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Meanwhile, just a few months ago, Mitt Romney spent millions accusing President Obama
of cutting Medicare by $716 billion.
Woe is Politico:
The president has never precisely defined what hard choices he would be willing to make on Medicare and Social Security. It’s not even clear what he would do if he had the power to remake the programs on his own, without worrying about opposition from Republicans or Democrats.
How incredibly sad. President Barack Obama just isn't willing to make hard choices on Medicare and Social Security. And, as everybody knows, with an unemployment rate of 7.8 percent, America's top priority is making "hard choices" to cut not just those programs, but Medicaid as well.

If only the president had done something courageous, like passing landmark health care reform legislation that will achieve $716 billion in Medicare savings over the next decade. If only he had been willing to take such a step despite the virtual guarantee that the Republican presidential nominee would run ads attacking him for it. If only he'd been willing to do something bold, like taking the risk of having Republicans claim that he had created death panels when what he really did was create an Independent Payment Advisory Board aimed at reducing Medicare costs.

But no, our lousy president hasn't been willing to make any tough choices at all. In fact, as Politico "reports" in the very same article that I quoted above:

Obama infuriated Democrats by proposing controversial changes to Medicare, Medicaid and Social Security during his failed 2011 grand-bargain talks with Boehner. The president was ready to make some entitlement concessions in the fiscal cliff negotiations last month, but that effort fizzled, too.
Wait. Hold on. You mean Obama has proposed additional cuts to Medicare and Social Security?

Continue below the fold to discover why Obama still sucks, at least according to Politico

Now at this point you might be a bit confused, because on the one hand Politico is ripping Obama for being unwilling to cut Medicare, Medicaid, and Social Security, but on the other hand, they are pointing out that he angered his own party when he proposed cuts to Medicare, Medicaid, and Social Security. Fortunately, your confusion will be short-lived, because Politico explains why Obama still sucks. The short version: the tax cliff deal made it impossible for him to get entitlement cuts because Republicans aren't willing to raise taxes again.

The fiscal cliff deal, which raised $600 billion in new revenue, may have actually made it more difficult to strike a grand bargain. That’s because Republicans aren’t willing to consider further tax hikes — a White House prerequisite to weighing any controversial cuts to entitlements.
Well, I guess that settles that. As we all know, if Republicans say no to something, then it's off the table. It should never be considered. Why? Because Republicans said no, that's why. And when they say no, they mean it. Except:
A senior Republican tax aide confirmed that Representative Dave Camp of Michigan, the Ways and Means chairman, planned to push forward this year with “revenue-neutral” tax reform, with the revenue target adjusted upward to the amount raised by the higher tax rates on the wealthy approved this month to resolve most of the so-called fiscal cliff.

The Republican aide said if the Senate can approve tax changes that raise revenues, it is possible that difficult negotiations between the two chambers could produce a final deal that would produce more tax revenue – but not as much as the Senate wants.

Huh. Maybe assuming Republicans say what they mean and mean what they say isn't really the best assumption to make. Maybe it's time to realize that Republicans like to bluff. And as long as Politico is going to perpetuate its misguided obsession with 20-year budget projections for Social Security, maybe they should give President Obama some credit for having done what they say he refuses to do.

Of course, what would really be nice would be to see the same level obsession on an issue like unemployment and economic growth, or maybe even climate change. After all, the fanciest projection in the world doesn't mean a damn thing without economic growth. And if we don't do anything to confront climate change, the only thing we can say for sure about the demographic forecasts for the future of Social Security and Medicare is that they are going to be wrong.

Originally posted to The Jed Report on Tue Jan 22, 2013 at 06:28 AM PST.

Also republished by Daily Kos.

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Comment Preferences

  •  What is the purpose of revenue neutral? Sounds (12+ / 0-)

    like a waste of time.

    Unless the purpose of it is to shift the burden from the rich to the poor.

    "Drudge: soundslike sludge, islike sewage."
    (-7.25, -6.72)

    by gougef on Tue Jan 22, 2013 at 06:37:05 AM PST

    •  The purpose is to balance out what upper (6+ / 0-)

      income level households and businesses pay, so you don't have two households at the same income, one paying an effective tax rate of 30% and one paying an effective tax rate of 15%.  You do that by eliminating deductions/exemptions and flattening the rates, so they both pay an effective rate of, say, 25%.  Right now, that is very much what is happening with upper level household incomes.  You can have two working professionals, making in that range between $250,000 an $1 million, paying an effective rate of 28% because of the AMT, and another household at the same income level, or even a millionaire, paying an effective rate of 15% or less.  

      For business, the same principle applies, and it has the added benefit of having  business make decisions based on what is best for their business rather than what tax breaks are available.  It's importantly for households for fairness.  It's important for business so that tax policy doesn't play a huge role in shaping business decisions.  

      •  To fix that, you'd have to treat capital gains (15+ / 0-)

        as ordinary income.  Something that I support, but I don't see the Republicans as supporting anytime soon, as their core constituency seems to be the rich...

        •  Yes you would (3+ / 0-)
          Recommended by:
          Sychotic1, NormAl1792, VClib

          If you lower the top rate enough, you can do that for upper incomes.  

          Historically, the effective rate for the top 1% has been at 20-22% or so (I think it peaked during the Clinton years).  If the top marginal rate was around 25% and there were few to no deductions, you probably could, for upper incomes, tax capital gains as ordinary income without losing revenue.    

          There are legions of people running the numbers.  

          •  :: sigh :: (8+ / 0-)

            How about simply taxing capital gains at the individual's marginal rate, and ending the discussion there.

            I hope that the quality of debate will improve,
            but I fear we will remain Democrats.

            Who is twigg?

            by twigg on Tue Jan 22, 2013 at 07:56:34 AM PST

            [ Parent ]

            •  twigg - that's only happened once (1+ / 0-)
              Recommended by:
              twigg

              After the Tax Reform Act of 1986 when the top rate was 28%. Historically long term capital gains tax rates have been one half of the taxpayers top effective rate.

              Every country in the G20 taxes long term capital gains at a lower rate than earned income. The US would never want to be the sole outlier and tax them both at the same rate, unless the rate was very low like after the TRA86. Countries with high capital gains tax rates have seen capital flight, and reduced long term economic growth. It would also reduce foreign investment in the US.  

              "let's talk about that"

              by VClib on Tue Jan 22, 2013 at 08:39:53 AM PST

              [ Parent ]

              •  That's not true (1+ / 0-)
                Recommended by:
                RandomNonviolence

                The UK taxes capitals gains at an individual's marginal rate.

                There is a calculation that strip inflation from the apparent gain, so that only the "real gain over time" is taxed, but then it is taxed at margin.

                I hope that the quality of debate will improve,
                but I fear we will remain Democrats.

                Who is twigg?

                by twigg on Tue Jan 22, 2013 at 08:57:29 AM PST

                [ Parent ]

                •  twigg, your source is wrong. UK rates are lower (1+ / 0-)
                  Recommended by:
                  twigg

                  for Capital Gains than ordinary income.

                  From the UK equivalent of the IRS HM Revenue and Customs

                  If you have overall gains work out which Capital Gains Tax rates apply and how to use your tax free allowance. For gains made in 2011-12 Capital Gains Tax is charged at 18 per cent, or 28 per cent for higher rate tax payers.
                  Ordinary income rates in the UK are higher than 18% and 28% with a top rate of 45% in 2013.
                    See
                  Income Tax rates and taxable bands

                  If you want to show the above is wrong, please do so using links to the official HM Revenue and Customs website.

                  The most important way to protect the environment is not to have more than one child.

                  by nextstep on Tue Jan 22, 2013 at 11:16:29 AM PST

                  [ Parent ]

                  •  Thanks (0+ / 0-)

                    They have changed it.

                    They should charge at the higher rate too, that is what they did when I was involved in finance.

                    There is no excuse for unearned income to be charged at a lower rate than earned income.

                    I hope that the quality of debate will improve,
                    but I fear we will remain Democrats.

                    Who is twigg?

                    by twigg on Tue Jan 22, 2013 at 12:30:11 PM PST

                    [ Parent ]

                •  Whatever we do (0+ / 0-)

                  it should be adjusted for inflation, like many other things in the tax code - interest income, for one. Not that I think that will ever happen. But isn't it a kick in the pants to pay income tax on the 1% you got from the bank when inflation was 3%?

                  We decided to move the center farther to the right by starting the whole debate from a far-right position to begin with. - Former House Majority Leader Tom DeLay

                  by denise b on Tue Jan 22, 2013 at 02:46:46 PM PST

                  [ Parent ]

          •  There are people who still buy that argument? (0+ / 0-)
            If the top marginal rate was around 25% and there were few to no deductions, you probably could, for upper incomes, tax capital gains as ordinary income without losing revenue.
            Best numbers I've seen say that you could set the highest tax bracket at 60% and the capital gains tax at 40% and see huge revenue increases. Honestly, anyone who actually believes the Laffer curve optimum point is below 50% is either cynically manipulating numbers or has been deeply deceived. (Indeed, it's probably up around 90%.)
            •  The comment wasn't about the Laffer curve (0+ / 0-)

              It was what appears to be a very rough estimation of what level of taxation would be needed to replace current revenue from high-income taxpayers, if capital gains and wage income were taxed at the same rate.  That's compared to the current preferential treatment given unearned income.

              The Laffer curve is something else entirely and you're right that the inflection point is likely well above 50%.  Of course, there are many variables that Laffer discussions never seem to take into account.  One is the relatively easy movement of capital across international borders, but the another is the social factor.  Getting to spend "only" 30% of your 10th or 100th million in income on luxuries still means you get lots more stuff.  It's a social construct that this extra stuff is somehow inadequate reward for being super rich.  But if you have a political and media establishment telling people that they might as well quit working if taxes go above 36% marginal rate, that's going to motivate some of them to do exactly that.  There's a social pressure to "go Galt."

              "And the President of the United States - would be seated right here. I would be here. And he would be here. I would turn - and there he’d be. I could pet ‘im." - Lewis Black

              by libdevil on Tue Jan 22, 2013 at 10:32:15 AM PST

              [ Parent ]

      •  adding to that... (1+ / 0-)
        Recommended by:
        NormAl1792

        ...one reason healthy care is so expensive is because there's a massive hidden tax subsidy that encourages shifting compensation into health care plans (because it is untaxed). i don't remember the ultimate resolution, but there was some stuff done on this in ACA, but there's still a huge problem. I don't really have a specific point other than it's just another example of how a convoluted tax code distorts preferences and economic action. a big part of the reason, i suspect, is that it's always easier to write a tax credit/cut than to spend money, so lawmakers look to the tax code to shape policy and reward supporters.

