One of the most eye-opening political discussions I had this year when I was visiting relatives was with a “swing voter” (he voted for Obama in ’08, and will probably vote for Romney in ’12, don’t get me started on the reasons). Like a lot of people in the area where I grew up, he’s hung up on the whole issue of government programs targeted at what he sees as the undeserving. When I pointed out that Medicare, which he received, was another government program, he told me that he had “paid for” his Medicare, and I had a really hard time trying to convince him that wasn’t true. It would probably have been easier if I had this table (from Kevin Drum):
We think the “get the government out of my Medicare” slogan is funny when it’s on a sign at a Tea Party rally, but the “I paid for it” position is a less obviously dumb, and I’d wager more widely held, view of Medicare held by the over-65 crowd. They think they’re entitled to it because they paid for it, and if the under-55’s are going to pay less to get less, well there’s some justice in that if you consider Medicare a something you pay for more-or-less directly with your taxes. If we had any decent reporting on Medicare, people might understand how ridiculous that is, but even though Medicare and Social Security are talked about constantly, the details are almost never explained.
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J.D. Rhoades
My Dad keeps saying this, in spite of the fact that, with the health problems both he and my mom have that have necessitated major surgeries and long hospital stays, there is no way in hell they’re not taking out way more than they’ve put in. There’s no way to convince them, and they’re perfectly willing to pull up the drawbridge.
Mudge
Kevin’s chart also shows that the imaginary citizen paid more in Social Security taxes than he will receive. What Social Security crisis? Your relative’s point of view is interesting and totally Republican. He paid and he deserves his Medicare. He does not say that he contributed to a societal health care program that guarantees health care to all citizens over 65 .
Selfish, egocentric, sociopathic bastards.
Maude
Thank you Ronald Reagan. The lies started afresh with him and they all grown up now.
arguingwithsignposts
I learned a long time ago that most people get more out of Social Security than they pay in. I have no problem with that.
hep kitty
So interesting how “independents” are incapable of independent thinking.
Funny, guess those people that want to keep gubmint hands off Medicare but consider others undeserving don’t have kids or grandkids, right?
Because otherwise, they do not share those much vaunted “family values” that includes wanting the best for your children. Wanting them to have more than you had growing up and having, at the least, a comfortable life without deprivation.
Well, hatred can make you do irrational things, I guess, including sacrificing your kids and grandkids on the republican altar of selfishness and greed.
c u n d gulag
Charts are the Devil’s playground, and math the language that is spoken in Hell.
Avoid both, and Heaven awaits!
sherparick
He also misunderstands Ryan/Romeny’s plan to coupon/voucherize the system. There is no reduction in Medicare tax for those under 55. They will be paying for his Medicare, but then getting a whole lot less.
By the way, the obvious political dynamic that will come into play if something like Ryan’s plan is enacted is that within an election cycle the Repubicans will start using resentment over this fact, that those born from 1959 on will be paying taxes for something they will never get, as a new political wedge to blame economic problems on a group whose voting power will be in gradual decline. They will simply state that what is good enough for those born after 1958 will certainly be good enough for those born in 1958 and before. That all these mooching and looting old freeloaders need to get back to work if they are not rich enough to provide their own insurance.
Downpuppy
Drum’s table is based on lifetime contributions adjusted by inflation plus 2% (about 7% per year). It makes Social Security look like a crap deal, when the payback is actually about 5 to 1. Stephen Ohlemacher ran this without explanation in the AP & I beat him severely about the head & shoulders.
Also, the use of the term “average” is misleading, since it’s mean & implies median.
Mark B.
They’ve been playing the same fucking shell game since Reagan. Cut taxes on rich people, neglect the infrastructure, run up a huge deficit, toss needy or sick people out on the street and claim everybody wins. When a democrat gets into office and starts to clean up the mess, they angrily blame him for creating it. It’s transparent, but apparently it works really well on the suckers who make up their base.
BrklynLibrul
Thank you for this post; you’ve out your finger on what ails the segment of the electorate that may decide the election for Romney.
kerFuFFler
The problem with Medicare funding is that we have paid for a salad bar but expect an all you can eat surf and turf buffet.
