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You are here: Home / Politics / The ClusterF**k Continues

The ClusterF**k Continues

by John Cole|  January 16, 200611:03 am| 81 Comments

This post is in: Politics, Republican Stupidity

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More of this, please:

With tens of thousands of people unable to get medicines promised by Medicare, the Bush administration has told insurers that they must provide a 30-day supply of any drug that a beneficiary was previously taking, and it said that poor people must not be charged more than $5 for a covered drug.

The actions came after several states declared public health emergencies, and many states announced that they would step in to pay for prescriptions that should have been covered by the federal Medicare program.

Republicans have joined Democrats in asserting that the federal government botched the beginning of the prescription drug program, which started on Jan. 1. People who had signed up for coverage found that they were not on the government’s list of subscribers. Insurers said they had no way to identify poor people entitled to extra help with their drug costs. Pharmacists spent hours on the telephone trying to reach insurance companies that administer the drug benefit under contract to Medicare.

Many of the problems involve low-income people entitled to both Medicare and Medicaid.

In a directive sent to all Medicare drug plans over the weekend, the Bush administration said they “must take immediate steps” to ensure that low-income beneficiaries were not charged more than $2 for a generic drug and $5 for a brand-name drug.

Maybe Bush and company are actually conservatives, and they are enacting things like the Prescription Drug Plan to make people appreciate limited government?

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81Comments

  1. 1.

    Paddy O'Shea

    January 16, 2006 at 11:17 am

    More Bush incompetence in action. If he’s not bombing cities or smearing Democratic war heroes, the Little President gets bored and longs for his video games. Or a nap.

    Be it proper armaments for our military, FEMA, or anything to do with the health and welfare of the American people, Bush just ain’t that interested.

    And the results are what has been described here, or still to be seen in New Orleans. Or in an even cursory examination of our casualties in Iraq.

  2. 2.

    Thomas

    January 16, 2006 at 11:26 am

    This sounds like every interaction I’ve had with customer services in the last three years. Switch cell phone plans, health insurance, car insurance, it doesn’t matter. It’s like trying to find the Northwest Passage. It’s no surprise it’s carried over to the government.

    I think we should bomb the call centers of Bangalore.

  3. 3.

    Paul L.

    January 16, 2006 at 11:29 am

    Paddy O’Shea Says:

    More Bush incompetence in action. If he’s not bombing cities or smearing Democratic war heroes, the Little President gets bored and longs for his video games. Or a nap.

    Be it proper armaments for our military, FEMA, or anything to do with the health and welfare of the American people, Bush just ain’t that interested.

    And the results are what has been described here, or still to be seen in New Orleans. Or in an even cursory examination of our casualties in Iraq.

    So George W. Bush just created the Prescription Drug Plan by executive order? Bush signed it. But to you, Paddy and the rest of the Bush haters, Congress who wrote the law gets no blame.
    If only Bush could bite his lip and say “I feel your pain”.

  4. 4.

    The Other Steve

    January 16, 2006 at 11:35 am

    So George W. Bush just created the Prescription Drug Plan by executive order? Bush signed it. But to you, Paddy and the rest of the Bush haters, Congress who wrote the law gets no blame.

    LOL!

    Time for your nap, Paul L. :-)

  5. 5.

    ppGaz

    January 16, 2006 at 11:36 am

    The health care crisis has already become a disaster even without the Medicare fuckup … the media are finally starting to notice. This ongoing series in a large Gannett paper is typical of what you are going to be seeing in the next few years …. working, middle class Americans absolutely fucked by the dysfunctional nexus between corporate medical power and the Republicans:

    Read it and weep

    System crumbling

    Family screwed

    Republicans are either going to (a) start getting this, and (b) backing away from their knee-jerk support of corporate healthcare interests, which is where these problems and the Medicare fuckups are coming from, or else the middle class is going to throw the GOP back into being a distant minority party again, where it belongs.

    It’s your choice, GOPers. Change, or die.

  6. 6.

    The Other Steve

    January 16, 2006 at 11:36 am

    Don’t worry about those insurers.

    The private insurers offering this stuff… if they aren’t profitable after 2-3 years, there is a provision in the bill to bail them out.

    Corporate Pork Welfare at it’s finest.

  7. 7.

    Paddy O'Shea

    January 16, 2006 at 11:36 am

    Paul L, yet another whiney voice in the “It’s never Bush’s fault!” choir.

    Old Georgie sure took a lot of bows when the so-called Prescription Drug Plan was enacted, didn’t he? Crowed loud and long. Even took credit for it.

    So what’s the new game plan on the apology right these days, Paul? Bush’s responsibility only lasts as long as the photo-op?

  8. 8.

    kenB

    January 16, 2006 at 11:37 am

    More Bush incompetence in action

    Not true. The main problem is that Congress came up with a ridiculously complicated piece of legislation, often short on critical details, with a very aggressive timeframe. CMS did the best they could, but they were about 4-6 months behind where they should have been, so everything was insanely rushed and scattered over the last couple of months. Final versions of important file specifications were only available in November (and some were changed even after that), there was not nearly enough time for HMOs to fully test the systems they had in place. CMS’s systems people didn’t plan well enough for the transition from the old program to the new, and so their main member processing system was unable to handle MA-PD enrollments in a timely manner.

