Obama Is About To Sign The Biggest Health Care Bill Since Obamacare

[one_voice]

WASHINGTON — President Barack Obama is poised to sign into law the most far-reaching health care reform bill since Obamacare, permanently ending the "doc fix" dilemma that has haunted Congress for more than a decade.

It also slashes Medicare benefits for upper-income seniors.

And in the strangest of twists, the legislation passed with overwhelmingly bipartisan support, an exceedingly rare achievement for a Congress that has all but ceased to address big, long-term problems.

*snip*

"Through this bold, necessary legislation, we have secured critical support for low-income seniors, for poor children, and for underserved communities across the country," said Pelosi.

The legislation has three broad components.

First, it fixes a gaping hole in the Medicare program by replacing the formula to pay physicians — known as the Sustainable Growth Rate — which imposes steep annual cuts that Congress has routinely overridden for 12 years. Instead doctors will receive a 0.5 percent pay bump for each of the next five years before transitioning to a new system aimed at paying them for quality of care.

Second, it cuts billions of dollars from Medicare. It requires seniors who earn between $133,500 and $214,000 a year (and couples making twice that amount) to pay more for insurance and prescription drug coverage, and cuts spending on supplemental Medigap plans in order to discourage over-utilization of services on the taxpayer dime. It also modestly reduces long-term spending on providers of hospice care, home health services and nursing homes.

Third, it extends the Children's Health Care Program for two years, moving the new expiration date to October 1, 2017. (Democrats had pushed for a four-year extension but House Republicans rejected that idea and Senate Republicans killed an amendment to that effect.)

*snip*

more: http://talkingpointsmemo.com/dc/obama-signs-sweeping-medicare-overhaul-bill

[JaneyVee]

1. KNR!

[NoJusticeNoPeace]

2. When you "means test" that which we paid for and is ours, we begin down a bad path

[TheProgressive]

5. Totally agree with your stateement.

Every pays in, everybody benefits.

I am afraid this will be attempted with Social Security....

[okaawhatever]

6. Medicare doesn't come close to paying for itself, and Medigap was never a promised benefit. We have

to stop these wrong beliefs if we want to sustain the system.

And even so, the Social Security shortfall will be more than evened out by the extra dollars the couple gets back from Medicare. The couple will have paid $122,000 in Medicare taxes but will receive $387,000 in benefits — more than three times what they paid in.

http://www.politifact.com/truth-o-meter/article/2013/feb/01/medicare-and-social-security-what-you-paid-what-yo/

[jeff47]

9. They aren't supposed to.

Social Security and Medicare are not savings programs. They are insurance programs.

[paleotn]

13. Exactly. (Nt)

[JDPriestly]

52. Nonsense. Increase lower wages and proportionately decrease the highest wages (the CEOs)

and more tax revenue will flow into Medicare because payroll tax revenues will rise.

The problem funding Medicare is mostly caused by the fact that while wages are stagnant, medical costs have skyrocketed.

Raising lower wages will also help solve the fears about the future of Social Security.

This is a bad move on Obama's part.

[okaawhatever]

55. An increase in lower wages won't solve the Medicare problem. Health costs rose double digits

for over a decade. In addition to that Bush added Part D which was legally forbidden from negotiating with drug manufacturers and caused billions in losses to the program. Even with the ACA lowering costs, we probbly won't ever get back to the place where Medicare pays for itself.

[JDPriestly]

56. It doesn't make much difference because the medical costs are so high for seniors that without

Medicare, the government will have to pick up the tab for many of us and impoverish not just us but our children who would otherwise maybe inherit a little something from us.

The cure is to reduce medical costs. One possibility is to change the rules so that Medicare, like the VA, can negotiate bulk costs for drugs with the pharmaceutical industry.

There really isn't much to be done about the high cost of Medicare. Children want their parents to live well, to be as healthy as possible, not to suffer and hopefully to live long.

[okaawhatever]

57. The ACA took care of the negotiating for drug prices problem. That is one of the reasons health

care costs have gone down. Medicare is a pretty lean program. Pretty much the only way to get the costs down is to means test. Even if you set the bar at a couple of million in assets you'll see a dent in the Medicare costs.