        •  The ACA did not help that, frankly. (1+ / 0-)
          Recommended by:
          VClib

          Speaking as an employer, we have continued to see premiums rise.  And, from a purely economic perspective, it would be much more advantageous to our business to pay the tax rather than subsidize health insurance.  We want to continue to provide good health insurance coverage for our employees, but the ACA is not making that easy.

          Here's just one example.  For a young and healthy employee, a comprehensive policy of the kind required by the ACA with low deductibles and little out of pocket expenses makes no economic sense.  They are much better off financially with a very very high deductible policy -- the kind that covers mainly catastrophic health care -- and to pay the costs of things like annual visits out of pocket, ESPECIALLY when they could combine that kind of catastrophic coverage with a HSA.  The out of pocket costs are generally far less then the premiums.  The ACA is going to effectively do away with that option, and the employee contribution for those employees is going to go up significantly.

          The ACA did two things, I think:  (1) it taxes "Cadillac" plans (which is going to provide a further financial disincentive for us to continue to provide the kind of coverage we have been providing); and (2) it says that we have to put on the paycheck the amount we are paying that employee in non-taxable income in the form of health care premiums.  Most of our employees believe that is a prerequisite to taxing those benefits as income.  

          •  George Will wrote a column yesterday (0+ / 0-)

            about the hidden consequences of the ACA tax in conjunction with community rating/guaranteed issue rules.  I didn't look into it, but he said Roberts said the tax could not be penal, ensuring it remained a choice vs. a mandate.  Thus people would pay the tax, and then jump in when sick.  Meaning the healthy pay higher premiums.

            It was a pretty strong argument at face value, and I say that about once every election cycle with George Will.

            This must, Lambert thinks, have momentous — and deleterious — implications for the functioning of the ACA. The problems arise from the interplay of two ACA provisions — “guaranteed issue” and “community rating.”

            The former forbids insurance companies from denying coverage because of a person’s preexisting health condition. The latter, says Lambert, requires insurers to price premiums “solely on the basis of age, smoker status, and geographic area, without charging higher premiums to sick people or those susceptible to sickness.”

            The point of the penalty to enforce the mandate was to prevent healthy people — particularly healthy young people — from declining to purchase insurance, or dropping their insurance, which would leave an insured pool of mostly old and infirm people. This would cause the cost of insurance premiums to soar, making it more and more sensible for the healthy to pay the ACA tax, which is much less than the price of insurance.

            ...

            So, Lambert says, the ACA’s penalties are too low to prod the healthy to purchase insurance, even given ACA’s subsidies for purchasers. The ACA’s authors probably understood this perverse incentive and assumed that once Congress passed the ACA with penalties low enough to be politically palatable, Congress could increase them.

            But Roberts’s decision limits Congress’s latitude by holding that the small size of the penalty is part of the reason it is, for constitutional purposes, a tax. It is not a “financial punishment” because it is not so steep that it effectively prohibits the choice of paying it. And, Roberts noted, “by statute, it can never be more.”As Lambert says, the penalty for refusing to purchase insurance counts as a tax only if it remains so small as to be largely ineffective.

            http://www.washingtonpost.com/...

            "Small Businesses Don't Build Levees" - Melissa Harris Perry

            by justmy2 on Tue Jan 22, 2013 at 07:21:19 AM PST

            [ Parent ]

            •  I agreed with Will on that as well (2+ / 0-)
              Recommended by:
              slinkerwink, VClib

              The financial incentives in the ACA are perverse.  

              The ACA provides a financial incentive for a business (1) to keep the number of full-time employees under 50; (2) to reduce employees from full-time to part-time whenever possible; and (3) to cancel health insurance and pay the tax instead.  

              And the more employers chose option (3), the more expensive health insurance will become for those of us who do provide it.  

              •  Yes, end employer-based health insurance (3+ / 0-)

                which accomplishes little other than to depress wages and drive up healthcare costs by keeping employees blind to the true costs of their care.

                Once we reach a critical mass of people on the exchanges, single-payer or single-payer-lite (public option) will be a breeze.

                (-2.38, -3.28) Independent thinker

                by TrueBlueDem on Tue Jan 22, 2013 at 07:54:23 AM PST

                [ Parent ]

                •  There is one little problem with that, noted by (2+ / 0-)
                  Recommended by:
                  coffeetalk, VClib

                  the CBO --

                  coverage on the exchanges is very expensive to the government, about 50% more than Medicaid.

                  But -- good to see that you agree with my continuing assertion that the CBO headline is false, that ACA will increase the deficit, not decrease it.

                  If you don't think that you agree, dig more deeply into the CBO report and you'll find that they expect only about 4 million people to lose employer-provided health benefits.

                  If that goes up greatly, projected deficit reductions disappear, and that's even though subsidies are based on the second lowest cost "silver" plan in an area. Silver plans cover only 70% of health care costs, a concern when those costs are rising as they are.

                  Maybe that's the pain we have to endure to reach the gain, but I think some people are going to be unpleasantly surprised next year.

                  LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                  by dinotrac on Tue Jan 22, 2013 at 08:13:52 AM PST

                  [ Parent ]

                  •  Well, ideologically I'm fine with that (0+ / 0-)

                    No deficit hawk here. Breaking up our inefficient patchwork system and centralizing healthcare even further around the public purse will speed reform dramatically.

                    (-2.38, -3.28) Independent thinker

                    by TrueBlueDem on Tue Jan 22, 2013 at 08:23:30 AM PST

                    [ Parent ]

                    •  Which would be great if people only suffered (0+ / 0-)

                      ideological illnesses, injuries, and bankruptcies.

                      It probably is good to get people yelling and screaming, though. If we really want our economy to do its job, we can't keep weighing it down with exorbitant costs for sub-standard care.

                      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                      by dinotrac on Tue Jan 22, 2013 at 08:41:31 AM PST

                      [ Parent ]

                      •  I don't see how this hurts individuals (0+ / 0-)

                        as much as it does the government coffers. With subsidies, expanded Medicaid, and guaranteed issue, personal bankruptcies should drop noticeably. The red ink shifting from the bank accounts of the ignored masses to the federal budget is the bitter pill for what ails us. I'm hopeful (without reason given recent history) that the ACA is the beginning of a long arc towards more progressive taxation, as well.

                        (-2.38, -3.28) Independent thinker

                        by TrueBlueDem on Tue Jan 22, 2013 at 09:06:37 AM PST

                        [ Parent ]

                        •  I'm not sure that it does, not sure that it (1+ / 0-)
                          Recommended by:
                          TrueBlueDem

                          doesn't.

                          Don't know about that expanded Medicaid.  CBO estimated that 6 million (not sure about that number, but I think it was 6) would be forced off Medicaid, and only half of them would purchase insurance on the exchanges.

                          Whether bankruptcies will go up or down will be dependent on

                          1) the cost of care,
                          2) benefits available to people prior to ACA and after.

                          The silver plan only covers 70% of costs. 30% can be a pretty big number. Mind you, lots of people have insurance that leaves them on the hook for 20%, so the net may be a wash if more people are buying insurance, and especially if people opt to apply their subsidy to a gold plan instead of silver.

                          My real hope is not that the government simply picks up the tab, but that some real health care reform happens, care that encourages making and keeping people well instead of piling up prescriptions and procedures.

                          LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                          by dinotrac on Tue Jan 22, 2013 at 09:21:53 AM PST

                          [ Parent ]

                          •  Well, then you should certainly... (0+ / 0-)

                            ...hope that government picks up the tab. Because given the huge financial disincentives currently in place for preventative care, that's the only way it's going to happen.

                          •  I grew up with military care. (0+ / 0-)

                            I don't care that much about who pays, but I do care about the crappy way we deliver care today.

                            LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                            by dinotrac on Tue Jan 22, 2013 at 10:10:12 AM PST

                            [ Parent ]

                          •  Absolutely agree (0+ / 0-)

                            Cost containment is just as big of a reason for government-funded healthcare as ease of access. It's time to generate the mother of all "large groups" and negotiate fair prices and practices with providers and manufacturers.

                            (-2.38, -3.28) Independent thinker

                            by TrueBlueDem on Tue Jan 22, 2013 at 10:52:14 AM PST

                            [ Parent ]

                        •  Remember, one half of the states are not expanding (0+ / 0-)

                          Medicaid to include beneficiaries up to 133%, and one-half aren't setting up state exchanges.

                          Regarding it not "hurting individuals."  Are you aware that the typical catastrophic policy in the Mass Health Exchange was running $800 plus per individual (seniors) several years ago.  

                          If the federal exchange has premiums anything near that high (accounting for regional pricing), many senior couples will be priced out of the market.

                          The subsidy cuts off at annual income of $46,000 for couples.

                          Not to be contentious, but how many couples do you know who gross that meager of a 'household income,' are in the position to shell out $1600-$2000 per month for health insurance premiums?  Very few, I'm sure.

                          It's going to be a mess, I'm afraid (for some folks).

                          Mollie

                          “If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

                          by musiccitymollie on Tue Jan 29, 2013 at 12:18:14 AM PST

                          [ Parent ]

                  •  I absolutely believe this (2+ / 0-)
                    Recommended by:
                    VClib, nextstep
                    If you don't think that you agree, dig more deeply into the CBO report and you'll find that they expect only about 4 million people to lose employer-provided health benefits.

                    If that goes up greatly, projected deficit reductions disappear, and that's even though subsidies are based on the second lowest cost "silver" plan in an area. Silver plans cover only 70% of health care costs, a concern when those costs are rising as they are.

                    I think the number of people who lose employer-provided health benefits is going to grow significantly.  As I said above, the ACA provides financial incentives for employers NOT to provide health benefits.  
                    •  It's not news for anybody who actually looks at (1+ / 0-)
                      Recommended by:
                      VClib

                      the numbers.

                      Unfortunately, it's a lot easier to spout headlines.

                      And, honestly, I got caught a bit myself. Though I always realized the disincentives to employers, I didn't catch the 70% coverage part until quite recently.

                      One red flag in the last CBO report that was missed by many -- maybe intentionally -- was that several million current Medicaid recipients would end up uninsured because they would choose not to buy insurance on the exchanges.  The interesting part of that discussion was the revelation that it would cut earlier deficit reduction estimates because the exchanges are much more expensive than Medicaid -- in spite of being keyed to the so-called silver coverage.