    But really, with a new program of this magnitude, and with the aggressive implementation schedule, it was inevitable that there would be problems. If they really had postponed the drug benefit by a year to save money, it would’ve made for a really smooth roll-out in 2007.

    Actually, all things considered, it’s not nearly as bad as it could have been. As far as beneficiaries are concerned, everything should be pretty smooth by next month. The real headaches now will be for the states, the HMOs, and the pharmacies, as everyone tries to figure out who gets the money and how.

  9. 9.

    ppGaz

    January 16, 2006 at 11:40 am

    Too many f_’s, John? Sorry, I can rewrite.

  10. 10.

    DougJ

    January 16, 2006 at 11:44 am

    I don’t see how any of this is Bush’s fault. And why is that when James Frey lies in his book the liberals continue to lionize him, but when the Bush administration puts out fake news videos touting its new medicare plan, it’s some kind of federal offense?


    Oh, the hypocrisy!

  11. 11.

    neil

    January 16, 2006 at 11:44 am

    Maybe Bush and company are actually conservatives, and they are enacting things like the Prescription Drug Plan to make people appreciate limited government?

    Laugh if you want, but a lot of people in DC are probably soothing their consciences in exactly this way right now.

  12. 12.

    Paddy O'Shea

    January 16, 2006 at 11:45 am

    kenB joins the choir.

    So you’re saying Bush actually signed badly flawed legislation?

    Did he actually read the thing before he put his name to it? As bad as the Republican Porky Pig Congress is, you’d think this self-styled fiscal conservative president (who borrows a lot) of money would at least practice a little quality control before making this mess the law of the land.

    But perhaps he was more concerned with the happy headlines he hoped to get.

  13. 13.

    Paul L.

    January 16, 2006 at 11:46 am

    The Other Steve Says:
    LOL!

    Time for your nap, Paul L. :-)

    Back in your hole, The Other Steve :)
    There a retort as witty as yours.

    Paddy O’Shea, yet another whiney voice in the “It is all Bush’s fault!” choir.

  14. 14.

    ppGaz

    January 16, 2006 at 11:48 am

    Paddy O’Shea, yet another whiney voice in the “It is all Bush’s fault!” choir.

    Nothing is ever Bush’s fault, according to the apologistas.

    Aside to John: I’ll shut up now for a while. I swear.

  15. 15.

    chopper

    January 16, 2006 at 11:51 am

    So George W. Bush just created the Prescription Drug Plan by executive order? Bush signed it. But to you, Paddy and the rest of the Bush haters, Congress who wrote the law gets no blame.

    hah! yeah, the WH had nothing to do with it. bush didn’t meet with the GOP senate leadership 12/10/02 to “lay the groundwork” for including the prescription drug benefit into medicare refoms. bush didn’t push like hell to get the bill through congress. bush didn’t tout it as a signature acheivement for his administration. the WH didn’t pressure HHS to withhold information from congress about the cost.

    none of that happened. it was all congress from the get-go.

    this is bush’s bill, through and through. he pushed it from the start and claimed credit for it the day it passed.

  16. 16.

    Paddy O'Shea

    January 16, 2006 at 11:55 am

    Well, it appears that the “It’s All Bush’s Fault” choir has grown even stronger as of late. According to the new Zogby Poll Bush’s approval has fallen to 39%. With an astonishingly low 34% now actually admitting that they support his policies (whatever they are) in Iraq.

    http://www.zogby.com/news/ReadNews.dbm?ID=1056

  17. 17.

    Paul L.

    January 16, 2006 at 11:57 am

    ppGaz Says:
    Nothing is ever Bush’s fault, according to the apologistas.”

    I did not say Bush is blameless. Just that the Bush-hater assigned all the blame to Bush and none to Congress who wrote the law.

    BTW, can I judge John Murtha by the company he keeps?
    Murtha Gets Pink Badge Of Courage

  18. 18.

    kenB

    January 16, 2006 at 12:00 pm

    kenB joins the choir.

    Please. I thought y’all might be interested in some information from someone who, you know, has actually been working with this stuff every day for the last ten months. How silly of me — carry on.

  19. 19.

    Paddy O'Shea

    January 16, 2006 at 12:02 pm

    Paul L: The more hack lackeys like you smear Murtha, the stronger his support gets.

    If a man is known by his enemies, then the courageous Congressman from Pennsylvania is certainly approaching sainthood.

  20. 20.

    Steve

    January 16, 2006 at 12:04 pm

    What a great defense of Bush. “Hey, it was partially the fault of the Republicans in Congress too!”

  21. 21.

    Paddy O'Shea

    January 16, 2006 at 12:10 pm

    kenB: So, as an obvious expert on this matter, how is it you can remain incapable of explaining how the President of the United States could have signed such badly flawed legislation?

    Isn’t it true that the President plays a vital role in the process of checks and balances? And that deep-sixing rubbish such as this would be an important part of his responsibilities?

    (Of course, judging by the 1.03 trillion dollar borrowing spree this particular president has been on, balancing and checks don’t really go together in this case.)

