Key elements of debt deal leaked ~ ABC News.

[mzmolly]

http://blogs.abcnews.com/thenote/2011/07/white-house-republicans-strike-tenative-deal-to-raise-debt-ceiling-.html">HERE, according to Democratic and Republican sources, are the key elements:

A debt ceiling increase of up to $2.1 to $2.4 trillion (depending on the size of the spending cuts agreed to in the final deal).
They have now agreed to spending cuts of roughly $1.2 trillion over 10 years.

The formation of a special Congressional committee to recommend further deficit reduction of up to $1.6 trillion (whatever it takes to add up to the total of the debt ceiling increase). This deficit reduction could take the form of spending cuts, tax increases or both.

The special committee must make recommendations by late November (before Congress' Thanksgiving recess).

If Congress does not approve those cuts by December 23, automatic across-the-board cuts go into effect, including cuts to Defense and *Medicare. This "trigger" is designed to force action on the deficit reduction committee's recommendations by making the alternative painful to both Democrats and Republicans.

A vote, in both the House and Senate, on a balanced budget amendment.

*Democrats won't like the fact that Medicare could be exposed to automatic cuts, but the size of the Medicare cuts is limited and they are designed to be taken from Medicare providers, not beneficiaries.

Two sources briefed on the framework say the automatic cuts would hit Defense spending harder than Medicare.

Key points:

1. The 1.2 T in cuts happen over 10 years.
2. Any ultimate cuts to Medicare, are on the provider end. Beneficiaries are NOT impacted.
3. REVENUES are included, depending.
4. No adjustments to social security are noted as, "on the table" at this time.

Can someone (without ESP) tell me how this is "caving" or "capitulating" to Republicans, please?

[Skidmore]

1. If 2 is indeed there, perhaps it will help bring the cost of

medical services down to reasonable levels.

[mzmolly]

2. Wouldn't that be

great? :hi:

[William769]

3. IMHO if 2 is there it will mean

Medical providers will start dropping medicare.

The vicious circle continues.

[mzmolly]

6. That depends upon how cuts are

implemented.

[helderheid]

7. God I hope not.

[Peregrine Took]

8. Absolutely. That was the first thing that came to me. Many docs don't

take it now.

[Ghost in the Machine]

137. I guess it depends on where you live... most people around here are on either Tenn-Care or Medicare

from Disability or from Social Security, the doctors depend on it to survive in my neck of the woods...

[emulatorloo]

26. Medicare was cut in 92 with provider side cuts and providers did not "drop" medicare.

It all depends on what form the provider side cuts take.

[zalinda]

79. The better providers did drop it for new patients.

It is now the mediocre doctors and hospitals that will accept Medicare and Medicaid. More cuts, and we'll get the dregs.

zalinda

[mzmolly]

92. Is there a list?

I don't know of any providers who don't provide care to medicare patients, in my area.

[customerserviceguy]

107. Plus, the proportion of older folks was lower 20 years ago

With the baby boomers hitting retirement age, you will see many more providers opting out of Medicare. Those baby boomers, with their insurance coverage, made it possible for quite a few providers to keep accepting new Medicare patients. Now that they're going to need care, and there's no big boost from the 'echo boom' (working for lower wages than their boomer parents), providers will finagle ways to get out of the system.

[DURHAM D]

29. It will also mean that medicare supplemental premiums will go up.

Its a win for insurance companies and a loss for seniors.

[William769]

34. However it goes down

People on Medicare will be the losers.

You are correct.

[mzmolly]

46. Absolutely.

[William769]

59. When all your given is negitives.

Thats what you deal with.

[mzmolly]

62. When all you see are

negatives in spite of the facts being positive, this is true.

[William769]

71. I would like to see the facts first.

Speculation abounds & we have this Whithouse to thank for that. Friday there was talk of a secret plan from the White House, where is it? Just to name one.

The facts that we do know is tomorrow is Aug 1st, Seniors still do not know if they will get checks on the third. Just to name one. Now If you have any facts to the contrary now would be the time to post them.

[mzmolly]

72. That's a new and exciting

stance. I agree.

[phleshdef]

73. Thats logically no different than an argument for pro-"trickle down" economics.

Don't raise taxes on the job creators! They will stop creating jobs!

Don't put more cost burdens on Medical Providers! They will stop providing medicine!

Don't prevent banks from charging excessive fees and excessive interest rates, it will just trickle down to the consumers!

All of those arguments are exactly the same. I reject them.

And in regard to medical providers, its fairly ludicrous. You may have some that may stop accepting Medicare. But Medicare will remain a huge source of customers and revenue for medical providers, regardless of any provider payment adjustments. You are always going to have a good amount of medical providers that will want access to that base. And for the ones that do refuse Medicare, fuck em. I'm sick of those kinds of excuses being used as a way to dodge solving problems. Thats allowing market forces to hold the government hostage and its the source of just about all of our problems.

