Don’t hand me nothing I can’t hold

I know all the cool kids love the idea of “reforming” Medicare and Social Security, but it would be a disaster, both politically and morally, to cut the programs. A must read from Tom Edsall (via Atrios and reader P):

In this kind of conflict over limited goods, one of the most valuable resources that can get lost in the fray is the wisdom of the electorate at large. In this case, the electorate is pointing toward progressive tax increases for those closer to the top far more readily than members of the political class, for whom high-earners are a crucial source of campaign contributions.

The very nature of the basic security Americans are entitled to is at stake.

70 replies
  1. 1
    Todd says:

    Old white teatards first. Let’s give them the benefit of all the freedumb they are so eager to bestow on the rest of us to see how it works.

  2. 2
    Shortstop says:

    Must…resist…urge…to look it up. The Band? No. Yes. I can hear the chords in my coffee-patched brain.

  3. 3
    Shortstop says:

    @Shortstop: coffee-parched. Nice edit function, except for the “nice part.”

  4. 4
    Shortstop says:

    @Shortstop: er, that’s: except for the “nice” part.

    I’m slinking away now.

  5. 5
    Jeremy says:

    Well we are not going to get more tax rate increases with the GOP controlling the house. Also tax increases alone will not solve the issues with medicare costs soaring because of a aging population. I’m not advocating medicare beneficiary cuts but we do need to reform these programs in a smart way.
    If we do nothing than in a couple of decades there will be large automatic benefit cuts because the program will be insolvent.

    Some of the reforms the president laid out like cutting back on payments to providers, Pharmaceuticals, making wealthier folks pay more in premiums are not bad reforms. The ACA cut around 800 billion in Medicare which were useless subsidies. So these reforms are not bad ideas.

  6. 6
    jrg says:

    Where were these ‘cool kids’ when that imbecile Palin was running around calling common sense, money saving solutions like living wills ‘death panels’?

    Oh, that’s right, they were shitting themselves over fears they would be referred to as the ‘liberal media’. Starving grannie, well, I guess sacrifices have to be made…

  7. 7
    Litlebritdifrnt says:

    The only way to handle the so called “entitlement” programs is to reduce health care costs and do away with the payroll tax cap.

  8. 8
    El Caganer says:

    To use a phrase from the great American philosopher Frank Zappa, that’s sort of the crux of the biscuit, isn’t it? Since the political class makes the laws, and the political class takes its marching orders from the money people, us 99%-ers are dicked.

  9. 9
    Citizen_X says:

    @Shortstop: Huh, I don’t know. I have to download my coffee patch every morning to function normally.

  10. 10
    trixie says:

    What was it someone once said about “eating cake” or something like that? I forget how it ended.

  11. 11
    General Stuck says:

    I’m sure the catfood will be tasty and chocked full of vitamins and minerals.

  12. 12
    Ted & Hellen says:

    I know all the cool kids love the idea of “reforming” Medicare and Social Security,

    President Obama is a cool kid too.

  13. 13
    Belafon (formerly anonevent) says:

    @Litlebritdifrnt: And have medicare open to everyone who wants to join in it, by having it as a healthcare option at your job.

  14. 14
    El Caganer says:

    @General Stuck: I guess there’s an upside to everything….

  15. 15
    Paul in KY says:

    Not yelling at the author of this post, but members of the ‘political class’ ARE HIGH EARNERS!

    It is as much self interest (IMO) as anything that makes them be agin any tax raising on people in their tax bracket.

  16. 16
    General Stuck says:

    I’m not sure how much i can trust a guy named Edsall. But for the sake of argument, he is correct in the spirit world of happy endings, but in the real world, you are likely going to need republicans to ditch or raise the cap, or to increase revenue of any kind. It’s called politics and doesn’t matter that most people agree to raise their taxes. They always are for that, until they get their lighter paycheck. Even liberals.

    So to get this needed step for the country, there is a requirement for compromise in the real world of teh democracy, and you can fill in the blanks to what you could live with. But you can’t refuse to accept that reality. Then you become a wanker.

