Tuesday, September 20, 2011

King of Pain

I haven't yet read Obama's Big Idea, but if what I read here is true, we may as well kiss the 2012 election good-bye:
...require new beneficiaries to pay higher deductibles (for) Medicare coverage of doctors’ services and other outpatient care...The deductible, now $162 a year, is...increase(d)...further by $25 in 2017, 2019 and 2021...

...increase Medicare premiums by about 30 percent for new beneficiaries who buy generous private insurance to help fill gaps in Medicare...the White House said this protection “gives individuals less incentive to consider the costs of health care and thus raises Medicare costs”...

...raise $20 billion over 10 years by charging higher premiums to higher-income beneficiaries and by freezing the income thresholds so more people would have to pay the surcharge (up to 25% of all beneficiaries)...

...certain new beneficiaries to pay co-payments for home health care, which is now exempt from such charges. The co-payment would be $100 per episode, defined as a series of five or more home health visits not preceded by a stay in a hospital or a skilled nursing home...

...Revise the formula for calculating Medicaid payments to states, saving $15 billion over 10 years. Restrict states’ ability to finance their share of costs by imposing taxes on care providers...

...Cut $3.5 billion over 10 years from a prevention and public health fund created by the new health care law.
I particularly like the "rob Peter to pay Paul" aspect of that last one. Why worry about the opposition dismantling the ACA when you can simply do it yourself?

And I just love the concept of slamming old people with higher premiums just because they were able to cobble together enough cash to buy some Medigap to fend off potential bankruptcy---because otherwise they have "less incentive" to keep their spending costs low. Just buying the damned supplemental insurance isn't evidence enough that they want to keep their costs down. They need to lose a fucking leg! Goddammit, in this New World of Pain, the last thing you want to do is reward the sickest members of your society (who are already on fixed incomes that you want to ratchet down even more with your fucked-up chained CPI) with affordable coverage for their sicknesses. Slackers!

And I realize that the prospect of paying a $237 deductible may not seem like much to someone currently earning $60, $70, or $80k a year--but once you're on a fixed income and earning $12-$14k, that's going to look a lot more like a choice between buying groceries or an examination of that sore spot inside your mouth, and a lot less like a drop in the bucket. The size of buckets, after all, being relative.

Obama’s budget director says the new plan will impose “a lot of pain,” (in this new S&M culture we call America that's the mot du jour délicieux.) That's certain to be true for the people who have already been writhing in agony. And it's going to be true for a lot more who are teetering on the precipice. But the wealthy who have been doing all the squealing? Not so much. They have plenty of insurance, so whatever happens to Medicare (and certainly to Medicaid!) isn't going to matter one whit to them. And really, since that's where the campaign money is coming from, isn't that all for the best anyway?

In a world where "justice" has disappeared from the daily language, maybe it does sound fair to "share the sacrifice equally" between suburbanites with multiple SUVs parked at million dollar McMansions, and widows living hand to mouth in little apartments in working-class ghettos. Maybe the entire definition of "justice" is now passe.

I can't wait to see how he plans to "help" Social Security.

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