[William769]

80. I have lost 3 doctors this year because of dropping Medicare.

And this is even before any cuts that may be about to come.

Please forgive me If I don't see your logic.

And trying to connect this to "pro-"trickle down" economics." Was a major fail on your part.

[phleshdef]

86. I have countless family members on Medicare that have never lost any doctors ever due to dropping.

Your own supposed personal experience means about as much to me as mine does to you. You can interpret that however you like.

And no, my argument doesn't fail in the slightest. If you believe it does, then you are either unable to understand simple logic or you just refuse to.

You are making an argument that if we do anything that adds any perceived "burden" to the supply side, then that burden will trickle down to the demand side. Thats your argument, period. You can not refute that. Medical providers are the supply side. Recipients of medical service, in this instance the ones that rely on Medicare, are the demand side. The same argument you are clearly and irrefutably using is the same exact argument the pro-trickle down crowd uses.

So whether you like it or not, you just used a pro trickle-down theory argument as an argument against reducing certain payments to medical providers. Don't get mad at me over it. You are the one that made the argument.

[woo me with science]

100. There are so many you can't even count them, but you know they ALL kept their doctors!

That's an interesting family!

[William769]

102. Have at it.

http://thehealthcareblog.com/blog/2010/06/28/are-doctors-really-boycotting-medicare/

http://www.hbnradioshow.com/2011/03/texas-doctors-dropping-out-of-medicare-hits-new-high/

http://www.linkedin.com/groups/Why-are-many-doctors-dropping-138252.S.49553673?qid=46dfd5b4-6282-4b66-9c21-9c5e0aab49c0&goback=.gmp_138252

And many more.

Like I said MAJOR FAIL.

[phleshdef]

104. Putting major fail in all caps doesn't make you right. It just means you aren't to be taken serious.

Again, you are citing a trickle down argument to prove your point and you have thus far been entirely powerless to dispute that.

[William769]

108. I have yet to see you show anything to the contrary.

Well?

And speaking of "to prove your point and you have thus far been entirely powerless to dispute that." Ditto.

[phleshdef]

111. There nothing for me to show. You made a trickle down argument.

Thats what we are discussing, your trickle down theory as it applies to Medicare payment structures. You claimed you didn't make a trickle down argument. But with a few simple sentences, I clearly showed that you did. What do you want? Me to post a link right back to my own posts in this thread?

[JoeyT]

170. No, you dragged out a strawman and abused it so badly we should probably be calling 9/11 about now.

"Tax cuts increase jobs because rich people are benevolent and only need so much money so they'll give the rest away!" is a dramatically different argument than "If Medicare pays less and less so it becomes more trouble than it's worth, more and more doctors will stop accepting it."

You can't logically argue against the 2nd argument, so you drag out supply side economics and brutally savage it instead. Great going.

[treestar]

106. You're right. It's the same logic.

By that logic, we should never want tax increases on corporations - they will just pass it on to consumers.

[pipi_k]

171. Just wanted to add...

That with an ever-increasing group of Baby Boomers reaching retirement (and Medicare) age, any doctor who cuts a lot of patients on account of Medicare will likely only be screwing themselves in the process.

[customerserviceguy]

103. Ding, ding, ding, we have a winner

That's why I set up an HSA a year ago, and I'm trying to cram as much money into it as I can within the limits of tax law. I figure by the time I'm eligible for Medicare in either ten or twelve years (depending on what they do to the eligibility date) that I'll have a tough time finding a doctor to take care of me. My opthamologist cited the Medicare chopping block as the reason he was taking early retirement from his practice.

[Poll_Blind]

12. Horse with no Name: "Don't sugar coat this shit. Medicare cuts to providers WILL trickle down"

Don't sugar coat this shit. Medicare cuts to providers WILL trickle down

PB

[mzmolly]

19. Of course. Just after the COLA adjustments to SS take

place. I'm still waiting for that first prediction to pan out, ya know?

[William769]

28. What are COLA adjustments?

They seem to be a memory to me.

[mzmolly]

35. There was much talk about adjustments

to the cost of living for SS recipients.

[William769]

41. Thanks for the memories.

[durablend]

14. Oh yes

Medicare cuts are SURE to keep providers serving people. Yup.

:sarcasm:

[derby378]

4. We're looking as burned as Jennifer Schilling's HQ in Wisconsin

The teabaggers are getting everything they wanted, and the cherry on top is an unelected "Super Congress" that will push for further spending cuts that could hit us where we are the weakest. And those Medicare cuts hitting providers and not beneficiaries? Think again. That whole "health care reform" deal in 2011? The health insurance companies came out as the big winners - and the Democratic Party lost even bigger in November.