                      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                      by dinotrac on Tue Jan 22, 2013 at 08:38:21 AM PST

                      [ Parent ]

                    •  Employers retain a strong incentive (0+ / 0-)

                      Employers have a strong incentive to offer health care benefits.  Offering health insurance ties the employee to the workplace.  They can't leave their job without risking their financial well-being, and in some cases their very lives.  The exchanges and must-issue clause will alleviate this somewhat, but it's still going to be true of employers who offer better coverage than the mid-level exchange plans.

                      Of course, this also only applies to employers who don't have freely interchangeable employees.  For unskilled workers who are easily replaced, the employer has little need to indenture the employee through this method - poverty already does the trick.

                      "And the President of the United States - would be seated right here. I would be here. And he would be here. I would turn - and there he’d be. I could pet ‘im." - Lewis Black

                      by libdevil on Tue Jan 22, 2013 at 10:41:12 AM PST

                      [ Parent ]

                  •  You're spot on. That's the reason that the ACA (0+ / 0-)

                    didn't go into effect until AFTER the presidential election.

                    Mr. Mollie has been told that it's highly unlikely that his company will provide health insurance beyond 2013.

                    Mollie

                    “If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

                    by musiccitymollie on Tue Jan 29, 2013 at 12:10:53 AM PST

                    [ Parent ]

            •  My guess is the George is on vacation (2+ / 0-)
              Recommended by:
              justmy2, tommymet

              and an intern wrote the column.

              How else do you explain this?

              It was a pretty strong argument
            •  I suppose a rough comparison (0+ / 0-)

              would be with states that allow auto owners to opt out of carrying insurance.  The question is the extent to which that changes the risk pool as many carriers now offer uninsured motorist coverage to owners who do carry coverage

            •  Who is "Lambert," please? N/T (0+ / 0-)

              Mollie

              “If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

              by musiccitymollie on Tue Jan 29, 2013 at 12:06:46 AM PST

              [ Parent ]

          •  Why health care is tied to employment (4+ / 0-)

            in the first place seems wrong.

            "Onward through the fog!" - Oat Willie

            by rocksout on Tue Jan 22, 2013 at 07:37:21 AM PST

            [ Parent ]

          •  I don't disagree with some of that, but... (1+ / 0-)
            Recommended by:
            graphixart
            For a young and healthy employee, a comprehensive policy of the kind required by the ACA with low deductibles and little out of pocket expenses makes no economic sense.
            Speaking for myself, when I was a young and healthy employee (I'm still healthy, by the way) I checked out the high-deductible-plus-HSA plans. Only to find that none of them made financial sense, unless I literally never went to the doctor. Basically, two doctor visits in a year, plus one lab work-up, say for a culture for a sinus infection, and the low-deductible PPO plan was the same price (and the Kaiser HMO, which also qualifies for the ACA, was cheaper still.) Add the one (generic) maintenance drug that I'm on now, and the difference becomes stark.

            Everywhere I worked, I did the same calculation. It has never once made sense. They would have come out differently if I were paying 100% of the premiums of both plans, I admit, but not as much different as you think. The savings in a good year would have been on the order of hundreds of dollars, and the potential losses would have been one to two orders of magnitude greater.

            (2) it says that we have to put on the paycheck the amount we are paying that employee in non-taxable income in the form of health care premiums.  Most of our employees believe that is a prerequisite to taxing those benefits as income.
            That's one of the silliest 'slippery slope' arguments I've ever seen. If the government decides to tax those benefits as income, then they can do that at any time, and putting those numbers on an employee's check makes it no easier.

            Indeed, one of the major ideas behind that (IIRC proposed by a Republican) was the whole 'free market'/'people should know what they're spending on health care' argument.

            I'm no ACA partisan, but blaming the ACA for the fact that providing health insurance is becoming more and more onerous for employers is like blaming your cell phone for your $800-a-month power bill.

          •  Well, it is a prerequisite to taxing that benefit (0+ / 0-)

            as income.

            As recommended by the Fiscal Commission under "Tax Reform."

            Mollie

            “If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

            by musiccitymollie on Tue Jan 29, 2013 at 12:03:41 AM PST

            [ Parent ]

        •  one example of this was the killing of (3+ / 0-)
          Recommended by:
          coffeetalk, VClib, BrianParker14

          the consumer interest deduction under Reagan.  Banks immediately responded with home equity lines thereby allowing consumers to keep their consumer interest deduction hidden as a home mortgage.  Great for the banks as it moved unsecured credit into secured credit but lousy for the homeowner as such lines usually carried rates comparable to credit cards instead of traditional mortgages.

          Even when there is an attempt to correct a distortion of economic policy, it can result in new, unintended distortions

          •  Great example. (2+ / 0-)
            Recommended by:
            VClib, BrianParker14

            I remember when you could deduct consumer interest, and the rise in home equity loans when that was changed.  

            And home equity loans played a role in the bursting of the housing bubble, because many "underwater" homeowners are "underwater" not because of original mortgages, but because they had taken a lot of equity out of their houses in the form of home equity loans.  That all happened because for consumers, interest is not deductible unless it's secured by your home.  

            •  absolutely (1+ / 0-)
              Recommended by:
              coffeetalk

              We bought a condo at short sale.  The original buyer paid $61K.  We bought for 79K- but in the meantime, the owner took out mortgages totalling $150K and then walked away.  If they had kept their original mortgage, they would be in an equity position, instead, they kept the $90K  taxfree and the rest of us bailed out the bank for the loss.  Normally, the 71K  difference between the loan and the eventual sale price would have been taxable- but  current relief for under water houses makes that gain a free ride paid for by the rest of us.

              Many lost equity in the housing crash, especially if they bought at the peak.  But many also made out like bandits, if they mortgaged up their houses and took the cash.

              As my father used to say,"We have the best government money can buy."

              by BPARTR on Tue Jan 22, 2013 at 08:52:28 AM PST

              [ Parent ]

              •  Do you really believe that? (0+ / 0-)
                But many also made out like bandits, if they mortgaged up their houses and took the cash.
                Actually, that sort of thing was so microscopically, vanishingly rare that it surprises me to see anyone who actually experienced it firsthand.

                I went hunting statistics on that kind of thing last year, and was literally unable to find any numbers at all. Just a few spectacular news stories in a few places. (And incidentally, in at least some states the bank can sue someone for doing something like that, because it's either considered fraud or bad faith, and get their money back anyway.)

                •  well, yes, I do believe it. (0+ / 0-)

                  We have purchased several condos at short sale and foreclosure in the past 3 years.  Most of the sellers 1) had a second mortgage which was eliminated by the sale- and for which they simply got to keep the cash and 2)  had not paid a mortgage payment for over a year.  As the purchasers, we saw the individuals' records.  In a typical example, the individuals had put 5% down on a 150K condo, but did not pay their mortgage or condo HOA fees for 12-15 months.  Rent for an identical condo is $1250/mo, so they saved  more than $15K in rent, living rent-free.  They also kept the second mortgage of 4$50,000.  that much more than covered their initial downpayment.

                  We have seen this a number of times in the condos we bought.
                  Were the banks largely responsible for setting up this scam, and did they steal from the rest of us when they sliced and diced the mortgages and sold them as derivatives?  Of course.  the banks stole far more from us than the individuals.  Andthey made "loans" on properties which should not have ever been given a loan regardless of the buyer's financial situation.  Did all those buyers who have actually profited from foreclosure set out to scam the system- I don't believe so. ( Unlike the banks who deliberately set out to screw the system.)

                  None-the-less, many of the unfortunate who "lost their homes" actually made out better financially than if they had rented for the entire period.

                  The rest of us paid for both the banks and the inidviduals.  
                  By the way, every time a house sells at short sale, realtors start knocking on the doors of the houses nearby trying to convince the neighbors to walk away from their homes too.

                  Those of us who pay our mortgages pay for everyone else.   I understand that this is a more nuanced view than most here have of the housing crisis, but I believe there is lots of blame to go around.

                  As my father used to say,"We have the best government money can buy."

                  by BPARTR on Thu Jan 24, 2013 at 09:54:57 AM PST

                  [ Parent ]

      •  here is how you do that... (3+ / 0-)
        Recommended by:
        grrr, TrueBlueDem, BrianParker14

        stop passive investment income lower than active working income...

        see...easy...no need to try to spin the public to think the only way forward is to "pretend' to eliminate deductions...

        "Small Businesses Don't Build Levees" - Melissa Harris Perry

        by justmy2 on Tue Jan 22, 2013 at 07:16:06 AM PST

        [ Parent ]

        •  so, how would you cover retirement? (0+ / 0-)

          isn't passive investment income replacing active working income the definition of retirement?

          •  Roth 401ks/IRAs would work fine (1+ / 0-)
            Recommended by:
            justmy2

            Tax-free retirement income, but in strictly limited amounts. Works great. Of course, some people (Romney) can get away with fudging the numbers in a significant way, but it certainly wouldn't shelter more than a few percent of his investment income, so I'm not even too bothered by that.

          •  Are you supposed to be taxed differently when (0+ / 0-)

            you retire?

            When did that start?

            Passive investment income is passive investment income regardless of age.

            Roth 401K and Roth IRA if you want to pay a different tax rate.  Just because you deferred the tax doesn't make one more eligible for a lower tax rate.

            "Small Businesses Don't Build Levees" - Melissa Harris Perry

            by justmy2 on Tue Jan 22, 2013 at 10:57:04 AM PST

            [ Parent ]

      •  I think very few businesses make decisions (3+ / 0-)
        Recommended by:
        TrueBlueDem, Kickemout, orlbucfan

        based upon tax policy.  Sure they may decide to buy a van instead of an auto because the van is treated as a truck or they may accelerate a vehicle purchase a couple of months so as to crowd their purchases into the same tax year.  However it is naive to think a small business buys a van because of an associated tax break instead of because it needs a new van

        •  Absolutely incorrect. (2+ / 0-)
          Recommended by:
          VClib, BPARTR

          The way our business is structure is due, in large part, to tax considerations. Once you get above a handful of people, only a fool would run a business without tax advice as to how to structure your operations for the most favorable tax treatment.  The tax policy is not always the factor that ultimate drives everything, but tax policy figures into almost everything  business does, and sometimes decisions are changed by the tax considerations.  That goes from the basic business structure to how and when the owners are paid to how you compensate employees to decisions about leasing business space to long-term capital investments in IT.  I have a hard time thinking of any major decision where tax policy does NOT play a role.  Even when we buy things, whether we expense it or whether it's a capital expenditure often comes up and factors into decision making.  I am a lawyer, but not a tax lawyer, but the person who assists us in running the business side of our firm makes those consequences clear.  