    Another question: If so esteemed an expert as yourself has been working on this particular boondoggle, how is it the result was so badly flawed? I would hope having someone such as yourself there to protect our interests would safeguard us from such disasters!

  22. 22.

    Bob In Pacifica

    January 16, 2006 at 12:11 pm

    It was a Rethug deal with Pharma. Bush was behind it, the Rethug Congress enacted it. People on the left called it for what it was and what it would be. So now that it’s been proven wrong it’s incompetence?

    It’s not incompetence. It’s a logical tradeoff made by those in power. They deliberated and then they sold you fuckers off.

    But don’t worry, something else will come along to whip up you guys. You’ll get washed along in a wave of hate and vote against your interests again, and beat your chests until you are disappointed again, and then you’ll whine that all would be well if only these guys weren’t incompetent. They weren’t so incompetent when they filled out their deposit slips.

  23. 23.

    demimondian

    January 16, 2006 at 12:11 pm

    What a great defense of Bush. “Hey, it was partially the fault of the Republicans in Congress too!

    Well, it follows directly from the new Republican meme that Ross Douthat has expressed in L’affaire Ambramoff:

    That’s a great G.O.P. talking point: some Democrats are so sleazy, they get involved with the likes of us . . .

  24. 24.

    Paul L.

    January 16, 2006 at 12:13 pm

    Paddy O’Shea Says:
    Paul L: The more hack lackeys like you smear Murtha, the stronger his support gets.

    If a man is known by his enemies, then the courageous Congressman from Pennsylvania is certainly approaching sainthood.

    hack lackey? Pot, Kettle.

    How did I “smear” Murtha by pointing out his photo-op with Code Pink?
    It is on their site

  25. 25.

    kenB

    January 16, 2006 at 12:18 pm

    Jeez, you guys are really out there. I mostly agree that the drug benefit was poorly thought out, and Bush certainly deserves a major share of the criticism for that. But to try to blame him for a temporary glitch in the initial rollout is simply absurd.

    If so esteemed an expert as yourself has been working on this particular boondoggle, how is it the result was so badly flawed?

    Hopefully by the end of the month you too will be able to get those meds that you so clearly need.

  26. 26.

    Paddy O'Shea

    January 16, 2006 at 12:27 pm

    While we’re on the topic of the “It’s All Bush’s Fault” choir, here’s another shocking finding from Zogby.

    The question: “If President Bush wiretapped American citizens without the approval of a judge, do you agree or disagree that Congress should consider holding him responsible through impeachment?”

    52% said yes.
    43% said no.
    06% said they couldn’t really say.

    To put things into context, only 36% supported holding hearings to consider impreaching Clinton, with a mere 26% supporting actual removal from office.

    Who exactly believes impeachment needs to be considered here?

    Progressives 90%
    Libertarians 71% (Real ones, I suspect)
    Liberals 65%
    Moderates 58%
    Conservatives 33%
    Very conserv 28%

    The choir just gets louder all the time.

    http://www.democrats.com/bush-impeachment-poll-2

  27. 27.

    Krista

    January 16, 2006 at 12:35 pm

    I mostly agree that the drug benefit was poorly thought out, and Bush certainly deserves a major share of the criticism for that. But to try to blame him for a temporary glitch in the initial rollout is simply absurd.

    If the drug benefit was poorly thought out, though, won’t this be more than a temporary glitch? A “temporary glitch” implies that the plan is pretty much fine, with just a couple of small administrative bugs to work out. But if it’s as poorly-thought-out as you say (and as everybody else here says), than it will probably take a fair bit of time to get everything sorted. And in the meantime, there are certain life-saving meds that people are not able to take because they can’t afford them. It just seems to me that if you’re going to be implementing a plan that can have immediate and marked effects on peoples’ health, you want to go over it with a fine tooth comb, and not roll it out until you’re ironed out every possible error – because there will still be errors that you haven’t thought of. It seems that Congress and the President did not take this seriously enough – maybe because none of them have ever been in the position of not being able to afford whatever healthcare they need.

  28. 28.

    DougJ

    January 16, 2006 at 12:38 pm

    KenB, a lot of of these lefties blame Bush for absolutely everything. Get used to it. There’s a lot of pre-911 thinking that goes on here, a lot who believe that we can continue to do things the way we did before we were attacked. Let’s just just be thankful they’re not in power.

  29. 29.

    kenB

    January 16, 2006 at 12:46 pm

    It just seems to me that if you’re going to be implementing a plan that can have immediate and marked effects on peoples’ health, you want to go over it with a fine tooth comb, and not roll it out until you’re ironed out every possible error

    First of all, thanks for your reasonable response. The date that Congress set was 1/1/06. Everyone at CMS, all the systems people at the HMOs, pharmacies, etc., would have been overjoyed to be able to delay the rollout until things were truly ready, we all saw the train wreck that was coming, but that just wasn’t a possibility. Partly for the obvious political reasons, but partly also because attempting to delay it would have created new problems.

    But with a program of this magnitude and complexity, I’m not sure that any amount of time would have been enough to make it all work from day one without a hitch. Some problems just don’t get discovered until the program goes into production.