[mzmolly]

10. What? The tea party wanted a potential revenue increase?

I'm sorry derby, you can't make up your own cynical facts.

[derby378]

24. The secret word, boys and girls, is POTENTIAL

In the real world, that means never. I'm right on this, and you know I'm right. Look at who's in charge of the House.

[mzmolly]

44. Did you see the ESP disclaimer

above? I don't want predictions. I want to comment on the deal, once I have the facts. This article is the closest I've seen to any actual details. It's a shame that potential good news is rejected off the bat, here. Don't you agree?

[derby378]

66. You speak of "potential," but don't want any "ESP?"

Come on.

http://www.youtube.com/watch?v=53BfjIalG60&feature=related

[mzmolly]

69. I speak to the information in the article.

I'm not making up facts. The "potential" I noted, is laid out above.

[derby378]

77. Fair enough

But my reading of the article pins any potential tax increases on the creation of an unelected "Super Congress," which does not sit well with me at all.

[mzmolly]

81. It doesn't sit will with Republicans

either, from what I understand. ;)

[helderheid]

5. Thanks for posting this, mzmolly

[mzmolly]

11. My

pleasure Helderheid. :hi:

[boston bean]

9. why no automatic revenue increases, where the wealthy and corporations are targeted? nt

[mzmolly]

16. There are automatic increases, depending.

And, automatic cuts to defense. If we want fairness in the tax code, it's up to US to prevent a Republican majority in the house.

[enlightenment]

51. Really?

I just read the article you cited and it says nothing about 'automatic increases'. It says exactly what you quoted, which is that there could be increases - or there could be additional cuts.

Your desire to prove your point is starting to move from the reality of what was written to the fantasy of what you want to believe. Understandable, but you might want to dial it back a notch.

[mzmolly]

57. Feel free to parse words on the "automatic"

thing if you wish.

What point am I trying to prove? All I've ever said is, wait for facts before collectively whining about a so called deal. That's it.

[enlightenment]

115. mzmolly, I think you need to look up the definition of

'could'. It doesn't mean what you think it does, and my proper reading of the sentence is hardly parsing.

Further, for you to suggest that all you're saying is 'wait for facts' is ludicrous on its face. You challenged other DUers in your OP to show you how the 'facts' that you drew from the article were caving or capitulation - and you continued to respond in this thread to any challenge by pulling those 'facts' out and slapping them on the table.

I responded to you when you went the extra step of adding something to the article that simply is not there. You show me the part where 'automatic revenue increases' are included in the article and I'll be happy to cede you the point.

[mzmolly]

123. The Bush tax cuts are set to expire

automatically. That's something the Republican Party currently takes issue with.

Also, speaking of reading carefully, you may wish to see the word "depending" in my statement, above. ;)

We 'could' include tax increases in future deals, and if Republicans don't support that, they'll be essentially agreeing to cuts in military spending. Fine by me.

[fishwax]

122. where are the automatic increases?

[mzmolly]

130. If nothing else, the Bush tax cuts are

set to expire, and this compromise doesn't change that.

[fishwax]

134. well, that's true, but not really related to the issue of automatic spending cuts per the deal

But yes, the Bush tax cuts should expire next year.

[mvd]

13. We'll have to see how much revenue is included. I'm..

not optimistic based on this little info. Have to make sure the Medicare cuts don't get passed down to beneficiaries. If this is the deal, it will prevent Obama from going below a grade of C for me. I don't like it, but not the absolute worst possible deal.

[mmonk]

15. The concept that we are in a crisis that requires us to try and balance the budget

and cut spending in a time of the greatest recession since the Great Depression.

[mzmolly]

17. We have a jobs crisis that can't be dealt with by spending more,

unless we have some way to address the deficit, first.

[mvd]

23. I think we create more jobs by spending more

Cuts have been shown not to lead to jobs in times of recession.

[mzmolly]

30. Exactly. And who holds the purse strings

right now?

[mvd]

36. Unfortunately, Congress. I would have framed the debate..

about jobs being more important to start. Even though you can't force Congress to spend, it would have been a start.

[Skidmore]

31. We have a jobs crisis because the banks and businesses have

sat on trillions of dollars rather than investing in the nation, mzmolly. The crisis is entirely the making of the corporate and financial sectors of the economy.

[mzmolly]

I agree. So the government

has to step in. It's a shame that Republicans control the proverbial purse right now.

[mmonk]

45. I see they have you ideologically in some respects.

[mzmolly]

49. Not necessarilly. Please share your plan for negotiating spending

on jobs with the Republican house. I'm all ears.

[mmonk]

74. My post secondary expertise is in economics, not these political positions.

[mzmolly]

78. Gotcha.

:hi:

[mmonk]

82. No problem.

I didn't mean that you are ideological but the premise they are presenting is an economic fallacy and is contained within an ideology.