I have no problem with people getting back what they paid in plus interest, even if they're worth a billion dollars. I do have a problem with Medicare going into the red for someone who has a few million sitting around. The medicare dollars that are spent on the multimillionaire can be spent lowering the deductibles of those with lower incomes.

One might think the wealthy don't waste their time with Medicare, but that hasn't proven to be the case, especially with medications.

[JDPriestly]

65. What percentage of Medicare expenditures go to those with incomes that would require them

to bear a larger share of their medical costs?

In my experience with such people (and I have only a tiny bit), they rather like to pick exclusive doctors and health cures that are probably not covered by Medicare. Maybe that is just what I have seen in my extremely narrow experience in this area.

How much percentage-wise will be saved in Medicare costs with this measure?

I ask that because I am thinking that perhaps this means testing will further disenchant these very rich people with the entire Medicare system. In this age of oligarchy, we who have very small incomes as we age might be better off if the oligarchs (and people with incomes at that level are potential if not actual oligarchs) share an interest in supporting and adequately funding programs like Medicare.

I fear that this cut in Medicare will lead to yet another division based on economics in the interests of rich versus poor. Now that this bill has been signed, the very rich will have yet another reason to look upon the rest of us who really need Medicare's assistance as leaches on them.

I prefer social systems that treat everyone equally in terms of benefits whether they are rich or poor. We are all in this together. That is especially true in the final days of life.

We do not take our wealth with us.

A better solution would be to raise estate taxes and recoup money after the death of a person. The entire estate tax system needs to be reconsidered and strengthened. After death is probably the least painful time to have to pay taxes. Don't you think? Doesn't hurt the deceased at all.

So instead of increasing the share the wealthy pay for medical costs under Medicare, we should increase estate taxes. That's my preference.

[okaawhatever]

66. Well, the house just passed a bill eliminating the estate tax. Obama has promised to veto it

but if we get a Republican president in 2016 it will become law. I agree with your concern that if you eliminate some of the Medicare benefits there will be less support for it. That is why I said give them back at least what they put in plus interest. I don't know if that woudd work, or if the wealthy would still fight it.

The study/report I read was a couple of years ago and it said that almost everyone uses the prescription benefits because it doesn't affect your purchase experience. Pharmacies are set up to handle Medicare the same way they handle regular Rx. It also commented that even the very wealthy will use Medicare if they actually go in the hospital. They will pay the extra amount for top of the line doctors and a private room, but they'll make sure Medicare pays all that they will first.

I agree, I don't like the idea of messing with Soc Security or Medicare but todays senior citizens are the wealthiest group of seniors this country has ever had and that is going to get worse since those working in the post-Reagan years don't typically have the retirement benefits. Something has to be done.

Today's seniors are getting back more than they put in from SS & Medicare. That trend will change (I can't remember for what year but in the next couple of years) and the SS trust fund will deplete to where they can only pay 77% of today's benefits. Why take away from the people who paid more into it to give today's multi-millionaires what they haven't paid into it?

The obvious solution is to cut spending in other areas like defense and add more to the SS trust fund, but with the current political climate you can't count on that happening.

[JDPriestly]

67. Is there maybe a typo here?

I agree, I don't like the idea of messing with Soc Security or Medicare but todays senior citizens are the wealthiest group of seniors this country has ever had and that is going to get worse since those working in the post-Reagan years don't typically have the retirement benefits. Something has to be done.

American seniors today are, I think, much poorer than their parents were. I can say that about my own family. And the housing crisis hit a lot of seniors really hard.

Plus, the fact is that extended families where the seniors live in or near the homes of their children became a thing of the past in America especially beginning in the 1930s and 1940s. In addition, women, who used to help their children take care of the grandkids and also take care of the great-grandparents (my mother and grandmother took care of their mothers as they aged) are working and not able to care for the elderly (or the very young). So, you have seniors out on their own in the years in which they need the most care right before death.

And the cost of nursing home care is outrageous. Anywhere from $5,000 to $10,000 PER MONTH (!!!!!!) are prices that I have known of and you probably would not want your mother in a place that charges only $5,000 per month.

So, children of middle-class parents

The big problem is that the wages from which the payroll taxes are now being withdrawn have not kept up with the increase overall in the costs of medical care. This is partly due to the new technology, techniques and discoveries of all kinds including pharmaceuticals.

