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To be clear, the title of this diary isn't an exact quote. But I just finished watching Senator McCaskill (D-MO) tell Meet the Press host David Gregory that she believes that Democrats and Republicans can and should agree to means-test Medicare by raising co-payments and co-insurance based on income.

Now let's make sure that we're all on the same page. If we means-test Medicare, then we're cutting Medicare benefits. We can't write to our elected officials and sign petitions demanding that they don't cut entitlement benefits while simultaneously agreeing with the notion of means-tested Medicare.

Paul Krugman opposes the idea.

The usual argument against means-testing — which is entirely valid — is that it (a) doesn’t save much money and (b) messes up a relatively simple program. The reason it can’t save much money is that there are relatively few people rich enough to be able to afford major cost-sharing. Meanwhile, the good thing about Medicare, as with Social Security, is precisely that it doesn’t depend on your personal financial status — you just get it.

We shouldn't agree to complicate Medicare benefits in order to "simplify" the tax code. Nor should we agree to introduce changes that could ultimately turn Medicare into a program in which 100 percent of us are not fully vested, thereby allowing more and more people to perceive it as a program that doesn't affect them--similar to how many perceive Medicaid.

Krugman continues by pointing out that mean-testing Medicare favors the super rich at the expense of the moderately rich.

So what’s the difference between means-testing and just collecting a bit more taxes? The answer is, class warfare — not between the rich and poor, but between the filthy rich and the merely affluent. For a tax rise would get a significant amount of revenue from the very, very rich (because they have so much money), while means-testing would end up imposing the same burden on $400,000 a year working Wall Street stiffs that it imposes on billion-a-year hedge fund managers.
McCaskill's silence, this morning, on allowing Medicare Part D to negotiate prescription drug prices was deafening. Of course, she could have also introduced Meet the Press viewers to the notion of Medicare for All, but chose not to.

Time to call our representatives and let them know that no entitlement benefit cuts means no entitlement benefit cuts. Period.

UPDATE: Thanks to ItsSimpleSimon for posting the relevant video clip and transcript in his 10:30 AM comment below. Here is McCaskill’s money quote from that clip:

I think we can get to means testing fairly easily, more aggressive means testing, some higher co-pays for those people who can afford it...I mean, we’ve got to get to a point where we are really having people who can afford to pay for their health care, having them to take that responsibility instead of the government...I think aggressive means testing for people who can afford it makes sense as we look at long-term savings in the Medicare program.

Poll

Do you support means-testing Medicare?

13%62 votes
86%400 votes

| 462 votes | Vote | Results

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Comment Preferences

  •  I don't support means-testing, but (11+ / 0-)

    I know Medicare already imposes slightly higher premiums for part B on those who have over $85,000 in income in the previous year, and if they made the monthly income-based supplement a little higher for those people I think that might be a change that's easier to swallow than raising the eligibility age or cutting benefits across the board. But there's a big difference between raising the premium for wealthier beneficiaries and cutting them out of the system altogether, which is a terrible idea for all the reasons you stated.

    •  Good Point. (7+ / 0-)

      Medicare is not "free". There's all kinds of costs already associated with it, especially if you are making middle class income. What's on the table is cutting out the working middle class altogether, and making Medicare into a Medicaid type program limited to the non-working poor. Senior small business owners, and those on salary who cannot afford to retire at 65 would get screwed.

      "Force is as pitiless to the man who possesses it, or thinks he does, as it is to its victims; the second it crushes, the first it intoxicates.” Simone Weil

      by chuco35 on Sun Dec 02, 2012 at 09:18:21 AM PST

      [ Parent ]

  •  she is Reagan in a skirt (8+ / 0-)

    nothing more and nothing less. We need better democrats than this.

  •  I'm very concerned that we are going to get sold (21+ / 0-)

    out on Medicare by a sufficient number of Democrats that may break ranks and side with the Republican on this.  This could serious fracture and damage the Democratic unity and enthusiasm we've worked so hard to rebuild in this last few years.

    The means is the ends in the process of becoming. - Mahatma Gandhi

    by HoundDog on Sun Dec 02, 2012 at 08:31:59 AM PST

    •  I am holding every one of them accountable (17+ / 0-)

      Don't think you can allow other Democrats to vote for this BS and be held harmless.  If the Senate and Obama approve this then everyone in the party needs to take the blame in 2014 and 2016.  

      If you can means test people then you can also tax them and unless they are putting that means test way up in the clouds with those they agree to tax it is totally unacceptable.  

      And don't lie that you aren't cutting Social Security because the Medicare premium comes out the Social Security payment.  You think people won't notice?

    •  That's my fear as well. However, (3+ / 0-)
      Recommended by:
      Gooserock, divineorder, HoundDog

      our ideas are winning the debate, and we can't get discouraged about 2014 and beyond because of what happens during this lame duck. Despite what happens hear, we need to recognize our strengths, be prepared to lose a few battles, and press on to elect more progressives in the next election and the election after that.

    •  One Thing's For Sure, We'll Get Sold-Out By Every (0+ / 0-)

      RepubliKlan. I bet even the Maine twins will tow their "protect-the-rich" party line.

      I suggest we keep our sights on the enemy - the RepubliKlans - because they are the problem. Of course if we we focus on the Republiklans then we'll have to focus on just who it is who votes for RepubliKalns, and that may hit a bit too close to home for some:

      And before you try that lame excuse that's it only Southern White Males who vote in the majority for RepubliKlans, spend some time examining the state exit polls from the 2012 elections - esp CA, IL, MD, MI, NJ, NV, OH, & PA. That is, if you can handle the truth...

      I am not now, nor have I ever been, a member of the Republican Party.

      by OnlyWords on Sun Dec 02, 2012 at 09:45:45 AM PST

      [ Parent ]

      •  I'm not sure if I'm interpreting you comment (3+ / 0-)
        Recommended by:
        grrr, T Maysle, SoCaliana

        correctly OnlyWords?  

        I hold all of our politicians accountable for all of their votes, and am sophisticated and clever enough to focus on "more Democrats" before the elections.  But, I hope I haven't given anyone the impression that I'm just a cheerleader here.