  17. 17
    askew says:

    Entitlement reform doesn’t have to be a bad thing and it doesn’t mean that benefits get cut. They could raise the cap on SS, which is a very progressive idea. They could allow the government to negotiate to lower drug prices. It drives me nuts when liberals claim that entitlements shouldn’t be touched. Benefits shouldn’t be lowered but there is plenty of other good things that can be done to improve the programs.

  18. 18
    Villago Delenda Est says:

    @Litlebritdifrnt:

    One person’s “outrageous medical costs” is another person’s “glorious, sacred profit.”

    So there’s that problem to deal with…

  19. 19
    liberal says:

    @Jeremy:

    Some of the reforms the president laid out like cutting back on payments to providers, Pharmaceuticals, making wealthier folks pay more in premiums are not bad reforms.

    In the long run, the only way to prevent a health insurance/health care delivery system from imploding is to control costs by socialization, combined with “death panels”.

    There are so many market failures in health insurance and medicine itself that the only way to get efficient care (mean, care that will yield good long-term health outcomes given a budget constraint) is by top-down control.

    If we leave everything up to “the patient and her doctor,” the economy will be destroyed.

  20. 20
    handsmile says:

    @Shortstop:

    Actually, “coffee-PATCHED” works as a clever metaphor: a temporary fix/repair (caffeine) to the problem (misfiring cerebrum).

  21. 21
    MomSense says:

    @Litlebritdifrnt:

    Removing the SS payroll tax cap would be so simple, efficient, and fair. House Republicans will never allow it.

    I really can’t stand them.

    Watch for some announcements about Medicare reimbursements. It has been in the works for some time now and the President had sort of a passing line about it in the SOTU but it will be a great change. The fee for service model creates too much incentive to perform unnecessary tests and procedures which do not improve patient outcomes. Places like Mayo Clinic–have better outcomes for less money. I’m excited about it.

    Rep. Pingree and Sen. King are sponsoring legislation to allow Medicare to negotiate prescription drug prices. It is based on a program here in Maine that Chellie co-sponsored and then Gov. King signed into law. This will be a huge cost cutter as well.

  22. 22
    MomSense says:

    @General Stuck:

    It better be since I certainly pay enough for it now for my feline masters.

  23. 23
    Chyron HR says:

    @Ted & Hellen:

    I sure am glad you followed your boy Zimmerman’s example and courageously put Obama down like a rabid dog for the good of America, instead of just complaining on the internet like a coward…

    Oh… wait…

    …never mind.

  24. 24
    liberal says:

    @MomSense:

    Removing the SS payroll tax cap would be so simple, efficient, and fair.

    It’s not truly fair unless it applies to capital gains, too.

  25. 25
    liberal says:

    @askew:

    Benefits shouldn’t be lowered but there is plenty of other good things that can be done to improve the programs.

    Any “improvement” of the programs will just result in a better bottom-line for the so-called unified budget, which will result in heightened demands from the thugs on the right for more tax cuts for the rich.

  26. 26
    Xboxershorts says:

    Well DUH….This has been the Peter G Peterson Foundation’s publicly stated position for several decades now.

    There’s nothing quite like Billionaire funded think tanks proposing Billionaire favored positions that always effectively reduce the Billionaire’s contribution to an orderly society.

  27. 27
    Villago Delenda Est says:

    @liberal:

    Wealth needs to be taxed every bit as much as income does.

    The parasites at the top need to be made to suffer.

  28. 28
    Litlebritdifrnt says:

    @liberal:

    Ditto that. Last November my mother had a heart attack over here, she was in the ER for 30 minutes before they airlifted her out to a heart center. The bill for that 30 minutes? $16,000.00.

    Here’s another idea, cap the amount a “non-profit” hospital can pay it’s CEO’s etc, if they insist that they have to pay more then they lose their “non-profit” status and have to pay taxes.

  29. 29
    The Moar You Know says:

    If we do nothing than in a couple of decades there will be large automatic benefit cuts because the program will be insolvent.

    @Jeremy: People have been saying this about Social Security. It flat out isn’t true. It might be true about Medicare but I don’t know that. And there would be a lot of incentive for the destroyers of the safety net to lie about it. Shorter me: I’d like some proof of this assertion.

  30. 30
    shortstop says:

    @Citizen_X: Ha! Also too, someone should invent a caffeine body patch modeled after the nicotine version. Less peeing, more freeing.