The current seniors have not paid in enough that they should be exempt from feeling a little of the pain from the changes necessary to save Medicare. I think that slightly higher co-pays for well-to-do seniors would be one reasonable policy. (I really hate the way the Ryan plan kicks the can down the road for ten years keeping current seniors benefits and expenses from changing one iota while dooming the plan for the rest of society.)
Younger citizens should also expect to pay more into the system—-a slightly higher rate coupled with getting rid of the cap on income subject to this tax—–or at least raising the cap significantly.
When people are confronted with how expensive this surf and turf buffet of medical treatments is we may as a society decide to go on a bit of a diet. Yeah, this is the “death panels” part. We need a sober discussion of end of life care. Research has shown that doctors themselves partake significantly less of heroics in the final days and weeks. I think they understand how a lot of additional procedures and treatments merely prolong agony. Perhaps a study of doctors’ choices for their own end-of-life care could help shape policies for what Medicare should reasonably cover.
A lot of people reject the notion that $$$ should be considered when your are thinking about life and death issues. But think about it, would you rather have several tens of thousands of dollars to enjoy over the course of your life—–taking music lessons, going dancing, traveling with your family—-or do you want to finance an orgy of painful and ultimately doomed procedures that drag out your final days?
gypsy howell
I hope your swing voter has plenty of money stashed away in the event he needs long term nursing home care, because his vote for Romney will ensure that he’ll need every penny of it after they slash Medicaid funds.
If not, I hope he has a family member who has room for him in their home, and are willing and able to quit their job so they can stay home with him to give him that round the clock nursing care.
Well, maybe he’ll get lucky, and die early and quickly. That IS what he’s counting on, right?
John D
@Downpuppy: Um, average *is* mean. And implies mean. Why would you think it implies median?
danimal
The inability/unwillingness of the press to publicize simple, factual truths about entitlements is a crime against the American people.
BGK
Again, I trot out my 70-plus-year-old mother as a counterexample. Despite not being a math person, she knows with absolute certainty that she got back her lifetime Medicare taxes in full by about year three of her retirement. Also too that, if not for Medicare and her federal retiree supplemental, my father’s ultimately fatal stroke would’ve left her homeless and absolutely destitute.
She just about has a stroke herself trying to convince her low-info friends of these facts. I’m trying to convince her it’s OK to drink more.
jwb
@John D: I think what Downpuppy is saying is that mean is a poor representation of “average” when you are dealing with things like income, because the distribution gives excessive weight to high incomes. And in general government and academic studies use medians rather than means in reporting these kinds of things. Of course, the obvious question is if mean is not the right measure, what would this chart look like using median? Given that taxes for Medicare and SS are capped, it’s also not clear to me how far mean and median might be off.
gypsy howell
@sherparick:
I wish more people were asking Romney and Ryan why that should not be the case right now, if their plan is so fucking great. Unshackle our current seniors to access the awesome power of the free market in medical care!
BGK
@danimal:
Fiqqst.
The good Dr. Maddow was on fire in her low-key way about this last night. She might’ve even been impolitely suggesting the press’s job wasn’t stenography.
hep kitty
@gypsy howell:
Must be nice to be a flaccid swing voter, deluding himself that he may not one day be one of those people who need help, like for instance when his body starts failing from old age?
It’s stunning – like you said, it only makes sense if you’re pretty damned rich already. If you’re not, well, you’re basically as brainwashed as the average middle class republican.
Downpuppy
@John D: The average guy, reading the phrase “the average guy”, will think that it’s the wage of the average guy. In fact, the pay of the guy in the middle is well below the mean, & getting lower. Ohlemacher in particular was very loose in his implcations, and I had to really dig through the Urban League study to figure out what they were talking about. There’s no excuse in a study for using “average” instead of “mean” – mean is clearer, and saves 3 letters.
RSA
@gypsy howell:
Amen. I also want to ask, “What’s the fallback if your policies don’t work as well as you expect them to?” (I know that the real answer is “People will be sicker and die sooner.”)