        Before election I lower my standards to "more Democrats" after elections I raise them back up to "better Democrats."

        After maybe 300 or 400 or more posts pulling all the stops to elect and re-elect Obama and defeat Republicans out of the 600 plus I have here I hope I have sufficient good will to share with you that I am not entirely satisfied with his positions on the wars, civil rights, the FISA reversal, or even the original diversion of Medicare funds to pay for the ACA, which I supported.

        And, there will be some inferior Democrats I will support primary challengers for by more progressive challengers if they vote for cuts to Medicare, Medicaid, or Social Security.  

        I will certainly castigate any and all that do, in a fair, balance, and strategic manner.

        I don't know exactly what you mean by "lame excuse" and raising the issue of "can I handle the truth?"  I'm not aware of any deficiencies in either of these categories.  

        Do I misunderstand your point? Is it that older white males seem to be not as liberal as others?  Not in my case.  

        If instead you are implying that if we are not careful and look the other way if our Democratic leaders support Republican policies for fear that we may otherwise do worse with older white male voters you need to spell out the hypothesis more explicitly before I react to what I'm trying to imagine you are suggesting.  I am not totally unsympathetic to this line of thinking as I've used it more than I like this last year to pull all the stops to elect as many Dems as we could.  But, if you suggesting that we incorporate this kind of thinking into a automatic modus operandi on a proactive basis, I will probably disagree.

        The means is the ends in the process of becoming. - Mahatma Gandhi

        by HoundDog on Sun Dec 02, 2012 at 10:41:56 AM PST

        [ Parent ]

        •  I support your comment. (1+ / 0-)
          Recommended by:
          greenbell

          I'm also wondering if the lack of discussion about cutting back on defense spending is just simply the gender issue again. The uniformed military is about 85% male or thereabouts.

          I'll have to research the split in the entire Pentagon, but I hardly think it's majority female. So cutting defense would involve mostly males, that I can tell.

          Meanwhile, cutting other social areas might involve more women and children. I'd have to see actual numbers on that.

          Have you analyzed possible budget cuts from that angle? Impact on American women versus men?

  •  Eh. (6+ / 0-)

    If an older person is rich, and doesn't need any help paying for healthcare, it certainly wouldn't bother me for them to pay either for all of their care, or at least pay more than those who cannot afford it. And the fact that they paid in over their lifetimes doesn't bother me at all - if they ended up poor, they'd get the benefit of the safety net. So their contributions instead go to help someone who needs it. Who really gives a shit if the Mitt and Ann Romneys of the world have to dig into their bank accounts to pay for medical care?

    •  All you have to do is tax their income (14+ / 0-)

      Why screw up Medicare and open the barn door way wide so that the premiums go waaaay up for those with smaller and smaller incomes?  Do you really think they are going after the wealthy?  Oh no, this will be the TAX ON THE MIDDLE CLASS.  Cut your payroll tax and then when you are too old to do anything about  it screw you on health care premiums.   Then when you howl about the huge premiums you have to pay for Medicare they can say well we have a little voucher for you to take to our favorite insurance lobby.

      They are trying to phase out Medicare altogether.  Both parties.  And it may give me a stroke it makes me so mad!

      •  How about we just fight for what (2+ / 0-)
        Recommended by:
        gramofsam1, Cat Whisperer

        is truly important? Like the availability of medical care for the poor and indigent? Let's drop the fight for the phrase "zero cuts to Medicare!" (even if those cuts only hit wealthy people) and instead fight for what is real? The Tea Partiers are united in opposing any taxes whatsoever, no matter what. We mock their intransigence, their inability to recognize that compromise in a democratic society is essential.

        Then we chant "Zero cuts, zero cuts!".

      •  Replace Medicare with taxes and you ... (0+ / 0-)

        sound exactly like the Tea Party railing against  tax increases for the rich. Just sayin' (see below with your comments edited to replace Medicare means testings with tax increases for the rich - which are both essentially the same concept - ie those who have more should pay more)

        Why screw up the tax code  and open the barn door way wide so that taxes go waaaay up for those with smaller and smaller incomes?  Do you really think they are going after the wealthy?  Oh no, this will be the TAX ON THE MIDDLE CLASS.  
        •  Fine with me at least the Tea Party has the (2+ / 0-)
          Recommended by:
          chuckvw, grrr

          passion to defend their side of this issue.  I have equal passion on my side.  I'm not going to throw old women to the curb just so the Democratic Party can appear callous and cool.  I'm not one bit cool on this issue.  It just boggles my mind that we are seriously holding the extremely wealthy all but harmless with token increases in the tax rate at best while we gleefully throw a signature Democratic program on the fire and say to hell with the old and the sick.  

    •  Big Difference. (14+ / 0-)

      The brilliance of the SS program was that it was not the dole. You benefited because you paid in. Brilliant because it became a popular program since everyone had a stake in it, as opposed to welfare, for example, which could easily be painted as a wasteful handout of our tax monies to the unworthy and ungrateful "other". Same goes with Medicare (although not Medicaid).

      If you turn Medicare into Medicaid, as would happen with means testing, it would become just another welfare program subject to much more forceful political winds against it. As it is, after working hard for decades, at 50-60 years of age Medicare becomes a very, very popular program, if it isn't already, to most all workers not in the 1%. If you put it out of their reach, despite taxing the shit out of them every paycheck for decades, because they are, or expect to become, successful earners, you almost guarantee its political demise.

      A better solution would be to make all income subject to tax withholding, since the rich are often able to define their income as investment income, and avoid paying these taxes. That would surely fund the program, and I wouldn't shed a tear on paying for Sheldon's medical bills if we taxed him on all of the income he banked.

      "Force is as pitiless to the man who possesses it, or thinks he does, as it is to its victims; the second it crushes, the first it intoxicates.” Simone Weil

      by chuco35 on Sun Dec 02, 2012 at 09:41:35 AM PST

      [ Parent ]

  •  I'd rather see a reevaluation of what medical (3+ / 0-)
    Recommended by:
    doc2, eXtina, Aquarius40

    services and expenses are covered, and which ones might be eliminated.  I'm no expert on Medicare, but if the feds keep reducing the reimbursement rates to doctors, it will imperil the program by making doctors opt out of accepting patients on Medicare.  I'd rather see reimbursement rates remain where they are, but cut back on the number of medical menu selections that are covered.

