the initial disability claims backlog and the appeals hearing backlog. The Budget also dedicates a significant amount of funds to Social Security program integrity efforts so that the right amounts are paid to the right person at the right time. Fight Waste and Abuse in Medicare and Medicaid.  Reducing fraud, waste, and abuse is an important part of restraining spending growth and providing quality service delivery to beneficiaries.  In November 2009, the President signed an Executive Order to reduce improper payments by boosting transparency, holding agencies accountable, and creating incentives for compliance. This Budget puts forward a robust set of proposals to strengthen Medicare, Medicaid, and CHIP program integrity efforts, including proposals aimed at preventing fraud and abuse before they occur, detecting it as early as possible when it does occur, and vigorously enforcing all penalties and recourses available when fraud is identified.  It proposes $250 million in additional resources that, among other things, will help expand the Health Care Fraud Prevention & Enforcement Action Team (HEAT) initiative, a joint effort by the Departments of Health and Human Services and Justice.  As a result, the Administration will be better able to minimize inappropriate payments, close loopholes, and provide greater value for beneficiaries and taxpayers. In addition, to help those most affected by the recession, the Budget will extend emergency assistance to seniors and families with children, Unemployment Insurance benefits, COBRA tax credits, and relief to states and localities to prevent layoffs.
The emergency assistance referenced here is a one-time payment of $250 to seniors who did not receive a Social Security cost-of-living increase for the first time since its creation. This is something seniors desperately need as they continue to struggle thru this economic recession. Tribune’s Swampland blog has a concise ‘Winners and Losers’ description.  Of course, now it’s Congress’ turn to craft budget resolutions of its own.  Or as CBS  News puts it:
“Staffers all over the Capitol are pouring over each proposed cut and each spending proposal carefully to start picking which battles need to be fought.”



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