But I have to say that a lot of medications now are not prescribed and not paid for by Medicare. We buy them off the counter. That is especially true for chronic conditions. So Medicare does not begin to cover the huge medical costs of seniors as it is.

Cutting Medicare for the very wealthy is just a way to begin chipping away at it and hurting all of us.

We should cut our military expenses -- especially in Germany and the Middle East. Germany has a generous balance of payments surplus and is capable of doing more to secure the peace in its area. It has been a long time since WWII. Germany and other NATO countries that are doing well should share more of the burden for peacekeeping in the world. It should not be such a heavy burden on the US. And in the Middle East, a country like Saudi Arabia should be spending much more of its wealth and sweat on peacekeeping.

We should not have to pay for so much peacekeeping in the world. And we should make sure that Muslim countries are in the forefront in controlling Muslim extremism and fanaticism in their own backyards. When we, a nation of mostly Christians, act as peace enforcers against Muslim extremism and authoritarianism, then we add to the illusion that our objections are about their religion rather than that our objections are about their rampant cruelty and THEIR militarism. I don't think I am explaining this well, but I hope you understand. We appear to them to be the infidel when we are not concerned about the differences in religion but rather in the horrible attacks on civilians regardless of religious differences. That is why Muslim countries should be responding to the extremists and terrorists who share their religion. We should take a back seat and avoid the religious aspects of the conflicts. I think that Obama probably agrees with me on this, but it is a difficult policy to implement if countries like Saudi Arabia do not want to take upon them their responsibility to maintain peace.

[okaawhatever]

68. I googled to find an article about todays seniiors being the wealthiest and went through

many articles but couldn't find what I was looking for. I did find an article that said the same thing about Canada's seniors.

I remembered that Obama put Medicare taxes on cap gains now so the Medicare fund will last a little longer. I think it was scheduled to be depleted in 2018.


http://business.financialpost.com/personal-finance/retirement/richest-seniors-ever-how-the-luckiest-generation-keeps-making-money-and-spending-it

[cstanleytech]

29. Wait, so those who have the money shouldnt have to pay for their care???

[JDPriestly]

53. Those who have money very likely paid the maximum or close to it into Medicare while they were

working. They have paid for their care.

If wages had not pretty much stagnated for at least 30 years, we would have higher revenue from the payroll taxes and next to no or no problem paying for Medicare. The disparity in incomes is the problem here, not the Medicare program which promised the same medical care for all seniors.

[PoliticAverse]

3. Despite several DU posts on it DU seems a lot more interested in Clinton's logo than this bill. n/t

[still_one]

4. Primary care doctors were really not being treated fairly. Hopefully, that will

address that issue

[Downwinder]

7. ???

"cuts spending on supplemental Medigap plans in order to on the taxpayer dime"

Cuts whose spending? Is Medigap a Medicare program or private supplemental insurance?

Who controls "discourage over-utilization of services?" Most people I know just do what the Dr. says. Who is pushing preventive care, the patients?

[tammywammy]

10. Medigap

http://www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html

[freshwest]

14. Good link. I can't afford anything but A & B, though. n/t

[ananda]

16. Medigap is NOT an advantage plan.

..

[tammywammy]

36. I didn't say it was

I just gave the link explaining what Medigap is.

[freshwest]

46. Thanks for the information, tammywammy. I didn't know what it was.

A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles...

If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.

That's for those with enough after housing, etc. to pay for more. After a while, there is no more to pay. IOW, another payment some of us can't afford. 'That's the breaks,' as they say. But that will help a lot of people.

[ND-Dem]

50. who will it help?

[freshwest]

51. Not me. But I hear people who have it tell me they like it. EOM. n/t

[BrotherIvan]

8. I don't know much about the bill and hope it's good

But some of it sounds like rationing. And this part I don't agree with one bit.

It also modestly reduces long-term spending on providers of hospice care, home health services and nursing homes.

I get edgy when they mess with Medicare. Mess with the Pentagon if you've got to cut somewhere!

[SoapBox]

15. + a bazzilion to "Mess with the Pentagon" instead of Medicare.

Those cuts to hospice, home health and nursing homes are very concerning, as those would be services used by the poorer end of the spectrum.