    It's not that difficult to prioritize medical procedures based upon life saving, related to serious chronic ailments, and more discretionary procedures.  If you want to call that a death panel, call it what you will.

    There's a reason people tend to overindulge at an all you can eat smorgasbord.

    Oregon: Sure...it's cold. But it's a damp cold.

    by Keith930 on Sun Dec 02, 2012 at 08:37:40 AM PST

    •  Well, that's where we are heading anyhow. (1+ / 0-)
      Recommended by:
      emelyn

      That is the way all advanced countries deal with end-of-life choices. There has to be some form of rationing. Keeping people alive who have little quality of life is extraordinarily expensive. We can spend as much keeping an 85-year old alive for a couple of weeks as we could spend providing life-saving surgeries for people in their 30's. If we had enough money for everyone to have access to every conceivable care, that would be terrific. But no amount of taxation is going to get us there.

      •  My mother is 91 (5+ / 0-)

        and she is treasure and joy to everyone who knows her - I know because they all tell me over and over again.  To assume that older people have no value is to not know any.  Of course she would not want to be kept alive to no purpose.  But when she broke her arm at 88 she needed surgery to keep her out of a nursing home and so she could live without pain.  She is the most resilient and determined person I know.  She has taught me more in the last 6 years than in her first 85.

        •  Very nice story, but off point. (4+ / 0-)
          Recommended by:
          emelyn, OnlyWords, gramofsam1, Aquarius40

          There is a point all elderly people reach where they have so many health issues that quality of life is no longer possible; just quantity of life. At that point triage needs to take place, priorities set. It is a complex decision, but our society's obsession with living on no matter the cost (or suffering of the dying) must change. Your mother wasn't dying, she broke her arm.

          •  Just so much bullshit. You must be spending too (3+ / 0-)
            Recommended by:
            chuckvw, Miggles, Malvern

            much time on

            Move Single Payer Forward? Join 18,000 Doctors of PNHP and 185,000 member National Nurses United

            by divineorder on Sun Dec 02, 2012 at 09:11:44 AM PST

            [ Parent ]

          •  You mean like the oncologist (3+ / 0-)
            Recommended by:
            chuckvw, KenBee, Malvern

            who threw Dad out of the hospital 36 hours before he died?  I guess that was triage.  Yes, he was dying for sure.  He didn't have to die like that totally disoriented being moved in his final hours but he had a bean counter doctor who got points for metrics.  Dying? Kick him to the curb.

            His nurse came to the wake.  Love nurses.  They care.

          •  Those decisions are already being made (7+ / 0-)

            When doctors, after consulting with next of kin, write "do not resuscitate" on the patient's charts.  My wife's aunt has been in a nursing home for six months and has been barely conscious and doesn't recognize her niece on the few occasions she is even awake.  Her prospects of regaining any quality of life are zero, and no effort will be made to prolong her life when the next crisis comes.

            "We have always known that heedless self-interest was bad morals, now we know that it is bad economics." Franklin Delano Roosevelt, Jan. 20, 1937

            by Navy Vet Terp on Sun Dec 02, 2012 at 09:28:49 AM PST

            [ Parent ]

            •  Absolutely (2+ / 0-)
              Recommended by:
              Navy Vet Terp, KenBee

              When my Dad got cancer they ruled out almost every available treatment because he was too old.  I don't deny that was the right medical decision but they also treated him like he was an old bag of bones who wouldn't die quick enough to suit them.  And he had plenty of insurance so money wasn't the issue at all.  It was the metrics that are already in place to evict people from the hospital as soon as possible.  

              One reason that the medical profession cannot deal with these issues is that they refuse to deal with families.  The doctor says to me "Doesn't your mother know your father is dying".   And I wanted to say "You never told her he is dying!!".  You expected someone married 57 years to guess and she didn't want to know.  So if they would act like caring professionals instead of bean counters maybe they would be able to discuss end of life issues with patients to everyone's benefit.  But as long as the one and only thing they are thinking about is "what is in it for me" that isn't going to happen.

      •  Where's link for his crap (1+ / 0-)
        Recommended by:
        Miggles
        That is the way all advanced countries deal with end-of-life choices.

        Move Single Payer Forward? Join 18,000 Doctors of PNHP and 185,000 member National Nurses United

        by divineorder on Sun Dec 02, 2012 at 09:10:20 AM PST

        [ Parent ]

      •  Health care delivery reform (0+ / 0-)

        and cost control would get us there. But the big givers won't allow it.



        Those who do not move, do not notice their chains. Rosa Luxemburg

        by chuckvw on Sun Dec 02, 2012 at 10:51:46 AM PST

        [ Parent ]

    •  Quality of life is important too, (1+ / 0-)
      Recommended by:
      quill

      and I suspect some of those things you may see as worthy of elimination are things others experience as vital to making their lives worthy of living. For example, some people would see things like chiropractic adjustment as no necessary, while those with certain ailments would know that with needed adjustments they will be in constant pain. Not all bodies work exactly the same.

                             Just my two cents,
                                   Heather

      Torture is ALWAYS wrong, no matter who is inflicting it on whom.

      by Chacounne on Sun Dec 02, 2012 at 08:46:47 AM PST

      [ Parent ]

    •  A friendly reminder that (6+ / 0-)

      ObamaCare includes a significant amount of Medicare "reform", including achieving savings based on outcomes of care rather than quantity of care. If properly implemented, the Affordable Care Act will work to bring down these costs (no "rationing" needed).

    •  Do you know anyone on Medicare? (1+ / 0-)
      Recommended by:
      Brooke In Seattle

      Unless you can afford fairly expensive supplementals there's nothing like a smorgasbord.

      We already have your system. It's called the emergency room.

      What a shame we didn't accomplish real health care delivery reform. This entire discussion would be moot. But the big givers needed protection...



