In the unconscionable shadow play over the normally pro forma raising of the nation's debt ceiling, Congressional leaders wrestling to find $2.5 trillion in spending cuts to fund tax giveaways to the rich have run into a brick wall trying to cut Medicare. Angry mobs descending on Republican town hall meetings this Spring to denounce Rep. Paul Ryan's (R-WI) scheme to gut Medicare put paid to that idea. Howling townsfolk with pitchforks and torches.
Privatizing Social Security was equally unpopular with the ever-powerful senior lobby. Privatizing Social Security, while a coveted goal for Republicans and their Wall Street cronies, doesn't have anything to do with balancing budgets anyway. Contrary to right-wing demagoguery, Social Security is solvent for decades, and is, with the slightest of tweaks, likely to remain solvent as long as Republicans don't start plundering it.
As the relentless Republican juggernaut blundered ahead demanding ever larger and more extravagant tax subsidies for the ultra-rich in exchange for raising the debt ceiling, Democrats, instead of holding the line on profligate tax expenditures for those who already have so many mega-yachts and private jets they have to find whole new countries to park them in, decided the best way to help Republicans keep the fat cats gorging themselves on very, very fancy feasts was to throw upwards of a quarter of America's population under the bus.
68 million Americans, including uninsured low-income adults, children, the disabled, and millions of seniors needing nursing home care, count on Medicaid and the Children's Health Insurance Program for health care.
For politicians looking to subsidize billions in tax giveaways to the ultra rich, the bugaboo in cutting Medicaid was those millions of seniors in nursing homes. Democrats, and possibly a few Republicans dosed with Adderall and Ritalin, understood Not Touching Medicare applied to any program that provided health care services to seniors.
Thus, Medicaid was eminently slashable except for those pesky seniors in nursing homes. Seniors vote, have lobbies that can take you on cushy junkets, and, possibly owing to their age and experience, know their way around a pitchfork or a torch.
Politicos figured the best way to deal with Medicaid was to separate the well-represented senior wheat from the under-represented low-income chaff.
"A lot of us are concerned that Medicaid as it effects nursing home patients and people with a disability is irreplaceable," said Rep. Rob Andrews (D-NJ), cleverly buzzing in and telling Alex which two groups dependent on Medicaid have powerful lobbies that can treat you to expensive junkets. Andrews said, "For low-income people who are otherwise healthy, there may be creative ways to help fulfill our obligations for health care," neatly disposing of those on Medicaid who don't have powerful lobbies that can treat you to expensive junkets.
Sen. Jay Rockefeller (D-WV), who inherited enough money to pay for his own junkets, said, "Medicaid suddenly looks like the sacrificial lamb." Rockefeller co-authored the CHIP legislation that extends health insurance to millions of kids from low-income families.
Andrews did not specify which creative ways might fulfill health care obligations to low-income people, as Republicans would surely obstruct any attempt to cop bullets from defense appropriations for the poor to bite.
Of course, low-income folks who are otherwise healthy with Medicaid will rapidly become otherwise very unhealthy without Medicaid.
Now, if anyone was really interested in controlling costs and balancing budgets, the real correct answer is to extend Medicare to everyone.
Talk about saving money. Medicare's administrative costs run at around three percent, not least because there aren't any high-flying fat cat CEOs shovelling dumptruckfuls of cash at mega-yachts, private jets, trophy wives, trophy mistresses and trophy private service providers. Administrative costs make up 5%-10% of large corporate group insurance plans. For small groups, as much as a quarter of premiums goes toward administrative costs. Administrative costs on individual policies, like the ones Ryan wanted seniors to buy in his Medicare Couponization scam, run a whopping 40%.
Implementing efficiencies, such as utilizing physical therapists and nurse practitioners wherever possible instead of ordering up MRIs, CT scans, and countless tests, then referring patients to expensive surgeries every time someone has a nosebleed would go a long way toward cutting health care costs, to say nothing of cutting off all those useless layers of insurance company profit parasites intent on gorging themselves on dumptruckfuls of cash for mega-yachts, private jets, and trophy partners.
To say nothing of cutting off all those useless layers of hospital corporation profit parasites intent on gorging themselves on billions for their mega-yachts, private jets, and trophy partners. After gorging on a few billion here and there, they're likely to make themselves governor of a large southern state, as did Rick Scott of Florida. As both a Rick, like Texas' Rick Perry, and a Scott, like Wisconsin's Scott Walker, billionaire ex-hospital mogul Rick Scott must surely be in the topmost eschelon of Republican Scott-Rickhood.
Which brings us to the real problem. No one around the Beltway is really interested in controlling costs or balancing budgets. If they were, they'd be extending Medicare to everyone and seriously reforming revenue so 20% of Americans won't always own 84% of everything in America. What Republicans and not a few Democrats really want is to keep coddling the richest, most powerful capitalists on Earth with trillions in tax giveaways paid for by slashing trillions in services for the rest of us. The real problem is all those Beltway pols pandering to all the Rick-Scotts among them.