          With our clients, I have seen multi-million dollar business deals shaped by tax considerations.  Any time a client makes a significant investment, or a merger, or an expansion, the tax lawyers are in the middle of it, calculating the tax consequences.  

          •  Which is basically the problem (1+ / 0-)
            Recommended by:
            entlord

            First of all, you and entlord are talking about two different things.

            You are thinking of 'business' the same way Republicans do, as 'big business' (or at least medium-to-large business). Remember, 'a handful of people' describes the vast majority of businesses in the US. So he's quite right... a relatively small percentage of businesses, the bigger ones, base their major actions around tax law.

            Second of all, perhaps one of the major problems in the US today is the very attitude you talk about. The 'lower your tax burden in every way possible' is certainly one of the major reason that business has purchased the US government wholesale, and gets very good returns on that investment.

            And in my personal experience I have seen a company purchase another company, and treat it in very specific ways due to specific tax implications... and these behaviors caused the merger to fail pretty badly, and the purchased company get entirely shut down and written off as a loss after two years. There is no guarantee that things would have worked better with more integration between the two companies, but they couldn't have gone any worse. Basically, the tax lawyers scuttled any chance of success for the merger, because they wanted everyone kept at arms' length for some unknown reason ('subsidiary' vs 'merger' or some such rot). Result? Huge waste of company money, 120 people laid off.

            Another, less dramatic example: company I worked for suddenly decided that they wanted to lease laptops instead of buying them, for tax reasons. We had to change suppliers (old supplier didn't have in-house leasing and the companies offering leases gave awful prices), the new supplier was much less reliable (over a 100% failure rate per year!), and we lost a lot of employee productivity (every field laptop failure means a day or more of lost employee time, possible lost data, and lost morale). It clearly cost us more in productivity than we were saving in taxes. We switched back, but that was extremely painful and expensive too.

            These days, if a company I was working at were to start making decisions too heavily weighted towards the advice of their tax accountants, I would seriously consider my options.

            •  thank you for clarifying what I was saying (0+ / 0-)

              After 40 years owning businesses, I never allowed tax considerations to be the ultimate driving force behind my decisions; they were part and parcel of the process of decision making.
              Coffeetalk's POV smacks more of Wall Street, in my eyes, while my experiences are grounded in Main Street

              •  I assure you I am not Wall street (1+ / 0-)
                Recommended by:
                VClib

                I'm a partner in a local law firm.

                But even simple things -- like whether you are a corporation or an LLC -- are often driven by tax implications (Louisiana has a corporate franchise tax that applies to corporations, not LLC's).  Or you might vary the  timing of a major purchase.  Or you might change the structure of a payout to a retiring partner.  Or you might negotiate certain renovations of your office space into your lease.   Or taxes factor in when you decide whether to buy or lease equipment.  Or when deciding whether to hire an employee or an outside contractor for a service.  

                I agree that when people look SOLELY at tax consequences, that can lead to bad decision making.  But I can't imagine running a business without looking at the tax consequences of what you are doing.  No rational business wants to pay more in taxes than it owes under the law.  We certainly don't.  If people were happy to pay more than the smallest amount they owe under the law, companies like H&R Block would go out of business.  

                We don't make tax consequences the sole factor in decision making.  No sane company does.  But it factors in, and can sometimes -- certainly not always -- change what we do, how we do it, or when we do it.  

                These days, if a company I was working at were to start making decisions too heavily weighted towards the advice of their tax accountants, I would seriously consider my options.
                I never allowed tax considerations to be the ultimate driving force behind my decisions; they were part and parcel of the process of decision making.
                I agree with this.  The key is "too heavily weighted."  You certainly won't do something that's a bad business idea just because of the tax break -- that's stupid.  But if a company I was working at made major decisions without factoring in tax implications, I would seriously consider my options.  Because that means they are not smart about finances.  

                The point is, the more complex the tax code -- the more that exemptions, deductions, special rules for special circumstances factor into what you pay -- the more tax policy figures into that decision making.  If you are going to pay roughly the same regardless of those decisions, tax policy is far less of a factor.  I'd prefer the latter situation -- if a business has $x in profit, it's generally going to pay about  $y in taxes, and there's not much room for maneuvering to adjust your tax burden.  That's how you  lessen the role tax policy plays in decision making.  

                •  if you are referring to Mom & Pops (0+ / 0-)

                  the majority of them do not pay anything in income taxes because they are sole proprietorships, S corps, PAs or other possible tax structures.  Tax consequences are a very small consideration in their decisions. but then the businesses I had grossed less than $1M annually

              •  Anyone with more than the most primitive (2+ / 0-)
                Recommended by:
                VClib, BrianParker14

                understanding of business, union agreements or economics knows that when evaluating the profitability dimension of alternatives, the relevant profit to consider is on an after tax basis.  The profit dimension is not the only dimension to consider in first rate decision making.

                The most important way to protect the environment is not to have more than one child.

                by nextstep on Tue Jan 22, 2013 at 03:38:37 PM PST

                [ Parent ]

                •  In many business decisions, the tax consequences (0+ / 0-)

                  are secondary to other considerations as least on the Mom and Pop level of S corps, sole proprietorships and such entities but then what do I know?  I am only a farmer, the grandson of a sharecropper.

                  •  It is not a matter of basing decisions on taxes (1+ / 0-)
                    Recommended by:
                    VClib

                    It is basing the profit part of the decision making on after tax profit instead of before tax profit.

                    One should not ignore tax consequences, nor should one decide based on what minimizes taxes.

                    The most important way to protect the environment is not to have more than one child.

                    by nextstep on Tue Jan 22, 2013 at 04:50:38 PM PST

                    [ Parent ]

          •  That tax policy spurred the purchase of (0+ / 0-)

            HummVee's.  Something they all needed.

      •  Regressive tax alert (2+ / 0-)
        Recommended by:
        happymisanthropy, liberte

        "flattening the rates" = punish the poor

        Good explanation of the thinking behind this idea.  Thank you.

        •  That's such an incorrect way of thinking (1+ / 0-)
          Recommended by:
          VClib
          "flattening the rates" = punish the poor
          The top marginal rate is pretty meaningless to me when viewed in the abstract.  What is important is how many dollars I pay -- and for that, I need to look at the EFFECTIVE tax rate.  

          You can lower top marginal rates and have the rich pay MORE in federal income taxes.  Look at the fact that the rich paid MORE under Clinton, with a top marginal rate of 39.6%, than they when the top marginal rate was 70% in 1979.  See the SECOND chart here.  That's due primarily to the Tax Reform Act of 1986, which put into place a system of lower marginal rates and fewer deductions/exemptions/shelters.

          •  I'm curious... (1+ / 0-)
            Recommended by:
            denise b

            ...do you know how misleading that comparison is?

            In 1979, the top marginal rate applied to much fewer taxpayers than the top marginal rate in 1996. So what you're implying is that the top 1% in 1979 found ways to get around the 70% tax bracket, when in reality very few of them earned enough to be in it. Very few.

            Here are the real numbers: people making over $201k in 1979 were in the top tax bracket, and in 1979 it applied to less than 0.1% of the population. Income distributions were a lot flatter in 1979, because we had not really started the 'all the money goes to the rich and everyone else gets nothing' that came into fashion in the 1980s and has continued to this day.

            Whereas the top bracket in 1996 was $263,750, and applied to the entire top 1% since the income cutoff for the top 1% of taxpayers was $283k. (citation).

            So what you're really saying is, 'taxing less than 0.1% of the population at 70% for part of their income, and then averaging that amount earned in with the other 0.9% of the top 1%, didn't earn as much in 1979, when the income distribution in the country was MUCH flatter, than taxing 1% of the country at up to 39.6%.'

            Oh, and need I mention that in 1979 the US economy was heading into a really nasty recession? And everyone was earning less as a result? And therefore paying less taxes? Whereas in 1996, well, I don't know if you're old enough to remember 1996, but we were doing pretty well.

            •  No, you misread what I was saying. (2+ / 0-)
              Recommended by:
              nextstep, VClib

              I wasn't using "paid more" as "overall revenue to the federal government."  I was using "paid more" as the percentage of income paid in federal income taxes. Someone at the cut-off level for the top 1% paid more, as a percentage of that household income, in 2000 with a top marginal rate of 39.5% than someone in the top 1% in 1979 when the top marginal rate was 70%.  

              My link was to historical EFFECTIVE federal individual income tax rates, based on CBO data.  What the data shows is that, in 1979, when the top marginal rate was 70%, the top 1% of households paid an effective federal individual income tax rate of 22.7%.  In 2000, when the top marginal rate was 39.6%, the top 1% of households paid an effective federal individual income tax rate of 24.5%.  A household in the top 1%, as  general matter, paid more in federal individual income taxes when top marginal rates were "flatter" with fewer deductions than a household in 1979 before the rates were flattened and many deductions/exemptions were limited.  

              The point is that a system where you flatten rates and eliminate deductions does not necessarily mean that a rich household pays less in federal individual income taxes.  It can, or it cannot -- depending on how you structure it -- where those top rates start (your point) and what income is actually subject to those rates (my point).

              •  Not picking a fight (0+ / 0-)

                Just some feedback.  Statements like this make me suspicious:

                "paid more" as the percentage of income paid in federal income taxes
                Often relative percentages are used to obfuscate what is happening.  

                I also just might not understand, and have not meditated enough on what you replied.

                Thanks for the reply!

                •  What it means is that, on average (1+ / 0-)
                  Recommended by:
                  VClib

                  (to overly simplify) someone making $1 million in 1979, when top marginal rates were 70%, would have paid, on average, $227,000 in federal income taxes, after factoring in all deductions, exemptions, etc.

                  Someone making that same $1 million in 2000, when top marginal rates were 39.6%, would have paid, on average, $245,000 in federal income taxes.  That's because, in part, less of that $1 million was deductible, exempt, or sheltered (due to the Tax Reform Act of 1986), and in part because where the top bracket started -- more of that $1 million was subject to the 39.6% rate than in 2000 than was subject to the 70% rate in 1979 (adjusted for inflation).  