El Cid
Not to mention, god damn-it, if I’m going to pay taxes (and I certainly do), one fucking useful thing I would want my tax money to do is have my fucking fellow Americans get god-damned medical care when they fucking need it.
Linda Featheringill
Why do people younger than 59 support the Republicans and their Draconian Medicare plans, when it’s obvious that they would truly get screwed if these plans became reality?
If these younger folks voted with a clear head it wouldn’t matter how the oldsters voted.
BTW, about 2/3 of current Medicare recipients hate the Republican plan. [Where did I see that?]
ETA:
I really don’t want to get into a generational war this morning but why do you guys keep blaming the oldsters for stuff that your peers are bringing on themselves?
dr. bloor
Your “independent” relative isn’t dumb or lacking in the data needed to figure it out–he’s willfully ignorant. The SS problem and system is actually explained with some regularity on the teevee (if not every time they run a story about SS). But that aside, have him dig out one of the contribution summaries he got from the Social Security administration every fucking year and do twelve seconds of back-of-the-envelope math.
When I’m finally elected king of the world, “means testing” will involve Voight-Kampff Empathy Testing, and the results won’t be pretty.
Xantar
Serious question because I don’t understand actuarial economics and such: how has this been sustainable for all the decades? It looks like for as long as Medicare and Social Security have existed, people have been getting more benefit from them than they have paid in. I know there are projections about when they will run out in the future, but if this is the way it’s been for the history of the programs, how come they haven’t run dry yet?
WereBear
It is completely about selling pretty lies instead of facing harsh truths.
It totally does not surprise me that people get to retirement age without ever having gone toe-to-toe with Reality; no matter their circumstances.
They have spent a lifetime using their brains for rationalization instead of rational thought.
jwb
@hep kitty: There was a story in the NYT yesterday that confirms the feeling I’ve had since about last December: there are in fact very few actual swing voters this year, and even fewer of those live in states that actually matter. So we have about $2 billion in advertising money chasing 3-5% of the voters—and even that seems high to me. But at those numbers (which come from the NYT story) and assuming my calculator works better than McMegan’s, that means the campaigns will be spending about $300 per swing voter.
jurassicpork
My erstwhile collaborator and colleague Mike Flannigan is in Tampa in advance of the GOP convention and has begun posting the surreal the Mike Flannigan Diaries at Pottersville. Part II will be posted tonight, he promises.
Steve
“You paid for your Social Security, don’t let the politicians take it away” was FDR’s original selling point, which has been cleverly adapted to apply to Medicare as well. It would be a shame to debunk our own side’s arguments after they’ve worked so well for so long.
amk
teh greyladay
“The Romney-Ryan proposal to reshape Medicare by giving future beneficiaries fixed amounts of money to buy health coverage is deeply unpopular in Florida, Ohio and Wisconsin, according to new polls that found that more likely voters in each state trust President Obama to handle Medicare.
Medicare ranks as the third-most crucial issue to likely voters in Florida, Ohio and Wisconsin – behind the economy and health care, according to new Quinnipiac University/New York Times/CBS News polls of the three swing states. The Republican proposal to retool the program a decade from now is widely disliked.
Roughly 6 in 10 likely voters in each state want Medicare to continue providing health insurance to older Americans the way it does today; fewer than a third of those polled said Medicare should be changed in the future to a system in which the government gives the elderly fixed amounts of money to buy health insurance or Medicare insurance, as Mr. Romney has proposed. And Medicare is widely seen as a good value: about three-quarters of the likely voters in each state said the benefits of Medicare are worth the cost to taxpayers.
The polls’ findings on Medicare underscore the risk Mr. Romney took when he chose Mr. Ryan to be his running mate
amk
Dumb Mitt Romney Quotes
El Cid
@Steve: At worst, slightly different wording such as “paid into” or “you put so much of your hard-earned income into” sounds the same.