      Those who do not move, do not notice their chains. Rosa Luxemburg

      by chuckvw on Sun Dec 02, 2012 at 10:50:37 AM PST

      [ Parent ]

    •  Hell, yes, I overindulge! (1+ / 0-)
      Recommended by:
      KenBee

      My Medicare A+B premiums will be $104.90 per month in 2013.  I indulge in one flu shot and one wellness physical per year.  At least I have for the past 4 years.  There are a few of us who have lived and are living in poverty who just can't afford copays and deductibles.  Winter is cold for those who have lost all their body fat.

      (-7.62,-7.33) l'Enfer, c'est les autres.

      by argomd on Sun Dec 02, 2012 at 01:28:32 PM PST

      [ Parent ]

  •  Bad idea. (8+ / 0-)

    The right would love the idea but for everyone else it's the first salvo in a war against benefits. They've hated Medicare since it originally passed.

    Obama supposedly took price negotiations off the table for Pharma in exchange for their support of the ACA but for how long? Did it bind the party too or will they too be an option when he leaves office?

    "The human eye is a wonderful device. With a little effort, it can fail to see even the most glaring injustice." Richard K. Morgan

    by sceptical observer on Sun Dec 02, 2012 at 08:44:17 AM PST

  •  F MTP and the rest (8+ / 0-)

    The three Democratic senators out representing us today: Claire McCaskill, Mark Warner and Dianne Feinstein. Meet The Gasbags.
    And then Grover Norquist gets an invite. I was almost tempted to watch that but couldn't stomach David Gregory that early in the morning.

  •  Your assumption is false. (8+ / 0-)

    Means-testing is not a cut to benefits.  Recipients receive exactly the same benefits.

    Means testing is no more a cut to benefits than eliminating the cap on Social Security taxes.

    This is not even an arguable point.  Your diary is simply false.

    BTW, since you don't seem to know, Medicare is already means-tested.  Tell me, are the people who are currently paying more in premiums receiving fewer benefits?   And are you horrified by that "class warfare," or you support cutting the premiums for rich people?

    Art is the handmaid of human good.

    by joe from Lowell on Sun Dec 02, 2012 at 08:52:06 AM PST

  •  From the online dictionary: (3+ / 0-)
    Recommended by:
    emelyn, gramofsam1, askew
    ben·e·fit  (bn-ft)
    n.
    A payment made or an entitlement available in accordance with a wage agreement, an insurance policy, or a public assistance program.
    Means-testing is not a cut to benefits.  Period.  The payment made, the entitlement available, under Medicare is not altered to even the slightest degree by either the existing means-testing, or by any proposed expansion.

    Art is the handmaid of human good.

    by joe from Lowell on Sun Dec 02, 2012 at 08:56:41 AM PST

    •  If your office visit co-pay is raised, then (5+ / 0-)

      that is a benefit cut. If your co-insurance payment for a procedure is raised, then that is a benefit cut.

      In such circumstances, the payment made (entitlement available) under Medicare is reduced by the amount of the increase in the co-payment and/or co-insurance.

      That, my friend, is a benefit cut. Period.

      •  Office co-pays, yes. Premiums, no. (2+ / 0-)
        Recommended by:
        gramofsam1, askew

        Once again, here's the definition of benefit:

        ben·e·fit  (bn-ft)
        n.
        A payment made or an entitlement available in accordance with a wage agreement, an insurance policy, or a public assistance program.

        There is nothing in there about how the public assistance program is funded.  Period.  Whether some of the funding comes from premiums or not has nothing to do with benefits.  Double-entry bookkeeping was invented during the Renaissance, and an increase in a program's revenues is not the same thing as a reduction in outlays.

        I agree that increasing office copays would be a benefit cut. Raising office co-pays means reducing the payment made from the government to the provider, leaving the enrollee to pay more.  That is a reduction in benefits, since the public assistance program is making less of a payment.

        But increasing premiums does not reduce the payments made by the government (the benefits) by a single penny.  It increases the revenues that come in.  The "payments made...in accordance with...a public assistance program" do not change at all.

        Art is the handmaid of human good.

        by joe from Lowell on Sun Dec 02, 2012 at 09:41:01 AM PST

        [ Parent ]

        •  Joe. With respect, you're arguing with yourself. (2+ / 0-)
          Recommended by:
          slinkerwink, Miggles

          My diary complains about benefit cuts, not increased premiums. Unless I misunderstood your comment here, we agree.

          •  Your diary mentions "co-insurance." (1+ / 0-)
            Recommended by:
            gramofsam1

            Are you using that term differently than "premiums?"

            Are you saying means testing of premiums - the payments beneficiaries make into Medicare - is not a benefit cut?

            I was reading your usage of "co-insurance" to refer to Medicare beneficiaries' payments into the system, their premiums.  Was I misreading you?

            Art is the handmaid of human good.

            by joe from Lowell on Sun Dec 02, 2012 at 09:51:29 AM PST

            [ Parent ]

            •  Yes, co-insurance is not the same as premiums. (3+ / 0-)

              Co-insurance is the share that a patient pays for medical care above the deductible. For example, if there is a $5,000 outpatient procedure, and if the deductible is $50 dollars, and if the co-insurance is 20 percent, then the patient would pay $990 ([$5,000 - $50] x .20). There is usually a cap on co-insurance payments. For example, if the co-insurance cap in my example is $5,000, then the insurer would pay 80 percent of the cost of care up to the cap and 100 percent above the cap. One way to means test would be to have, for example, a $5,000 co-insurance cap for beneficiaries below a certain income level and a $10,000 cap for beneficiaries above that income level.

              I don't actually know the details of the co-insurance percentages and caps in Medicare, but this example illustrates how they work.

              •  Gotcha. So, what are your thoughts on premiums? (0+ / 0-)

                A previous commenter brought up the idea that "net benefits"- benefits received minus payments in - is the relevant variable when it comes to the "welfare effect" and political support.  I disagreed, pointing to the existing means-testing of premiums and the higher dollar amount that high-income-earners pay in throughout their working lives, neither of which has reduced support for the program.

                What do you think?