                  The point is that you can lower marginal rates, eliminate deductions and exemptions, and have a situation where a household making $1 million actually pays more -- in actual dollars -- in federal income taxes.  "Flattening rates and eliminating deductions" does NOT necessarily mean that the rich pay less and the poor pay more.  It depends on how you do it.  And you can calculate that in advance, using IRS data.  

      •  Yes. And it's time for all of us to stop giving (0+ / 0-)

        credence to Politico.  It is much more like Fox News than a legitimate news organization.  When will we ever learn?

    •  Whenever anyone mentions these two loaded phrases: (0+ / 0-)

      Entitlement reform and
      Revenue neutral tax reform....

      Hold tight to your wallet and watch...
      And don't bend over!!!!!

      The Republicans are fixing to screw anybody who works for a living....or ever has worked for a living.

    •  Modern jurnalism r to checks on internuts blogs (0+ / 0-)

      den cull it research. Real facts not onboard at this time.

      Our money system is not what we have been led to believe. The creation of money has been "privatized," or taken over by private money lenders. Thomas Jefferson called them “bold and bankrupt adventurers just pretending to have money.” webofdebt

      by arealniceguy on Wed Jan 30, 2013 at 07:55:06 PM PST

      [ Parent ]

  •  For centuries from now, philosophers (7+ / 0-)

    will argue and opine on how a "revenue-neutral" bill can produce revenue.  Apparently, it is easier to do than passing a camel through the eye of a needle.

  •  Thanx...for reading Politico (rag) so... (1+ / 0-)
    Recommended by:
    TomP

    ...I don't have to.

    Obama infuriated Democrats by proposing controversial changes to Medicare, Medicaid and Social Security during his failed 2011 grand-bargain talks with Boehner. The president was ready to make some entitlement concessions in the fiscal cliff negotiations last month, but that effort fizzled, too.

    I am General Maximus Decimus Meridius. Father of a murdered son, husband to a murdered wife and I shall have my vengeance in this life or the next.

    by 2questions on Tue Jan 22, 2013 at 06:39:17 AM PST

  •  Politico should hang out here more... (11+ / 0-)

    If they did, they'd think Obama already gutted Social Security and Medicare.

    But wait... most of our folks who have that opinion got it from some weakly sourced piece on Politico.

    /dividebyzero

    You wanna f*%^ with Big Bird? You gotta come through me.

    by DaveV on Tue Jan 22, 2013 at 06:40:07 AM PST

  •  It's about time we got back to (13+ / 0-)

    demonizing the very idea of beating up on old people and proposing to throw them into poverty and make them suffer after a lifetime of harder work than most of the richie-richies have ever done? What has happened that this idea can be so boldly bandied about in plain daylight? We need to work to make it toxic again.

    Jon Husted is a dick.

    by anastasia p on Tue Jan 22, 2013 at 06:46:34 AM PST

  •  If Obama sucks because he won't consider (10+ / 0-)

    more cuts to social programs, then why don't Republicans suck (at least equally) because they won't consider additional tax increases?

    There are two ways to address the deficit: spending cuts and tax increases. Our political discourse has been tilted waaaaay too much toward the first and not nearly enough towards the latter.

    •  because we have a spending problem...not (2+ / 0-)
      Recommended by:
      mollyd, Brooke In Seattle

      a revenue problem...yada yada yada....

      I have even heard Dems start to espouse this nonsense..

      "Small Businesses Don't Build Levees" - Melissa Harris Perry

      by justmy2 on Tue Jan 22, 2013 at 07:22:22 AM PST

      [ Parent ]

    •  Now you're making sense (0+ / 0-)

      But sorry, there's no room for that in public policy debate and the news media, especially if it involves calling out the flaws of the GOP.

      Politico seems particularly brazen in this article, as though they're trying to advocate for cuts while leaving the GOP completely out of the story, as if they had no position or role.

      Democratic Leaders must be very clear they stand with the working class of our country. Democrats must hold the line in demanding that deficit reduction is done fairly -- not on the backs of the elderly, the sick, children and the poor.

      by Betty Pinson on Tue Jan 22, 2013 at 08:36:44 AM PST

      [ Parent ]

  •  On the other hand, Politico is correct (3+ / 0-)
    Recommended by:
    puakev, midwesterner, VClib

    to point out that there is a HUGE long-term problem with Medicare, and the President has not put out HIS solution to the problem.  

    Read the Medicare Trustees Report.  Under the MOST FAVORABLE assumptions about the effect of the ACA on costs, if we continue to do the "doc fix" (which any sane person knows we have to do or doctors will stop taking Medicare patients), Medicare alone is projected to grow to over 10% of GDP -- that's 10% of every single dollar generated by every single person in this country.  That's unsustainable.  And the Trustees Report makes clear that's under the most favorable assumptions, and that the actual number could be substantially higher.  

    And we don't have a history in this country of grossly OVERESTIMATING the costs of social programs -- exactly the opposite.  

    I completely understand that the Ryan proposal is a complete non-starter.  I understand that Democrats don't want to cut benefits.  What I want to hear is the President's vision of how to address this serious long-term problem.   What I want to hear is for the leaders in Congress to put forth the Democratic solution to the very real problem.  I hope I hear it in the President's state of the union address.  

    We probably have 10 years before it's an immediate problem. But that means you are talking about people who are now 55, planning their retirement.  They deserve a clear view of what Medicare will be for them when they retire.  It would be irresponsible of the President, and Congress, to ignore the problem.  

    •  Economic inequality, poverty, and (24+ / 0-)

      unemployment are more immediate problems.

      Much of the defict hysteria masks a desire to overturn the 20th Century.  

      Join us on the Black Kos front porch to review news and views written from a black pov—everyone is welcome.

      by TomP on Tue Jan 22, 2013 at 07:09:17 AM PST

      [ Parent ]

      •  Ignoring facts do not make them go away (1+ / 0-)
        Recommended by:
        VClib

        Medicare is a huge long-term problem.  That is a fact.   Read the Trustees report.  The longer we wait to address it, the more difficult it becomes to deal with.  

        It is irresponsible to wait until it becomes a crisis and affects current beneficiaries.  

        •  Healthcare is the huge long term problem (13+ / 0-)

          If you deny benefits, the person still needs the care.  If you are going to ration it where shall we start?

          Shall we deny Cheney his heart?
          Bill his bypass?
          Bush Sr., a month in the hospital on IV antibiotics
          Hillary her specialists?

          Or just my family?  

          Put the focus on care first.  How are we going to provide healthcare?  And where do we have to cut and who do we have to tax to guarantee that care is provided?  

          •  The longer you deny health care (raising MC age) (4+ / 0-)

            for a sick person the worse the person's health becomes and the more expensive to treat.

          •  ACA will lower health care costs (1+ / 0-)
            Recommended by:
            TomP

            and that will have a positive impact on the cost of labor and the economy.

            The only fly in the ointment is lack of cost control on private insurance.  In spite of the medical loss ratio restriction, there's very little in ACA right now that controls private insurance costs.  That needs to be fixed or it will screw up everything quickly.

            Democratic Leaders must be very clear they stand with the working class of our country. Democrats must hold the line in demanding that deficit reduction is done fairly -- not on the backs of the elderly, the sick, children and the poor.

            by Betty Pinson on Tue Jan 22, 2013 at 08:53:45 AM PST

            [ Parent ]

        •  as greenbell said (0+ / 0-)

          health care costs overall are growing faster than medicare costs.

          Which means the cost of health care will destroy our economy before the cost of Medicare does.

          Which means we need to fix the cost of health care, and then Medicare will be fine.

          the purpose of the second amendment is to promote a well-regulated militia, in the same sense that the purpose of the first amendment is to promote a well-informed electorate.

          by happymisanthropy on Tue Jan 22, 2013 at 08:44:51 AM PST

          [ Parent ]

          •  happym - fixing the cost of healthcare (1+ / 0-)
            Recommended by:
            greenbell

            will take a decade or more of significant investment by the federal government. We have two fundamental problems, a lack of primary care physicians and nurses and the practice of defensive medicine (unique to the US). To date I have seen no discussion at the local, state or federal level on either of these two issues, which is the answer to rising health care costs.

            "let's talk about that"

            by VClib on Tue Jan 22, 2013 at 08:48:18 AM PST

            [ Parent ]

            •  Where do nurse practitoners fit in? (0+ / 0-)

              At the VA, I am treated by a nurse practitioner. It seems this alleviates the need for primary care physicians but could result in a shortage of nurses. Except, one might expect an increase in those entering the nursing field if they can go a step higher without the need to become a doctor. And, by the way, the VA outpatient care is one efficient operation. An ounce of prevention is truly worth a pound of cure.

              If you don't want to be kept in the dark and lathered with horse dung, stop acting like a mushroom.

              by nomorerepukes on Tue Jan 22, 2013 at 10:28:34 AM PST

              [ Parent ]

              •  Nurse practitioners and physician assistants (0+ / 0-)

                are clearly part of the mix we need to help solve the shortage and their numbers can be increased more rapidly than physicians. However, the requirements and education for those positions continues to become more expensive and time consuming. Not that long ago a nurse with a Masters of Science in Nursing (MSN) had a short path to become a Nurse Practitioner. Now a Doctor of Nursing Practice (DNP) is required. It's a much shorter path than becoming a board certified physician in family practice or internal medicine, but these are serious advanced degree programs. We need a very significant increase in primary care physicians, NPs, PA, and RNs and that will take a big investment that no one is even discussing. We need to change the fundamental supply/demand equation to put downward pressure on costs.

                "let's talk about that"

                by VClib on Tue Jan 22, 2013 at 10:48:44 AM PST

                [ Parent ]

                •  One last question (0+ / 0-)

                  Is there a shortage of doctors per se or is there a shortage of doctors entering general practice? In other words, is their an over specialization problem?

                  If you don't want to be kept in the dark and lathered with horse dung, stop acting like a mushroom.

                  by nomorerepukes on Tue Jan 22, 2013 at 11:25:28 AM PST

                  [ Parent ]

                  •  Both - but there is a mix issue (0+ / 0-)

                    Physicians in primary care earn less and that is one of the issues driving medical students to specialties and sub-specialties. And because most of the care is provided by primary care clinicians that's the place where the reimbursement cuts come first from all payers, public and private.

                    The problem is that nearly all analysis is focused on the price of care. What does Medicare pay for an annual exam, or what does Blue Cross pay for a CT scan? None of the analysis is focused on actual costs. What does it actually cost to provide care? That's where we need to focus the attention. It's one of the places we need to see real research. The other is defensive medicine. We teach and practice medicine very differently here than anywhere else in the world. It's one of the primary reasons our health costs are double other first world countries.  

