Smart. Sharp. Funny. Fearless.
Tuesday, September 27, 2016

If even the architect of Medicare privatization can admit rising health care costs are driving our fiscal problems, maybe there is common ground for reform.

The Washington Post’s Wonkblog had a brilliant idea to ask 18 economists and policymakers to submit their “favorite” — as in most revealing — charts or graphs of 2011. Our own Mike Konczal had a good entry, but I was particularly intrigued by this entry from Rep. Paul Ryan.

“Health care costs are the primary drivers of the debt,” the chart declares, and Ryan explains that “Relentlessly rising health care costs (coupled with demographic changes) are driving the growth of these programs.”

It’s easy to see this as just a veiled argument for Ryan’s plan to end Medicare (yes, I said it; come and get me, Politifact), but we should also acknowledge that there’s a big shift here in language about the long-term deficit. A few years ago, we were told that it was an “entitlement crisis” — and demographic changes were not an afterthought, but an essential fact — that made changes to Social Security and Medicare necessary. We just couldn’t afford benefits for all those people. It was liberals like Henry Aaron of the Brookings Institution and Peter Orszag during his stint at the Congressional Budget Office who began to produce charts like Ryan’s. “There is no entitlement crisis other than health care,” Aaron insisted. “There is no practical way to deal with public health-care spending other than by general health-care financing reform.”

  • freethinker

    It might be a worthwhile pursuit for Mr. Schmitt to track the expansion of health care cost increases in relationship to government’s ‘help’ in reducing costs and the growing deficit of health care providers. Having been in the business for over 40 years, I’m pretty sure you can find a direct correlation. By the way, it seems that every program that wants more money has targeted new taxes for top (pick a number)%. I doubt that any actual increase in government revenues from such a tactic would actually fund one of them, let alone all of them. These calls for more taxes on the top (pick a number)% are a con job on poorly informed citizens.

  • Wolfboi70

    I know this is wrong, and I often times am critical of people who do what I am going to admit I do, in this single instance… When I see the name “Paul Ryan” ANYWHERE NEAR THE WORDS “Healthcare” “Social security” or “Medicare” Ive just conditioned myself to not even read what he has to say thouroughly, or even really give it ANY THOUGHT WHAT SO EVER, I know through changing views, there may be some better ideas comming from him, but the man is just so out there, so out of touch with reality that its hard to even give him more than a fleeting moments thought. He just doesnt get it, and I think the best way to teach congress and senate about healthcare, is to REVOKE AND NEVER….NEVER OFFER THEM MEDICARE UNTIL THEY ARE OLD LIKE ANY OTHER AMERICAN…AND FORCE ALL MEMBERS OF BOTH HOUSES TO GET HEALTH INSURANCE IN THE SAME MANNER AND FROM THE SAME COMPANIES THAT THE MAJORITY OF AMERICANS DEAL WITH!! No breaks, no perks, no exceptions….pre-existing…tuff crapola for you…suck it up…. I can assure you, in less than a decade we would have a form of public option available, or the whips would be cracking on the bastard insurance companies, and they would regulate the living crap outta these lawless companies…. mark my words

  • LogicObserv123

    It would appear that the private insurance “salesman” above is the only one attempting a “con” job by misinforming citizens and diverting them from consideration of historical fact and logic, this time in order to justify an entirely separate right-wing agenda called “protecting the ultra-rich from contributing back to the society that made them rich in the first place.”

    1. Stating that there “might” be a correlation between government “help” in reducing costs and the increase in both insurance costs and care delivery costs, which the last statistics I read put at 500% ABOVE the average Cost-Of-Living increase statistic, is a tad disingenuous, especially coming from someone who “has been in the business for over 40 years”. Several questions arise.

    2. Why would someone in the business not have access to statistical information that would prove, or at least point to, a direct correlation and present it as part of his argument? One very good possibility is that no such correlation exists, and that for-profit insurers, for-profit pharmaceutical companies, and for-profit hospitals and care deliverers decided to cash in maximally in the absence of any governmental controls whatsoever on their rapaciousness, and the fact that private insurers provide the money to do so by industry collusion (price-fixing) soaking both employers and policy holders. (Remember that these same insurers bought an anti-trust exemption from Congress so they cannot be prosecuted for price-fixing in an industry that is monopolistic in nature)

    In short, the number of insurance providers in any state is limited, and where else you gonna go for medical care? They have a lock on the industry and a license to steal without fear of recrimination, so why not steal? That is a prime example of American Exceptionalism at work. Every other industrialized nation in the world has dealt with with problem, Except us.. We are a nation of thieves and con men with a dumb-ass population of sheep willing to be sheared. You gotta admit, that IS exceptional-ly STUPID.

    3. Consider that for-profit medical insurers started a business based upon a screamingly obvious inherent conflict of interest. They can increase their profits by NOT providing the very coverage they are selling you, and they take every opportunity they can find to NOT provide that coverage in the case that you have the audacity to get really sick, or to grow older, or to have a “pre-existing condition increasing the odds that you are going to cut into their profits. The irony is that the only “Death Panels” that ever existed in this country are medical insurers themselves. “No life-saving procedure for that baby. I have an annual bonus to think of, and nobody’s little rug rat is going to cut into it. Besides, that’s what Bakes Sales and heart-rending public appeals are for.”