  30. 30.

    Kimmitt

    January 16, 2006 at 12:47 pm

    Maybe Bush and company are actually conservatives, and they are enacting things like the Prescription Drug Plan to make people appreciate limited government?

    Unfortuately, I do buy the idea that the Bush Administration is deliberately enacting poor policy at the expense of our most vulnerable for the purpose of supporting the thesis that all domestic policies are poor.

  31. 31.

    DougJ

    January 16, 2006 at 12:52 pm

    Unfortuately, I do buy the idea that the Bush Administration is deliberately enacting poor policy at the expense of our most vulnerable for the purpose of supporting the thesis that all domestic policies are poor.

    Put away your tin foil hat and spend a little time away from Camp Casey. You’ll find that your view are pretty far out of the mainstream. No president is perfect — no, not even Saint Willie — and I’m sure there’s been some less than perfect legislation enacted by this one. But the only reason that you hear so much whining about Bush’s mistakes is that liberals dominate the MSM.

  32. 32.

    Pb

    January 16, 2006 at 12:53 pm

    I’d just like to chime in here and say that chopper is absolutely right about this, and it’s no surprise that Paul L. can’t address any of his substantive points. To expand on one of these:

    Medicare Drug Benefit May Cost $1.2 Trillion

    The White House released budget figures yesterday indicating that the new Medicare prescription drug benefit will cost more than $1.2 trillion in the coming decade, a much higher price tag than President Bush suggested when he narrowly won passage of the law in late 2003.

    Beginning with his January 2003 State of the Union address, Bush pledged to keep the total cost of the drug benefit to $400 billion over 10 years. An estimate by the Congressional Budget Office was close to Bush’s figure.
    But shortly after Bush signed the program into law in December 2003, the White House revised its projection to $534 billion, but it never offered a detailed breakdown of that estimate.

    Last March, Richard S. Foster, Medicare’s chief actuary for nearly a decade, said administration officials threatened to fire him if he disclosed his belief in 2003 that the drug package would cost $500 billion to $600 billion. Lawmakers in both parties accused the administration of concealing important information that could have derailed passage of the bill.

  33. 33.

    chopper

    January 16, 2006 at 12:53 pm

    There’s a lot of pre-911 thinking that goes on here, a lot who believe that we can continue to do things the way we did before we were attacked. Let’s just just be thankful they’re not in power.

    yeah, i know how 9/11 totally changed the way we look at medicare prescription drug benefits.

    seriously, do you listen to yourself sometimes?

  34. 34.

    Krista

    January 16, 2006 at 12:54 pm

    But with a program of this magnitude and complexity, I’m not sure that any amount of time would have been enough to make it all work from day one without a hitch. Some problems just don’t get discovered until the program goes into production.

    I agree that there would have been hitches no matter what. However, it seems that this is much more than a mere hitch. You agreed that it was poorly thought out, so it’s definitely more than a hitch, I’d say.

    You say that delaying it would have caused new problems, but I really have a hard time believing that these new problems would have been worse (or the same) as the well, clusterf**k that currently exists. Maybe I’m wrong. What new problems do you think would have arisen?

    And as far as the obvious political reasons…well…maybe I’m naive, but I have issues when the people’s health is put in jeopardy due to political reasons. I know it happens, I know it’s always happened, but I’m never going to approve of it.

  35. 35.

    Steve

    January 16, 2006 at 12:55 pm

    DougJ still manages to score points. What a wonder to behold.

  36. 36.

    DougJ

    January 16, 2006 at 12:57 pm

    Chopper, 911 changed everything, medicare included. If you don’t understand that, you’re no better than the lunatics at Camp Casey.

  37. 37.

    Paddy O'Shea

    January 16, 2006 at 12:58 pm

    Steve: There is no DougJ. According to most of the glue sniffers on this blog, he is me.

    Haven’t you heard?

  38. 38.

    tb

    January 16, 2006 at 1:05 pm

    A lot of of these lefties blame Bush for absolutely everything. Get used to it. There’s a lot of pre-911 thinking that goes on here, a lot who believe that we can continue to do things the way we did before we were attacked.

    “Pre-911 thinking” my ass. Where do you get that? He’s the *fucking* *President*. His people rammed this prescription drug thing down our throats. It was his baby. So if it’s a crap program *he’s responsible*.

  39. 39.

    Steve

    January 16, 2006 at 1:06 pm

    Paddy: Why don’t we take a poll on that.

  40. 40.

    Paddy O'Shea

    January 16, 2006 at 1:07 pm

    KenB: Temporary glitches in health care can lead to serious problems for the victims, you know.

    Look at what suffering the temporary glitch in your parents’ birth control procedure caused them.

  41. 41.

    Paddy O'Shea

    January 16, 2006 at 1:08 pm

    Steve: That would be interesting. Why don’t you?

  42. 42.

    Krista

    January 16, 2006 at 1:16 pm

    Look at what suffering the temporary glitch in your parents’ birth control procedure caused them.

