# Will the Dems successfully use the GOP's stance on Medicare against them? **URL:** \ **Category:** Great Debates\ **Created:** [April 16, 2011, 3:29pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611 "2011-04-16T15:29:45Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [May 29, 2011, 12:48am UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/81 "2011-05-29T00:48:52Z")
> [@DJ\_Motorbike](#): > > I think it would be run down for the same reason government housing projects tend to be run-down. Just like some spend their entire lives in housing projects some would choose to spend their entire lives using government health care. Of course you’re creating an entrenched class whose very existence relies on someone else providing everything. You’re creating poverty. > > Currently nobody is denied at least minimal care. Nobody gets turned away. There is Medicade, other state run programs, charity care or you could do the unthinkable and pay your medical expenses out of your own pocket. Hospitals and clinics are willing to work out payment plans if all else fails. There was a time where I needed medical care and didn’t have insurance. Guess what. I didn’t demand that someone else pay for it. I paid the bill out of my own pocket. Weird - I know. > > Personally, I like Ryan’s plan & if I were given the responsibility of choosing that’s the one I would pick. It’s not going to happen, but neither will single-payer. What an alternate universe you inhabit. Over 60 percent of bankruptcies are caused by health bills. Of those over 80 percent, had insurance. Serious illnesses can destroy your financial health. ---
**Author:** ![Implicit](https://avatars.discourse-cdn.com/v4/letter/i/6a8cbe/32.png) [@Implicit](https://boards.straightdope.com/u/Implicit)\ **Post date:** [May 29, 2011, 1:02am UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/82 "2011-05-29T01:02:01Z")
> [@gonzomax](#): > > What an alternate universe you inhabit. Over 60 percent of bankruptcies are caused by health bills. Of those over 80 percent, had insurance. Serious illnesses can destroy your financial health. A universe where there are no other countries obviously. Since single payer, or even a hybrid system with private insurance, works fine in most other countries in the world. > [@DJ\_Motorbike](#): > > Personally, I like Ryan’s plan… That explains a lot. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [May 29, 2011, 1:13am UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/83 "2011-05-29T01:13:54Z")
> [@DJ\_Motorbike](#): > > I don’t see why insurance companies would necessarily have anything to do with a premium privatized market. If you have the money all you have to do is go to a doctor and say, “Hey, I’ll pay you more than what the government is offering if you treat me.” Once that is established all of the best doctors will wind up working for the upper classes. Whoever is left over will wind up working in the run-down public system. So you’d rather not have the public system at all? How is this logical? The poor will still be poor without government subsidy. At least with payroll tax, the well-off have to contribute something to the public good. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [May 29, 2011, 1:18am UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/84 "2011-05-29T01:18:08Z")
> [@DJ\_Motorbike](#): > > I think it would be run down for the same reason government housing projects tend to be run-down. Just like some spend their entire lives in housing projects some would choose to spend their entire lives using government health care. Of course you’re creating an entrenched class whose very existence relies on someone else providing everything. You’re creating poverty. Oh, now I see your confusion. You think, “an entrenched class whose very existence relies on someone else providing everything,” is by definition poor. But in fact that’s what an aristocracy is. > **[Urban Dictionary: trust fund baby](https://www.urbandictionary.com/define.php?term=trust%20fund%20baby)** > > trust fund baby: A \[young person\] whose parents are wealthy and have set up a trust for their son or daughter. The \[trust fund\] ensures that \[the child\] will... The financiers skim off half of every dollar of American productivity for the bankers, the pensioners, and the plutocrats. I suggest they at least chip in for a public health system. ---
**Author:** ![DJ\_Motorbike](https://avatars.discourse-cdn.com/v4/letter/d/90ced4/32.png) [@DJ\_Motorbike](https://boards.straightdope.com/u/DJ_Motorbike)\ **Post date:** [May 29, 2011, 3:09am UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/85 "2011-05-29T03:09:23Z")
> [@foolsguinea](#): > > Oh, now I see your confusion. You think, “an entrenched class whose very existence relies on someone else providing everything,” is by definition poor. But in fact that’s what an aristocracy is. > > [Urban Dictionary: trust fund baby](http://www.urbandictionary.com/define.php?term=trust%20fund%20baby) > > The financiers skim off half of every dollar of American productivity for the bankers, the pensioners, and the plutocrats. I suggest they at least chip in for a public health system. If by that cite you mean to infer that I’m from a well-to-do background you couldn’t be more wrong. An Aristocracy is a form of government. [QUOTE=gonzomax] What an alternate universe you inhabit. Over 60 percent of bankruptcies are caused by health bills. Of those over 80 percent, had insurance. Serious illnesses can destroy your financial health. [/QUOTE] From [here](http://articles.cnn.com/2009-06-05/health/bankruptcy.medical.bills_1_medical-bills-bankruptcies-health-insurance?_s=PM:HEALTH): > [@](#): > > However, Peter Cunningham, Ph.D., a senior fellow at the Center for Studying Health System Change, a nonpartisan policy research organization in Washington, D.C., isn’t completely convinced. He says it’s often hard to tell in which cases medical bills add to the bleak financial picture without being directly responsible for the bankruptcies. > > “I’m not sure that it is correct to say that medical problems were the direct cause of all of these bankruptcies,” he says. “In most of these cases, it’s going to be medical expenses and other things, other debt that is accumulating.” It’s conveniently buried on the second page of that article. ---
