Viewpoints: Fighting to a draw on Medicare; A coming era of austerity

Dec 1 2012

The Wall Street Journal: The Death Of 'Mediscare'
Since Nov. 6, Republicans have, for perfectly understandable reasons, expressed their deep disappointment with the election results. But even in defeat something significant and positive occurred: Republicans fought Democrats to a draw on the issue of Medicare (Dan Senor and Peter Wehner, 11/29).

The New York Times' Taking Note: Medicare Off The Menu
But the charge has everything to do with the other conversation going on in Washington today as the two parties try to avert a fiscal deadline of spending cuts and tax hikes. Republicans have demanded that Democrats put painful Medicare cuts on the table in exchange for tax hikes on the rich, yet they ran an entire presidential campaign on the misleading notion that Mr. Obama was cutting Medicare too much. Now they sit mute across the table from White House negotiators, refusing to expose themselves by saying what Medicare cuts they actually want to make, and demanding that Democrats go first (David Firestone, 11/29).

Chicago Sun-Times: Democrats Should Pay Heed To Dick Durbin On Medicare, Medicaid
Progressives in this country would be wise to listen to Dick Durbin, Illinois' senior senator. The No. 2 Democrat in the U.S. Senate this week essentially pleaded with his fellow progressives to give up the false notion that raising taxes on the wealthiest will alone solve the nation's crippling debt problem. This comes as talks on averting the Jan. 1 fiscal cliff of tax hikes and crippling spending cuts near a crescendo. Durbin is right -- and the sooner progressives and Democrats get that, the sooner they can get to work on shaping the cost-cutting to Medicaid and Medicare that must be part of any realistic long-term deficit-reduction plan (11/29).

The Washington Post: Austerity And Morality
America is entering a period of prolonged austerity. The entitlement commitments made by past generations have been rendered untenable by demographics and health cost inflation. The problem is no one's particular fault, but it is very, very large. Failing to get our borrowing under control would deny our children the lives we have had in this country (Michael Gerson, 11/29).

The Washington Post: Cliff-Jumping With Barack
Why are Republicans playing the Democrats' game that the "fiscal cliff" is all about taxation? … Where is the other part of President Obama's vaunted "balanced approach?" Where are the spending cuts, both discretionary and entitlement: Medicare, Medicaid and now Obamacare (the health care trio) and Social Security? (Charles Krauthammer, 11/29).

The New York Times: Class Wars Of 2012
Consider, as a prime example, the push to raise the retirement age, the age of eligibility for Medicare, or both. This is only reasonable, we're told -- after all, life expectancy has risen, so shouldn't we all retire later? In reality, however, it would be a hugely regressive policy change, imposing severe burdens on lower- and middle-income Americans while barely affecting the wealthy. Why? First of all, the increase in life expectancy is concentrated among the affluent; why should janitors have to retire later because lawyers are living longer? Second, both Social Security and Medicare are much more important, relative to income, to less-affluent Americans, so delaying their availability would be a far more severe hit to ordinary families than to the top 1 percent (Paul Krugman, 11/29).

Los Angeles Times: Dislodging Obamacare
Democrats are likewise deluding themselves if they think the law is safe because Obama wields the veto pen. The greatest threat to Obamacare was never a Romney presidency but Obamacare itself. The law remains vulnerable because of its unpopularity, the compromises that unpopularity forced on its authors and the Supreme Court's ruling that part of it is unconstitutional. These factors guarantee repeal will remain a viable issue, and -- I predict -- that the president will ultimately sign a bill making major changes, at the very least (Michael F. Cannon, 11/30).

The Washington Post: A Much-Needed Medicaid Reform
Medicaid has grown dramatically since its inception in 1965. It now accounts for 8.5 percent of all federal spending, and just under a quarter of all state spending. Between 1970 and 2010, the program quintupled from half a percent of gross domestic product to 2.7 percent. Federal forecasters expect Medicaid to reach 3.7 percent of GDP by 2020 -- due in large part to increased enrollment under health-care reform. Any serious plan to reduce the federal debt has to deal with spending, and, given the foregoing numbers, any serious plan to deal with spending has to address Medicaid. The question is how (11/29).

