CBO Finds Obama Plan Will Stimulate Economy and Reduce The Deficit

Economists have already analyzed Barack Obama’s job plan and concluded that it will help reduce the risk of another recession and increase jobs. The Congressional Budget Office has now analyzed the report and found that it will help reduce the budget deficit:

The Congressional Budget Office on Friday confirmed that President Obama’s jobs bill would be fully paid for over ten years and also gave its seal of approval to Senate Democrats’ version that includes a surtax on millionaires.

The CBO said that the original Obama stimulus bill would involve $447 billion in tax cuts and new spending—the same estimate given by the administration. It said the bill would raise $450 billion over ten years. The result is a $3 billion decrease in deficits over ten years.

The Senate Democrats’ bill, which replaces Obama’s taxes on the upper middle class with a 5.6 percent surtax on those with annual incomes above $1 million, raises $453 billion over ten years and reduces deficits by $6 billion. The tax kicks in in 2013.

Senate Majority Leader Harry Reid’s office highlighted that the CBO affirmed 60 percent of the stimulus comes in the form of tax cuts rather than spending and that most of the tax relief is for workers.

CBO also said that the bill “could have a noticeable impact on economic growth and employment in the next few years.” CBO under its own rules is prevented from factoring in increased unemployment, and the possible increased tax revenue that could result into its cost estimate.

Of course Republicans will continue to oppose the plan for two reasons. First of all, they would prefer that the economy continues to do poorly in the hope that this will cause voters to take out their frustrations on the Democrats as occurred in 2006, which is also why they have used their power in Congress to extend the downturn and reduce job creation. Secondly, Obama’s plan, while good for the country, results in higher taxes for the wealthy. Promoting lower taxes on the wealthy is the primary goal of Republicans, even if we have tax rates below those present when Ronald Reagan was president.

Planned Islamic Community Center Turns Politicians Of Both Parties Into Babbling Idiots

The planned Islamic Community Center planned near ground zero has resulted in a lot of nonsense. Most of it has come from the right, who mischaracterized it as a Ground Zero Mosque, with the right wingers showing no respect for either freedom of religion or property rights. Some of the nonsense also came from the Democrats. I really don’t know what Nancy Pelosi is talking about here, as she speaks of looking into “who is funding the attacks against the construction of the center.”  Her clarification does not make much more sense. (Of course this is not the first time I’ve questioned if Nancy Pelosi was making sense).

What is obviously going on here (along with Harry Reid trying to sound like a conservative on this in the midst of a tough election campaign) is that the Democrats still have absolutely no idea how to counter the the hateful and ignorant rhetoric from the far right. Instead they look at the polls and find that a majority of Americans support the conservative position in this and fear saying anything meaningful.

If  Islamic terrorists who had flown planes into the World Trade Building had wanted to build a mosque near ground zero I would understand the opposition. Of course those who desire to build the Community Center had no more connection to 9/11 than Saddam Hussein did.

As long as the Democrats fail to provide leadership and manage to speak out intelligibly on such issues a majority of people will listen to the right wing position. Democrats need to counter Republican rhetoric and misinformation with intelligent and factual responses. They won’t win by chickening out and hoping that Rachel Maddow or liberal bloggers will manage to bring some sense to the debates.

Update: Not Howard Dean too.

The Worst People In American History–To Conservatives

Right Wing News conducted a survey of conservative  bloggers to find out who they thought were the worst twenty-five people in U.S. history. John Wilkes  Booth beat out Nancy Pelosi, but only by one vote. Jimmy Carter leads, followed by Barack Obama. Both are well ahead of Timothy McVeigh, who also trails Ted Kennedy, FDR, and LBJ.  The results:

23) Saul Alinsky (7)
23) Bill Clinton (7)
23) Hillary Clinton (7)
19) Michael Moore (7)
19) George Soros (8)
19) Alger Hiss (8)
19) Al Sharpton (8)
13) Al Gore (9)
13) Noam Chomsky (9)
13) Richard Nixon (9)
13) Jane Fonda (9)
13) Harry Reid (9)
13) Nancy Pelosi (9)
11) John Wilkes Booth (10)
11) Margaret Sanger (10)
9) Aldrich Ames (11)
9) Timothy McVeigh (11)
7) Ted Kennedy (14)
7) Lyndon Johnson (14)
5) Benedict Arnold (17)
5) Woodrow Wilson (17)
4) The Rosenbergs (19)
3) Franklin Delano Roosevelt (21)
2) Barack Obama (23)
1) Jimmy Carter (25)

It also appears that, in their view, we are living in really bad times considering how many of the worst people in American history are now living or were around in the not very distant past.