    4. The other irony is that when “Medicare” was introduced, and it placed limitations on what it would pay for various treatments and procedures, based on what was “common average prices in a given area”, our sweet, dedicated care providers went ballistic at the idea that they could not also collude in price-fixing and squeezing every last red-cent out of sick people.
    So these sweet committed healers refused to accept Medicare patients for a while. God knows it is Un-American to contemplate a Doctor having to pass up the opportunity to buy a second Lamborghini in which to make that commute to a hospital, where you can buy a $.50 Tylenol for $15.00.

    5. The other question that arises… Who CARES if raising taxes on very rich people and corporations does not “fund” any program completely? “freethinker” has doubts, so what? Who cares if raising those taxes doesn’t eliminate the deficit in ten years? The logical and mathematical truth is, every little bit helps. The historical truth is, during the Clinton administration taxes were raised, and a substantial deficit was erased completely and turned into a surplus in less than eight years, and the rich people and corporations and workers thrived in spite of it. Right wingers do NOT have historical fact on their side. They don’t even have statistical proof on their side, ever. SO they are forced to make up stuff, generally known as lying in most circles.

    6. Why anybody would believe for a moment anything that an insurance salesman would say is a complete mystery, especially one connected to an industry based on an inherent conflict of interest, and one which is a morally repugnant con game to begin with. I agree that the Affordable Care Act is an abomination, except for the 5 or 6 provisions outlawing the worst practices of medical insurers. But any piece of legislation requiring 2,500 pages of verbiage is a complete joke.

    One suspects that 2,400 of those pages were written by the health insurers themselves to protect their profitable little con game from extinction. They provided written “talking points” to all their right-wing puppets in Congress, and these lazy-ass bozos read these documents into the Congressional Record verbatim, and repeated this BS endlessly on every talk show they could get on, not even pretending that they thought about the problem themselves and arrived at their own conclusions.

    7. What SHOULD have happened is a six-page revision to the Medicare act allowing every single citizen of this country to participate in Medicare if they so chose. This would have created a really large pool of participants, spreading risk appropriately across a huge segment of society, and creating a huge very stable fund to pay for medical costs, while at the same time providing the muscle of numbers to actually drive ALL care costs down, something the Medical Insurance Con Game does not care to do nor is it capable of doing it. If it did or if it could, it would have happened already over the last 30 years, instead of rising 5 times faster than virtually every other endeavor. If 95% of patients are Medicare patients with a cap on charges for various services, are all the doctors gonna quit? I don’t think so. They haven’t all quit in other nations. They just stopped gouging the populace, preventative care became available, drug costs capped and better outcomes resulted.

    The insurance industry fought tooth and nail against this, bribing Congress and spending over $1,000,000 PER DAY on lobbyists and God only knows how much more on websites to dispense whopping gigantic lies to the populace. It worked, and we are still stuck with rising costs, higher costs and poorer healthcare outcomes than nations just slightly more intelligent than us, and we STILL have 50 million of our citizens unable to afford health insurance premiums that now equal or exceed a reasonable mortgage payment. For those of you who didn’t just fall off the turnip truck yesterday, that was not always the case.

  • kurt.lorentzen

    There are lost of good points here. Yes, the insurance agency, suppliers of medical equipment (GE – who pays no taxes!), and other profiteers who grow rich on the backs of the infirm are a big part of the problem. But human nature says people will take whatever they’re given – hence the growth of the “entitlement culture” over time since the beginning of entitlement programs – there’s just no disputing that this has occurred. The idea that healthcare costs are the major reason behind the “entitlement crisis” (spending crisis) is not a question of ideology, it’s very simple math. And since government has gotten into the business of paying any amount on a medical bill (ok, that’s not true – but they pay waaayyyy more than any of us 99 percenters could if we were paying out of pocket), medical costs have risen at a rate at least 5 times the rate of inflation. If we immediately csncelled medicare, closed all the HMOs and made health insurance illegal, you’d be able to visit your family doctor for $25 a visit next week. I’m not saying that’s the answer – the point is healthcare costs (medical, dental, optical) are severly out of proportion with EVERYTHING else. That’s a sham perpetuated by campaign contributions from big pharma and big insurance – we’ve been sold down the river by our “public servants”.

  • snarky

    Unfortunately, if the US continues to support “for profit” health insurance providers for billing services, the ability to control health care costs will be impossible.

    Also, in a big way, Supply Side Economics is the fuel that feeds this frenzied engine of profit. In my opinion, every one of America’s economic woes are rooted in SSE.

  • valszy

    Health Care costs in the U.S. will never be close to being controlled as long as HUGE profits are able to be made by insurance & pharmaceutical companies, doctors and hospitals who invest in expensive equipment then order slews of tests in order to make as much profit as possible. Treatments, tests etc need to be evaluated as to both medical and cost effectiveness. As long as huge profits are in the mix this will never happen.