    Now, Paddy…

  43. 43.

    kenB

    January 16, 2006 at 1:17 pm

    Krista, the things that make Part D poorly-thought-out aren’t related to the things that caused some beneficiaries to not be able to get their meds on January 1. The latter problems will get worked out, they were just a consequence of the short timeframe and (IMHO) the inevitable rollout difficulties. The former are things that won’t get worked out in one, two, or twenty-four months without changes to the legislation — they have to do with larger questions about how the benefit structure is set up, whether the government’s money is being spent wisely, etc.

    As to whether it’s fair or not to expect everything to work perfectly right out of the box, if you did a survey of programs (private or public) that took several years to design and build, I’d bet you’d find a very small minority that didn’t encounter some problems in the implementation phase, and a national program like this, involving thousands of different entities, is more vulnerable than most.

  44. 44.

    Paddy O'Shea

    January 16, 2006 at 1:19 pm

    Krista: I was merely expressing sympathy for the victims.

  45. 45.

    Krista

    January 16, 2006 at 1:27 pm

    kenB – so why the big rush on rollout, then? I know that a huge plan like this will have some bugs to iron out, but as you said upthread:

    But really, with a new program of this magnitude, and with the aggressive implementation schedule, it was inevitable that there would be problems. If they really had postponed the drug benefit by a year to save money, it would’ve made for a really smooth roll-out in 2007.

    Who pushed for this aggressive implementation? And did Bush not have the authority to delay the rollout? Or were they just all thinking about midterm elections and hoping for the best?

    And, if a regular Jill like me can figure out that a big plan like this would have glitches to work out, why couldn’t those involved with implementing it figure out the same thing, and have contingency plans in place?

  46. 46.

    Krista

    January 16, 2006 at 1:30 pm

    Krista: I was merely expressing sympathy for the victims

    I know, hon. No need to escalate things, though. We have enough people on here who disagree with us in an unreasonable fashion. It’s refreshing to have a civil debate on here for once. :)

  47. 47.

    Ancient Purple

    January 16, 2006 at 1:38 pm

    But to try to blame him for a temporary glitch in the initial rollout is simply absurd.

    This is silliness at it finest.

    We are not talking about a “glitch” here. We are talking about the states having emergency legislative sessions and exectutive orders filed in order to make sure that Grandma gets her insulin.

    The Medicare bill wasn’t just flawed, it was a disgrace. Medicare was forbidden to negotiate for cheaper prices, the vote was held open for over three hours in the House so arms could be twisted, and millions of people fall into the donut hole where they have to pay full price for drugs even if they are Medicare Part D eligible. This is just a flawed bill to you?

    Bush is responsible and should take the blame. Last time I checked, it was the responsibility of the executive power to be a check and balanace against the legislative power. The problems with the bill were no secret and Bush could have told Congress to try again. However, he didn’t. He just signed off on the bill. Pardon me for expecting Bush to do his f’ing job.

    It is bad enough that he didn’t do his job.

    It’s even worse when people give him a pass for not doing his job.

  48. 48.

    kenB

    January 16, 2006 at 1:53 pm

    Why not delay the rollout? Well, bear in mind that CMS isn’t the only player here — this is a nationwide effort, with thousands of companies (HMOs, pharmacies, pharmacy benefit managers, etc.), and many of the states, creating new systems, re-designing old ones, creating new business practices, hiring lots of new workers, etc. Everything was being scheduled for January 1. To just announce on December 1 that everything was on hold would have been extremely disruptive. Maybe if they had done that back in June, it might have been feasible, but at that point it wasn’t so clear that there would be problems — at least, not clear enough to get Congress to agree to allow for the delay.

    Should there have been contingency plans? Well, yes, I suppose, but that’s easy to say, harder to figure out what it means in practice. The one thing I can see that would have made some difference would have been for CMS to tell HMOs to go ahead and accept beneficiaries’ low-income claims at face value and to assure them that CMS would reimburse the plans later in those cases where the members didn’t truly merit the lower co-pay. But they probably weren’t authorized to do that.

  49. 49.

    Pb

    January 16, 2006 at 1:55 pm

    KenB, Ancient Purple,

    See above–some of the problems (with the cost of the bill, say…) *were* secret, and were deliberately and maliciously concealed from Congress by the White House. Guess who rightly should shoulder the blame for that…

  50. 50.

    ppGaz

    January 16, 2006 at 1:56 pm

    It is bad enough that he didn’t do his job.

    It’s even worse when people give him a pass for not doing his job.

    Of course, “job” is squishy here.

    As far as the large moneyed corporate interests are concerned, he did his job … he presided over the creation of a windfall for the fat cats who wanted a chance to reap the rewards of gratuitous privatization of the benefit. He did his job …. for them.

    He did a job …. on us.

  51. 51.

    kenB

    January 16, 2006 at 1:59 pm

    The last thing I’ll say on this subject is that it’s very instructive when you have first-hand knowledge of a subject that’s getting news coverage, because it helps you see how woefully inadequate the news coverage really is. People read a few articles and think that makes them experts, but there’s way more going on than can be covered in a few paragraphs of ink or pixels.

  52. 52.