Chat Noir
@kerFuFFler:
My dad, 83, had a heart attack in mid-January this year. He went ahead with open heart surgery, was in ICU for two months, transferred to a different unit, never improved, and then died at the end of March. I wondered at the time why anyone would recommend open heart surgery to an 83 year old man who wasn’t in good health anyhow. When I ask my mom why they opted to have the surgery, she said they weren’t really given a chance to refuse. She says now if she had it to do over, she wouldn’t want him to have the surgery. The heart attack caused major damage to his kidneys and he never recovered.
It was horrible seeing him at the hospital in his last month (I live out of town so I only saw him for a week in mid-February but it was clear he wasn’t improving). And the final tab for his medical care was more than $750,000.
peorgietirebiter
@gypsy howell:
Ryan just trots out the solemn promises we’ve made current recipients that these folks have planned their entire lives around. It would be a sin to break those promises. Paul “my word is my bond” Ryan, like most sociopaths, is good at this stuff. Consider yesterday’s ” rape is rape, end of story” reply to the press.
grandpa john
Well here is one ol codger who will defend Medicare until my last breath and defend it for everyone
At age 75 I have received so far not counting everyday doctor visits ,lab fees, etc (i am diabetic so extra lab tests are required)
1. An angioplasty with stints inserted
2 . A CPAP machine for sleep apnea
3. Yesterday I received my Insulin pump kit to insure better control of insulin.
All this was paid for by medicare plus my supplemental insurance.
My wife has a hospital type bed with controls for raising and lowering head and feet. this also was paid for by medicare , I am a retired teacher, there is no way we could have paid for all the care we receive without medicare.
Kirbster
People need to get over the idea that Medicare is some sort of individual pre-paid medical annuity. Everyone over 65 gets the same benefits from Medicare regardless of what he or she has paid into the system. My mom, for instance, was a full time homemaker who never paid into the system, but received benefits anyway once she turned 65. The system is going to be severely strained as more and more people turn 65. The only way to save Medicare long-term is to broaden it into the single-payer universal system with premiums based on total income (not capped, wage income) like we should have had all along. There would still be a place for private insurers to offer supplemental health care policies to turn a basic Medicare plan into a deluxe, everything-is-covered plan.
WereBear
Every single person I’ve talked to, faced with such a dilemma, tells the same sad story. Ironically, ask any older person dealing with health issues, and this is the LAST way they want to go.
Yet, somehow, so many wind up going that way. How much of it is due to Palin and her “death panels” propaganda?
The Karmic debt involved must approach quantum levels.
Someguy
@Chat Noir:
Realistically, when people hit 75 or so, there should be no more ICU. My mom was an exception – heart attack 15 years ago, triple bypass and she’s doing well – but it was still a half million, and pretty much everybody over that age who has gone into that level of treatment was just on their way to a slow death. Anecdotes aren’t data but I can’t count using all my fingers and toes how many family members, family friends or acquaintences have gone that way. To the extent we’re even willing to provide that sort of care it should be privately funded, and not burden the taxpayers. End of life care = the last year or two – generally comprises over 90% of a person’s lifetime medical costs. Cut it just a little short and we no longer have a health care crisis.
Mudge
The Medicare tax does not have an income cap like the Social Security tax. One of the continuing problems with discussions of Medicare is the unfortunate tendency to lump it with Social Security. Medicare will have funding problems fairly soon (unless medical cost increases slow down), but Social Security will not have funding problems anytime soon and fixing its problems are easy.
It should also be noted clearly that if the govenment spends less on Medicare benefits, individual citizens will spend more out of their own pocket for health care or they will go without. Health care costs will not decrease, just the fraction of those costs that the Medicare will pay. It should be reiterated that Obama’s $700B savings will come at the expense of payments to Medicare Advantage providers, doctors and hospitals, not through a decrease in available health care for seniors.
Sly
The smarter than average Republican would probably bring up the rate of return on the Medicare/SS trusts. Yes, they put in less than they got out, but much of this is due to the fact the funds earn interest over time. One of the largest pool of investment capital in the world is the Social Security Trust Fund. Why do you think there’s such a drive to privatize it? So that money goes toward “productive investment” instead of government-issued securities.