AARP Joins Physician Groups In Blasting Congress For Inaction On Medicare Payment Fix

The failure of Congress to act on the Medicare “doc fix” has led to protests from medical organizations and the American Association of Retired People who have pointed out the harm this will do to the Medicare program and people dependent upon Medicare for their health care. The American Academy of Family Practitioners has called on Congress to stop harming patients and do their job. The American College of Physicians has blasted Congress for causing “Irreparable damage to Medicare” as seniors and military families face loss of access to health care. AARP sent the following letter to every member of Congress urging action on Medicare, warning that their inaction “threatens access to physician services for millions of Medicare beneficiaries.”

On behalf of millions of AARP members, I urge you to immediately pass legislation that ensures seniors have access to their physicians, and provides much needed fiscal relief to the states and to unemployed individuals.

Regrettably, given Congress’s failure to reach timely agreement on a Medicare physician pay package, the Centers for Medicare and Medicaid Services has now been forced to implement a draconian 21.3 percent reduction in their reimbursements.  This cut threatens access to physician services for millions of Medicare beneficiaries – especially those living in rural and other underserved areas.

While Congress continues to debate temporary patchwork solutions, people on Medicare are growing increasingly anxious about whether they will be able to find a doctor when they need one.  Seniors, who have paid into Medicare their entire working lives, deserve the peace of mind of knowing they will be able to find a doctor who will treat them.

AARP urges Congress to act immediately to stabilize doctor reimbursement rates for as long as possible until a permanent solution can be found.   For nearly a decade, Medicare patients and the doctors who treat them have been held hostage by short-term patches to an unworkable Sustainable Growth Rate (SGR) formula.  In the months to come, we look forward to working with Members of Congress from both sides of the aisle to repeal the SGR formula and replace it with a permanent physician payment system for Medicare that rewards value and ends the uncertainty for patients and providers alike.

In addition, enhanced Medicaid funding to states to assist them with the added costs of providing health coverage to low income individuals and for home and community based services must be extended.

Finally, we urge the extension of unemployment benefits for those unable to find jobs during this economic downturn.

AARP members are counting on you to address these critical issues immediately to protect their health and economic security.

Congress Plays Chicken With Medicare

Medical blogs have been protesting the failure of Congress to resolve this problem. For example, Dr. Rob warns that Congress is playing “a great big game of chicken.”

  • The house is playing chicken with the senate.
  • The Democrats are playing chicken with the Republicans.
  • They aren’t in the cars themselves, we are.  Doctors and patients are careening toward destruction in the name of political gamesmanship.

Surely they will flinch.  Surely someone will understand the consequences of the crash.  But you know what?  Sometimes each side expects the others will be the ones who flinch.  Sometimes nobody flinches.  Sometimes the cars crash and people are killed.

There are two potential ways to resolve this deadlock. The quickest would be for Nancy Pelosi to go along with Senate Majority Leader Harry Reid, House Majority Leader Steny Hoyer, and Rep. Robert Andrews (D-N.J.), the Chair of the Education and Labor health panel, and allow the House to vote on the temporary fix passed in the Senate last week.

Nancy Pelosi has been insisting on a different course by attaching the Medicare “doc fix” to other unrelated legislation. The Senate is attempting to pass legislation which includes some of Pelosi’s goals, but it is questionable if the Senate could pass such legislation without watering it down to the point where Pelosi would not find it acceptable.

For Nancy Pelosi to be the one who, at present, is blocking passage of this legislation might be political suicide for the Democrats, risking turning over control of Congress to the Republicans in November. The Democrats are already on shaky ground with seniors. As Ezra Klein pointed out earlier today, health care reform has become more popular since passage–except with seniors. The Democrats cannot afford to further alienate the senior vote, which tends to turn out more heavily in off year elections than the younger voters who are more likely to stick with the Democrats.