    Ancient Purple

    January 16, 2006 at 2:04 pm

    Guess who rightly should shoulder the blame for that…

    I don’t deny that. However, the issues I pointed out were public knowledge, especially the issue regarding Medicare being forbidden from negotiating for lower costs. Everyone knew that was a provision in the bill.

  53. 53.

    Pooh

    January 16, 2006 at 2:29 pm

    ooh KenB plays the “if you only knew what I knew” gambit. Never seen that one, have you.

    DougJ, you are a god.

  54. 54.

    jcricket

    January 16, 2006 at 2:29 pm

    The two biggest legislative disgraces of the last 6 years are this Medicare “Big Pharma Giveaway” Drug Plan and the Bankruptcy bill. Both are examples of the Republican government kicking-back to their biggest donors and saddling the rest of us with huge bills.

    The Medicare drug plan will cost the government far, far more than the Republican party wants to admit (as evidenced by their illegal attempts to squash actuarial reports that were honest about the costs).

    And the bankruptcy bill will do nothing but create a de-facto debtors prison for millions of Americans because of the sky-rocketing healthcare costs, usurious lending practices and limited job-loss insurance that exist in this country.

    Why poor white Americans continue to vote Republican is beyond me. Are they really so afraid of terrorists, colored-folk and gays that they’re willing to sign away their own chance at financial success? Or do they really believe “trickle-down economics” will someday work for them? Either way, they’re complicit in their own demise.

  55. 55.

    ppGaz

    January 16, 2006 at 2:44 pm

    People read a few articles and think that makes them experts, but there’s way more going on than can be covered in a few paragraphs of ink or pixels.

    I think the “people” are correctly concerned that the “experts” are going to continue to do them more favors.

  56. 56.

    tb

    January 16, 2006 at 3:24 pm

    Or do they really believe “trickle-down economics” will someday work for them?

    They don’t seem to think in those terms; Republicans don’t really talk much about the alleged merits of supply-side economics these days. They seem to have figured out that they didn’t need an economic theory, they needed a marketing strategy (which basically amounts to “Who wants free candy?”). Now that they’re in power and free to govern as they please, it’s clear that supply-side economics is to real economics what intelligent design “theory” is to real science. Bullshit theoretical window dressing to allow them to take the money.

  57. 57.

    ppGaz

    January 16, 2006 at 3:51 pm

    Bullshit theoretical window dressing to allow them to take the money.

    That might be the clearest and most succinct description of it that I’ve seen. Well stated.

  58. 58.

    Andrew

    January 16, 2006 at 3:54 pm

    They don’t seem to think in those terms;

    They do to some degree. I remember a survey during the 2004 election cycle where something like 99% of respondents thought that they were in the top quarter of incomes or would be within their lifetimes.

  59. 59.

    Otto Man

    January 16, 2006 at 4:09 pm

    Now that they’re in power and free to govern as they please, it’s clear that supply-side economics is to real economics what intelligent design “theory” is to real science. Bullshit theoretical window dressing to allow them to take the money.

    Supply-side economics always struck me as one of those eat-yourself-thin crackpot diet plans. “I can eat my weight in ice cream every day and my weight will actually go down!” sounds exactly like “We can all pay much less in taxes and tax revenues will actually go up!” Only a loon would believe either.

  60. 60.

    Otto Man

    January 16, 2006 at 4:12 pm

    I remember a survey during the 2004 election cycle where something like 99% of respondents thought that they were in the top quarter of incomes or would be within their lifetimes.

    I’m not sure about those numbers, but I recall a similar poll after the 2000 election that showed that 19% of Americans thought they were already in the richest 1% and another 20% thought they one day would be.

    It seemed that Gore’s complaints about how well the richest 1% would do under Bush’s tax proposals might have worked against him, since 39% of the people thought that applied to them.

  61. 61.

    muddy

    January 16, 2006 at 4:15 pm

    I’m on Medicare, and I hate this program. I hate it as a recipient and I hate it as a taxpayer. It is a severely flawed plan and that was clear from the outset. At least to me.

    As far as doing a bad job so people will want to rid themselves of excessive government, I would wish that Bush would demonstrate his phony conservatism in some way that did not abuse the old and the sick. But I guess that’s just the kind of guy he is. The old and the sick may not contribute $ enough to matter to him.

    My personal reaction is more along the lines of this: Get the old people and the disabled really really stressed out. Deprive them of their medications (just temporarily, you know, just a little breaking-in period). Due to the combo of no meds and extreme stress, lots of old and sick people die and Medicare and Social Security will be more solvent. Bush will then take credit for the solvency but say that those people keeled over due to their fear of terrorists.

    I’d like to say I was joking darkly here, but at this point who can tell.

  62. 62.

    Pb

    January 16, 2006 at 5:29 pm

    kenB,

    The last thing I’ll say on this subject is that it’s very instructive when you have first-hand knowledge of a subject that’s getting news coverage, because it helps you see how woefully inadequate the news coverage really is.

    Does this apply to you, though? If so, feel free to enlighten us peons, any day now. Just because you appear to have nothing to contribute now, no comments, no rebuttals, no facts…

  63. 63.

    kenB

    January 16, 2006 at 5:59 pm

    feel free to enlighten us peons, any day now

    Sorry, I tried to share my higher knowledge with you all, but you rejected my teachings and decided to follow the path of darkness. So now I must leave you to wallow in the world of your own limited perceptions.