                    "let's talk about that"

                    by VClib on Tue Jan 22, 2013 at 01:06:57 PM PST

                    [ Parent ]

          •  Plenty of ways to cut Medicare costs w/o (1+ / 0-)
            Recommended by:
            greenbell

            cutting benefits.

            Let's drag out the list for the umpteenth time this week (and next week and the week after that...)

            Allow Medicare to negotiate prescription drug prices

            Get fat out of reimbursement rates to medical supply, etc. corporate sector.  

            Democratic Leaders must be very clear they stand with the working class of our country. Democrats must hold the line in demanding that deficit reduction is done fairly -- not on the backs of the elderly, the sick, children and the poor.

            by Betty Pinson on Tue Jan 22, 2013 at 08:56:11 AM PST

            [ Parent ]

        •  Fixing the economy first (1+ / 0-)
          Recommended by:
          Brooke In Seattle

          will take care of many of the deficit related problems.

          The main reason we have a deficit is because of unemployment.  

          Let's keep the horse ahead of the cart.

          Democratic Leaders must be very clear they stand with the working class of our country. Democrats must hold the line in demanding that deficit reduction is done fairly -- not on the backs of the elderly, the sick, children and the poor.

          by Betty Pinson on Tue Jan 22, 2013 at 08:50:47 AM PST

          [ Parent ]

      •  immediate problems indeed (8+ / 0-)

        10 year projections aren't worth much.

    •  where is it written? (9+ / 0-)

      "people at 55, planning their retirement...deserve a clear view..."

      Ideally, yes. But I'm not sure that any working-class American (excluding the independently wealthy) has ever had the luxury of a "clear view" going into retirement, no. matter. how. prudent.

      "Show up. Pay attention. Tell the truth. And don't be attached to the results." -- Angeles Arrien

      by Sybil Liberty on Tue Jan 22, 2013 at 07:17:56 AM PST

      [ Parent ]

      •  So your solution is just to ignore (1+ / 0-)
        Recommended by:
        VClib

        the problem, and in 10 years, tell people  reaching 65, oops, sorry, we don't have enough money to fund Medicare, so you are on your own?

        Frankly, I expect the people running this country to be more responsible.  

        •  asdf (7+ / 0-)

          one solution is to drop the Medicare age to 60, allowing healthier people to buy into the program. Possibly, ACA itself will reduce the burden on Medicare since we no longer will have uninsured people delaying addressing health concerns and showing up at age 65 needing quadrillion tests/rx.

          Another is to negotiate better rates with drug companies.

          Dems in swing districts: INSIST your republican rep incr tax on the wealthy -gerrymandering makes rep vulnerable...swing district list: http://www.dailykos.com/comments/1162387/48457188

          by grrr on Tue Jan 22, 2013 at 07:30:09 AM PST

          [ Parent ]

          •  Not a solution.. (1+ / 0-)
            Recommended by:
            VClib

            Negotiating drug prices does not produce NEARLY enough in savings, from the estimates I've seen. It's only a small start. Again, read that report.  It's very stark about the magnitude of the long-term problem.  But at least it helps, if a little.

            But as for the ACA reducing Medicare costs, that report takes into account the most favorable assumptions about what the ACA will do to reduce costs.  The 10% of GDP is using those "most favorable" assumptions. That's what is the most frightening.  If the ACA does not reduce overall costs as much as the most optimistic hopes, the Medicare number will be far worse.  That's what that report says.

            •  No single solution is going to have a huge effect (3+ / 0-)

              "Fixing" Medicare without wrecking it is going to be very much a bunting game....which doesn't play well in the political area, especially when you have a fair number of people using the actual challenges of Medicare as a pretext to dismantling it altogether.

              It is possible to answer any one of the many viable suggestions offered in these comments by saying "xxx  does not produce NEARLY enough in savings, from the estimates I've seen. It's only a small start."

              However, what about

              1. negotiated drug prices
              2. lowering the qualifying age
              3. encouraging prevention
              4. increasing the payroll tax
              5. revamping the fee structure
              6. reducing unemployment and otherwise fixing the larger economy

              as a collective answer?

              We are the principled ones, remember? We don't get to use the black hats' tricks even when it would benefit us. Political Compass: -6.88, -6.41

              by bmcphail on Tue Jan 22, 2013 at 09:34:33 AM PST

              [ Parent ]

          •  grrr - negotiating drug prices is a 2-4% savings (2+ / 0-)
            Recommended by:
            coffeetalk, grrr

            when viewed in the context of total healthcare costs. It's not enough to bend the curve.

            I don't know how adding people at age 60 to the Medicare pool helps unless they pay premiums that give Medicare a profit to defer the costs for those over 65. Before I turned 65 I was paying $2,000/month health insurance premiums and I now pay just over $100. So Medicare is providing me a 95% discount. If Medicare had been available to me at age 60 what would my premium be so that the entire system was more financially stable? I know this is a common view here and I am just trying to understand the economic benefits to the Medicare system (not the 60-65 group) if it was implemented.

            "let's talk about that"

            by VClib on Tue Jan 22, 2013 at 08:55:37 AM PST

            [ Parent ]

            •  $2000 a month? (0+ / 0-)

              Are we talking for you alone or for you and a spouse? Are we talking someone with chronic health problems living in a state where you can not be denied coverage as long as you maintain continuous health insurance? Are we talking the Cadillac of plans or are we talking the Yugo of plans? So many variables, so little time to crunch the numbers.

              If you don't want to be kept in the dark and lathered with horse dung, stop acting like a mushroom.

              by nomorerepukes on Tue Jan 22, 2013 at 10:43:36 AM PST

              [ Parent ]

              •  Me alone, cancer survivor, individual policy (0+ / 0-)

                Must issue policy because of continued coverage through various group plans, all with Blue Shield. OK plan, but not nearly as good at Medicare in terms of deductibles, and co-pays. I had true Cadillac coverage for about a ten year period from '85-'95, and it was nowhere close.

                "let's talk about that"

                by VClib on Tue Jan 22, 2013 at 10:53:21 AM PST

                [ Parent ]

        •  purely an observation on my part (5+ / 0-)

          not even a pretense at resolution - here's one tho

          Rx: Start by passing legislation making the negotiation of Rx prices (as per the VA) mandatory as it should have been all along.

          And then fraud: going after Medicare fraud with big guns. example: banning physicians with records of habitually ordering up ambulances for patients who don't actually need medical treatment in transit...ban them from the Medicare system.

          ... couple of starters

          "Show up. Pay attention. Tell the truth. And don't be attached to the results." -- Angeles Arrien

          by Sybil Liberty on Tue Jan 22, 2013 at 07:38:57 AM PST

          [ Parent ]

    •  Each "doc fix" provides new (0+ / 0-)

      opportunity for abuse.

    •  Shrug. Medicare is the tool to hold costs (13+ / 0-)

      down.  First thing on the agenda is, get rid of the nonsense of raising the age for Medicare. Second, do more of what Medicare already does, which is determine best practices and proper remuneration.  

      Because soaring medical costs aren't solved by less Medicare.  

      That's not even "gun control". It's more like "massacre control".

      by Inland on Tue Jan 22, 2013 at 07:28:43 AM PST

      [ Parent ]

    •  The Paul Krugman response... (6+ / 0-)

      Obama should announce an effort to make deeply unpopular and painful cuts in Medicare to stave off future cuts in Medicare?

      Putting that aside, what you are talking about is nonsense. Medicare can't be saved if the cost of health care continues to rise as it has over the last decade.  That's what your 10% of GDP number means, not that Medicare is unsustainable, but that our entire healthcare system is unsustainable.

      And President Obama has already proposed and passed the most aggressive response to the challenge of rising medical costs this country has ever attempted.  

      If you think the Medicare Trustees know what the world (or Medicare) will look like 20 years from now, I have a bridge I'd like to sell you.

    •  Let the Republican party take the lead & the heat (0+ / 0-)

      Why would Obama & the Dems propose the unpopular cuts to entitlements? Time for the Republicans to re-brand themselves with sensible and moderate (NOT Ryan's voucher-care) proposals.

      Of course I'm hallucinating or something.

    •  Other countries cover 100% of their pop on 10% (4+ / 0-)

      Most other developed countries cover everybody in their country on less than 10% of their GDP (and usually have better "outcomes" - like living longer).  Of course the way they do it is universal coverage via "socialized" medicine.

    •  There is no huge long term problem w/ SS (2+ / 0-)
      Recommended by:
      DSPS owl, denise b

      As Krugman recently pointed out, problems with SS are not definite and won't occur for another 20-30 years.

      Any problem the SS Trust Fund has now is related to 1. The feds not wanting to honor its debts to SS and/or  2. The poor economy (high unemployment) along with wage compression in the 99% of workers is resulting in lowering what's being paid into the trust fund by workers.

      That part of the problem is easy to fix - economic stimulus to a full employment economy which will add as much as a decade or more to SS Trust Fund assets.

      Krugman:

      O.K., you can argue that the adjustment to an aging population would be smoother if we commit to a glide path of benefit cuts now. On the other hand, by moving too soon we might lock in benefit cuts that turn out not to have been necessary. And much the same logic applies to Medicare. So there’s a reasonable argument for leaving the question of how to deal with future problems up to future politicians.
      This is a key argument about how SS & Medicare benefit changes need to be divorced from the current faux deficit hysteria.

      Democratic Leaders must be very clear they stand with the working class of our country. Democrats must hold the line in demanding that deficit reduction is done fairly -- not on the backs of the elderly, the sick, children and the poor.

      by Betty Pinson on Tue Jan 22, 2013 at 08:49:12 AM PST

      [ Parent ]

      •  Spot on (0+ / 0-)

        with respect to the annual interest the government has to pay to the Social Security Trust Fund. My sentiments exactly. It they want to slay the goose which lays the golden egg it must be because they see more gold in the carcass. As with all addicts, deficit hawk addicts can not see beyond there next fix.

        If you don't want to be kept in the dark and lathered with horse dung, stop acting like a mushroom.

        by nomorerepukes on Tue Jan 22, 2013 at 10:58:33 AM PST

        [ Parent ]

    •  You have to look at Medicare as part of a whole (1+ / 0-)
      Recommended by:
      denise b

      Health care consumes about 17% of GDP at present and this is only growing. (Inc rates of age related illnesses etc....) Medicare costs are driven by the lack of younger/healthier people over which to spread costs.