**Author:** ![DJ\_Motorbike](https://avatars.discourse-cdn.com/v4/letter/d/90ced4/32.png) [@DJ\_Motorbike](https://boards.straightdope.com/u/DJ_Motorbike)\ **Post date:** [May 29, 2011, 3:14am UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/86 "2011-05-29T03:14:38Z")
> [@Implicit](#): > > That explains a lot. What does it explain? ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [May 29, 2011, 6:09am UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/87 "2011-05-29T06:09:04Z")
> [@DJ\_Motorbike](#): > > What does it explain? [Whistleblower tells of America's hidden nightmare for its sick poor | US news | The Guardian](http://www.guardian.co.uk/world/2009/jul/26/us-healthcare-obama-barack-change) Here is a story about a health care exec, who suddenly had to face the results of what his companies have done to health care for the poor. ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [May 29, 2011, 6:16am UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/88 "2011-05-29T06:16:31Z")
> [@DJ\_Motorbike](#): > > If by that cite you mean to infer that I’m from a well-to-do background you couldn’t be more wrong. An Aristocracy is a form of government. > > From [here](http://articles.cnn.com/2009-06-05/health/bankruptcy.medical.bills_1_medical-bills-bankruptcies-health-insurance?_s=PM:HEALTH): > > It’s conveniently buried on the second page of that article. If that serves as a rebuttal to you, reread it. It is vague and does not deny it. It merely says in his opinion it is difficult to determine if other financial problems added to the problem. No argument. The claim is about the poor and those who had to declare bankruptcy. He probably did a study for a right wing think tank or was financed by the health industry. ---
**Author:** ![The\_Second\_Stone](https://avatars.discourse-cdn.com/v4/letter/t/bbe5ce/32.png) [@The\_Second\_Stone](https://boards.straightdope.com/u/The_Second_Stone)\ **Post date:** [May 29, 2011, 7:13am UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/89 "2011-05-29T07:13:25Z")
I think that the Republicans went to the hardware store, bought some rope, plank and nails, built themselves what they thought was a platform, but which the voting public (that is, “old people” by a very high percentage margin) are going to decide is a gallows and vote them out of office en masse and then use the rope to hang the creeps. Between this and the insistence on not raising the debt ceiling the Republicans have, in my idiotic opinion, conceded the 2012 race on the Presidential level in its entirety, and are putting their possible gains in the House and Senate in serious jeopardy. But what do I know about the future. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 29, 2011, 1:57pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/90 "2011-05-29T13:57:07Z")
> [@Evil\_Captor](#): > > Under the circumstances, yes, because nobody trusts Republicans and conservatives on these issues any more. Medicare and Social Security are both tremendously successful programs, and nobody believes that anyone who tries to tinker with them really wants to improve them, even though they clearly could use some tinkering with in some areas. It’s just a conservative/libertarian agenda to get rid of both programs. > > On edit, take what China Guy said and transfer it to “The American voting public.” It’s what we all think. If this was intended to answer my question, does this also mean that nobody will trust the Democrats and the moderates on these issues any more either? You really cannot say that Medicare is tremendously successful when it is on track to insolvency. **Simplico** , your explanation of what was actually accomplished in the Healthcare Reform Act is useful, thank you. Yes, a very good stat and one that cost much politically to accomplish. Experimenting with limited versions of various ideas is not all that hard to do. Setting up the board that would be outside of partisanship is nice in theory. The problem of course will come when that independent board actually gets down to trying to implement anything. And unfortunately mandating a limit on the growth of the program really doesn’t do anything, any more than mandating the river to not flood. She gonna flood mandate or not; the issue is which levees you blow and which towns get hurt the most. The cohort over 65 will get bigger and bigger, their care per person per year will get more expensive, and the funds coming in are not on track to cover it. I completely agree that the Healthcare Reform Act approach of trying to figure out what can actually inflect the cost of healthcare curve down is a vital part of any approach, but it won’t be enough. Again, the need to do something more does not excuse doing something as stupid as the Ryan Plan, but we can’t just kick the can down the road forever, so afraid of the third rail that we never try to cross the tracks. ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [May 29, 2011, 4:47pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/91 "2011-05-29T16:47:12Z")
> [@foolsguinea](#): > > At least with payroll tax, the well-off have to contribute something to the public good. Conservatives do not believe in making the country strong. That would be Socialism. They believe in looking out for Numero Uno. The country can collapse, as long as they’re not taxed. ---