[BrotherIvan]

19. I have personal experience with this

Home health care and hospice were absolute lifesavers with my mother's terminal cancer. I would quite literally have had a nervous breakdown caring for her without them. The people who made these cuts obviously don't think about those things. In fact, end of life care with extraordinary measures in hospitals is far far more expensive than home health care (which keeps a person in his or her home rather than a hospital bed) and hospice by orders of magnitude.

As an aside, if they want to make healthcare cheaper, teaching doctors how to do clinical diagnosis again rather than running five tests for every patient problem would go a long way. Doctors use testing now because they are too lazy to look up symptoms in a book or because they want to cover their butts. But for mild issues, a good, knowledgable doctor is just as effective as an expensive test. My 2 cents.

How how about somehow regulating price gauging in prescriptions? I know that Medicare does its best, but how about Congress (constantly lobbied by pharma) do something to get our prices to be somewhere in the same galaxy as Europe and Canada?

There are many things that can be done to make our healthcare come down from the most expensive in the world. Medicare is a great program. Imagine if young and healthy people were paying into it to offset the costs of the seniors who need it. I never go to the doctor but I would GLADLY send my insurance premiums to Medicare instead of my insurance company which I hate. That's how you fix Medicare.

[Mojorabbit]

42. + a kabillion. nt

[freshwest]

17. People I know in such situations get virtually nothing from Medicare, Medicaid foots the bill as it

far exceeds what Medicare does pay for their care. When one asks them about Medicare, it's more like 'Medicare? Pfft!'

It's Medicaid that keeps them able to live there, as it pays the majority, not Medicare. I've wondered if the various changes will enable more people to get on Medicaid that don't qualify right now. If a state has agreed to Medicaid expansion, all for the better. JMHO.

[BrotherIvan]

21. My mother qualified for all of these services through Medicare not Medicaid

Becuase she had the asset of her home--her final wish being that she died there and not the hospital--she did not qualify for Medicare. For someone needing nursing home care, that may be the case as the cost of nursing homes are astronomical and Medicare pays very little.

But Medicare has excellent home services currently if your doctor is supportive in ordering them. Once the patient is on hospice, even more services are available which is why I recommend hospice to anyone caring for a terminal relative who has reached the end of treatment options. People have a misconception that signing onto hospice means an instant death sentence. Not so as I personally know two people who lived over two years while on hospice. The people who work there are extremely caring, knowledgable and professional--and after dealing with the coldness and runaround of doctors and hospitals, meeting people who actually cared about my mom and wanted her to happy and comfortable was like angels had come to our aide.

Home health and hospice are great options for people and cost so many magnitudes less than hospitals or nursing homes. For families caring for elderly relatives, they need as much help as they can get.

[bbgrunt]

25. this mirrors my experience.

[freshwest]

26. That is excellent. The people I know sold their homes for medical care long before getting Medicaid.

Their only asset was their social security check and it all went to the places they lived, for many years, as their health needs were very high and required constant staffing, day and night. I am glad your mother had the options that she did. Not all do.

So I am not acquainted with what to me, sounds like the best thing possible. I am on Medicare, my state doesn't give me any help, I can't afford any extra policies or home health care, nor doctors anymore. I sold my home to pay for the care of my family members as there were no options at the time.

Home health care was nowhere near as available then as now. A very cruel state of affairs when a person has to put a person in care to get help. And I don't have assets, but my SS is too high for state help. I will die alone at my rented place.

But I have no regrets, really. I took care of my family, just as you have yours, and that allows me to sleep at night if I am able to sleep. Really, it does me good to hear your story.

Everyone's life is so different. Thanks for showing me another side of life.

[BrotherIvan]

39. So sorry you are facing this

It's why we should be expanding Medicare, never cut it. I hope you can find some help or maybe even a situation where you live with someone to help out. The best advice I have is to try to contact a medical Social Worker or a Medicare person who can walk you through your options. I was truly surprised at how much help we got when we found a doctor that was willing to write orders. But all of the info came from the nurses and social workers.

Nursing home costs were so outrageous, it was far less expensive to keep my mom at home with help. The places I called were $600 A DAY! and Medicare would only pay for $200 so it wasnt' an option. Through Medicare there was a hospital bed, all kinds of equipment, supplies, a nurse who came three times a week for blood draws and to check medication. With hospice the level of care was even better with extra people coming to help bathe here and even pick up prescriptions. Still, I nearly died of stress and almost lost my job trying to care for her, so it was no walk in the park. I remember when I was picking up a prescription, I looked so run down and tired, the pharmacist looked at me with pity and said (guessing my situation) "I took care of my mother too." She was very kind and told me to get as much help as could. I listened to her and am forever grateful to her for her kindness.