      The real solution is a single payer plan. We can achieve cost containment. (The VA delivers care at about 2/3 the cost of FFS medicare.)

      What is unsustainable is the rate of medical inflation.

      THe ACA is bending the curve downward but we need single payer to truly contain costs.

      The private health insurance system is dying in the US as a model for financing health care.

  •  You have to give Pete Petersen credit (9+ / 0-)

    he has the entire beltway, both sides, sipping from his kool-aid...

    my recommendation to Politico (as usual)

    Kick rocks!

    "Small Businesses Don't Build Levees" - Melissa Harris Perry

    by justmy2 on Tue Jan 22, 2013 at 06:58:00 AM PST

    •  Though it doesn't say much for the Beltway crowd (1+ / 0-)
      Recommended by:
      justmy2

      Anyone with half a brain can see through Peterson's BS.  The DC bubble must have a problem with oxygen deprivation or some other anomaly that affects the ability of its inhabitants to think rationally.

      Democratic Leaders must be very clear they stand with the working class of our country. Democrats must hold the line in demanding that deficit reduction is done fairly -- not on the backs of the elderly, the sick, children and the poor.

      by Betty Pinson on Tue Jan 22, 2013 at 08:58:33 AM PST

      [ Parent ]

  •  one thing we need to get straight here (8+ / 0-)

    "Politico" is not a news source.  It's a right wing blog machine.

    "Kossacks are held to a higher standard. Like Hebrew National hot dogs." - blueaardvark

    by louisev on Tue Jan 22, 2013 at 07:01:03 AM PST

  •  - OR-Let's look at it this way... (14+ / 0-)

    The President IS making the hard choice of not making cuts to Social Security, Medicare, or Medicaid in spite of the pressure and push-back from the rethuglicans.  That would make a nice headline...

    being mindful and keepin' it real

    by Raggedy Ann on Tue Jan 22, 2013 at 07:03:31 AM PST

  •  Politico = FoxNews with a softer touch. (8+ / 0-)

    Join us on the Black Kos front porch to review news and views written from a black pov—everyone is welcome.

    by TomP on Tue Jan 22, 2013 at 07:06:43 AM PST

  •  Mitch Turtlehead is having one too, right now (6+ / 0-)

    on the Senate floor.  His opening speech is showing he has no interest whatsoever in compromising and facing the fact they lost and puking out the same old tripe about "strengthening" medicare and social security.

  •  why the f^(K do we need (11+ / 0-)

    the god damned "grand bargain"?  Interested in "fixing" Social Security? Raise the fucking maximum taxable income for FICA (the mechanism that funds SS), which hasn't been raised in years, to oh, say, $250K or even $450K.  Bam! SocSec is now solvent for the maximum viewable window of 75 years that the SocSec board of trustees is allowed to utilize.  Interested in "fixing" medicare?  Remove the goddamned Medicare Part D provision, allow the government to negotiate with Pharma for better rates for prescription drugs. Bam! Billions of dollars saved.
    So why do the fucking Very Serious Assholes always have to talk about cutting the programs rather than do even just marginally intelligent things?  Is it cuz the VSA aren't that intelligent?  And if so, why the f^(k does anyone listen to them about anything?

    •  They dumb themselves down (2+ / 0-)
      Recommended by:
      orlbucfan, bmcphail
      Is it cuz the VSA aren't that intelligent?  And if so, why the f^(k does anyone listen to them about anything?
      Maybe it's this, something I've observed among the Villagers too (are they one and the same?):

      The VSA's seem to think that most likely voters are either low info., and/or rather stupid, unable to grasp what they, the VSAs, just know to be the "proper" narrative on issues, and that that proper narrative is to cut spending on "entitlement" programs, so they simplify their narratives and as a result dumb themselves down. And, yes, I am being serious, not snarky.

      If you engage in a dumbed-down narrative, it really does rub off. Brains are plastic, you know...again, speaking from a biological perspective.

      SS can be extended with a cap lift, hear that from the VSAs? SS is an insured benefits program, and the program does not (by law!) not add to the deficit; hear that on Politico lately?

      "We will find fulfillment not in the goods that we have, but in the good we can do for each other." ~ RFK

      by paz3 on Tue Jan 22, 2013 at 08:18:32 AM PST

      [ Parent ]

    •  The VSP's want to cut the Social Safety Net... (2+ / 0-)
      Recommended by:
      YoloMike, Brooke In Seattle

      ...because they're paid to want to do that. And some of them believe the bullshit from Pete Peterson, Erskin Bowles, Alan Simpson, et al.

      Also, they're millionaires. They've never had to worry about being poor. So they literally don't see the problem with hurting millions of people because of the destructive ideas of a band of detached deranged greedy obscenely wealthy psychopaths. And since they're rich, they get to be on television spouting about "shared sacrifice" and other such nonsense. They literally don't give a shit about anyone outside of their world. We do not exist to them but on spreadsheets.

      Anyone advocating cuts to Medicare ought to take a trip to Florida or Arizona and have their "serious" policy idea with retirees, the disabled, and to the working poor. And I'd be shocked if they weren't chased out of town with torches and pitchforks.

      The Grand Bargain must be stopped at all costs to protect the 99%.

      by cybrestrike on Tue Jan 22, 2013 at 08:28:17 AM PST

      [ Parent ]

    •  Someone is gonna make a lot of money (3+ / 0-)

      That's the only reason they're pushing it.  Private profiteering.  They could care less about a deficit or any other such nonsense.

      Likely they want to hide some language in the bill with cuts to benefits that allows people to voluntarily siphon off money from their SS contribution to Wall Street.

      That's what 401K's are for, but Wall Street has already pissed away most of everyone's 401 K fund, so they need a new infusion of cash.

      Democratic Leaders must be very clear they stand with the working class of our country. Democrats must hold the line in demanding that deficit reduction is done fairly -- not on the backs of the elderly, the sick, children and the poor.

      by Betty Pinson on Tue Jan 22, 2013 at 09:04:51 AM PST

      [ Parent ]

  •  Hard Choice Is Never Raising SS Payroll Cap (6+ / 0-)

    Funny how that is

  •  Is the title right? (0+ / 0-)

    Has a sad?   Or is it "is sad"  ?  

    Good story otherwise.  :)

    Gandhi's Seven Sins: Wealth without work; Pleasure without conscience; Knowledge without character; Commerce without morality; Science without humanity; Worship without sacrifice; Politics without principle

    by Chris Reeves on Tue Jan 22, 2013 at 07:31:04 AM PST

  •  why read Politico? (2+ / 0-)

    After all, if I want to see that POV there is always Red State or Hot Air

  •  Politico: Reach-arounds for Republicans (1+ / 0-)
    Recommended by:
    a2nite

    It's their unwritten motto!

    "There's no ideology [t]here [on the right]. It's just about being a dick." Bill Maher, June 22, 2012.

    by caseynm on Tue Jan 22, 2013 at 07:38:53 AM PST

  •  I don't understand this obsession with (13+ / 0-)

    the notion that all federal programs should be revenue-neutral. Meaning, all federal programs that directly benefit everyday people, retirees and the less well-off, which means not only Social Security and Medicare but also the Postal Service and public schools. NO ONE within the Very Serious Personocracy is calling for, say, the military or programs that provide subsidies to corporate megafarms or oil or coal companies, to be revenue-neutral.

    We're having the wrong conversation and asking the wrong questions about all this spending. Sure, we should decide which programs we need and which we can do without, and those we decide to keep we should make as cost and results-effective as possible, to cut down on fraud and waste and maximize desired outcomes. But the idea that any of them have to be revenue-neutral is simply idiotic. Government is not a business. It's SUPPOSED to "lose" money.

    My point is that if entitlement programs can't become financially self-sufficient even if made maximally efficient without cutting benefits, then they should be allowed to spend more money than they take in, with the deficit plugged from general revenue. And if that results in higher overall deficits, then tough.

    Either accept and deal with it, or raise taxes and cut spending in areas that could actually stand some cutting, like the military, without hurting a damn person who shouldn't be hurt (meaning, someone who's not a top executive at or shareholder of Boeing or Raytheon).

    But don't tell me that socially beneficial and necessary programs should pay for themselves AND refuse to cut spending on non-socially beneficial or necessary programs that don't pay for themselves. It just makes you look like a cruel and disingenuous idiot. Which is what you are (not you Jed, the fiscal scolds).

    We need to change the frame, from being about money and what we can and can't afford, to being about what's right, and what we need and don't need. Or, really, about both, and how it's hypocritical to attack entitlement programs for running deficits while being ok with military programs for running far bigger deficits. We need most of the former. We don't need much of the latter.

    "Liberty without virtue would be no blessing to us" - Benjamin Rush, 1777

    by kovie on Tue Jan 22, 2013 at 07:39:11 AM PST

  •  its because CEO & Pres of Politico Head of Reagan (5+ / 0-)

    Foundation and former Reagan staff worker

    obama is the end of the reagan era and the beginning of the Obama era , so he and all the little reaganites at politico parading around as serious and supposedly non biased stenographers are sad

    http://en.wikipedia.org/...

  •  Thanks for clearing that up for me (0+ / 0-)

    All this time I thought that Politico sucked.  Silly me!

  •  You can't win for losing (1+ / 0-)
    Recommended by:
    Kickemout

    "It’s not even clear what he would do if he had the power to remake the programs on his own, without worrying about opposition from Republicans or Democrats."

    If Obama did try to fix the safety net, he would get complaints from Democrats for doing too much.  He would also get complaints from Republicans for doing too little.

    Sometimes a person is damned if he does and damned if he doesn't.

  •  Tiger Beat on the Politico (0+ / 0-)

    (h/t Charles Pierce)

    Jim VandeHei, husband to the aide of disgraced felon and former Speaker of The House Tom Delay, is sad they went all in for Rmoney.

  •  They just need to give him a bit more time. (0+ / 0-)

    “The probability that we may fail in the struggle ought not to deter us from the support of a cause we believe to be just.” – Abraham Lincoln

    by Sagebrush Bob on Tue Jan 22, 2013 at 07:49:07 AM PST

  •  Too bad Politico isn't in print (5+ / 0-)

    At least then one could use it to wrap a fish or line the bottom of a canary cage.

  •  Youch. Kind of forgetting the rules of the game, (1+ / 0-)
    Recommended by:
    happymisanthropy

    are we?

