Mitt Romney has made a lot of mistakes during this campaign, from his $10,000 bet to listing the number of American cars his family owns, including his wife’s two Cadillacs. He made another error today which might harm him with the senior vote–announcing he will not sign up for Medicare when he turns 65. This hardly makes him appear to be concerned about the future of the program.
Besides being out of touch with the concerns of voters, Mitt Romney has a very difficulty time differentiating between fact and fiction. His dishonesty reaches the levels previously seen by George Bush and Richard Nixon. I spent the day treating patients, many of whom are on Medicare. Medicare has been a highly successful program which provides health care to those over 65 and many who are disabled. Fortunately, while I was busy, Think Progress has looked at Romney’s lies about Medicare. Romney’s campaign released five questions about the program, most based upon misinformation (but Think Progress did get two points wrong).
QUESTION: Why Is President Obama Ending Medicare As We Know It By Allowing It To Go Bankrupt In Less Than 15 Years?
FACT: Medicare is not going bankrupt. The Congressional Budget Office reports that one portion — Medicare Part A or hospital insurance — will become “insolvent.” As Igor Volsky has reported, “Dedicated revenues will not be sufficient to pay all of its bills and the hospital fund will meet about 90 percent of its commitments, rather than the full 100 percent. In the succeeding years that shortfall will slowly widen and then contract, so that in 2085, Medicare could pay out 88 percent of its obligations.” By lowering annual payment updates to providers, savings from the Affordable Care Act will extend the life of the trust fund by nine years.
QUESTION: Why Is President Obama Ending Medicare As We Know It By Funding Obamacare Through $500 Billion In Medicare Cuts For Today’s Seniors?
FACT: The health law does not cut Medicare’s current budget. As ThinkProgress has previously explained, it slows the growth in the program by removing $500 billion from future spending over the next 10 years — not cutting from current senior’s benefits. The cuts help stabilize Medicare by eliminating overpayments and slowly phasing in payment adjustments that encourage greater efficiency. As a result, the law extends the life of the Medicare trust fund by nine years and allows seniors to retain all of their guaranteed Medicare benefits.
QUESTION: Why Is President Obama Ending Medicare As We Know It By Creating An Unaccountable Board To Ration Care For Today’s Seniors?
FACT: The proposal is statutorily prohibited from rationing benefits or increasing co-pays and will go into effect unless Congress acts to alter the proposal or discontinue automatic implementation. And the board will be composed of doctors, economists, and consumer representatives who will be confirmed by the Senate and will be tasked with designing a savings plan if health care spending increases beyond a certain threshold.
QUESTION: Why Is President Obama Ending Medicare As We Know It By Destroying Medicare Advantage For Today’s Seniors?
FACT: Far from destroying Medicare Advantage, the choices available through the program are “stronger than ever,” the White House reported in February. Nancy-Ann DeParle, White House deputy chief of staff for domestic policy, explained that premiums for Medicare Advantage are lower and enrollment has been higher since the Affordable Care Act made the changes to Medicare Advantage, which Republicans derided. “As reported last year, 99.7 percent of people with Medicare still have access to Medicare Advantage plans,” DeParle said.
QUESTION: Why Is President Obama Ending Medicare As We Know It By Ending Access To Care For Today’s Seniors?
FACT: As has been explained, the Afforable Care Act does not cut current benefits, is not disappearing, and has actually expanded options for seniors enrolled in Medicare Advantage. And many presidents have made changes to Medicare since 1965, including Republican idol Ronald Reagan, without ending care for seniors or destroying Medicare. Reagan even instituted a series of reforms that are strikingly similar to some of the payment changes included in the Affordable Care Act (policies Romney now refers to as cuts or price controls).
There are a some further clarifications which should be made. Regarding the false claims of Medicare going bankrupt, while neither Part A or B is going to go bankrupt (unless we have Republicans managing the budget), it is Part A and not B which is at greater risk without changes. Romney will be in Part A and is declining Part B, so his decision could not be related to concerns about Medicare B being fiscally sound.
Romney is also wrong about his claims of cuts to Medicare. The cuts were to subsidies to private insurance plans which receive more money to care for Medicare patients than patients in the government plan. If the free market is always so superior to government, as conservatives believe, why does it cost more to care for the same patients in private Medicare Advantage plans than in the government plan? Of course it comes as no surprise that Republicans favor corporate welfare for the insurance industry.
The post at Think Progress, however, makes two mistakes in discussing the Independent Payment Advisory Board (IPAB), which is opposed in its present form by many Democrats as well as Republicans. First, the prohibition against rationing is virtually meaningless. The IPAB could do many things which could reduce Medicare benefits as long as it is not called rationing. It could also change the structure of Medicare in ways which could reduce access to care, as we’ve seen with the fiasco following the implementation of a flawed payment formula which has already made it more difficult for many Medicare patients to be accepted by physicians.
The second major error made by the post at Think Progress is to claim that proposals from the IPAB “will go into effect unless Congress acts to alter the proposal or discontinue automatic implementation.” I’ve seen many liberal blogs defend the IPAB based upon a mistaken belief that its proposals are subjected to an up or down vote by Congress The IPAB is structured so that it will be virtually impossible for their rulings to be overturned by Congress. (The original House version of the health care reform legislation did not make this mistake as was the case with the Senate version).
An IPAB which is not accountable to Congress risks causing harm even if their intentions are good. The situation could be far worse if it becomes dominated by conservatives who are hostile to the program. Does anyone really think it would be a good idea to risk that in 2013 Mitt Romney, should he be elected, and the Republicans could pack the IPAB with people who share their hostility to Medicare? Not only would it not be possible to block the recommendations of such a board under a Republican government, it would also be difficult or impossible to reverse them even should Democrats be elected afterwards.