There are two problems with this argument;
1) Even with the rate of return, beneficiaries are still receiving more than they put in. The “profit” generated by the trust funds largely exist to keep up with inflation. The Social Security trust does a better job of this than the Medicare trust, but that’s only because Medicare is up against a rate of medical inflation that is higher than the general rate.
2) The rate of return is only guaranteed by the government’s taxing power and its ability to pool massive amounts of financial resources through government-issued securities. To the extent that people earn these benefits is largely due to the fact that they are U.S. citizens and have a well-functioning government. That’s the reason that the rate of return is low – because that’s how investment works. Safe investments don’t make you rich.
David Hunt
@John D:
In my statistics intro class, they taught me that average isn’t a technical term, but a layperson’s term. It can be used to represent one of three things: mean, median, or mode. I never saw mode used in the low level course I took, but see how it could be useful in some circumstances. Almost everyone who says “average” is referring to the arithmetic mean, but when trying to measure things like income, real studies and meaningful statistics almost always use the median income earners. It helps you weed out outliers and not say that average income is going up when what’s really happening is a few really rich people are getting richer and everyone else is barely holding on or getting poorer.
kerFuFFler
@Chat Noir: I am so sorry for the ordeal your family went through, and of course the loss of your father. Thanks for sharing your story!
My dad just turned 90 and is suffering from multiple myieloma ( spelling???). He has had to stop taking chemo treatments because they were killing him faster than the disease—-he could not eat, and he kept falling down (it’s lucky he did not break anything!). So at this point, he gets occasional transfusions which really help him and he uses and oxygen tank about an hour a day.
But recently his doctor scheduled him for a biopsy where they would drill into his hip to assess the progression of the disease. My father has has this procedure done before. It caused him pain for weeks. And now since he is no longer willing to take chemo, there is no point in assessing the progress of the disease in this fashion. It would have zero impact on their course of treatment for him. It would subject him to needless pain and risk him getting a serious infection for NO GOOD REASON! They can take a simple blood test to determine when he needs transfusions and they can monitor his blood oxygen to advise him on his oxygen use.
Fortunately my dad is a smart man who does not assume that the doctor always knows best and he questioned him on the merits of the biopsy and then refused it when the doctor could not justify it. I am afraid there are too many doctors and hospitals that perform expensive, unnecessary procedures. We need to tackle this problem in a comprehensive way.
shortstop
Awesome post — thanks for this.
grandpa john
@Linda Featheringill: Linda this is one oldster that thinks that medicare as it is must be preserved. Perhaps because I am not a greedy asshole like so many republicans, I would like to know that my daughters and grand daughters will also have access to the same benefits as mine. some of us seniors still believe that it is not all about us and that we care about family, and have the compassion for others that Jesus preaches in the new testament, in other words we are Christians by our actions and not false Christians in words.
Matt; 19-23 Every tree that does not bear good fruit is cut down and thrown into the fire, Thus, by their fruits you will know them.
Not everyone who says to me, “Lord,Lord,” will enter the kingdom of heaven, only those wh do my Fathers will.
Many will say to me” did we not prophesy in your name and drive out demons and perform miracles?” Then I will tell them ,” I never knew you. Away from me you evil doers”
Judas Escargot, Acerbic Prophet of the Mighty Potato God
As others have pointed out, this meme was planted deep into their psyche by Papa Reagan. The infection is incurable, and will remain until they die.
Outrage at the one food stamps recipient they saw buying a pack of cigarettes that one time. But for the bankers and private equity parasites raping the nation? Nothing.
In my personal circles, I’ve kind of had it… openly telling any would-be Romney voters that they might as well break into my pension accounts and steal the money, because that’s exactly what a vote for Romney equates to. At my age, there’s simply no time to replan or start over.
I also remind them that if my generation loses ours, that we’re quite likely to dedicate the rest of our lives to help the Republicans take away theirs as well.