    If you are on the side of slash and burn, it is up to you to decide what should be slashed and burned.

    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

    by dinotrac on Tue Jan 22, 2013 at 07:58:35 AM PST

  •  The Grand Bargain is a Grand Illusion (3+ / 0-)
    Recommended by:
    greenbell, orlbucfan, midwesterner

    For the republicans, reform of entitlements means the end of social security. But social security isn't an entitlement, it's a government managed pension system that everyone who pays taxes contributes for their entire adult life. The only caveat is that the first $106,800 of income is taxed for contributions to the system. Medicare is not an entitlement either. Medicaid and food stamps are entitlements but ending those would cost more in the long run.

    A well managed system would of course be much more reformable, however the republican controlled state legislatures will throw as many monkey wrenches into the system as possible.

    Knowledge is Power. Ignorance is not bliss, it is suffering.

    by harris stein on Tue Jan 22, 2013 at 08:08:27 AM PST

  •  When Politico first arrived on the scene, (2+ / 0-)
    Recommended by:
    orlbucfan, Brooke In Seattle

    I had faint hopes that it would be just what it was promised to be - an independent, intelligent and well reasoned reviewer of all things that happened inside the bloatway.

    My hopes were dashed by the second week of its existence.  It was far to happy to act as a mouthpiece for the Bush administration. After Obama's election, its rightward tilt continued, and seems to grow stronger.

    Perhaps the media company that owns it believes the GOP propaganda that ours is a reich wing country. Despite the last election, that is. And the 2008 result. And 2006.

    Actually, it is a pity. We could use indie writing, especially within the Bloatway. Alas, Politico cannot, or perhaps, refuses to provide it.

    What we call god is merely a living creature with superior technology & understanding. If their fragile egos demand prayer, they lose that superiority.

    by agnostic on Tue Jan 22, 2013 at 08:10:02 AM PST

  •  Politico's attitude ... (0+ / 0-)

    My country-club Republican sister completely buys into this sad, woe-begotten tale that Obama has been a lousy president who hasn't done a damn thing when he had so much promise. Last night she even said that she thought Hillary would have been a better president. Coming from her that was fairly remarkable since she was totally opposed to President Hillary in 2008.

    When I push her I never get a straight answer about why she thinks he has been such a do-nothing president so I've given up. Last fall I even proposed the radical idea that perhaps a recalcitrant Republican congress might bear some responsibility, but then she spouts the equivalent of "they all do it".

    Somehow we need to break through this right wing echo-chamber. It's really hurting our country.

    "Let us not look back to the past with anger, nor towards the future with fear, but look around with awareness." James Thurber

    by annan on Tue Jan 22, 2013 at 08:13:03 AM PST

  •  I'd like to say a word for the Boomers (5+ / 0-)

    I know, I know, our demographics are going to strain many social support systems.  But, we started paying into Social Security when the WWI era Americans were collecting money they'd never contributed.  We started paying into Medicare for the WWII generation which escaped paying in for much of their working lives as well.  We are the first generation to have fully paid the payroll tax for both for all of our working lives.  So I really get fed up with people acting like we're the moochers and the takers when we haven't even barely started getting any return on all the years we've paid in.  

    However, I do believe we have been undertaxed since the Reagan era and I do support increased taxes of all types particularly on the upper middle class which we are unrealistically exempting from a little more pain.  There may not be a lot of rich people according to some, but there are plenty of people making over $100K.

  •  Public Option (2+ / 0-)
    Recommended by:
    greenbell, midwesterner

    Obama could also have said if he supports Medicare buy in (supported by all Democratic senators and Berny Sanders and blocked by the Connecticut for Lieberman delegation) .  The Medicare advantage fiasco shows that the CMS can make huge profits if it is allowed to compete with private insurers.  would that be enough to finance the Medicare shortfall ?  Well not without the IPAB and other reforms not blocked by Joe Lieberman.  

    But that is not one of the painful choices we must make, because it would be painful for insurance executives (and shareholders and yes employees) and we can't have that.

  •  Translation: Punch Me. (0+ / 0-)

    Clearly "Politico" needs a punch in the face, but them all being a minor, we really aren't allowed to give them a smack.

    But seriously, how do we have yet another conservative TOOL running around the world calling itself "journalism" and being taken seriously at all? I just don't get it.

  •  A point of negotiating (0+ / 0-)

    As in the fiscal cliff, step, rock negotiations...

    It is teh stupid of the Democrats to offer cuts to Social Security, Medicare or Medicade. it damned if they do, damned if they don't.

    The universal sound bite coming from the progressives should be:
     "We are not the one asking for the cuts to Social Service Programs. You are. If you are demaning cuts then you should put them on the table."

    Let the negotiations start from there.

    It's like asking which toe you watch chopped off to make you walk better. Fuck 'em. You want it cut, conservatives.
    Speak up. We are waiting.

    I support OWS, Anonymous and Democracy! Collective. Transparent. Enclusive!

    by lightsocket on Tue Jan 22, 2013 at 08:59:31 AM PST

  •  And is cost a problem or is it a sign of success? (1+ / 0-)
    Recommended by:
    bmcphail

    If we looked at this the way we look at defense, the more we spend the safer (healthier) we are.  And there is some truth there.   Yes, it costs more.  Yes, it costs a greater percentage of GDP, but do we want to go back to the life expectancies we had 100 year ago?  We refuse to go back to the level of military expenditure we had 100 years ago.  We must figure we're getting something for the money.  I do doubt that with defense, but healthcare is actually a relatively modern thing so there isn't a fixed level of GDP that is necessarily appropriate.  You can't say we spent X in 1812 or 1912 so X is appropriate now.

  •  Thanks to DKOS we keep our heads straight (3+ / 0-)

    That Politico story is an excellent example of the rhetorical war of disinformation and distortion (yes, in a word, propaganda) that is the corporate media. I'm amazed that we have a re-elected President Obama considering that from the first day of his administration this kind of shit has been incessantly shoveled into US ears and eyes. One has to conclude that, despite the mainstreamed and anti-democratic bullshit, US citizens aren't as easily misled as I worried they were.

    The GOP gambled that through a shitty economy and their own legislative sabotage they would win the Senate and White House and undo ACA before it was most widely implemented; and before beneficiaries realized the actual benefits of the program. And even with the huge advantage of Citizens United, the liars and greed-corrupted class warriors FUCKING LOST. US citizens will begin to see that what has been demonized as 'socialized medicine' is a basic feature of the implicit social contract laid out in the Declaration of Independence.

    During the process that passed the ACA I was angry that Obama didn't push for "a public option," and I was angry that the Democrats self-sabotaged their own political advantage by using the phrase "public option" instead of "Medicare for All". I was angry, in short, that Democrats poorly presented an overwhelmingly popular policy proposal so that they could trade it away in acts of bullshit bipartisanship. I still think the ACA is basically a bungle in terms of the heathcare reform the country needs--both to stop unsustainably escalating costs and to guarantee a basic sense of security would allow US citizens to channel their energy more optimistically.

    But for all my anger during the politics of getting ACA passed I'm still amazed that it got done. In being implemented, ACA will mark a progressive step forward that will be as hard to take back as Social Security and Medicare themselves.

    I still think Obama's basic failure in going along with the austerity-mongering continues to cost dearly.  I think of it as abetting the widespread investment banking abuses in the form of allowing the abusers to skate away with loads of free money--not just the write off of the toxic transactions on their books, but all the Fed "loans"--and then in turning the crisis itself into an opportunity to aggressively attack the social safety net. That there is any talk of Medicare cuts (let alone Social Security cuts) is an enormous political failure for the Democratic party and an enormous political success for the party whose most powerful constituents have behaved like pirates during the past decade.

    The Inauguration address is great. I hope the man can keep his own words in mind as his opponents keep up the call for austerity and slam every move this president makes to make good on the new promises. I hope for the day when Obama makes the speech that explains why he cannot work in bipartisan good faith with leaders of a Republican Party who defend the interests of sociopaths/pirates and in doing so behave like anarchists, nihilists, and cry babies.

  •  here are the "hard choices" (2+ / 0-)
    Recommended by:
    greenbell, bmcphail

    that the President (& Congress) must face regarding Social Security and Medicare:

    a) Should we make some modest adjustments to Social Security that will ensure we sustain the program well into the 22nd century, without cutting benefits to current or future recipients (i.e. raise the cap on the income that Social Security is taken out of and/or reduce benefits a little for those earning more than a million dollars a year), or should we make radical changes to the program that will sustain the program long-term, but reduce benefits for everyone (i.e. privatization, raising the retirement age, etc.)?

    b) Should we make modest adjustments to Medicare to ensure it will be sustained well into the next century, through things like allowing the program to negotiate drug prices and reducing benefits  a little for those earning more than a million dollars a year, or should we raise the eligibility age and reduce benefits for everyone?

    Those are the "hard choices" that those on the right, including Politico, keep insisting on. We should give them what they want: Put their questions on the table for the entire country to see. Should we reduce benefits for everyone or make more modest adjustments to extend the longevity of those programs. That's the hard question. (Of course, to me, the answer's simple in both cases: make modest adjustments guaranteed to ensure the solvency of both programs while making sure that we don't reduce benefits for those who need them the most (those earning less than a million dollars a year)).

    In fact...the President and his team should barnstorm across the country having town hall meetings posing those exact questions. (It might, in fact, be a good way to start framing the 2014 Congressional elections...going on the offense against a lot of Republicans who have made it clear what their choice is.)

    My recommendation in 2012 was that the Democrats should always ask the following question during their campaign: Why is it that, when only a few relatively modest adjustments are necessary to ensure the solvency of Social Security (& Medicare) well into the next century, Republicans are insisting on needless, radical changes that will reduce people's benefits?

    That, in my opinion, should be the cornerstone of the Democrats entire 2014 campaign.

  •  Why do they want to screw American retirees? (1+ / 0-)
    Recommended by:
    Oh Mary Oh

    The cap on Social Security contributions should be raised to cover all (earned and unearned)  income not just the  measly $110,000.  Why are the superfluous rich so sacred that not even a hair on their head or a penny in their Cayman Island bank accounts can be touched?

  •  I hereby rename them Fauxlitico. (0+ / 0-)

    Pour yourself into the future.

    by Troubadour on Tue Jan 22, 2013 at 09:49:07 AM PST

  •  Somehow I doubt the Politico article mentioned (0+ / 0-)

    that the 400 wealthiest people are worth more than the bottom 150 million because that would weaken their argument.

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