  31. 31
    Scott S. says:

    @Chyron HR: Shush, don’t talk to the Republican troll. Maybe he’ll go back to freeperland if he gets bored here…

  32. 32
    Waynski says:

    @Litlebritdifrnt:

    The only way to handle the so called “entitlement” programs is to reduce health care costs and do away with the payroll tax cap.

    This. And let’s all make an effort across the board to never call them “entitlement programs” They’re earned benefit programs, goddamit. When I hear Paul Ryan, (a guy a few years younger than me who inherited a few million dollars and will have government benefits for the rest of his life, as he did in the beginning of his life), say we should change the programs for people under 55, I want to hit him square in the face with a machete. I’ve been working since I was 14, ya fuck ya.

  33. 33
    liberal says:

    @Litlebritdifrnt:
    Hospital exec pay is just a tiny part of the problem.

    The big problem is that there’s no price signal that enables the system to weed out treatments whose net benefit is either zero or too small to be worth the cost.

    In addition, as far as I can tell there’s not really any way to devise incentives to create such a price signal. Doctors, hospitals etc are paid per service. Sure, you could say “we’ll pay you instead for outcomes,” but the outcomes we really ultimately want to target are long-term outcomes, and there’s no way AFAICT that that can be done with a market-based system.

  34. 34
    Litlebritdifrnt says:

    OT but the vet just called. Flossie is out of surgery and sleeping off the anesthetic. I can pick her up after 3:30pm. *breaths sigh of relief*

  35. 35
    liberal says:

    @The Moar You Know:

    People have been saying this about Social Security. It flat out isn’t true.

    It depends on the meaning.

    Social Security cannot become “insolvent,” because if there’s not enough money coming in and/or left in the trust fund, they’ll cut benefits. So not insolvent, in the sense of current law not requiring a bailout.

    In terms of the span of a few decades, even pretty optimistic/friendly observers agree that it’s very unlikely that the program will pay out all scheduled benefits, absent changes. That isn’t the end of the world, but absent huge increases in immigration, it’s almost certain to happen.

  36. 36
    Amir Khalid says:

    @Litlebritdifrnt:
    That’s good to hear. Yay Flossie!

  37. 37
    Litlebritdifrnt says:

    @liberal:

    Yeah but how can a hospital call itself a “non-profit” and then essentially make $500 million in profit a year?

  38. 38
    liberal says:

    @Waynski:

    They’re earned benefit programs, goddamit.

    SS is; Medicare/Medicaid isn’t. (In an accounting/actuarial sense, not in a “fair/just” sense.)

  39. 39
    liberal says:

    @Litlebritdifrnt:
    You won’t get an argument from me that the notion of “non-profit” has been corrupted beyond all recognition, particularly in something like health care where IIRC the non-profit charters usually have something about service to the community.

    But in terms of exploding health care costs, fixing that isn’t really addressing the problem, which is that medicine itself, not just medical insurance, should be socialized because of too many market failures.

  40. 40
    Villago Delenda Est says:

    @Waynski:

    Yeah, it’s rather hilarious that people who have inherited a fuckton of money wail about “entitlements”. We can start by stripping them of their ACTUAL entitlements, and see how much they like it when they’re the focus of “reform”.

  41. 41
    MomSense says:

    @liberal:

    Don’t even get me started…

  42. 42
    liberal says:

    @MomSense:
    That’s cool.

    I understand that there’s a pragmatic political argument for not taxing capital gains for SS.

    But a lot of people put forth the argument that, in addition, it’s just not to tax cap gains, which is hogwash (at least in the context of the debate about raising the cap).

  43. 43
    Cassidy says:

    @Chyron HR: It’s a one note whistle. You can’t penetrate the bigotry, so don’t waste your time.

  44. 44
    Violet says:

    @Litlebritdifrnt: Yay! Such a relief.

  45. 45
    liberal says:

    @Villago Delenda Est:

    Wealth needs to be taxed every bit as much as income does.

    That’s a little bit confused. I think you mean “capital” and “labor” rather than “wealth” and “income”.

    Though I’m actually in favor of taxing wealth more and income less.

  46. 46
    Roger Moore says:

    @liberal:

    In terms of the span of a few decades, even pretty optimistic/friendly observers agree that it’s very unlikely that the program will pay out all scheduled benefits, absent changes.