                Art is the handmaid of human good.

                by joe from Lowell on Sun Dec 02, 2012 at 10:11:56 AM PST

                [ Parent ]

                •  I'm for simplifying the tax code. For me, (1+ / 0-)
                  Recommended by:
                  joe from Lowell

                  that means taxing income from labor, investments, and yes, inheritances at exactly the same rates. If we were to eliminate the payroll cap on Social Security taxes, and apply the Medicare tax to all sources of income, then I'd be thrilled.

                  (One possible caveat might be that maybe we shouldn't apply a SS tax to investments and inheritances since such sources are not used to calculate benefits).

                  •  I'd prefer tax hikes to premium hikes, too, but... (0+ / 0-)

                    I'd be hard-pressed to oppose any system of collecting more money from rich people to pay for public health care programs, short of actually mugging them in the street.

                    Art is the handmaid of human good.

                    by joe from Lowell on Sun Dec 02, 2012 at 10:25:48 AM PST

                    [ Parent ]

      •  This isn't just a semantic point, btw. (2+ / 0-)
        Recommended by:
        gramofsam1, shrike

        Reducing what people get out of the system would, indeed, have the detrimental "welfare effect" you mention.  It would be a case of "that poor person is getting more than me."  Actually reducing how much of wealthy retirees' medical treatments are covered by Medicare would likely make them less willing to support the program, because they aren't getting as much out of it, and seeing poorer people getting more.

        But changing how much they pay in order to get the same benefits as everyone else would not - in fact, it has not.  We currently fund Medicare by collecting a % of incomes, and wealthy income-earners pay more.  This hasn't led to a reduction in support.  We currently means-test Medicare premiums, and that hasn't led to a reduction in support.

        Reducing what rich people get out of Medicare makes it a program for the poor.  Reducing what they put in, while ensuring that they get the same coverage as everyone else, does not.

        Art is the handmaid of human good.

        by joe from Lowell on Sun Dec 02, 2012 at 09:48:21 AM PST

        [ Parent ]

          •  Thanks. Sorry I misunderstood you earlier. (1+ / 0-)
            Recommended by:
            gramofsam1

            Art is the handmaid of human good.

            by joe from Lowell on Sun Dec 02, 2012 at 10:09:27 AM PST

            [ Parent ]

              •  are we seeing 'means testing' being parsed here (0+ / 0-)

                somehow?

                Are there several hidden definitions so the phrase can be plopped into a conversation to sound reasonable, then parsed when attacked for it?

                Above you gave the , or should I say one definition of means testing in an application.

                I am starting to get grumpy and feel lied to somehow..rrrr.

                Can you explain once again if when you say 'means testing'  are you referring to the same mechanism, the same application that McCaskill is when she uses the same words?

                ....Cause I trust you more than Mccaskill at this point, she's a politician from a red state...and somewhere the mudslide from Bullshit Mountain is starting to smell again.

                Thanks for this.

                This machine kills Fascists.

                by KenBee on Sun Dec 02, 2012 at 02:30:44 PM PST

                [ Parent ]

                •  KenBee. I apologize for the delayed response. (1+ / 0-)
                  Recommended by:
                  KenBee

                  If you look at the transcript (see my update in the original diary for context) these two statements are about as specific as McCaskill would get...

                  higher co-pays for those people who can afford it
                  and...
                  we’ve got to get to a point where we are really having people who can afford to pay for their health care, having them to take that responsibility instead of the government
                  Now "higher co-pays" isn't me parsing McCaskill's words; those are her words. Co-pays are the office visit charges that we pay when we visit a doctor. Obviously raising co-pays from $25 to $50, for example, for some beneficiaries won't save much money. The real money is in the higher co-insurance percentages, higher caps on co-insurance, or a combination of the two (co-insurance is the percentage amount paid by the insured for any care that is over and above the deductible and below a specified cap...for example, 20 percent up to $5,0000 of care.) McCaskill only mentioned co-pays, but wonky discussions about means-testing Medicare typically refers to both co-pays and co-insurance, since Medicare would need the latter to be means-tested too to realize any significant savings.

                  What is Senator McCaskill talking about when she mentioned "having them to take that responsibility instead of government?" Hell if I know. But I don't like the sound of it.

                  •  thanks, no apology needed :> (0+ / 0-)

                    'means testing' phrase has been common to me anyway to refer to argue for access limits for SS, so to see it used in Medicare sounds almost like the same thing, another access limit and I thought they were talking about making Medicare unavailable for higher income 65yr olds.

                    This definition as you gave it is kinda shading that from the more original and widely used definition, I think, IMO humble opinion. Sounds like it's going to the sliding scale definition and isn't much of a 'test' if that.
                      It could be that it sounds snappy and reasonable and she is using it so as to coopt the 'business' oriented corruptobots she has to argue with, and all their pompous bullshit. Especially on the horrid tv show...

                    She looks so much better than what and who could have been in her seat, I'll certainly give her an 'Attgitrl and two thumbs up for representin.

                    This machine kills Fascists.

                    by KenBee on Sun Dec 02, 2012 at 08:06:23 PM PST

                    [ Parent ]

  •  Claire McCaskill ought to look at who supported (2+ / 0-)
    Recommended by:
    divineorder, Navy Vet Terp

    her.

    If she thinks that Democrats who are just Todd Akin's who don't like rape, she is sadly mistaken.

    If it weren't for the Committee structure in the Senate, I would have been just as happy to be criticizing Akin for such right wing views.

    Here's a means test.... you make over $200,000 a year in retirement, you keep paying into your FICA tax to support medicare and social security.

    Mitt Romney's moral compass points to the Cayman Islands.

    by captainlaser on Sun Dec 02, 2012 at 08:59:04 AM PST

  •  By all means, let's hold her feet to the fire, (4+ / 0-)
    Recommended by:
    IB JOHN, emelyn, CocoaLove, Aquarius40

    but let's also be realistic about what we can expect from her.  She is my Senator (I don't claim the other one) and I rememeber how Todd "legitimate rape" Akin was kicking her in the polls up until that quote.