:hi:

[mzmolly]

87. I presume economic advisors, will disagree

on the specifics of any deal.

I am ideological. I'm a leftist. Ideally, we'd see an increase in the debt limit and corporate tax reform linked directly to hiring in the US. We'd also be spending on a massive jobs/infrastructure/green technology program right now vs. talking about the deficit.

Though, I'm aware that Boehner and the Tea Party have a say at present and we can't negotiate perfection under the circumstances.

[mmonk]

113. Fair enough but negotiations never seem to yield progressive solutions.

At least not that I can remember in terms of economics except raising the minimum wage to a 1950's level and clunkers for cash.

[mzmolly]

116. Yes they do. There are simply a group of "progressives" who find

fault with every compromise, no matter the progress. We have no choice but to compromise unless we have a super liberal majority in the house and senate. I don't recall such a time in recent history.

[mmonk]

118. I guess it depends on what one calls progressive.

From an economics perspective, I haven't seen it recently.

[mzmolly]

121. Some consider the auto industry bail out and the stimulus

packages, progressive.

[mmonk]

144. They were but much of the stimulus went to cover budget cuts

instead of injecting additional aid into the economy as a stimulus boost and tax cuts weren't needed as taxes were already at historical lows and don't generate demand in a high unemployment and moribund economy. I was happy with the auto industry help except wages didn't need to be further compromised as that takes more income out of play.

[begin_within]

18. But cuts to Medicare providers do affect beneficiaries, won't they?

[mzmolly]

27. 1. cuts to providers are not necessarilly

set to happen. 2. We don't know what kind of cuts to providers may end up in any deal down the road.

[Donnachaidh]

96. YES. Doctors will drop out of the program or refuse to take on new patients

THEY have that choice to do so. The patients are screwed yet again.

[mzmolly]

128. We have no idea how provider cuts will be factored

in. They may simply be cuts to hospitals who release patients too soon, as has been discussed.

[Donnachaidh]

139. doctors hear the word *cut* and they drop patients

Obama just gave them the excuse to kick the poor to the curb. There's no *suzie sunshine-ing* way to spin this.

It's an epic FAIL on the part of this administration.

[Donnachaidh]

142. :ahem:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=439x1623167

Tell me again how the beneficiaries *won't* be affected? :sarcasm:

[mzmolly]

150. Did you bother to read the article?

If not, see my reply in that particular thread.

[Paula Sims]

20. One concern will be doctors dropping Medicare patients. . .

Granted, I'm sure #2 is not the exact wording, but even in the same meaning, I can see personal physicians not taking Medicare patients or up-scale hospitals not taking Medicare patients because their share will be cut -- possibly forcing the patient to pay more. There are several doctors that are dropping different insurance plans because the plans want more money for themselves. I can see this happening with this Medicare proposal. Sadly, who's really hurt is the family doctor; and my guess is that the number of Medicare patients that a plastic surgeon sees is pretty small.

Same principle as school vouchers: just because you have a voucher doesn't mean that a school has to accept it.

[cantbeserious]

21. "automatic across-the-board cuts go into effect" -- and *Medicare

Read 'Em and Weep.

[Parker CA]

22. This is an article from last night. Things have changed according to reports today, so this outline

may not reflect what is being included in the actual current discussions.

[mvd]

32. True. Will wait until the final deal to fully judge

:hi:

[mzmolly]

37. What reports list specifics of a deal, today?

I'm interested in taking a look. :hi:

[Parker CA]

47. Read Krugman, Dave Weigel and David Corn on Twitter and watch MSNBC. The ABC

report was denied last night by WH press corps about 30 mins after it was released.

Still nothing set in stone, but from what I've been reading all morning the details being discussed are not looking good.

[mzmolly]

The ABC report was not specifically denied

to my understanding. Commentary about a "cave" by Democrats, was.

I don't consider Krugman to be fair to the President. As for Corn, Weigle and others, I'd need to see what their looking at in order to judge anything.

[Motown_Johnny]

25. But Da Caving... And Da Fail... and POTUS is an (R) !!!!!!!

:sarcasm:

[alcibiades_mystery]

42. You forgot the other "Repeat ad Nauseam" Talking Points: "Utter weakness...utter weakness..."

Just say it a lot, and it's like it's almost true!

Meanwhile, back in the real world, the GOP has completely caved on the making the BBA a condition precedent for debt, totally caved on the short term deal, and completely opened the door to revenues by making their pet defense programs subject to massive cuts if the committee recommendations on REVENUE are rejected.

Oh, but we "lost."

Please. It's quite clear that some people simply WANT to lose, and thus they hear what they WANT to hear.

[mzmolly]

67. Absolutely

agree. :toast:

[bowens43]

58. You should remove the sarcasm tag......

it is caving and the POTUS is far to the right of center......

