Monday, March 11, 2013

Blue screw, red screw: Which screw do you choose?

Is Obama fixin' to screw us? He stood fast against entitlement reform for a brief period -- when his poll numbers were high. Now they aren't. So far, he seems to be willing to allow a few nibbles at the edges of Medicare and and Social Security, but if the Republicans budge on taxes -- and budge they will -- then the nibbles will dig deeper.

Spring's almost here, and Paul Ryan is showing off his fashionable new Medicare position. Also see here. Remember when Ryan railed against the $716 billion that Obama "stole" from Medicare -- following a plan that Ryan himself had earlier endorsed?
But Ryan's message has always had two problems. First, President Obama's cuts to Medicare are on the provider side; he's reducing payments to hospitals and doctors in order to fund better benefits for seniors and cover low-income people under the Affordable Care Act. And second, by shrinking the pool of Medicare recipients to the oldest and the sickest, Ryan's plan would leave the program in far worse shape than anything proposed by the administration.

It's also worth noting a small, rhetorical problem with Ryan's message: He doesn't disagree with the president's Medicare cuts. And as he revealed yesterday on Fox News Sunday, he plans to include those cuts as part of his budget for House Republicans...
But all of that is the prelude to Ryan's big, big new idea -- which is, of course, a very familiar idea: Privatization. Privatization almost always costs more, thanks to the profit factor and corruption.

They privatized parking meters in Chicago. Did parking get cheaper?

This site debunks commonly-heard myths about privatization:
Cost overruns combined with hidden and indirect costs, such as contract monitoring and administration, can make privatization more expensive than in-house services for governments. In fact, the Government Finance Officers Association estimates that hidden and indirect costs can add up to 25% to the contract price.
An audit report from the Wisconsin Legislative Audit Bureau revealed that the state's department of transportation wasted more than $1 million by outsourcing almost half its engineering work to private contractors over the past five years. The audit found that about 60% of these outsourced jobs could have been done at a lower cost by state workers, which would have saved the state $1.2 million.
Governments cannot anticipate the cost of privatization failures, from the overtime expenses of sending city work crews to correct sloppy work by private road maintenance companies to the massive ordeal of rebuilding entire outsourced departments when a contractor's costs, delays or service breakdowns become unsustainable.
Am I the only one who recalls the "privatized" Katrina clean-up effort, a scandal worse than the Bush administration's immediate response to the storm? Companies run by cronies of Republican bigwigs would get clean-up contracts at massively inflated prices, and then those companies would subcontract the gig to others. Sometimes, the subcontractors would hire subcontractors, until someone finally found a guy from Mexico who was willing to do the actual work for less than minimum wage.

C'est le capitalisme. Imagine what similar games will do to Medicare.

Lyin' Ryan's other big money-saving idea is repealing Obamacare -- which, according to the Congressional Budget Office, will reduce the budget deficit by $143 billion dollars. It accomplishes this trick by making preventative care (which is cheaper than emergency care) more affordable. That number goes against Ryan's libertarian religious values, and so he simply refuses to accept any facts which contradict his ideology.

Skydancing has an excellent piece on Ryan's horrifying proposals:
Ryan explains that he plans to turn Medicare into a voucher program and Medicaid, food stamps, and “49 different job training programs spread across nine different government agencies” into block grants and let the states decide what to do with the money.
Even Fox News host Chris Wallace thinks that Ryan's plan is delusional.
It seems to me that the best (bad) example of privatization is with the Medicare Advantage programs. They replace Medicare for their enrollees.

It was sold as a program that would save money of course, but of course it has to be SUBSIDIZED. How could it be otherwise? Private companies HAVE TO MAKE A PROFIT. Medicare doesn't.

It's just mind-boggling how so many ordinarily sensible people are letting themselves be bamboozled by these thieves.

Carolyn Kay
There's no money to maintain the Social Security system and Medicare. But there is plenty of money to carry on with the F-35 fighter program (@$500 billion so far) even though experienced fighter pilots have testified that the plane will be a "sitting duck" in air to air combat. There's also plenty of money to maintain whatever it is we're doing in Afghanistan to keep the supplies of heroin and opium flowing. (The Taliban, a bunch of illiterate religious fanatics, shut down the opium harvests in the country within six months. We've been there eleven years, and now Afghan heroin makes up 90% of the world market. Heckuva job, Brownie.)

Grandma will have to eat cat food so the corporate officers of Lockheed and their Pentagon counterparts can rake off the profits and graft to which they are entitled. Maybe someone can pass the hat so she can upgrade to Fancy Feast this week. George Carlin predicted this years ago in terms too x-rated to reproduce here.
Here's a thought: what if chipping away at medicare and medicaid is less about caving in to ideology and more about handling declining birth rates by forcing people to retire later?
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