**Author:** ![Simplicio](https://avatars.discourse-cdn.com/v4/letter/s/c37758/32.png) [@Simplicio](https://boards.straightdope.com/u/Simplicio)\ **Post date:** [May 29, 2011, 5:45pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/92 "2011-05-29T17:45:52Z")
> [@DSeid](#): > > You really cannot say that Medicare is tremendously successful when it is on track to insolvency. Well, its on the track to insolvency because of growing healthcare costs, but thats not really the fault of Medicare. Healthcare costs of Medicare patients is actually growing considerably slower then those of the general population. Measured the same way, your health insurance is undoubtedly on track to insolvency as well, regardless of where you get it from (assuming you live in the States). Which I think is the other thing that gets lost in these debates. Medicare’s problem isn’t really a Medicare problem. Health costs are growing too fast, such that a growing number of even the middle class can’t afford coverage, and it isn’t showing any signs of slowing down. If the US gov’t simply gave up on helping people pay for their healthcare, the problem would be moved off the gov’t books, but it would still be huge, as increasingly large numbers of people wouldn’t be able to afford care, and those that do will see ever greater shares of their income absorbed by insurance costs. > [@](#): > > I completely agree that the Healthcare Reform Act approach of trying to figure out what can actually inflect the cost of healthcare curve down is a vital part of any approach, but it won’t be enough. If the cost of health care curve is bent down, then the other changes needed to ensure solvency will be relatively easy and minor. If the curve isn’t bent down, then other changes will be meaningless. > [@](#): > > Again, the need to do something more does not excuse doing something as stupid as the Ryan Plan, but we can’t just kick the can down the road forever, so afraid of the third rail that we never try to cross the tracks. But there is no law you can pass that solves the problem this year even if you were dictator of the US, other then just getting rid of Medicare (which is basically what the Ryan plan does). And again, that still doesn’t really solve the root problem of medicine becoming too expensive, it just washes the gov’ts hands of that problem. Solving Medicare’s problems is going to be a long process thats going to play out over the next two decades, and its going to happen under the framework that was created by the ACA. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [May 29, 2011, 5:48pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/93 "2011-05-29T17:48:18Z")
> [@DJ\_Motorbike](#): > > I don’t see why insurance companies would necessarily have anything to do with a premium privatized market. If you have the money all you have to do is go to a doctor and say, “Hey, I’ll pay you more than what the government is offering if you treat me.” Once that is established all of the best doctors will wind up working for the upper classes. Whoever is left over will wind up working in the run-down public system. > > There’s no “if” this will happen. I guess you’re okay with that. I plan on working hard and making as much money as I can so that I am not stuck using a run-down government-rationed public hospital. So, to some extent I’m okay with it too, but I just think it’s somewhat immoral to actually want and work for the implementation of such a system. A two tiered system exists in various OECD nations, and I don’t hear the public complaining about it. Canada, France, Germany, etc. I don’t hear rancor about disbanding the public system there. Where are the legions of French people marching in the streets demanding a health care system like the US has? Health care debates all tend to be very ironic because the arguments made against a theoretical public system exist in the current system the opponents generally promote (a private system). Death panels, rationing, gross inequality, a 2 tier system, poor quality care. The arguments all used as theoretical arguments against what could happen with public health care (and to promote private health care) but all are real life current situations in our private health care system. We already have death panels, rationing and inequality. Saying ‘a public system will cause death panels, inequality, lack of access to care and inequality’ is laughable to people who know how the current private system works. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [May 29, 2011, 6:06pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/94 "2011-05-29T18:06:49Z")
> [@DJ\_Motorbike](#): > > If there is now (and I’m not arguing there’s not) imagine how much more there will be when you’ve created a system that encourages increased demand (it’s free!) & greater scarcity. The greater demand will be there because of people who languish with illness now. In the long run it will recoup some of the money on their treatments. As for the scarcity, when the demand for doctors rises more people will get into the industry. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 29, 2011, 6:24pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/95 "2011-05-29T18:24:52Z")