Keep spinning for these idiots, I find it amusing.

[Motown_Johnny]

91. He is the most liberal person who could be elected

farther left than Clinton (who was his only serious opponent).


Go ahead and be amused.


This isn't that bad (if the OP is true) and complaining because you aren't happy isn't helping.

Besides, you shouldn't believe anything at this point. There is no guarantee this will ever make it through The Senate much less The House.

[woo me with science]

109. What utter nonsense. nt

[Motown_Johnny]

166. who could have been elected who is more liberal?

come on

woo me with some facts here

[JBoy]

33. The trigger needs to include some automatic tax increases if they don't agree on a plan

that's the only way to ensure revenues get included with any agreement. Otherwise the teabaggers will do the same shit.

[alcibiades_mystery]

48. Not at all

The triggers with across the board cuts essentially do the same thing, since they have to own up to the fact that thir districts rely heavily on government programs. They can either watch programs prized by their district evaporate, or vote for tax increases. It splits the practical function from the ideology, and gives them nothing to hide behind. In addition to that, we managed to negotiate harsher cuts to defense and only provide3r side cuts to Medicare. Then we completely disabled their demands on BBA.

How is any of this a loss?

[JBoy]

64. The baggers will be able to cling to their "no tax increases" position

unless something clearly punches a hole in that. The deal as described would allow another "no tax increase" solution just by obstructing.

[alcibiades_mystery]

85. I'm not worried about what they'll be able to claim

I'm worried about the actual policy mechanisms. Besides, they can claim that all they want until December 23 of this year, by which time they either have to vote on revenues (tax increases) or admit that they would rather see cuts in defense and programs in their districts. How is that not a win?

[NoodleyAppendage]

52. BINGO! There's nothing in there to get the knuckle draggers not to kill the commission ideas. n/t

J

[alcibiades_mystery]

89. Except large cuts to defense and to programs in their districts

Yeah, but aside from that, nothing...

:eyes:

The triggers actually put Dems in a better position: if there are cuts proposed, or cuts across the board, they can pick which ones are less onerous. If there are revenues proposed, as there no doubt will be given the composition of the committee, that puts the GOP in a much more precarious position, since they will either have to admit that their no revenue pledge is bullshit, or see their pet projects go up in smokes.

In other words, the GOP have to admit that an all cuts approach hurts people in their districts, and hurts their own prized (defense) programs.

[NoodleyAppendage]

95. When have the Repukes shown recently that they really care about defense cuts?

I'm not seeing the same Repuke response to defense spending and cuts that they did under the Bushes and Reagan. I'm glad you have more faith than I do. Lately I've only see the Democrats ability to capitulate and negotiate themselves into a corner.

J

[alcibiades_mystery]

124. The GOP has only

accepted the projected cuts from winding down the wars. They have not accepted cuts otherwise, and the triggers would presumably (as across the board cuts) hit specific programs. I'm happy enough to see the obstructionist GOP explain to their home distrits why they prefer X, Y, and Z defense cut rather than raising taxes on the wealthy, or why protecting some arcane corporate tax loophole is better than an infrastructure project in their district. That's what they're gonna be up against, and it's ot a matter of faith or trust. It's matter of the actual mechanism. Alternatively, I'm happy enough to see actual defense cuts happen (in addition to them explaining them). So, that seems like a good trade-off.

I know a lot of people here perceive the Dems to be capitulating, but I don't, and it has nothing to do with faith. Quite the opposite, in fact. Those who see capitulation and caving at every turn seem to be the ones who simply take it on faith that there's a capitulation rather than looking at the specific instances.

[DURHAM D]

38. This is BS. Its from last night. But I think you know that.

Senator Reid has already spoken today from the floor of the Senate and said that "everything" is on the table. That means SS.

[mzmolly]

39. Of course. Anything reasonable is "bull" and any talk about being willing

to negotiate, means that SS is doomed.

If you have newer "facts" I'd like to see them.

[mvd]

43. I hope mzmolly's thread has the right specifics

SS being on the table other than raising the cap would be awful.

[EFerrari]

63. Yep. n/t

[mzmolly]

93. Follow up question. How long are we allowed to speculate on a chained COLA to SS?

:shrug:

[adhd_what_huh]

40. We get to say it is a balanced approach that includes revenues

This will drive the TeaDipShits crazy. Wait for the town hall meetings where the Retards are confronted on letting revenues be a part.

We win...they loose.

Even if there are no revenues we still win because they are making granny pay for the corporate jets.

This is the 3d Chess game.

SORRY FOR NOT BEING CYNICAL.

[alcibiades_mystery]

53. It does include revenues by making the committee bipartisan and

planting across the board cuts: the committee WILL recommend revenue generation. The House GOP ideologues can either vvote for it or watch their defense pet projects and prized programs in their districts go up in smokes. Granted, it is not an automatic increase in revenue, but it's pretty damn close, and even BETTER than the Reid plan of yesterday.