    The biggest risk to Social Security right now is that right wing assholes will selectively default on the government debt held by the SS trust fund when it’s finally time for it to start paying out. If we continue to honor that debt, Social Security should be solvent for most of a lifetime, which is a far longer time frame than economists can predict with anything remotely resembling accuracy.

  47. 47
    Litlebritdifrnt says:

    @Violet:

    Cue embarrassing photos of her in an Elizabethan Collar this weekend :)

  48. 48
    some guy says:

    The biggest risk to Social Security right now is the benefit cut called “Chained CPI.”

  49. 49
    Ted & Hellen says:

    @Chyron HR:

    Wow. You’re a pig.

  50. 50
    gene108 says:

    @Villago Delenda Est:

    One person’s “outrageous medical costs” is another person’s “glorious, sacred profit.”

    And glorious sacred profits keep a lot of people employed…again a conundrum in the winner-loser picking contest that will get proposed…

  51. 51
    FlipYrWhig says:

    Do we collectively have to be this goddamn stupid that we can’t differentiate between KINDS of cuts, most obviously _savings_ which would mean less money being spent without hurting anybody, vs. cuts that mean less money being spent _via_ hurting people? You can, in fact, reform these programs. Not everyone who says “reform” actually means “fuck it all to hell.” You know who reaps the most benefit from failing to be smart about the way we talk about these things? Not old, poor, sick people. Hospital administrators and medical device manufacturers, who are filthy stinking rich because they take the inefficiencies the government pays for and pocket them.

  52. 52
    ericblair says:

    @FlipYrWhig:

    Do we collectively have to be this goddamn stupid that we can’t differentiate between KINDS of cuts, most obviously _savings_ which would mean less money being spent without hurting anybody, vs. cuts that mean less money being spent _via_ hurting people?

    If your goal is good government, yes. If your goal is WINNING!!1!!, then no.

  53. 53
    Fair Economist says:

    Also tax increases alone will not solve the issues with medicare costs soaring because of a aging population.

    I hear this a lot, but it’s still wrong. Increasing the payroll tax by 2% – far less than the increases from the Greenspan Commission under Reagan in the ’80s – would make medicare solvent indefinitely.

    I’m all for sensible cuts (e.g. negotiating drug prices and cost effectiveness testing), but taxes *can* solve the medicare shortfall, completely, all by themselves.

  54. 54
    danielx says:

    I just knew there was a reason why senators in particular tend to vote in accordance with the wishes of high income voters and corporations as opposed to what repeated polls and surveys say that a majority of voters want.

    I never could understand why Evan Bayh did some of the things he did. This explains everything!

  55. 55
    FlipYrWhig says:

    The Edsall piece (I just read it) is strong. I still do think that we need to keep working at ways to find savings in Medicare, though, rather than finding ways to infuse more funds into the system while allowing skimmers and scammers in various medical fields to walk away with millions and billions of dollars. We don’t need to bend over backwards pleasing scooter stores and talking diabetes meter-makers. They’re a scourge, and we subsidize them lavishly, and we should stop.

  56. 56
    Bill Arnold says:

    @Roger Moore:

    The biggest risk to Social Security right now is that right wing assholes will selectively default on the government debt held by the SS trust fund when it’s finally time for it to start paying out.

    This. The “social security crisis” is urgent in the minds of the minds of the right because it means repaying debts incurred over decades where working people were overpaying into the social security trust fund, and this debt repayment would be done in part at least by higher income taxpayers. I.e. it’s arguably all about preventing tax increases on the rich.
    Increasing the cap would have a similar impact on the top income earners, but it’s a separate concern. It might be sell-able as a means of avoiding redemption of the social security trust fund.

    I often wonder whether the story would be different if the Social Security trust fund were invested in something like a basket of safe foreign government bonds. Would we feel differently if Germany refused to honor debt held by the U.S. government?

  57. 57
    FlipYrWhig says:

    @FlipYrWhig: I also agree with a view that Edsall criticizes in the piece, to wit, that it’s not a smart use of public funds to subsidize the retirements and health care of already-wealthy people. I get why we do it–politics, art of the possible, and such–but it doesn’t sit right, not when there are poorer struggling people having to fend for themselves.

