Obama's Medicare Hypocrisy
By DICK MORRIS
Published on
TheHill.com on April 19, 2011
Piously posturing as the savior of Medicare, President Obama lashed out
at the House Republicans for embracing the budget proposed by Budget
Committee Chairman Paul Ryan (R-Wis.). But a comparison of the
president's own plans for Medicare with those in the Ryan budget shows
that the Democratic cuts are far more immediate and drastic than
anything in the GOP proposal.
While the Republican Medicare changes only take effect in 2021, Obama's
cuts will begin hurting seniors right away. The president's healthcare
legislation imposed a hard spending cap on Medicare
-- the first time
it has ever had one -- which he has just proposed lowering by another
one-half of 1 percent of GDP (a further cut of about $70 billion a
year).
Obama's cuts, which will take effect immediately, are to be administered
by his newly created Independent Payment Advisory Board (IPAB) of 15
members appointed by the president. Its recommendations for cuts in
Medicare services or for reductions in reimbursement will not be subject
to congressional approval but will take effect by administrative fiat.
Right now.
The IPAB will be, essentially, the rationing board that will decide who
gets what care. Its decisions will be guided by a particularly vicious
concept of Quality Adjusted Life Years (QUALYS). If you have enough
QUALYS ahead of you, you'll be approved for a hip replacement or a heart
transplant. If not, you're out of luck. Perforce, many of these cuts
will fall on those at the end of their lives, reducing their options to
accommodate Obama's mandate to cut costs. If death comes sooner, well,
that's the price of aging in Obama's America.
Ryan's approach is totally different. First, he does nothing at all to
cut benefits for those now on Medicare or for anyone who turns 65 before
2022 (leaving me in the clear!). Second, the Republicans would leave the
elderly in charge of their own medical decisions by letting them spend
their Medicare money as they wish. The subsidy they would receive for
health insurance would permit them to buy plans tailored to their needs.
Just as a myriad of insurance-company plans sprang up to fill the
mandates of the new prescription drug benefit, there will likely be
quite an array of choices for the elderly of 2021. Finally, the savings
from Ryan's plan will be plowed back into Medicare, prolonging its life,
rather than being diverted, as Obama would do, into paying for a new
entitlement for younger people.
But the most important difference is that Obama's cuts are now and
Ryan's are not. Any budget projection is a guess. When the projection is
made two to three years in advance, it is conjecture. Ten years away it
becomes fantasy. Who can possibly tell how the American economy will be
doing a decade hence? What revenues will it generate? And the only thing
less certain than guessing about the economy is projecting healthcare
costs.
Medicine is on the verge of a revolution akin to that which followed the
creation of antibiotics. Genetic medicine and ultimately nanotechnology
are about to change everything. No longer will we fight cancer by
cutting or burning or poisoning diseased cells. Instead, we will use DNA
and RNA to predict cancers and grow healthy cells. Who knows what the
costs will be? Possibly, they could be lower than our current range of
therapies.
And, between now and 2021, Congress will be able to change the Ryan plan
as it chooses. But the early deaths triggered by the rationing decisions
of Obama's IPAB cannot be saved. Their decisions are, for the elderly of
today, irreversible.
Democrats are drooling over the prospect of conducting the elections of
2012 over Medicare. They better watch their steps. The truth might come
out!
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(c) COPYRIGHT 2011, DICK MORRIS AND EILEEN MCGANN.
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