[mzmolly]

70. Indeed.

:hi:

[NoodleyAppendage]

50. SUCKS. Where's the motivation for Repukes to go with the commission?

I'm only seeing positives for the conservatives on this POS agreement. So, this commission will "recommend" tax increases and cuts, then Repukes will run against it causing the commission's recommendations to go down in flames at which point only painful cuts go into effect? Boy! That's a great deal, Mr. Obama. Thanks for screwing over the vast majority of your constituency. Good luck in 2012. You will need it and don't YOU DARE COME HERE looking for votes.

J

[mzmolly]

68. Tax increases and cuts to the military?

:hi:

[NoodleyAppendage]

97. Tax increases will be DISCUSSED by the commission, but if the Congress doesn't go along...

...then essentially it's all pain on the spending side with some defense cut backs (which lately haven't been the poison pill to Repukes as they have been in the past).

It's a POOR DEAL. No matter how beautiful you paint a pig. It's still a pig.

J

[mzmolly]

101. So thankful you're here to translate the bad news

for us. Thanks.

[Name removed]

54. Deleted message

Message removed by moderator. Click here to review the message board rules.

[mzmolly]

61. Then why aren't you crying over at Free Republic?

eom

[seabeyond]

55. thanks for the update, thus far mz. nt

[lumberjack_jeff]

56. Because the deal alternative is "no deal" which means executive action

For a president who is so comfortable with most of the unitary executive bullshit adopted by his predecessor, he sure is squeamish about doing this, despite the defensibility of it.

[mzmolly]

65. Time will tell.

However, I'm not sure that this supreme court would ultimately decide on the 14th amendment in a rational manner.

[tomp]

60. cutting the provider end is bad, too....

...if you're a provider or use a provider.

i fully expect them to try to fix the "health care problem" on the backs of health care workers and provider institutions who are already overworked beyond belief and over-extended in trying to help people who can't pay.

people have to get this straight: this whole fucking debate is bullshit kabuki theater from both parties, AND we need increases in services, not cuts. the balancing must come from bleeding the rich, period. anything else is an attack on the people (that's right, the rich are not "the people", they are blood sucking traitors who care only about themselves).

[Name removed]

76. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Name removed]

75. Deleted message

Sub-thread removed by moderator. Click here to review the message board rules.

[ZombieHorde]

83. If providers are getting less money, they will be less likely to accept Medicare patients.

Many providers already don't accept Medicare patients because the make very little money off them.

[Coyote_Bandit]

84. It is a high stakes game of chicken

played by some asshats that need to lose their jobs.

If not for the political posturing and oneupsmanship they could have reached this deal some time ago - or gone straight for a clean deficit limit increase. But no - we had to go through this little exercise to see who might blink - and to take the spotlight off this issue in the upcoming election.

[former9thward]

88. You are really in a dream world if you think cuts to Medicare providers

would not impact beneficiaries. What a spin.

[mzmolly]

90. How about regulating drug prices?

Would that have the same impact?

[Donnachaidh]

94. putting the cuts on the provider end WILL adversely effect Beneficiaries

Anyone who has medicare that has tried to find doctors willing to take it NOW fully understand that.

What better way to destroy a medical safety net for poor people than make it so unpalatable to the doctors required to see those poor people?

Mission fucking accomplished -- thank you for putting the cuts on the backs of the poor YET AGAIN Mr. Obama.

:grr:

[Change Happens]

98. I SUPPORT THIS PLAN, as presented!

[Whisp]

99. woah...

''*Democrats won't like the fact that Medicare could be exposed to automatic cuts, but the size of the Medicare cuts is limited and they are designed to be taken from Medicare providers, not beneficiaries.''

some here will not like that, they are betting and wanting cuts to the beneficiaries Not the providers so the funhatefest can go on.

[durablend]

119. Still dreaming I see...

Because those cuts WILL trickle down to real people.

but as long as it's A WIN for TEH ONE, that's OK!

[treestar]

105. Thanks for the actual information

Over ten years - means the Rs caved.

[MadHound]

110. Trading the cow for a handful of magic beans,

Guaranteed cuts, vague promises of more revenue, and all of this coming at a time when we need to be spending more, on job creation, rather than making cuts.

These cuts will insure that our economy remains in the tank, and drive it further down. As we've seen time and again, austerity programs simply don't work when it comes to increasing economic growth and well being.

In short, this deal makes absolutely no economic or fiscal sense. It is a gift to the rich and corporate, and sounds the death knell for the middle, working and poor classes.

