Let's begin the debunking of this shameless exercise in lying to the American public with this: the so-called 'cuts' to Medicare in the Affordable Care Act were really an end to the Bush-era effort to privatize it. Subsidies were eliminated and/or phased out over time, forcing insurers to compete with traditional Medicare. This means they don't get guaranteed profits, courtesy of the American taxpayer and so they have turned to their bought-and-paid-for senators to distort the truth and erode growing support for "Obamacare". In fact, they're so intent on perpetuating these mythical cuts that they have written a competing Medicare handbook to the official government version.
From the transcript:
VAN SUSTEREN: The government has Medicare new 2012 book out. And you guys have a competing Medicare 2012. This is your book. Is this a parody?
SEN. TOM COBURN, R-OKLA.: You might consider it. It's much more truthful than the other one.
VAN SUSTEREN: In what way?
COBURN: In terms of describing what the Obamacare legislation has done to Medicare patients.
BARRASSO: How they took $500 billion away from our seniors on Medicare not to save and strengthen Medicare but to start a whole new government program for other people, how they will have unelected bureaucrats decisions about who gets what care and how much the government pays for it. You can go item by item why Medicare is more at risk now in terms of going bankrupt than it was before Obamacare passed.
What follows is an effort to spark an inter generational war. In addition to being dishonest, it's nothing more than yet another cynical attempt to pit youngers against elders for votes and support, something Republicans can't find much of these days.
VAN SUSTEREN: So if I am clear, we were on an unsustainable path before President Obama's national health care. Then he shepherded through the national health care and we are still in the unsustainable path. But you say $530 billion was taken out of Medicare. Where -- what was it taken from? And where did it go?
COBURN: It's going to go for a innovation council, $10 billion. It will go to subsidize the state exchanges, mandated care that all of us will have to buy if we don't -- can't demonstrate that we have it. So there is a subsidy there.
So we are taking money that people have paid into Medicare, taking it out of Medicare and subsidizing the care for people who have not paid into Medicare.
COBURN: That's part of it. But the vast majority is going into other programs for other people for health care that Medicare dollars weren't paying for to begin with.
Got that? All the Medicare withholdings from your paychecks are counted as 'not paying' by Senator Coburn. Leave it to Greta to just let him go on and on over it too with no challenge.
The next statement is so outrageous he ought to be tried for it:
And remember, Greta, we have a problem. The hospital trust fund by the most rosy scenario, if you assume we are going to grow 4.5 percent, everything you would not assume, will be bankrupt in 2026. The conservative scenario of that by Medicare trustees is 2016. If you look at it, that's declining every year. It will be 2014 by 2013.
So the trust fund that actually pays for your hospitalizations will be bankrupt in less than four years. That money came out of that trust fund to go for these other programs. So what are we going to do? We're going to go to the marks with the international financial problems we are going to borrow money to pay for hospitalizations for our seniors? No, we're not. But we created all of these new wasteful programs and other programs in the health care that will take that money that should have been there and put it miles per hour else.
Shorter Tom Coburn: I will lie on cable news to scare you silly. He ignores the fact that hospitals agreed to cuts in Medicare reimbursements and the actual dollars cut were to Medicare Advantage, not hospitals and providers. The only group who didn't agree to cuts as part of the Affordable Care Act were doctors; specialists, actually. Specialists like Coburn and Barasso. Enter Greta at the ready to lob the softball to these two grifters so they can whine:
VAN SUSTEREN: It seems that is a problem we are going to feel in the near future, but not as near as the problem that's going to hit in January. A lot of doctors are going to lose a lot of reimbursement under Medicare, which I assume will discourage a doctor from wanting to care for people. It's going to be harder to find a doctor, or am I wrong on that?
BARRASSO: I think you're absolutely right. It's going to be harder for someone on Medicare to get a doctor to take care of them, especially if they move or their doctor retires. It's going to be much more challenging.
VAN SUSTEREN: And I don't blame the doctors. Frankly, I know you are both doctors, but it takes an awful lot to get to become a doctor. And to be submerged in this paperwork and to get the fees reduced, it's hard to run an office.
COBURN: One, if you really practice medicine the way we are trained, there is no way you can pay your nurses and overhead on reimbursement. But they don't because Medicare has such low over-imbursement, they end up seeing way too many people to be able to afford to see the patients and keep their office open. And what we will see is that going on down.
So the real question for Medicare is you have a Medicare plan, but if you can't get a doctor, do you have health care? That's what's happening across the country, the people who are turning 65 this year and becoming Medicare eligible, half of them are having trouble finding a physician.
VAN SUSTEREN: But even under the cut, if you find a doctor, under Medicare in light of the economic pressure we are putting on the doctors, they have to push you through quickly, so you don't get your questions worried and so I am not sure the level of care, especially if you get older and have health problem. The quality is going to go down.
COBURN: And one of the things that's a consequence of that, when the doctor doesn't spend the appropriate time with you, what do they do? They order a whole bunch more tests to cover what they didn't get to ask you about so that they make sure they are not missing anything. So we increase all of this testing that is really unnecessary because we won't reimburse and recognize the value of a physician relating to a patient and paying them for the time that they will spend with the patient.
BARRASSO: And the president uses the word coverage and care interchangeably, but they are very different. There may be a time coming very shortly where someone with a Medicare card can't get care.
What these senators are touching on is the overall, overarching issue we have with health care in this country. By offering universal health care to the poor and elderly but not everyone else, we've created a system that rewards exclusivity and treatments that might be cutting-edge but aren't necessary. The 'free markets' should not apply to health care. I note, for example, that neither of these two doctors mention the fact that they are very wealthy men because their chosen professions allowed them to become so. If we had no markets and a single payer system, the issues they're whining about wouldn't exist. On the other hand, they wouldn't be as wealthy either.
What bothers these men most about the changes to Medicare? The Affordable Care Act shifts dollars to outcomes and away from markets. Yes, it is an imperfect model but it is one that begins to force providers and patients alike to deal with health care within a universe of limited resources which should be available to all. The hospital trust find will not be bankrupt in four years if the dollars are spent helping people to stay out of hospitals rather than funding every unproven treatment available. It will benefit from removal of insurer subsidies.
It's apparent that these two would like to continue to profit on the backs of hard-working Americans who have paid for and expect to receive Medicare benefits. I will enjoy watching them extol Obamacare's benefits in a few more years. Watch for it. It will come.