Democrats Split As Nancy Pelosi Betrays Seniors

Nancy Pelosi’s irrational behavior regarding the Medicare “doc fix” is creating rifts between Pelosi and other Democrats. For the past several months we’ve had a repeated pattern of the Democrats taking the lead in trying to fix the problem while the Republicans have blocked passage. Suddenly it is Nancy Pelosi who is jeopardizing Medicare.

The Senate passed a six month temporary fix last Friday which differed from the House proposal. While far from perfect, the Senate bill would have at least bought some time to again work on a long term solution. It was initially assumed that the House would quickly approve the Senate bill but instead Pelosi has insisted she will not act upon a Medicare fix which does not also include the jobs proposals in the House bill.

While fighting for the jobs proposals are admirable, this should not be done at the expense of passing the Medicare fix. Failure to pass the fix endangers the Medicare program and will cause seniors, the disabled, and military families to have difficulty getting access to health care. (Medicare directly covers seniors and the disabled while Tricare, which covers active members of the military and their families, bases its fee schedule on the Medicare fee schedule).

As Nancy Pelosi and Harry Reid took differing positions, Politco reported this morning that  Congress battles as Medicare burns. There even appears to be some disagreement with Pelosi among the House Democratic leadership, as reported by The Hill:

Rep. Robert Andrews (D-N.J.), the Chair of the Education and Labor health panel, tells The Hill that Congress should quickly pass a bill delaying cuts to Medicare physician payments. The comments seem at odds with House Speaker Nancy Pelosi’s (D-Calif.) statement Monday that the House should hold off on taking up the Senate’s Medicare doc fix until the Senate passes a tax extenders bill, which some House members fear might go nowhere if it’s uncoupled from the must-pass doc fix.

“Leverage is less important than ensuring seniors can see their doctors,” Andrews said as he was entering a meeting in the office of House Majority Leader Steny Hoyer (D-Md.). “So I think it’s important to pass it.”

As I said earlier as my Facebook status, also posted to Speaker Pelosi’s FB page (and on Twitter in an abreviated 140 character version):

Nancy Pelosi: We expect Democrats to fight to preserve Medicare, not give Republicans political cover to destroy it. So far it has been the Republicans who have been blocking the payment fix, but if you follow through with threats not to pass the latest temporary fix passed by the Senate the Democrats become responsible for endangering Medicare, and risk losing the senior vote.

Nancy Pelosi Gambles With Future Of The Democratic Party By Rejecting Medicare “Doc Fix”

Harry Reid might be the leader of a House of Congress from Nevada but it is Nancy Pelosi who has turned into quite a gamble–a gamble which if she loses will probably turn the Democratic Party back into a minority party. On Friday the Senate passed a six month Medicare “doc fix” but regrettably could not also pass jobs legislation. Now Nancy Pelosi is threatening that the House will not pass the Senate bill until they also pass jobs legislation.

If her gamble works and the Senate passes the original House bill as opposed to the more limited Senate bill then Nancy Pelosi will come off as a legislative genius. However this is a very high stakes gamble. If she fails then it will be the Democrats who will receive much of the blame for the failure of passage of the Medicare fix.

Failure to pass the Medicare fix will lead to serious limitations on medical care for the elderly and disabled individuals now on Medicare. In addition, Tricare pays based upon the Medicare fee schedule so this will also adversely affect U.S. military personnel and their families.

Conservatives already are beginning to realize that Nancy Pelosi might have handed them a tremendous gift. Ed Morrissey writes:

In other words, Pelosi has handed the Senate Republicans the key to a filibuster not just in the Senate but also in the House, all to demand a massive expansion of the deficit on two separate fronts.  The GOP couldn’t have possibly asked for a better political position even if they had begged Pelosi not to throw them into that briar patch.  And if the “doctor fix” fails to get out of the House, it won’t be Republicans who get the blame, since Pelosi can call a vote on that any time she desires.

Let’s hope that Republicans manage to keep this advantage for as long as it takes Pelosi to realize that she’s blown it.