Baltimore Sun: Facing The Fiscal Cliff, Obama Can't Back Down Again
As official Washington nervously ponders the approaching fiscal cliff and the potential economic chaos it entails, President Barack Obama faces a precipice of his own in the challenge of making use of his re-election victory. Unless he emerges from this, the last major crisis of his first term, with the appearance of political strength and skill in navigating it, he risks losing public confidence that he has the stuff to take the country where he wants it to go in his second term. More than the specific details of any deal with House Speaker John Boehner and his resistant Republican cohorts on taxes and spending, Mr. Obama needs to demonstrate more steel in confronting GOP obstructionism than he showed in the previous showdown over deficit reduction (Jules Witcover, 11/30).

Minnesota Post: REAL ID, No Child Left Behind, And The Future Of The Affordable Care Act
The ACA's health care exchanges appear to be the next in a series of ambitious federal programs that share the following lineage: The establishment of sweeping goals without clear funding mechanisms, followed by implementation during a period of economic crisis. While Congress may be able to muster the political will to enact such programs, the federal government increasingly seems to be unable to whipsaw states into complying with the vast complexities and costs of their mandates. ... It is almost certain that the ACA's directive to run millions of uninsured Americans through (largely) non-existent state exchanges will face similar hurdles (Matt Ehling, 11/29).

Detroit Free Press: GOP Continues Health Care Tantrum
If you thought the Detroit City Council was the main attraction at the Museum of Governance by Self-Delusion, perhaps you've not met the members of the Michigan House of Representatives. The House's GOP majority failed this week (for at least the third time) to pass legislation that would set up a Michigan-based nonprofit to manage the health care exchanges required under the Affordable Care Act. This, after the Supreme Court decreed this summer that health reform is here to stay. And after the Nov. 6 election handed a second term to President Barack Obama and two more U.S. Senate seats to the Democratic majority (11/30).

Kansas City Star: Struggle Over Medicaid Is Shaping Up In Missouri
As you may have heard, some sore losers who didn't like the way the national election turned out have petitioned for Missouri to secede from the union. That prompted a more fun-loving group to ask that the rest of the nation be treated to a gigantic pizza party in the event of Missouri's departure. It's probably a bit early for the partiers to be firing up the ovens, however. Before it takes on the rest of the union, Missouri must resolve the war within itself. Democratic Gov. Jay Nixon threw down the gauntlet Thursday when he announced his 2014 budget would include federal money to vastly expand the state's Medicaid program (Barbara Shelly, 11/29).

Los Angeles Times: Patients' Choices Narrower, Yet Cost Of Insurance Rises
It's hard enough having a serious condition like cancer or kidney failure. It's even worse, some might think, when your health insurer says you have to buy your medicine from the pharmacy of its choice -- or pay the full amount for expensive life-saving drugs elsewhere. Yet that's precisely what Anthem Blue Cross is telling people who require so-called specialty medicines, which are used for complex conditions and can cost thousands of dollars a month (David Lazarus, 11/30).

Los Angeles Times: Safe Peanut Butter, And Beyond
Citing the conditions at Sunland as well as its history of health violations, the U.S. Food and Drug Administration put at least a temporary hold on those plans Monday, suspending operations at the plant and exercising for the first time its new authority to shut down potentially dangerous food facilities. Luckily for consumers, this was made possible by the Food Safety Modernization Act, signed into law nearly two years ago -- and long overdue even then. But other, much more sweeping changes required by the law haven't yet been implemented (11/29).

The Seattle Times: Dental Therapists Are Not The Right Fit For Washington State
Some believe dental therapists could be used to provide care to additional Medicaid patients and extend hours for community health centers. We can achieve the same result by employing more young, unemployed dentists looking for work in this struggling economy, or by increasing the number of dental residents who are already expanding capacity in community health centers. The problem is not due to a shortage of dentists but a shortage of dental funding (Danny Warner, 11/28).