Yes, I know, not convincing anyone, nor winning any hearts and minds. But I’ve kind of had it with people who’ve done nothing but vote themselves tax cuts for 40 years, and expect me to sacrifice when the bill comes due.
Fuck ’em.
Chat Noir
@kerFuFFler: Thank you. And interesting story about your dad. After our family’s ordeal, my mom is totally soured on the medical profession. One of the doctors that treated my dad told my mom at one point, “I promise you he will get better.” My cousin and I both heard the doctor say that and we were both aghast that the doctor would make such a proclamation.
@Someguy:
@WereBear:
I didn’t realize how prevalent extraordinary care is for elderly patients like my dad.
numfar
Does the chart take inflation into account?
Some Loser
Yeah. Funny. I get the same thing from the libertarian-types. They’re against government assistance unless it benefits them. If it benefits them, it stops being government waste or giving to the undeserved, it becomes benefits they earned. Isn’t that lovely? Libertarians hate taxes and the government up until the point where the program they are funding benefits them; then, they earned the benefit. They paid their taxes! Can you imagine? A glibertarian proudly exclaiming about how he paid his taxes and he deserves government aid!
Shit, man, he paid his taxes; the subsidiary for the college rightfully belongs to him. He paid his taxes; of course he should benefit from Social Security. He paid his taxes; he deserves government aid!
A proud libertarian shit, I say. Fuck him, I say. Selfish asshole, I say. A low down piece of trash, I say. A typical low-thought libertarian, I say. Still, I must say, he was more intelligent than the more common variety Republican. Too bad, though. He’s voting for Palin.
Waynski
@sherparick:
This is a really good point. How long will people under 55 be willing to pay for benefits that not only they’re not going to get, but benefits that are going to the same racist coots and wingnuts who deliberately fucked them over? Old folks need to think about that.
kerFuFFler
@Xantar: When Social Security and Medicare were started they started paying out benefits right away to seniors even though the first seniors in the program had not paid into it at all. Medical technology was no what it is now, and people had larger families in general so that the taxes the younger people paid in easily covered the expenses of the older generation.
When Medicare was first designed, it had a mechanism for adjusting the tax to accommodate changes in the actual expenses. Unfortunately that did not work out because Congress had the power to “override” the automatic adjustments and for decades, every politician who did not want to override them was deemed “anti-Medicare, anti-senior”. So now the system is dangerously out of whack.
Now families are smaller and the array of medical possibilities has exploded so it will not be possible to keep the exact same structure and have it keep working.
NCSteve
Someone needs to point out the unstated ni-CLANG when white middle to working class people talk about the “undeserving” and “self-reliance” and “government trying to do to much.”
They change the words around a bit, and changed the accompaniment from a big loud brass band to a barely audible solo flute, but the song is the same. The only thing different is that Atwater’s master plan of “abstracting” things so that people don’t have to confront the subconscious ugliness implanted by their Galtian overlords that’s actually driving their conscious opinions has fully succeeded.
Of course Romney won’t let go of the welfare work requirement lie. He will repeat it over and over again no matter how many bitter tears Glenn Kessler cries. And given that Romney won’t stop fanning the flames of racial resentment, it’s about damn time for Team Obama stop trying to dress up the truth about the real theft that’s occurred since 1980 with pacific feel-good uplifting generalities. It’s time to come right out and tell people out that tat for thirty years, there has been a vast upward redistribution of wealth that began under Reagan continued under Bush I, abated under Clinton and resumed with a vengence Bush II. Don’t have to go waving pictures of Chairman Mao. Just put some damn animated graphs into commercials showing the growth in the wealth or income (either will work) of the top 10% and the bottom 60% and just flat out tell people we’re running out of time to fix it before the we turn into a third rate power.
Judas Escargot, Acerbic Prophet of the Mighty Potato God
@Waynski:
Exactamundo.
See my comment above.
wrb
The argument doesn’t depend on the rate of return of the trusts, It is instead that if they had invested the money as they wanted, the rate of return would have resulted accumulating the full amount they will draw.
Which isn’t unreasonable, looking at the figures in the chart.
The offset is that they might have lost it all too.