> [@Simplicio](#): > > …Measured the same way, your health insurance is undoubtedly on track to insolvency as well, regardless of where you get it from (assuming you live in the States)… Except that insurance companies can and do raise premiums. Costs go up, their inefficiencies do not go down, but they take more in to make up for it. Medicare isn’t doing that. It can’t. The cost curve needs to be deflected but realistically it is not going to deflected by enough. Dictator approach? In addition to the Healthcare Reform Act measures increase the age that Medicare fully kicks in by, making it go up, say 6 months of age per 3 years going by such that by 2030 the age of qualification is 68 . Allow those younger but over 65 to buy in at market competitive rates. Consider some means testing to identify some who can pay some portion of the full premium even over the new gradually increasing entry age. Consider extending the program down in age as an optional buy-in program at market competitive rates as well. Details dependent on exact numbers. ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [May 29, 2011, 6:27pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/96 "2011-05-29T18:27:50Z")
I wonder in DJ land, if people just go to the doctor for something to do. It is free, so i think I will go waste an afternoon sitting in a waiting room. What a Palinesque argument. ---
**Author:** ![Simplicio](https://avatars.discourse-cdn.com/v4/letter/s/c37758/32.png) [@Simplicio](https://boards.straightdope.com/u/Simplicio)\ **Post date:** [May 29, 2011, 6:47pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/97 "2011-05-29T18:47:20Z")
> [@DSeid](#): > > Except that insurance companies can and do raise premiums. Costs go up, their inefficiencies do not go down, but they take more in to make up for it. Medicare isn’t doing that. It can’t. Medicare revenues have been adjusted upwards several times. With the Medicare trust fund plus revenues, its currently as solvent as your private healthinsurance. Projected into the future it isn’t solvent, but neither is your private plan. > [@](#): > > Dictator approach? In addition to the Healthcare Reform Act measures increase the age that Medicare fully kicks in by, making it go up, say 6 months of age per 3 years going by such that by 2030 the age of qualification is 68. And when costs keep going up, you’ll have to raise it to 71, and then to 75 until eventually there isn’t really any meaningful Medicare, just a program that covers seniors in the last year or two of their lifetimes. This is just the Ryan plan by other means. Also note that most medical spending happens in the last year or two of life, so cutting younger people from the program saves much less money then you’d think, even ignoring the growing cost of healthcare. > [@](#): > > Consider some means testing to identify some who can pay some portion of the full premium even over the new gradually increasing entry age. Means testing Medicare doesn’t work well, because the average elderly have no incomes, only assets. And if you means test their assets, you end up asking them to sell portions of the retirement portfolios or housing to pay for care, which was what the program was meant to prevent in the first place. Of course you can try exempting such assets, but then you end up with only the very rich being asked to pay, which is OK but doesn’t raise very much money, as the rich are a very small number of people. Plus you end up with the same problem as above. Once you means test to cover the shortfalls, you keep having to lower the bar until most people aren’t getting medicare at all. Tweaks like raising the eligibility age or means testing might be useful once the growth in costs is under control (since even then, we’ll be left with a program thats pretty expensive), but currently, its a waste of political capital to try and impliment them. The real savings are in slowing the growth of health costs to that of GDP, any political capital should be expended to that. ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [May 29, 2011, 6:51pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/98 "2011-05-29T18:51:30Z")
> [@gonzomax](#): > > I wonder in DJ land, if people just go to the doctor for something to do. It is free, so i think I will go waste an afternoon sitting in a waiting room. > What a Palinesque argument. Indeed. I currently have insurance, but I hate going to doctors. I’d have to be pretty sick or injured. However I did read on a message board that caters to the ultra-Right, one person who said that if we had UHC he’d go to the doctor all the time just to get his tax’s worth. :rolleyes: ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [May 29, 2011, 7:00pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/99 "2011-05-29T19:00:19Z")
> [@Johnny\_L.A](#): > > Indeed. I currently have insurance, but I hate going to doctors. I’d have to be pretty sick or injured. > > However I did read on a message board that caters to the ultra-Right, one person who said that if we had UHC he’d go to the doctor all the time just to get his tax’s worth. :rolleyes: He was lying to create and back a fake argument. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 29, 2011, 7:33pm UTC](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611/100 "2011-05-29T19:33:08Z")
**Simplico** , again, I do not believe that deflecting the cost curve should not be done; I am merely, IMHO realistically, stating that it won’t be deflected enough. You exaggerate the amount of Medicare [spending at the end of life](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1464043/)and the older the end of life the less the cost. > [@](#): > > Medicare last-year-of-life expenditures were lower for those dying at older ages. Last-year-of-life expenses constituted 22 percent of all medical, 26 percent of Medicare, 18 percent of all non-Medicare expenditures, and 25 percent of Medicaid expenditures. Raising the elgiblity age by three years would keep as many years of elderly life covered as were when the plan was created. Allowing those younger to buy in would lower the cost for all. [Previous page](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611.md?page=4) [Next page](https://boards.straightdope.com/t/will-the-dems-successfully-use-the-gops-stance-on-medicare-against-them/578611.md?page=6)