  58. 58

    @danielx:
    A big chunk of it is because they want to be reelected, and the country’s most reliable voters (by far) are hate-driven assholes who have decided to burn the country down rather than let anyone but themselves get a hand up out of poverty.

  59. 59
    opie jeanne says:

    @Waynski: I thought he was the guy whose father died and he collected SS in order to attend college. Was there a lot of family money that is just not mentioned?

  60. 60

    @opie jeanne:
    Yes, there was. You see, the REST of his family was very, very rich. SS got him through college, and upon graduation a family friend gave him a 100k per year job that only went up from there. Romney’s story is similar. The true advantage of starting out wealthy are contacts. There’s always another rich person to make sure you never have to work your way up.

  61. 61
    Jim, Foolish Literalist says:

    @opie jeanne: His great or great-great-grandfather founded Ryan construction, which is a massive company that boomed thanks to the Eisenhower infrastructure programs. Ryan’s only ‘private sector’ experience is in the company’s PR dept where he earned about $1,800 over a few years in between wingnut welfare gigs and election to Congress. His father was an attorney who didn’t work for the company, but I think they were pretty solidly UMC when he died. Ryan carefully shades his bio to make it sound like he had to get a job to help his widowed Maw pay the rent. Reading between the lines, it sounds like he used his SS benefit as spending money while he was in college, the media duly adopted his plucky orphan insinuations. I don’t know how much money Ryan inherited, but his father-in-law is an oil guy, and his wife has a fat trust fund.

    Ryan’s whole biographical slight-of-hand con job with the Beltway media is a massive indictment of the Village.

  62. 62
    Jim, Foolish Literalist says:

    The Ryan Construction company today.

  63. 63
    WereBear says:

    @Litlebritdifrnt: Yay! I suppose you will get the usual useless advice to “keep her quiet.” As if!

  64. 64
    liberal says:

    @Roger Moore:
    I completely agree that the biggest risk is one of political default.

    But I’m just discussing projections here, and I think it’s a very, very good bet that without changes the program will not be able to fund benefits at current levels, even within my lifetime (and I’m not young).

  65. 65
    liberal says:

    @FlipYrWhig:

    … that it’s not a smart use of public funds to subsidize the retirements and health care of already-wealthy people…

    How is it a subsidy when these already-wealthy people actually did pay into the system?

  66. 66
    FlipYrWhig says:

    @liberal: good point, although people who paid into the system tend to get back more than they paid in as I understand it… Nonetheless, it doesn’t comport with my vision of liberalism or the welfare state to have a policy to give money to people who don’t need it when people who do need it get hosed. Like I said, _politically_ it’s certainly defensible: we don’t want people who pay in feeling resentment for the needier people who benefit. But it is true that we’ve decided to spend money further enriching rich people, and in most other areas, self-described liberals and progressives abhor that tendency.

  67. 67
    shortstop says:

    @Jim, Foolish Literalist:

    Ryan’s only ‘private sector’ experience is in the company’s PR dept where he earned about $1,800 over a few years in between wingnut welfare gigs and election to Congress.

    Libeling lib! He also drove the Wienermobile.

  68. 68
    liberal says:

    @FlipYrWhig:

    although people who paid into the system tend to get back more than they paid in as I understand it…

    Yes, if unreasonable definitions of “get back more” are used, like those that don’t take into account proper discounting.

    But it is true that we’ve decided to spend money further enriching rich people, and in most other areas, self-described liberals and progressives abhor that tendency.

    Also not really true. The number one way that government gives money away to rich people is via government-granted rent-collection privileges. By far and away, the biggest of those is land titles in the absence of high ad valorem land taxes. Yet bring up the idea of land value taxation, and many if not most so-called liberals and progressives will reject the idea.

  69. 69
    opie jeanne says:

    @Jim, Foolish Literalist: Thanks. There was a little mention of great grandpa and Ryan construction, but no indication that he benefitted from it. In fact, it looked like the article was written by him.

  70. 70
    opie jeanne says:

    @shortstop: Little Oscar probably turned over in his grave.

    ETA: I was going to make a rude remark about his weenie whistle but decided to be a better person. Almost.

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