    Is she a great Democratic senator? Hell no!  Is she about the best we can hope for from Missouri?  Yes.

    Don't get me wrong, if another candidate comes along that can better express Democratic ideals to Missourians I'll vote for them in a hot second in a primary. Until then, well, this is the hand we have to play.

    I lie to myself because I'm the only one who continues to believe me. - Vermin

    by 84thProblem on Sun Dec 02, 2012 at 09:02:45 AM PST

  •  Turning SS explicitly into a welfare program (6+ / 0-)

    makes it easier for the press and republicans to attack it.

  •  What Paul Krugman said. (1+ / 0-)
    Recommended by:
    MrJersey

    As for Claire McCaskill, in AZ most dems would be dancin' in the streets if she was our senator.  For us libs, however, it would be a slow, VERY slow, painful dance, and with a partner we thought had two left feet.  

  •  Lindsey Graham - Obama, Dems "totally immature" (0+ / 0-)

    I'm like, gag me with a spoon. MTP is, like, totally, whatever

  •  First of all, medical care is not a benefit. (4+ / 0-)
    Recommended by:
    greenbell, Sunspots, OnlyWords, KenBee

    Medical care is a response to a disutility. Almost no-one wouldn't rather not need care to begin with. So, medical care is a lesser of two evils.
    Secondly, the money paid out goes to a third party, the providers of care.  Since we no longer believe it is appropriate to make anyone work without compensation, depriving educated and skilled medical care providers of pay would be a crime.
    Thirdly, even threatening to deprive citizens of necessary services is criminal.  After all, deprivation of rights is the essence of crime and we've hired the Congress and paid them to provide, not deprive.
    Moreover, since the Congress is tasked with managing the currency, the argument that there is not enough money is a sham. Deferring to Wall Street to decide how much currency will be used and by whom is a dereliction of duty. The currency is not improved by being funneled through the banks.

    We organize governments to deliver services and prevent abuse.

    by hannah on Sun Dec 02, 2012 at 09:39:12 AM PST

  •  There is NO Reason For McCaskill To Talk Like This (3+ / 0-)

    She just got reelected.  She's in for another six years.  Her seat is not in jeopardy.  She doesn't have to worry for at least 4 years.

    She won.  It's over.  She could at least pretend to be a Democrat.  

    •  It's all part of the game (0+ / 0-)

      Those newly elected have to vote for the cuts.  Then they let those up for reelection in 2014 or 2016 vote against the cuts.  That's why I say hold them ALL accountable for the outcome.  Don't be played.

  •  How is this even a discussion? (5+ / 0-)

    Paid into the medicare system while working.  Then when I retired and took my SS benefits I was less than thrilled to see that I now pay $100 a month for medicare coverage out of my small ($1100 monthly SS benefit, and it is automatic, no choice in the matter).  I have paid and I still pay but I should pay more?  Give me an effing break.

    There are plenty of retired folks who receive quite a bit less than I do from SS and it is just excruciating to try to live on these very small amounts when food and gas prices raise every time I go to the store or gas station.  Those two categories are my biggest expenses each month and are not counted towards cost of living increases which we have only had one in the past 4 years.

    This past year is the only time I have used medicare and I have been retired for 10 years.  So I would think that I have paid plenty into the system and used very little, yet I should be penalized more?

    These people need to live in the REAL WORLD.  They have no idea what they are monkeying with and what adverse effects it may have on people in real need.  They just see numbers on paper and think they can move them around, increase them or decrease them and it is no big deal.  Not how it works.

    JMO

    *the blogger formerly known as shirlstars

    by Shirl In Idaho on Sun Dec 02, 2012 at 09:50:32 AM PST

  •  Six more years of this woman. (0+ / 0-)

    Ugh.

    Show us your tax returns !!!!!!

    by Bush Bites on Sun Dec 02, 2012 at 09:52:37 AM PST

  •  Saw MTP too. She did not say that at all. Unfair. (1+ / 0-)
    Recommended by:
    Gary Norton
  •  Ridiculous diary. Your quote is wrong. (4+ / 0-)

    You say "If we means-test Medicare, then we're cutting Medicare benefits." Ridiculous. She said something like "Even is Donald Trump needs medication (which he does) we shouldn't have to pay for it!" Exactly, means testing Medicare means those who can afford to pay more should. This is NOT the end of benefits to beneficiaries. This makes common sense to extend the life of the program.

  •  I'm tipping and recommending now. (0+ / 0-)

    Thanks for the clarification about premiums vs. coinsurance.

    I doubt I'm the only one who got that confused, though.  Maybe this distinction is worth mentioning in an update.

    Art is the handmaid of human good.

    by joe from Lowell on Sun Dec 02, 2012 at 10:23:22 AM PST

  •  Somebody talk to that woman (0+ / 0-)

    Doesn't she know what happened a month ago?

    All your Supremes are belong to us. For Great Justices!

    by thenekkidtruth on Sun Dec 02, 2012 at 10:23:43 AM PST

    •  "That Woman"? How Very Non-Sexist Of You... (3+ / 0-)

      and yes, McCaskill does know what happened in Missouri a month ago.

      32% of White Missourians voted for Obama
      65% of White Missourians voted for (R)money

      45% of White Missourians voted for McCaskill
      48% of White Missourians voted for LegitRape Akin

      94% of Black Missourians voted for both Obama and McCaskill

      It's Missouri, not Massachusetts...

      I am not now, nor have I ever been, a member of the Republican Party.

      by OnlyWords on Sun Dec 02, 2012 at 10:45:21 AM PST

      [ Parent ]

  •  So sad this diary mad REC list. Claire was good (6+ / 0-)

    today.....pushed back very strongly against Corker who was sitting next to her. This diary is full of hyperbole and I was very impressed with Claire today. Next time before a diarist trashes someone's sunday performance they ought to either give us a DIRECT quote or put up some video. Otherwise, now we have many commentors jumping on a bandawagon trashing Claire when at least to my view, there is another completely alternate interpretation of her policy stands today.

    •  I hear you RN. I saw the interview, got mad, (0+ / 0-)

      and ran to my computer to rage.