[customerserviceguy]

112. It seems like this is a recipe

for another screwing when the secret committee holds its' "who do we fuck" meetings in another few months. I also guarantee that if it contains even a whiff of something that a bagger can call a tax increase, that no matter even if there's a cut to the military, it will go nowhere in the House. The cuts that result are going to be most onerous when they do hit.

It's all a matter of how much pain we want to avoid now, in order to have it five months from now.

[mzmolly]

127. I don't have a problem with cutting medicare on the provider

end, depending. If that's the worst that can happen for rejecting a future deal, I'm not that moved.

[customerserviceguy]

167. I do have a problem with that

It means that the provider has two choices:

1) Opt out of Medicare.

2) Pass the true costs of covering Medicare patients off on to third parties, like insurers, or those who pay full fare for their uninsured medical care. Since under HCR, that's going to be the government, it's all a matter of which pocket gets picked.

Talk to me when the "super" committee gets done with it's decisions, and we'll see how much you're moved.

[mzmolly]

168. That depends

on the specifics. As for the super committee, we'll see how/if that pans out, or not.

[elleng]

114. Its not, its negotiating and compromising,

words many here don't want to hear, but that's life/governing.
:thumbsup:

[stranger81]

117. The biggest reason - creation of a Super Congress whose recommendations MUST

be accepted by Congress to avoid the trigger mechanisms. This is little more than an end run around representative democracy. Anyone who thinks Catfood Commission II will adopt recommendations that include substantial tax increases (e.g., 30% or more or so of the total package) is smoking something.

[Cleita]

120. Sorry on #2, beneficiaries are impacted.

Fewer of the better doctors will accept Medicare and put seniors at the mercy of those who may not be that competent.

[mzmolly]

125. A good Doctor

refusing to accept medicare? So much for being motivated by saving lives.

[former9thward]

132. All sorts of good doctors refuse medicare right now.

This will only make it worse. They are motivated by money and they don't want to be hassled by even more paperwork. Sorry if that does not fit with your fantasy world.

[mzmolly]

133. Can you name one?

Is there a list, so that such doctors can be properly shamed?

[Cleita]

138. I can name a list in my community that refuse to take

Medicare Advantage programs because of low and slow payments. Those same doctors will still accept traditional Medicare as it is but have warned those of us on Medicare that if the reimbursements aren't worth their while to keep their practices and insurance going, they will have to start refusing it. Some old people in my community who can't afford the supplemental insurance and have to get Medi-cal instead find themselves going to doctors they describe as the local pill pushers and who are so marginal they can't get other patients other than the poor on Medi-cal.

[mzmolly]

152. I've love to keep a list

and refuse to give these doctors a federally funded discount on their student loans, unless they accept medicare.

[Cleita]

154. Many of these doctors didn't need student loans

back when they went to medical school. Part of the Medicare contract is the doctors are free to refuse.

[mzmolly]

155. That needs to

change.

[Cleita]

161. I agree. The solution to this is in my signature.

Once everyone is on Medicare, everyone has to participate both patient and provider and things will be made better because people will insist on it. It happens every where there is a single payer system. In a tiered system like ours, those with the Cadillac health plans always want to diminish those with the government plan until nothing is left.

[mzmolly]

162. The Netherlands and Switzerland have a combined

program, like ours. That said, I would fully support medicare for all, if we could get it through the House and Senate.

[Cleita]

163. We have to change the face of Congress, but mostly

we need to push out the insurance companies. Allowing people not senior citizens to buy into Medicare (public option) would have accomplished this but as you saw our bought and paid for legislators wouldn't do it because of the insurance lobby. A public option would get the ball rolling.

[mzmolly]

164. The states can set up a public

option per HCR. Hopefully, this will lead to a more rational approach going forward. :hi:

[former9thward]

165. I don't shame them. I work for money too. Most people do.

If you can get through life without money and just good intentions more power to you.

[mzmolly]

169. It's one thing to work for a living, it's another to

exclude the poor from medical care.

Shame on any doctor, who would refuse to care for people on medicaid/medicare. Most doctors don't reject the reduced pay scale from insurance companies, do they?

[alcibiades_mystery]

131. You have an increasingly complex set of scenarios for

seeing this as bad.

The good doctors can take a haircut. Either we believe that providers are charging too much for services or we don't. In any case, if we talk of cost-cutting measures at all (and we certainly SHOULD), extrapolating them as "cuts to benefits" is easy enough, I guess, if you imagine every possible route through which they might end up that way. As for the notion that there will only be incompetent doctors left, that's quite the stretch indeed. You may run into such problems in rural districts, but it will be that there are NO doctors; however, that's even more reason for the GOP reps of those districts to accept revenue recommendations put out by the committee, or develop secondary programs.

You're now saying something like If A AND B AND C AND D all fall into place negatively (and they surely will!) then it's really bad! Therefore, it's really bad!

It's starting to be a reach, in other words.