Hopefully your health stays good and you can take care of yourself. I wish you the very best. And reach out here at DU because there are a lot of smart, caring people who seem to be willing to help. There is a lot of information that isn't readily available. It is a pain in the butt to work the system, but there are options out there.

[freshwest]

41. What a very kind reply. I am saving it to remind myself that maybe there is a way.

However, my health is broken from care giving and my family has passed except for those in care. I couldn't make 'the race to the end.' It is almost impossible for me to advocate or do anything for myself any longer. I am approaching a tipping point, but I stay as optimistic as I can while it is all sinking in what I am facing.

The problem I am finding with the doctors here is that they seem to have become more of 'product' sellers. If one can't buy the product, they have nothing to say to you. If you say you don't have the money, they have nothing to say.

I will attempt to talk to some of the nurses and social workers, although I was told I would have to be on Medicaid for them to take on the task.

I am blessed by getting a discount on my electric bill by the city owned utility here. I get my food at the food bank now as I have no cash at all. I'm just sorta hanging. I'd say lingering on but it sounds too dramatic.

I have one elderly friend who knows just how severe my condition is and no one else. The doctors want me to go to specialists I can't afford. I can't even get transported, much less purchase prescriptions they tell me to buy to get better.

There are some very knowledgeable people here, very true. Mineral Man's suggestion with a coupon service did save me enough money to buy an RX that seems to be good but it was very difficult for me to eke the money for it and I'm not sure how many more times I can do that.

Good luck to you and your health and that of your surviving family. I appreciate your advice and will try to do more, but I am just so tired.

[BrotherIvan]

43. I am so sorry, it should NOT be this way in our country

I feel for you in your situation. I really do. I'm going to think about it and see what I can find, but here is a link that shows some very brief Medicare things

http://www.medicare.gov/coverage/home-health-services.html

I hear you about doctors pushing (mostly prescriptions). I worked to get my mother's prescriptions from 19 down to four. I mean, she had terminal cancer and was bedridden, she didn't need all those so-called preventative medicines. It was costing a fortune. And after this experience, I am not a fan of most doctors for the reason you state and others.

One good thing is I found a doctor who made house calls. Because my mothers GP refused to write refills for her necessary medications if she did not come into the office--she was bedridden, duh--that's when I realized no doctor would help if they couldn't bill for an office visit. So I started calling doctors and found one that did house calls because he worked with stroke victims. He helped write the orders for things and his nurse was very responsive (he was an old curmuggeon but at least he would write the orders). If you live in a place with access to something like that, it would be a huge help. She lived in the suburbs and I was surprised to find there were three just in her area. I just would call a doctor's office to see if they knew anybody who did house calls. I think by the third one they gave me his name.

The other thing Medicare can help you with is rides to see your doctor. They probably have contracts with agencies that shuttle people who can't drive to medical appointments. So if you're still somewhat mobile but can't drive to an appointment, that might be a good solution. In Southern California, there is a company called Get About that will come and pick you up.

Also, have you contacted Meals on Wheels? I know that is a good program for seniors but I'm not sure of the specifics. They can deliver at least one meal a day to you. As far as I know they have locations all over the country. And if it's something you couldn't afford, I would be the first one in line to donate to the cause.

COST OF MEALS
No one is turned away from Meals on Wheels due to inability to pay. Your cost for meals is based on a sliding scale, and we work with you to determine an affordable fee for your budget based on your gross monthly income minus certain expenses. A limited number of sponsorship opportunities is available through Senior Connections, Jefferson Area Board for Aging (JABA), Crater District Area Agency on Aging, and directly through Meals on Wheels. The full cost of the meals is $6.00 for the daily main meal, and $5.00 for the sandwich meal.

Meals on Wheels can now accept SNAP (foodstamps) for payment.

I'm sure there are some things that other people can think of and suggest. But the best part is that you are sharp and smart. You are politically active and have so much information to share. I wish you the best, truly.