The problem is that the system was sold as insurance for which you paid. It wouldn’t have passed otherwise.
So changing that would give the appearance of reneging on a deal- making us, to a considerable extent, stuck.
kerFuFFler
@Someguy:
I’m with you in principle but it is often difficult to recognize at the outset when a person enters their own end of life sequence. Some treatments for the elderly really improve their lives while others just keep people alive indefinitely like some kind of creepy science project. But it is time for this country to confront this issue head-on.
wrb
@NCSteve:
I think this gets over emphasized. In my observation the anger isabout paying for people who don’t work equally hard. There is a belief that there are a disproportionate of such people in the black population, but the anger isn’t primarily due to blackness, it is directed toward those who don’t shoulder an equal burden.
People are just as angry at the white slob who spend all day on the couch watching TV living off a fraudulent workman’s comp claim.
If talking about groups, the major anger I hear it toward low-skilled immigrants. “I’ll pay in all my life and they will come and drain the benefits. And the better the benefits, the more will be drawn to come here. So we must oppose health care, good schools…- all those things for which I’ll be charged that would naturally attract freeloaders.”
It is less about blackness and brownness, imo, than about fear of being victimized by freeloaders.
Judas Escargot, Acerbic Prophet of the Mighty Potato God
@wrb:
I’ve known at least two ‘white slobs’ who fit this exact description.
Welfare-hating Republican voters, both.
(I seriously need to work harder to surround myself with better people, I guess…)
Paul
@Waynski:
I’m under 55. If they take away Medicare for those under 55, I will be among the first to demand that Medicare for those over 55 be eliminated as well. What’s fair is fair.
noabsolutes
This.
Really, the problem is that healthcare is structured as a market, so there isn’t a strong enough mechanism to constrain prices. Medicare does a good job of that itself, given how much buying power it has, but Republicans routinely keep it from doing the same with prescription drug prices and also refuse the kind of *actual market mechanisms* that would keep the costs of things like end-of-life care and heroic measures in check. If more people were in the system, we could do what the President did with Medicare Advantage and say, yeah we’re not going to accelerate the rise in healthcare costs by guaranteeing profits to private insurance companies. We could do similar things with preventive care, S-CHIP, and insurance for federal, state, and local government employees, and employees on government contracts, if we wanted, and that would go a long way.
We could also make Medicare taxes more progressive to keep up with the inflation thing– since top-earners’ incomes/capital gains go up faster than the rest of ours, their tax rates on everything should go up faster, anyway.
Of course, single-payer, blah blah blah bully pulpit, Obama is worse than Bush, &c. All true. And yeah, average isn’t a useful term in the chart and the correlation between how racist the older cohorts of the population are compared to the younger, in the aggregate, is a meaningful part of the whole “undeserving” complex.
Davis X. Machina
@Kirbster:
It’s a two-edged sword. That belief is what keeps it from being declared ‘welfare’ and delivered over to the death of a thousand cuts.
Davis X. Machina
@Waynski:
Think, yes. Worry, no. Not so long as a graph of the ages of who actually turns out to vote looks like this.
ksmiami
@Chat Noir: Same thing happened to my husband’s uncle. The cure was worse than the disease and he was in the OR for 16 hours as an 84 year old. When he “recovered”, he could barely talk or move and basically withered away rather fast. Just Horrifying and shame on doctors for pressuring desperate families.
Uncle Cosmo
@Chat Noir: Wow, does your story bring back the memories–In my father’s 85th year, after a bad scare with congestive heart failure (the hospital said, See him now & say whatever you need to–he may not make it to morning) he had a multiple bypass. The surgery itself went beautifully (one of the top cardiac surgeons in the world) but somewhere in rehab he aspirated something, which led to pneumonia, which led to 6 weeks of hell before he finally succumbed. Total bill (1998) $150K–& his insurance paid every penny.
(Now everything he left my mother [99 & severely demented] is in the process of being devoured by the Long Term Care Monster…but that’s for another thread, I guess…)
? Martin
The discussion about entitlement programs is all wrong. The entitlement programs were designed to revenue balance. Now, Medicare inflation has screwed that up a bit, but is also being fixed.