Morrissey is incorrect on an earlier point claiming, “the passage of the ObamaCare legislation whose financials were specifically predicated on keeping the Medicare reimbursement cuts in place.” A permanent fix was originally planned to be part of health care reform but Republicans made this politically impossible by counting the paper costs of this fix as part of the health care legislation.

Regardless of countless acts by the Republicans to play politics here and block a permanent fix, Morrissey is correct that the Democrats will pay the price politically if Nancy Pelosi is the one to prevent passage of the fix which has now passed the Senate. Loss of the senior vote will be devastating to the Democrats.

Republicans, Not ObamaCare, Are Chasing Doctors Out Of Medicare

The Houston Chronicle has an article about an increasing number of Texas primary care doctors not accepting Medicare, largely because of  uncertainty caused by the flawed physician payment formula which I’ve discussed here many times in the past.  I’ve seen several conservative blogs which are twisting this to claim that the doctors are leaving because of cuts in Medicare brought about because of Obama’s health care plan. This is totally false. Here are the facts:

  • The health care reform bill increases payment for primary care doctors, and does not cut Medicare payments as some conservatives are claiming
  • The problem with the flawed payment formula goes back to 1997, well before the current health care reform
  • The Democrats have been trying for several months, both as part of the health care reform legislation and in separate legislation, to fix this problem. They have proposed legislation that would both protect doctors from pay cuts and provide an increase in reimbursement.
  • The Republicans have repeatedly blocked these attempts, including filibusters in recent months which have greatly increased the uncertainty discussed in the article.

Despite the right wing spin, if doctors do not accept Medicare it has nothing to do with “ObamaCare” and everything to do with Republicans screwing doctors and our patients.

Related Stories:

Republicans filibuster fix in April

Republicans filibuster fix in March over Democratic objections

House passed temporary fix after Republicans blocked permanent fix

Harry Reid attacked by Republicans when he tried to fix the problem last fall

Obama criticized for trying to fix problem as part of health care reform

Republicans play politics, screwing doctors

Benefits of health care reform for primary care doctors. (Does anyone really believe that the AMA would have endorsed the plan if it cut physician pay rather than providing benefits for their members?)

Sue Lowden Backs Down on “Chickens For Checkups”

From time to time I’ve received everything from chocolate to venison from patients, but they have never given such gifts with an expectation of using them for payment for medical services. Nevada Republican Sue Lowden has raced a lot of ridicule since she suggested battering for medical services as a potential solution to the health care crisis. When we first heard this, many bloggers along with myself gave her the benefit of the doubt and at least thought she meant bargaining over prices, as opposed to bartering. I also noted that this happened to be the topic of the Dilbert cartoon published that same day.

Lowden stuck with this argument, and made it clear she was really advocating true bartering–chickens for checkups.

“Let’s change the system and talk about what the possibilities are. I’m telling you that this works. You know, before we all started having health care, in the olden days, our grandparents, they would bring a chicken to the doctor. They would say I’ll paint your house,” she said. “[That's] what people would do to get health care with their doctors. Doctors are very sympathetic people.”

“I’m not backing down from that system,” she added.

Greg Sargent reports she is finally backing down:

It took around two weeks and a good deal of national ridicule, but Nevada GOP Senate candidate Sue Lowden has finally backed off of her apparent advocacy for a “chickens for checkups” barter policy to bring down health care costs.

In an interview with a local station in Nevada today, Lowden clarified her original comments, claiming she’d been taken out of context. Lowden added she had merely made a “casual statement” designed to describe an ongoing reality, and hadn’t intended to offer a policy prescription.

“They took it way out of context,” Lowden said in the interview, blaming Harry Reid’s campaign tracker for plucking the quote out of an hour-long conversation about multiple topics.

“The truth of the matter is there is bartering going on in this state and in the country,” Lowden said. “It has been going on for years.” She added she had merely made “a casual statement talking about the reality of what’s going on.” Audio here.

In a follow up interview, Lowden spokesperson Crystal Feldman confirmed her intent. “Sue’s comment on bartering was never a policy proposal,” Feldman said, adding it was “an insight on how struggling families in Nevada are working to pay for medical care during these tough times.”