[BrotherIvan]

45. Here seems to be some more Home Health info

https://www.medicare.gov/Pubs/pdf/10969.pdf

[ND-Dem]

49. my experience with hospice is different from yours. some people were caring, others were

not, same as any facility. and as a whole, I'd say they deliberately speeded up my family member's death by actively denying fluids and getting irritated when family members gave them.

"hurry up and die" was the message.

[BrotherIvan]

62. I'm sorry to hear that, that's awful

Places like that should not be in business. It's so heartbreaking to hear about people in the most stressful time of their lives dealing with these kinds of struggles. I guess until you've been through it, you have no idea. I sure didn't. But we need to all start talking about it and how to fix it.

[yeoman6987]

27. My Mom was in the hospital for approx 40 hours

Had an operation was in intensive care. I was expecting to pay a ton. The bill was 67,000. My portion $125.00. Medicare and supplemental insurance practically pays everything. I was shocked to say the least.

[freshwest]

31. I know it's great for hospital things. But that's not my experience with LTC. Glad you got help!

[yeoman6987]

32. Excuse my ignorance, LTC?

[freshwest]

33. Not ignorance, just different paths of life. LTC = Long Term Care. For chronic, severe disability.

[yeoman6987]

34. Oh thanks!

I love this place so much. I have learned a ton!

[JDPriestly]

54. Yes. That is bad news.

The people who get hospice, home health services and nursing home care are the most in need of help usually. These include people who are dying.

That is really bad news.

I agree. Cut the Pentagon before you cut Medicare.

[BrotherIvan]

63. I think we should cut the Petagon before just about anything personally.

Especially after I visit actual first world countries and see what they get for their tax dollars.

[JDPriestly]

64. Yes.

[canoeist52]

11. So...cuts to hospice, home health care and nursing home care

were slipped in while everyone was distracted by The Campaign Spectacle. I figured they were up to something...

[NCarolinawoman]

20. They already cut home health care and hospice as part of the wheeling and dealing

that went on during the formation of Obamacare, The cuts went into effect July two years ago.

I should know because I am on palliative care and my home health care team keeps me informed. My palliative care doctor keeps me up on things as well. They've been emptying out beds with 92 year olds who have failure to thrive, These people are wasting away but they can't calculate a time period for their dying, so they are cutout of the program. My nurse told me of a multiple sclerosis patient who was fading fast, was sent home from hospice.

Nursing homes are already understaffed and it is ridiculous to be cutting aid to them. The workers get peanuts--I consider a good compassionate nursing home worker to be worth more money than rock stars, and professional athletes. It is not glamorous work. Most of the workers can't even afford cars.

[erronis]

24. People should be paid by the worth of their work - ++healthcare/teachers/etc. --politicians/military

I've always felt that someone that has to get up at 4AM to collect my trash (stinky job) should be paid a lot more than me (some computer worker.)

Same for Presidents and CongressCritters and "Important" People - they are riding high in their limousines and being fed at expensive restaurants. They probably don't even need $9/hour. Let's give their salaries to the people that take care of us in infancy, in sickness/wellness, while struggling, while dying.

I'm glad you have a good doctor, NCarolinawoman. Both of my parents were cared for at home and with hospice and a loving family. I will try to refuse any payments to a for-profit "health" corporation when it is my time.

My best wishes to you.

[NCarolinawoman]

69. Thank you.

I totally agree with you about the people who collect our garbage. I went through a long sanitation workers strike while living in Philadelphia. It was in the middle of summer. Those workers made their point! LOL Those people should get raises all throughout the country.

In 2005 my Mom had hospice care at home. She was 87, had congestive heart failure, and was tired of hospitals. She was considered a "failure to thrive" cause she kept losing weight and if out of bed, she would be out of breath. She was allotted 6 months and we were told she could "graduate" but go back on hospice care, if necessary. After 5 months, she died very peacefully-- she chose not to eat that day-- just wanted to listen to some of her favorite music, mostly hymns. Said good-by to us that evening, then it looked like she just fell asleep. Didn't even want anything for pain. That is the way hospice use to be.