[Cleita]

140. Do you get Medicare?

If you do then you will see they are already taking haircuts. On your paperwork you get from Medicare. There is the column that the doctor billed for. Another column for the amount Medicare approved of that can be anywhere from 10% to 50% less than their fee. Then there is the amount that Medicare pays that is 80% of that. The patient or their co-insurance must come up with the 20% in co-pays. Some doctors even waive the 20% for needy patients but considering the costs of running a practice sometimes get to the point that they can't any more. Really, they can't take any more haircuts.

[alcibiades_mystery]

145. So you're the AMA lobby, then?

Because this is what I hear from them.

It's perfectly acceptable to say that providers are pushed to the limit, and no more cost savings can come from that direction. If that's the case, fair enough. I'm not convinced that it's true. In any case, that Medicare sits on the other side of the trigger is precisely the point: they are setting up triggers that the Dems don't want to pull. If anyone wanted to pull the triggers, they wouldn't be good triggers. Putting them on the provider side incentivizes the intransigent GOP House to avoid pulling them as well (in addition to the defense and program cuts on the across the board triggers), to the extent that the GOP is itself going to come down on the AMA side, though they do so in order to make vapid arguments for so-called tort reform and the like.

[Cleita]

146. No, I'm the old people lobby.

I also work for doctors so I know what it costs to run a practice. Doctors are small business owners just like the beauty salon owner. If you want to bring down the costs of running a practice, give doctors a mal-practice insurance plan run by Medicare that cuts out the private insurance companies and put some laws in place that tame the ambulance chasing lawyers. Then you would see some real savings in medical costs which would bring down medical costs.

[alcibiades_mystery]

147. Tort reform!

From our progressives!

Fantastic.

What's your doctors' average take home?

[Cleita]

149. Right now, if he didn't have other income, it would

be less than minimum wage. It is a relatively new practice and he's building his patient base. He doesn't take Medicare or insurance because it would be too costly for him to do it now. We need Medicare for All, run by one single payer entity that also provides mal-practice insurance for a reasonable cost. This would put us in the same league as most of the industrialized nations of the world. But I supposed you are against socialism too.

[alcibiades_mystery]

153. Actually, I'm a Marxist

I agree with the goal. The way you have of getting there, however, is disastrous for all.

I'm not against a reasonable cost for malpractice insurance, but it's an immediate entry to corporate friendly tort reform, so not doable in the current environment.

Ultimately, I suspect our differences reside there: I think X is doable in the current environment, you think Y is doable. I have yet to hear how Y is doable. I understand that this makes me a "Quissling pragmatist" or some such similar nonsense, but until I hear how Y is doable, I'm going to stick with getting the best we can out of X.

Good luck.

[mzmolly]

157. Thank

you for your reasoned responses in this thread. :hi:

[Cleita]

159. Okay tort reform not doable in the current environment.

I agree with that. But since my doctor's speciality is pain management, we deal a lot with accident and worker's comp victims and these lawyers are in the middle of it. They do a necessary job but the compensation they get and how they get there is often out of line. They need to be reined in somehow. The worst though are the ones who go after the doctors for mal-practice, which is why the insurance is so high. There are treatments many doctors won't do because the risk is too high and their insurance premiums would go through the roof. Oh, I don't think everything I believe is doable right now. I'm just saying what the problem really is and how we should try to get to the right solution.

[Cleita]

160. ...

[scheming daemons]

126. AS PRESENTED IN THIS OP... this is a good deal.... but....

...the devil will be in the final details.


This deal as written above looks pretty damn good to me.

[mzmolly]

129. I'm with you.

:hi:

[Morizovich]

135. Deal?

What deal?

[kickysnana]

136. My Medicare provider gets much less han a vet gets for an appontment.

This is nuts.

[Cleita]

141. I guess senior citizens are less important than dogs. n/t

[readmoreoften]

143. Cutting to providers is the same as cutting patients because no one will accept it anymore. Hello!

[mzmolly]

151. We would need the details of any future

cut, in order to assume as much.

[Capitalocracy]

148. There are good cuts and bad cuts to defense.

Much of the cuts recommended by the debt commission to defense spending were on the backs of soldiers, in scheduled pay increases, benefits, and medical and psychological treatment. I don't think that should be on the table.

Anything where they have to approve a committee recommendation by a deadline in the future to avoid automatic cuts like that (yes, I know, I'm just assuming that's what they'll be like, but I think I have good reason to expect the worst) is bad news and will lead to a similar debacle to the one we're facing today.

Doesn't pass the smell test for me. We'll see what the details are.

[blkmusclmachine]

156. Double-speak for undemocratic "Super Congress." This is an absolute travesty.

This cannot stand.

[mzmolly]

158. LOL

I'm sorry, but many of the responses in this thread, border on satire.