  64. 64.

    ppGaz

    January 16, 2006 at 7:36 pm

    Via ABC Evening News, this from the brilliant governor of California, on the Medicare drug crisis:

    “We thought it was going to work, but sure enough, it didn’t.”

    Now that’s an endorsement of his party’s scheme if I ever heard one.

    ABC reports that some pharmacies have been “giving away drugs” to desperate recipients.

    The Governor of Minnesota suggested that the federal approach had “a lack of urgency.”

    Hmm, where have we heard this before?

  65. 65.

    ppGaz

    January 16, 2006 at 7:38 pm

    The old and the sick may not contribute $ enough to matter to him.

    Well, and then there’s the Stormy approach: Didn’t she decry the idea of “carrying” unhealthy people with her premiums?

    See, that’s the problem, unhealthy people. If could just be rid of them, then the great Republican America could flourish unfettered.

  66. 66.

    EL

    January 16, 2006 at 8:25 pm

    KenB,

    Can you comment on the programs many states and cities put in place to prepare? It’s admittedly from the media, but NPR had a good piece on what Baltimore had done to prepare, and how successful they were, intervening to keep people on their meds. What (beside foresight and funding) kept the feds from doing something similar?

    In your view, was it beaurocratic blindness, lack of funds, or something else that kept them from adequate short-term planning?

  67. 67.

    DougJ

    January 16, 2006 at 8:43 pm

    My personal reaction is more along the lines of this: Get the old people and the disabled really really stressed out. Deprive them of their medications (just temporarily, you know, just a little breaking-in period). Due to the combo of no meds and extreme stress, lots of old and sick people die and Medicare and Social Security will be more solvent.

    I don’t think that is much of a plan, frankly. You may not like the Bush plan, but it is clearly superior to the quackery you suggest.

  68. 68.

    Sojourner

    January 16, 2006 at 9:11 pm

    Unfortuately, I do buy the idea that the Bush Administration is deliberately enacting poor policy at the expense of our most vulnerable for the purpose of supporting the thesis that all domestic policies are poor.

    I don’t. I think it’s a free-for-all, money grab. Look at Norquist. Hiding behind his tax cut policy, he was stealing money from people. They don’t care about governing, they don’t care about policy. They only care about grabbing as much money as they can for themselves and their friends. They would literally be stuffing their pockets if the money came as cash rather than checks.

    Bloated and disgusting.

  69. 69.

    kenB

    January 16, 2006 at 9:31 pm

    EL, that’s a good point, given that states were ready to step in, it does seem like arrangements could’ve been made ahead of time.

    I don’t want to overstate my “expertise” — I’m not some sort of official, I’m just a programmer for a company that makes Medicare enrollment software. I’ve pored over the docs and listened to many of the weekly nat’l conference calls, but I don’t have the true insider’s story.

    From my point of view, there was plenty of bureaucratic blindness, or at least denial. As long as I’ve been in the biz, the CMS systems folk have been behind schedule, have made ridiculous last-minute changes to handle things that should have been anticipated, and have been lousy at disseminating critical and accurate information, and this rollout was certainly no different. On the conference calls, the HMO folks would ask important questions and would get a “we’ll get back to you” or “the person who can answer that isn’t on the call” or “can you email us that question” as a response; it was also apparent on some occasions that they were making up policy statements as they went along. You got different answers depending on who you asked and when.

    However, they swore up and down that everything would be ready; and from their point of view, it sort of was. A lot of the problems you’re hearing about were due to HMOs not having all their systems in place either, and that can only partly be blamed on the CMS schedule. It’s mind-boggling how little some of our clients know about all the regulations (even for the existing Medicare Advantage program) and how long they waited before even trying to figure all the Part D stuff out. CMS was taking it on faith that the plans would all do their part, without any mechanisms in place to ensure that they would.

    So, low marks all around, unless you grade on a curve. Of course, the states and municipalities were able to jump in because they had existing systems in place that they could temporarily reactivate, but it’s entirely valid to ask why there couldn’t have been some sort of official arrangement between the feds and the states to plan for that. The real fun is going to be when the states, feds, HMOs, and pharmacies all try to figure out who’s on the hook for all the emergency spending that was done.

    But what I was originally objecting to was the attempt to lay these problems at Bush’s feet — a lot of the bunglers at CMS have been there since way before Bush made it to the White House, and from my standpoint what we’re seeing is totally predictable. It’s not really fair to blame bureaucratic problems on the current administration, though of course it’s very tempting.

  70. 70.

    Sock Puppet

    January 16, 2006 at 9:38 pm

    I think you people are being far too cryptic regarding the intentions of this fellow Bush. It seems obvious to me that some MBA buried deep inside the Bush White House figured that if all these indigent old geezers were denied their medications for a few weeks, at least 10% of them would expire. And that 10%, valued out to around $45 million over the course of 3 years, would more than pay for an air attack upon a few government buildings in Tehran.

    Fiscal conservatism in action.