      As I said earlier, when I can find the transcript and/or video online, I'll post it. Again, feel free to forward the link if you can find it.

      That said...McCaskill made it clear that she supports means-testing Medicare. You said so yourself in your 10:19 comment. No misrepresentations here.

    •  Agreed. Just watched the show. Her comments (0+ / 0-)

      were referring to wealthy individuals who do not need Medicare....she used Trump as the example.  I do not get the trashing of her in this thread.

      Speak softly and carry a big can of tuna.

      by Cat Whisperer on Sun Dec 02, 2012 at 12:58:07 PM PST

      [ Parent ]

  •  We could save lots of Medicare Part D money just (2+ / 0-)
    Recommended by:
    Militarytracy, concernedamerican

    by letting Medicare negotiate for drug prices, just like the VA and other government agencies.  I don't hear any Democrats from drug company states (NJ and California, for example) floating that cost savings measure around.  Lots of Democratic hypocrisy on this one.

    And it feels like I'm livin'in the wasteland of the free ~ Iris DeMent, 1996

    by MrJersey on Sun Dec 02, 2012 at 10:30:04 AM PST

  •  The specific segment is up at MSNBC (1+ / 0-)
    Recommended by:
    OnlyWords

    URL here.

    Goes to a video - the interactive transcript is up, but copying is currently disabled.

    Embed below:

    Visit NBCNews.com for breaking news, world news, and news about the economy

    The language McCaskill uses starts (I think) at the 2:48 mark - navigation is easy at MSNBC using the transcript option. I've transcribed what I think is the portion prompting this diary.

    I think it's certainly a fight. And I think we have to be careful, we have to make sure ... I think we can get to means testing fairly easily.
    Some higher co-pays for people who can afford it. As I said before, Donald Trump may need medication, but he doesn't need the Government to pay for it. We've got to get to a point where we are really having a people who can afford to pay for their health care, having them take that responsibility.

    Gregeory: That's the position the President should adopt in your view?

    I think so. I think aggressive means testing for those who can afford it makes sense as we look at long-term savings in the Medicare program. But, here's the thing. Bob (Corker) and I both know, he and I are talking and I think we can get a deal through the Senate. The question is, I feel almost sorry for John Boehner. There is incredible pressure on him from a base of his party that is unreasonable about this; and he's got to decide - is his speakership more important, or is the country more important.
    And, in some ways, he has got to deal with this base of the republican party who Grover Norquist represents. And, you know, everybody's elevated Grover - I met with him for the first time this morning. Nice to meet him. But, who is he? ...

    •  point is MEANS testing isnt necessarily a bad idea (0+ / 0-)

      and she said nothing about upping the Medicare age which however IS an anathema to progressives.

      •  When I first saw the part in your comment on age (1+ / 0-)
        Recommended by:
        slinkerwink

        I scratched my head - for I was wondering where you were coming from.

        The diary makes no such assertion - so I'm wondering what are you trying to defend with that assertion? But, that isn't the main point of the diary as I read it.

        Anyway - glad you agree that means testing Medicare is exactly what she said.

        You think it is a good idea.

        I beg to differ.

        McCaskill offers a wedge, an expansion of one which was already created. This should tell you something about the consequence of adopting such an approach, the threshold will always be shifted, over time, to have higher fiscal pain inflicted on more and more recipients.

        After a while the result is little different from what Ryan was correctly tagged as proposing, changing Medicare into something that is not recognizable.

  •  So rather than the ACA (2+ / 0-)
    Recommended by:
    delver rootnose, Malvern

    insco/big pharma security act morphing into Medicare for all, Medicare will morph into a skimpy political football program for "the poor"...

    Gotta love our Village dems.

    Pre-election: Please send us money or The Evil will triumph...

    Post election: We won! Now fuck you and shut up.



    Those who do not move, do not notice their chains. Rosa Luxemburg

    by chuckvw on Sun Dec 02, 2012 at 10:30:59 AM PST

  •  quote from Claire's GREAT (not bad!) performance.. (1+ / 0-)
    Recommended by:
    Gary Norton
  •  Why are the words (1+ / 0-)
    Recommended by:
    delver rootnose

    Medicare and cuts used in the same sentence by any Democrat?

    She's already planning the next election.


    The religious fanatics didn't buy the republican party because it was virtuous, they bought it because it was for sale

    by nupstateny on Sun Dec 02, 2012 at 10:37:13 AM PST

    •  She said the 716B cuts Obama made were to waste (3+ / 0-)
      Recommended by:
      OnlyWords, Aquarius40, Gary Norton

      She was very polished today. I watched this show. I have been critical of Claire in the past and dissapointed sometimes because she is so talented and understands budgets - she was Auditor in Missouri. But she WAS ON POINT TODAY AND VERY IMPRESSIVE. No she wasn't Bernie Sanders today but she pushed back against her colleague Corker sitting next to her and usually DEMS on these Sundays shows go catatonic with niceness for some ungodly reason when they are sitting next to a Republican senate colleague. Not today. Watch it at 2pm on MSNBC again today if you do not believe me. She followed the first round table and believe me Geitner had his A game on!! Maybe the first time ever for him........I unfortunately watch MTP religiously every Sunday even though I usually hate it and generally complain to the show's producers afterwards about the awful round table guests they include.

  •  I know I am glad that McCaskill won, (1+ / 0-)
    Recommended by:
    Militarytracy

    but I think she's a bit of a dummy and have never much liked her.

    Hey, Republicans, the whole world is watching.

    by TAH from SLC on Sun Dec 02, 2012 at 10:41:14 AM PST

  •  Wasn't it great (1+ / 0-)
    Recommended by:
    delver rootnose

    getting her reelected?
    Nothing like a Blue Dog Democrat to make ya proud.

  •  Gotta love the brass on this Conservadem (1+ / 0-)
    Recommended by:
    delver rootnose

    The luckiest woman in Washington. Ugh.....

    Victory is sweet-November 6, 2012

    by al23 on Sun Dec 02, 2012 at 11:06:51 AM PST

  •  Medicare is going to take a hit.. (0+ / 0-)

    We are fooling ourselves to say it is not. The best that we can do is minimize the impact to average working people.

    but..changes are coming..

