I like Obama better than I have any President in recent memory. He is doing (IMO) a pretty good job at the running the country in very trying times and in cleaning out the Bush stables.
The one point where I would diverge is in the current budget debate. Something HAS to be done about entitlements or we’re going to go bust. I’m not a big fan of the Republicans insistence on maintaining the Bush era tax cuts for the wealthy, but unless there is a serious effort to reform entitlements we’re doomed. The Democrats really don’t seem to want to engage on this topic seriously which disappoints me.
Sure there has to be a serious attempt to tackle entitlements but you aren’t seeing serious proposals from the Republicans. For one thing you can’t separate entitlement reform from tax policy completely. If you are willing to raise taxes, you won’t have to cut entitlements quite that much which makes it easier to do. Furthermore proposals like Ryan’s actually want to cut taxes even more which is absolutely crazy because it means the budget can only be balanced by truly savage and completely unrealistic cuts in entitlements. And of course a lot of Ryan’s tax cuts will benefit the rich whereas the spending cuts will fall on the poor and middle-class who constitute 90% of the population.
The bottom line: if you take tax increases completely off the table, like most Republicans, you aren't serious about deficits.
Another thing: aside from taxes there are several other ways in which Republicans dogmatically oppose ways to cut the deficit.
For example the largest part of discretionary spending is defense and in general Republicans are much more resistant to cuts compared to Democrats. In the 90’s restraining defense spending was a key part of deficit reduction and Republicans fought it tooth and nail. Republicans also tend to like full-scale land wars like Iraq which usually get very costly very fast. The US has squandered a trillion dollars in the Iraq war for no advantage whatsoever and as far as I can tell most Republicans still think it was a great idea.
Secondly even when it comes to cutting entitlements Republicans oppose many solutions. For example one way to cut health spending would be for the government to negotiate harder with pharmaceutical companies to bring down drug prices; the VA has been very successful at doing this. Republicans oppose such proposals for Medicare. Another approach is represented by the IPAB which is a board set up in the recent health care reform which is explicitly tasked with reducing Medicare costs by changing the way Medicare pays for services. Again this is strongly opposed by Republicans.
To summarize, Republicans completely oppose any increase in taxes and actually want more tax cuts. They generally oppose cuts in defense spending. They oppose several proposals to cut Medicare costs. This is not a party which is serious about cutting the deficit.
Republicans are giving up on America as dead. As such, their plans are focused on getting as much meat off the bones as they can before it all rots. Further cut taxes for the most wealthy, and severely cut education and health (but not in ways which hurt the profits of their fellow vultures). The economic crash set up a sort of Prisoner’s Dilemma situation, and the country’s bones are now being urgently licked clean because someone else will do it if they don’t.
Obama hasn’t entirely given up (or at least claims not to have). If there is a way to survive, it is by both raising taxes on those who can afford it with the least harm to the economy, and at the same time cutting costs for Medicare, defense, and education, but not so far that we are sabotaging our own future (which we still intend to exist).
Abolishing Medicare with a fig-leaf voucher is “doing something about entitlements”. Obamacare gets a start on the sort of cost controls that are needed, and commonplace in UFC countries.
My understanding is that social security is in good shape, but the risks are exaggerated because lots of people want to privatize it for ideological or financial reasons (an extra $600 billion + a year would provide a lot of revenue for investment firms).
So I"m not too worried about SS, minor tweaks will keep it solvent until the 22nd century. If you raise the retirement age a year or so, raise the cap to 200k or more, raise the tax to 14% from 12.4, etc. you can keep it solvent. SS is not really in bad shape, much of that is exaggerated by people who want to give the image it is in bad shape so they can privatize it (aka a leninist strategy).
However health care inflation is the real problem. You can’t have inflation at 2-3% a year while medical costs go up 6-10% a year. The system will collapse doing that. Medical costs double every 10 years, and GDP and wages double every 25 years.
I don’t agree that the GOP has serious plans to deal with that. They have no plans to deal with medical inflation. Their plans are just to pass the costs onto seniors and the poor by cutting medicaid and turning medicare into a voucher system. The vouchers won’t be anywhere near enough to keep up with medical costs, so seniors will have to eat the losses.
The dems actually do have plans to cut medical inflation. Ex-budget director Orszag used to talk about how 1/3 of all our medical spending (about 800 billion) does nothing to improve health and may make us sicker. And the stimulus had 1.1 billion for comparitive effectiveness research to find the most cost effective medical interventions. And the health reform act had a lot of pilot programs to research ways to improve efficiency. Now Obama is making pushes for efficiency a bigger part of health reform.
So my view is the opposite. Medical inflation is the real problem with social programs and their viability, and the dems have serious efforts to deal with them, while the GOP is trying to pass the costs onto consumers which will just bankrupt tons of seniors in this country w/o addressing the underlying issue of medical inflation.
FWIW, there are some conservative, free market interventions that should help with medical inflation. Prescription drug shopping at pharmacychecker has allowed me to save a ton of money. So transparent pricing combined with competition would be a good move. But for the most part, I don’t think the GOP has any serious plans to reduce medical cost inflation. Their real goal is to dismantle the great society and new deal.
Our entire medical system is fundamentally flawed. It is money driven and has no price controls whatsoever. Medicare is prohibited from shopping for cheaper drugs because the drug corporations got to Obama early … There have been several attempts to end the gouging of Medicare for walkers, and other appliances. Congressmen stop it in its tracks in response to the corporations that profit from the overpricing.
The medical establishment owns the politicians. Someone eventually has to stand up to them ,but it wont happen.
The problem is not that our medical system is overpriced, but why it is.