  71. 71.

    kate

    January 16, 2006 at 9:48 pm

    My personal reaction is more along the lines of this: Get the old people and the disabled really really stressed out.

    Deprive them of their medications (just temporarily, you know, just a little breaking-in period). Due to the combo of no meds and extreme stress, lots of old and sick people die and Medicare and Social Security will be more solvent.

    I don’t think that is much of a plan, frankly. You may not like the Bush plan, but it is clearly superior to the quackery you suggest

    hahahahahahahahah!

  72. 72.

    kate

    January 16, 2006 at 9:49 pm

    oops meant to unbloke the Laughter!

  73. 73.

    kate

    January 16, 2006 at 9:49 pm

    er block sigh

  74. 74.

    The Other Steve

    January 17, 2006 at 1:45 am

    kenB wrote:

    But really, with a new program of this magnitude, and with the aggressive implementation schedule, it was inevitable that there would be problems. If they really had postponed the drug benefit by a year to save money, it would’ve made for a really smooth roll-out in 2007.

    Two years isn’t enough time?

    Wait a minute… This says the contract wasn’t awarded until May of 2005.

    http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=1466

    I suppose it’s possible that NDCHealth already had something similar and it just had to be modified. But even then, wow that is a tight timeline for systems integration to several dozen other companies for that measily sum of money.

    I wonder if they had to wait to see who donated the most to the Bush campaign in 2004 before awarding the contract?

  75. 75.

    The Other Steve

    January 17, 2006 at 1:52 am

    But what I was originally objecting to was the attempt to lay these problems at Bush’s feet—a lot of the bunglers at CMS have been there since way before Bush made it to the White House, and from my standpoint what we’re seeing is totally predictable. It’s not really fair to blame bureaucratic problems on the current administration, though of course it’s very tempting.

    My main disagreement with the Medicare Plan D program from the start was how overly complicated it was written. Well whose fault is that? Congress. Who urged Congress to pass this bill, and even gave the language for it? Bush.

    Bush is fair game, buddy. Your attempts to blame the troops for the orders they are given is lame.

  76. 76.

    EL

    January 17, 2006 at 2:47 am

    KenB, I can appreciate some of the issues involved, and the fact that there are always incompetents at every level, hired by every administration. However, I’m a little less willing to let the administration slide on this one. Bush wanted this bill, and got it when congress was very willing to give him what he wanted. I recognize he didn’t write it, but it was clearly written not to be of best benefit to the elderly, but to come up with something that would sound good to the elderly while not scaring the drug companies.

    I’m in the medical field, so I don’t automatically think the drug companies are bad (modern medicine wouldn’t exist without their products) but I also recognize that Medicare could have gotten a much better deal through negotiation.

    Having seen plenty of “on the fly” policy, I can see how that would foul things up even more.

    It sounds like we agree on this – if the cities and states could prepare, the feds could have also. I work for a medical group, and we got a lecture on medicare part D. Doctors, nurses, and administrators walked out shaking their heads – we had a hard time understanding how to evaluate different plans; I can only imagine what it’s like for seniors starting from scratch. I’d call this ill-conceived and poorly executed, with a dose of pollyannism thrown in. When you’re planning this stuff, you plan for confusion, for people to be unprepared, for sufficient trained people to answer phones and questions.

  77. 77.

    Faux News

    January 17, 2006 at 9:00 am

    I don’t see how any of this is Bush’s fault. And why is that when James Frey lies in his book the liberals continue to lionize him, but when the Bush administration puts out fake news videos touting its new medicare plan, it’s some kind of federal offense?

    Oh, the hypocrisy

    DougJ, I must tell you this: I have a platonic crush on you :-)

    We need cleared eyed patriots like you here at Faux News. When you get tired of Baloon Juice and its lousy pay let me know.

  78. 78.

    Mr Furious

    January 17, 2006 at 9:36 am

    From a reader at Josh Marshall’s site:

    Arbitrary drug classes like benzodiazepenes and barbiturates are specifically excluded from coverage. Congress left no clue as to the legislative intent of the exclusion. Someone seems to have decided that these two drug classes are incompatible with some Biblical teaching. Or maybe the competing drug classes are much more profitable for someone’s campaign contributors (as both benzodiazepines and barbiturates are cheap and produced as generics, unlike their likely treatment alternatives). As a result the nation’s psychiatrists are going batshit right now, trying to figure out what to do with patients on drug regimens for things like seizures.

    Worst. Legislation. Ever.

    Oh, and DougJ is in rare form…

  79. 79.

    The Other Steve

    January 17, 2006 at 10:51 am

    Worst. Legislation. Ever.

    I’d have to say it even makes the Volstead Act look good.

  80. 80.

    chopper

    January 17, 2006 at 11:24 am

    As a result the nation’s psychiatrists are going batsh!t right now, trying to figure out what to do with patients on drug regimens for things like seizures.

    well, that’s just f$cking spiffy innit.

    jesus, that put me inna foul mood.

  81. 81.

    Sojourner

    January 17, 2006 at 12:30 pm

    well, that’s just f$cking spiffy innit.

    And you’re surprised because… I mean we are talking about a Republican program. Remember they’re the party of small government because they suck at governing.

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