The problem for Lowden stemmed from the fact that she seemed to stray into advocating for a barter system, rather than just describing existing circumstances. In her original quote, Lowden said that “bartering is really good” to “get prices down in a hurry,” urging people to “go ahead and barter with your doctor.”

Republican Gets Health Care Ideas From Dilbert

Dilbert.com

Steve Benen quotes Sue Lowden’s ideas on getting down the cost of health care:

Lowden is a former state senator and chair of the Nevada Republican Party. She’s also, according to nearly every recent poll, the favorite to defeat Senate Majority Leader Harry Reid (D) in November. Lowden is not, as one might imagine, a supporter of recent improvements to the broken health care system, and she was asked at a candidate forum the kind of policies she’d prefer to see. Among her proposals:

“…I would have suggested, and I think that bartering is really good. Those doctors who you pay cash, you can barter, and that would get prices down in a hurry. And I would say go out, go ahead out and pay cash for whatever your medical needs are, and go ahead and barter with your doctor.”

I wonder if she had read today’s Dilbert strip (above) before making this suggestion. We know Scott Adams was joking, but apparently this Republican candidate is serious.

One problem is that pay to one’s doctor is a small part of health care costs. Presumably she means bargain as opposed to bartering to bring down the cost. For the sake of discussion, let’s say that a patient took her advice and I agreed to take 25 percent of the price for my office calls. That’s fine for someone who just needs one or two visits, but a person with serious chronic problems could still run up a huge bill over time. Insurance just might come in handy here (especially if the insurance cannot drop them because of having chronic medical problems).

The bigger problem which comes up when I have uninsured patients is not payment for the office calls but payment for everything I order outside of the office for diagnosis and treatment. Just because I agree to cut the charges for office calls (if Lowden meant bargaining) or agree to accept her goat (if she really means bartering), doesn’t mean that the reference lab I send the patient’s blood to will give them a break. The same is true if x-rays are needed. If surgery is needed the patient then not only needs to make a deal with the surgeon but also the facility where the surgery is performed.

If medications are needed it might be possible to give samples (but pharmaceutical companies are getting stingier with them). It might even be possible to get the patient free medications from a patient assistance program if their income is low enough to qualify. They also better be able to wait a while to get their medications.

This would be quite a challenge for a healthy person to go to all the work, and tolerate the delays, in order to receive medical care at a discount. (Hey, isn’t delays the reason conservatives say we should be terrified of the Canadian system?) If someone happens to be sick, this process goes from unlikely to succeed to virtually impossible. It’s just another unrealistic Republican suggestion for health care.

Republicans Causing Over 200,000 To Lose Unemployment Benefits

Because of Republicans blocking unanimous consent of a temporary spending measure over 200,000 people will have their unemployment benefits cut off on Monday. They might be restored retroactively, but many of these people are probably do not have spare money to hold them over. The Hill reports:

Starting Monday, more than 200,000 unemployed Americans won’t see jobless benefits they’re expecting because Congress failed to act.

The interruption in benefits will last two weeks at a minimum, according to Judy Conti of the National Employment Law Project (NELP), since lawmakers return from spring break on April 12.

As the two-week recess began, Congress was at an impasse over how to extend the emergency unemployment insurance program and other expiring provisions, including increased COBRA health insurance subsidies for the unemployed, the Medicare doctor payment rate and federal flood insurance.

Senate Republicans said the $9.3 billion, 30-day extension preferred by Democrats should be paid for, while Democrats said the bill’s cost didn’t need to be offset because the program was “emergency spending.”

Making matters worse, the Republicans are trying to play politics and blame the Democrats for the problem. They insist upon paying for this emergency spending now, but had no problems in the past with conducting the Iraq war or passing George Bush’s Medicare changes without funding them. They also have had no problems with the increases to the deficit caused by George Bush’s tax cuts which were initially provided to only the ultra-wealthy. Republicans have also blocked efforts to achieve a permanent fix to the flawed Medicare payment formula.

Harry Reid has scheduled a cloture vote for when Congress returns on April 12 but even if passed this delay can cause hardship for many who are now unemployed and dependent upon the benefits for day to day expenses.