  •  Looks like we are not done upgrading the senate. (1+ / 0-)
    Recommended by:
    delver rootnose

    Republicans espouse individualism, Democrats embrace citizenship.

    by SpiffPeters on Sun Dec 02, 2012 at 11:42:08 AM PST

  •  Democrats shouldn't even whisper any cuts... (2+ / 0-)
    Recommended by:
    greenbell, Brooke In Seattle

    ...to Medicare.  do you remember how that played out in 2010 for Republicans when they twisted the truth on Medicare "cuts"?  the truth of stopping overpayments to Medicare Advantage never got to the low information voters.  it was all OMG, Obama cut Medicare in the multitude of letters to the editor in our local paper.  don't give Republicans any opportunity to do the same again in 2014.

    I'm a blue drop in a red bucket.

    by blue drop on Sun Dec 02, 2012 at 12:01:56 PM PST

  •  Why does the GOP want to punish successful people? (0+ / 0-)

    I'm confused, it is OK to raise the cost of Medicare for people who have actually paid more into than others, but we cannot raise their taxes?  

    The reason of course is that the GOP will do anything they can to reduce support for the program.  Means testing Medicare or Social Security would help achieve that goal.

    The difficulty lies not so much in developing new ideas as in escaping from old ones! - John Maynard Keynes

    by Do Something on Sun Dec 02, 2012 at 12:07:51 PM PST

  •  Andrews - NJ says raise medicare eligibility age (0+ / 0-)

    We do have Benedict Arnoldcrats shilling to raise the eligibility age so what are they doing?  Throwing stuff out to see how much s**t hits the fan?  Where is the Democratic Party?  Why don't we know where it stands on Medicare?  When 68% of Americans say no cuts why are Democrats to the right of 68% of the people?  Who are they representing????

  •  Here we go again with this hair on fire crap (0+ / 0-)

    that led to us losing in 2010. There was the same crap said about $716 billion Obama cut from Medicare waste. The hair on fire cried he was cutiing benefits. Maclair didn't say a danger thing about cutting any  bfits)

  •  This May be Why (0+ / 0-)

    Progressive Dems don't want this Senate to vote on anything having to do with taxes and the social safety net. After the first Monday in January, Warren and Baldwin join the Senate as well as the new Dem Senator from ND, although I don't know where she stands. We also get a true progressive out of CT. Going over the fiscal cliff also means getting rid a more conservative Dem caucus in the Senate.

  •  I support limited, targeted means-testing for (0+ / 0-)

    people with incomes above a certain amount.  If you will, perhaps not a means-testing process at all, but rather a "cutoff" for income above which you just have to pay more or higher rates for Medicare.  

    My parents were on Medicare, but they could well afford to pay higher premiums, copays, etc. for their care.  They should have been asked to do so.  By no means were they earning as much as a Mitt Romney or a hedge fund manager--- no way.  But if upper middle class folks like my parents could afford more, then people earning 250,000 a year and more can certainly afford to be asked to pay more.  And they should be asked to do so.

    That's one more thing to add to my long list of small problems. --my son, age 10

    by concernedamerican on Sun Dec 02, 2012 at 12:47:06 PM PST

  •  I paid for it. I expect to be able to use it, (0+ / 0-)

    just like everyone else, regardless of my income.  You can't change the deal after the fact.  

    Intolerance betrays want of faith in one's cause. - Gandhi

    by SpamNunn on Sun Dec 02, 2012 at 01:28:03 PM PST

  •  McCaskill raises the dilemma I always find myself (0+ / 0-)

    in when supporting a dem I don't really like. This is a perfect example.

    And while I am not in MO, and while I realize the alternative--Akin--is just plain evil and nuts, having to support someone like her because we need to hold the senate just pisses me off in the end.

    Yeah, I do it. But I don't like it. Not one bit.

    202-224-3121 to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them. "We're not perfect, but they're nuts."--Barney Frank 01/02/2012

    by cany on Sun Dec 02, 2012 at 02:13:30 PM PST

  •  Considering the amount of support Democratic (0+ / 0-)

    voters around the country gave her in the last election you'd think she would't turn around so quickly and screw us over so totally.

  •  Just really absorbed her comment (0+ / 0-)

    "I mean, we’ve got to get to a point where we are really having people who can afford to pay for their health care, having them to take that responsibility instead of the government"

    The government?  the government??!!!!! People paid into Medicare their entire working lives.  Working for 40 or 50 years IS TAKING RESPONSIBILITY.  We are not MOOCHERS, Claire.  Medicare is not a poverty program. Medicare is a dignity program.

  •  means testing is excellent... (0+ / 0-)

    ...meaning that those with higher incomes would pay more of their Medicare costs. This would be far preferable to increasing the age, which would severely harm those with more modest and lower income folks who need Medicare.

    It's also better to means test than it is to raise costs or reduce benefits for middle and poorer folks.

  •  I favor single-payer and cutting out the insurance (0+ / 0-)

    companies.

  •  How bout we just cut off the teabaggers? (0+ / 0-)

    All of those retired, upper-middle class fucks drawing union pensions, SS and Medicare while simultaneously screaming about 2nd Amendment solutions to the Kenyan in the White House giving goodies to the brown people and yelling that every benefit not going to retired white people is socialism.  These are the people who supported the Ryan budget that kept THEM in Medicare but gave vouchers to everyone younger.  Fuck 'em!

    Political compass: -8.75 / -4.72

    by Mark Mywurtz on Sun Dec 02, 2012 at 07:24:48 PM PST

  •  Means testing mean reams of forms (0+ / 0-)

    To fill out twice a year, where if you make a mistake they threaten you with fines and jail time.

    It turns it into an anxiety producing system that makes you feel like it's all just too complicated.

    Means testing turns everything into a nightmare, especially for those that are not that literate or math oriented.

    Women create the entire labor force. ---------------------------------------------------------------------------------------- Sympathy is the strongest instinct in human nature. - Charles Darwin

    by splashy on Mon Dec 03, 2012 at 11:02:51 AM PST

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