Two Reasons Democrats DON’T Have a Medicare Plan
Ezra Klein has a post this afternoon in which he claims that Democrats have a plan to reform Medicare, but that this plan is fundamentally different from the vision conservatives have put forward. To which only two questions show the incomplete nature of Democrats’ supposed “plan:”
- How does the Democrat plan deal with changing demographics? As we previously noted, CBO has estimated that changing demographics represent at least half, and up to three-quarters, of the shortfall in entitlement programs over the coming generation. What this analysis means is that, even if the growth of health costs does manage to slow (and both CBO and the Medicare actuary think Obamacare’s cost reductions will not be sustainable in the long-term), slowing health costs alone won’t solve Medicare’s financial problems.
The House Republican budget addresses the demographic bulge in part by raising the Medicare retirement age for future generations. How does the President propose to address this issue? He doesn’t – he has consistently ducked it. Does he want to raise taxes (again) to address the demographic concerns? He won’t say. Will the President agree to raise the retirement age? Maybe – but he hasn’t said so publicly, and he most likely won’t before November 6. So the President’s views on how to address the “Baby Boom bulge” are unclear – because he has avoided these issues for political gain.
- Where are the IPAB nominees? Klein’s post admits that the “most famous” way the President would reduce Medicare costs is through the Independent Payment Advisory Board (IPAB). Klein also notes that the President has proposed “expanding IPAB’s mandate such that it can change Medicare’s benefit package” and lowering Medicare’s overall growth rate. But here’s the interesting thing: According to page 426 of the statute, the law appropriates funds for IPAB (originally $15 million, but lowered to $5 million last December) “for fiscal year 2012” – that’s the fiscal year ending this September 30. So Obamacare contemplates IPAB being up and running NOW – yet President Obama has failed to nominate any appointees to the board. If the President wants to save Medicare so badly – and IPAB is so critical to saving Medicare – what’s he waiting for? And if IPAB is so innocuous and won’t harm seniors, why is he waiting until AFTER his re-election campaign to announce who he wants to put on the board?
Klein would probably argue that conservatives will oppose whomever the President nominates, so there’s no point in the President putting forward appointees now who are going to get attacked. But it’s more than a tad hypocritical for Democrats to be gleeful about running “Mediscare” attack ads against conservatives – only for these same Democrats to claim they can’t put forward IPAB nominees whose records will be subject to similar public scrutiny. And given the massive powers of the IPAB officials – the rulings of these bureaucrats will be exempt from both administrative AND judicial review – there’s a good government argument to be made that the American people should have full knowledge of who these powerful people will be BEFORE they make their choice in November.
When it comes to both the demographic challenges facing Medicare, and the specific IPAB officials who will implement the lynchpin of Obamacare’s plan to lower costs, President Obama has failed to offer any specifics or any vision – meaning that even under favorable circumstances, the best grade one can offer for the President’s Medicare “plan” is an Incomplete.