Pretty much. However maybe some reforms will start on the state level and trickle up eventually. Vermont is about to pass single payer, and hopefully they will enact bulk negotiations of drugs & medical supplies.
Lets focus on Medicare since Social security can not cause debt. It is funded through payroll taxes and pays out accordingly. If it gets in financial trouble it has to cut benefits. In 30 years they will have to cut it to 80 percent. They are prohibited from causing debt. But a tweak and it will be a safety net for a long time. In these times of Republican finance ,we need a safety net badly.
Medicare is a piggy bank for healthcare companies and doctors. They help themselves to tax money showing no restraint.
No doctors do not lose money with Medicare. but they don’t make as much as they would like. They also are part of the corruption, investing in clinics and labs where they send their tests for huge profits. You do not need a MRI for a twisted ankle. But if you doctor gets a kickback or owns the clinic ,you will need one.
It all goes back to regulation, inspection and oversight. Those are the things the rich and powerful hate. Because it costs them access to your money.
I sincerely hope that the Veterans Administration health care system will be held up as a model.
I work there, I get my treatment there, and I know–from regular and frequent patient interaction–that the VA does an outstanding job of providing excellent medical care and prescription coverage. It has gone from the health care system ‘of last resort’ to the preferred provider–even among those who could easily pay for their own ‘outside’ care.
(Note: Unless there’s a service connected disability involved, a patient receiving treatment at the VA, and who also has sufficient income, does pay for their care or has a bill sent to their health insurance carrier. Everything ain’t always free.)
Geez, it only makes sense for the gubmint to use its vast purchasing power to negotiate the best deal for drug/equipment/sundry supplies.
Why is that even a matter of contention? Why do politicians these days have to be so politically polarized that they can’t see obvious solutions?
This isn’t a “Yes, we can!” thing. This is a “We already did!” thing.
I whole heartedly agree that the VA is great example of how an effective healthcare could be run but the system only works if you don’t have a large uninsured population.
IMHO I think both sides are doing what politicians do… Making a lot of noise. True change is hard, and generally unpopular. Our country didn’t get into debt overnight and we won’t get out of it until we realize that large parts of the system are broken at the most basic level, including healthcare.
So true… And the insurance companies contribute by “negotiating” rates, which doesn’t seem like such a bad thing, until you realize that they don’t actually get a discounted price. Instead, the hospitals mark up the cost of supplies and services in order to get reimbursed at the highest levels. This hurts the uninsured, who don’t realize that an IV catheter doesn’t actually cost 15.00. Most hospitals will adjust an uninsured person’s bill to match what an insurance company would pay, but people don’t know to ask. Instead they either fail to pay, or worse, they may go bankrupt in the process. This leaves the hospital footing the bill, so they raise their prices in an effort to recoup that money from the insured population. The insurance companies then turn around and charge more in premiums, creating a vicious cycle that helps no one, except maybe the insurance companies, who continue to post profits.
I think we should do away with subsidies to oil companies and some other cooperations that seem to do well anyway, cut the defense budget by bringing troops home from Afghanistan, cut out most of the perks available in Congress – everything from turning out the lights in their gym to reducing their pay to limiting group trips. Let those who live on teacher’s pensions or Social Security go through the budget with fine-toothed combs. I think we can find some spare change.
My Social Security raise for the entire YEAR was $1.20. It was a few pennies more than that last year.
Since I am almost 68, my Medicare will probably not be affected. But the Republicans act as if I shouldn’t be concerned then over any changes. Of course I’m concerned! Any compassionate person would be concerned for those who may lose Medicare and Medicaid. Most members of the GOP and Democrats think alike on this issue. If you are a young person, you may have no idea how much hospitalization and medicine costs.
Even young healthy people are one accident of health problem away from being poor the rest of their lives. We don’t care in America. Tough shit.
Nobody believes it can happen to them.
I get so sick of “entitlements” being limited to the entitlements of the poor, elderly, children… how about we get serious about the entitlements more commonly known as tax breaks for insanely profitable and wealthy corporations?
While we’re at it, how about getting serious regarding defense?
Let’s remember that the republicans had control of both houses for four years and control of both houses and the presidency for eight years. And what did they do? Put us in massive debt from two wars, an unfunded medicare drug bill, and removed regulation of the stock and banking markets which led to huge bailouts and deficits all around. Then a democratic president comes in and all of a sudden they wake up, grow a set of balls, and are shocked–shocked I tell you!–that there are deficits.
Yeah, republicans are something else. Their only strength is that they can latch on to a single falshood and repeat it to the point that it takes on the air of fact. They have no idea how to govern other than to defund the government, remove oversight, and wait for the inevitable crash to happen. Then blame the dems for it. Gotta hand it to them–their plan seems to be working.
You can interpret history in a lot of different ways. I was listening to some guy from the club for growth on the radio today and he explained away the recession of the early 90’s the economic prosperity of the Clinton years, the economic stagnation of the bush eyars, the recession we are currnetly in by blaming it all on Democrats and giving credit for all economic growth to Republicans.
As a former Republicans, the logic started to get very very strained during the Bush years and is held together by wishful thinking at this point.
This is not a bad idea. Tell seniors taht their medicare is on the line and they can choose between cutting specific programs or raising taxes or some combination of both. I bet they choose to do at least SOME revenue raising to mitigate the effects of Ryan’s proposed medicare cuts.
I never understood this tactic. As if gutting medicare will be OK with seniors as long as it doesn’t affect them, even if it is being gutted more than absolutely necessary not only yo preserve tax cuts but to implement even MORE tax cuts.
Its like they expect seniors to say “screw my kids and grandkids, I got mine”