[valerief]

12. Not as good as sacking half of the MIC budget and not as good as single payer.

[BlueMTexpat]

18. While I don't like the potential "slippery slope," the fact is

that my husband and I fall into the category of "better-off seniors" and can afford to pay more for Medicare/Medigap - so long as those who truly need the services - or are providing them - will actually receive the benefits. I definitely want such programs as Children's Health Care to continue and I do not want low-income seniors to be penalized by this heartless GOP-dominated Congress, etc. Nor do I want doctors who accept Medicare patients to suffer for that choice.

But so long as the MIC and the One Percent feel no pain, I do not like this.

I would very much like to know why those who contribute the least - proportionally - to our nation's social costs cannot contribute more, before we who have worked hard all our lives to finally reap the benefits of retirement must feel the pinch.

I would also like to know why Democrats generally will not fight a LOT harder for the One Percent to pay their fair share before having those of us in the fast-diminishing US middle class take up the slack.

Those are the hard questions. So, pardon me if I am not as impressed by this "accomplishment" as some may think I should be.

[yeoman6987]

28. You and I both are in the increase but I think it is great

Hopefully we will pay more every year. Why should we live well while paying Los for medical while the poor barely survive and pay the same as you and I do. Something very wrong there. Glad they are fixing it.

[BlueMTexpat]

61. As I noted, I am happy to pay for the increase

in order to keep programs alive and benefits available for those who need them most. I am fortunate to be able to afford those services and I firmly believe that they should be available to all. I certainly believe that those who are barely scraping even should not pay more.

But why are the premium increases geared only towards those in this income group? From the link:

It requires seniors who earn between $133,500 and $214,000 a year (and couples making twice that amount) to pay more for insurance and prescription drug coverage, and cuts spending on supplemental Medigap plans in order to discourage over-utilization of services on the taxpayer dime. It also modestly reduces long-term spending on providers of hospice care, home health services and nursing homes.

What about those whose incomes exceed those mentioned? That's my beef. Why can't they - for once - pay their fair share instead of asking for more and more tax breaks?

[djean111]

30. So many Democrats at the top are Third Way Blue Dogs that they really are not what

Democrats used to be. And the DNC is not going to back liberals at the top, IMO, no matter how earnestly we vote for them down-ticket. As Warren says, the game is rigged and the deck is stacked.

[BlueMTexpat]

59. It's time to repair

this stinking "game." Long past time, in fact.

[cprise]

37. I feel that slashsing medical benefits for upper-income is a mistake

If those people are really 'upper-income' then they aren't numerous enough to be a burden on the system.

And if the subsidized health system doesn't want the well-off as customers, then that system will come to be associated with desperate people in the public mind; Expectations and standards within the system will drop as a result. I have heard European health administrators talk on this very subject, and the mindset is diametrically opposite what is on display in this deal.

So this band-aid on the larger problem of not properly levying taxes could have a serious side-effect on the culture within the healthcare system.

[ND-Dem]

48. thank you for the voice of sanity. the people cheering for this are foolish. turning medicare into

a welfare program is a move that undermines political and popular support for it, and that's precisely the intention of the "bipartisan" politicos who passed it.

iow, support for killing it is bipartisan, like there's bipartisan support for killing every program that actually works and benefits ordinary people.

no wonder there's bipartisan support for assisted suicide. all part of our "betters" plan for the 99%.

[BlueMTexpat]

58. I agree that this "solution" is

not truly a solution.

But perhaps it was the best that could be done at this time ... with this Congress.

That is all the more reason to begin working right now on replacements for the GOPers.

[Cryptoad]

22. Cut Long term care .....?

So all those who find themselves at the end of life in a position where the nursing home has drained all your resources and not long can afford the $7 -$10 K / month for care and no family,,,,,, you are shit out of Luck, now......Death Panels starting to sound good....... the fix for medicare is an easy one but the politicians will not touch it..... make Fica Tax a progressive tax..... done!

[Hekate]

23. Kick and Rec

[AikidoSoul]

35. Yeah, but the MSM is giving the credit mostly to Boehner and McConnel.

Kick

[Cha]

38. KICK

[Zorra]

40. The greedy rich: Bleed 'em if ya can't eat 'em.

[joshcryer]

44. I was warned on DU that Obama was going to cut Medicare!

OMG, cuts, catfood commissions for the top 5%!

[ND-Dem]

47. "bipartisan support" = trojan horse that screws the 99%

[liberal_at_heart]

60. +1. If the Republicans support it you know something is getting cut somewhere and I don't

support cuts.