The way we should view these programs is that if the entitlement programs are in trouble, it’s only because our job creators have screwed up the income balance. Unlike with income taxes and whatnot, entitlement programs only pull money from the first $106K of income. That’s roughly 2x what the programs need to be sustainable – the thinking is that those at the top of the cap would cover the cost of those at the bottom, and the median income is the break-even point. The problem is that because we’ve shifted SOOO much GDP over the cap, that income has come from those at the bottom, and because that income doesn’t incur payroll taxes, the system has gotten out of balance.
These programs aren’t a measure of government management so much as they are a measure of how the ‘job creators’ maintain income balance in this country. If they are so determined to carry that label, then they should be similarly responsible for maintaining that balance. If they are unwilling to create jobs or increase pay for those at the bottom, then the payroll cap should be raised to a level that makes up the difference. If they think that’s unfair, then they need to drop this job creator bullshit for what it is, and let the government maintain the balance through other incentives, like raising minimum wage and raising taxes as needed.
Ding dong
Try working with younger disabled people who for sure are getting more out of medicare and ss than they paid in. These people are in their twenties to their forties and getting hundreds of thousands of dollars and will vote for the republican cuz of the black guy they won’t vote for.
? Martin
@Kirbster:
That’s true for Part A. Part B is more complicated, as everyone pays premiums on part B, and it’s already means tested. Part A definitely needs to be single payer everywhere all the time. That’s the part that fucks up the insurers anyway, so they might well be on board with it.
But Part B is just the mandate, and the argument for extending that everywhere, especially now that we’ve closed up the pre-existing condition loophole and everything – well, the argument against just keeping the mandate just isn’t there. There’s really not much to be gained or lost by changing that. Part D is really just an extension of Part B. And Part C would just vanish if Part A was universal, because it also just devolves into the mandate.
One of the biggest problems with Medicare inflation is the lack of a mandate. It’s pretty well documented that many, many, many older americans retire (or lost jobs) before 65 and because so few people get health coverage in retirement (death of unions) many people in the years just prior to Medicare kicking in have no health insurance. They figure they’ll just coast for a few years, and on their 65th birthday, they’ll go in and get the works done.
Well, it turns out that’s a wicked expensive way to do health care because lots of problems develop and get worse in those few intervening years and become really expensive to treat once they actually go in for treatment. Once the mandate kicks in, that should further knock Medicare inflation down – and I think we have a real shot if everything goes right for it to come down in line with inflation.
Matt McIrvin
@Linda Featheringill:
There’s been a tremendous amount of propaganda, over a period of decades, convincing these people that they’re going to get screwed anyway, because Medicare and Social Security will disappear in a fiscal cataclysm before they can collect a cent. If the programs are just going to disappear, they might as well support changes that they think will replace them with something more sustainable. It’s a self-fulfilling prophecy.
While the obvious sources are Republican politicians and ideological libertarians, I think the role of financial planners in this is under-appreciated. Every time the guy comes into the office to explain the benefits of buying into the company 401k, the first thing he says is that you’re never going to see a penny from Social Security. People nod sagely and the spiel goes on. The last time I heard it, the guy referred very obliquely to Bush’s plan to privatize Social Security, so I guess we’ve gone to the second-order version.
wrb
@? Martin:
Exactly.
A simple point that should be repeated again and again is that if the cap is raised the “crisis”
vanishes.
Very few seem to get that. They really believe there is a crisis that makes reduction of benefits inevitable.
If the cap it eliminated all together, and perhaps, the amount the 80-90% pay could actually be reduced. If assessments are made against unearned income- above say $1m- and against inheritance they could be reduced by a lot.
Why not get more from the 1%?
Downpuppy
@wrb: Which isn’t unreasonable, looking at the figures in the chart.
This is why I go nuclear when charts like this are presented without explanation of what went into them. That $55,000 in lifetime Medicare taxes is utterly bogus. Should be more like $15-20,000, unadjusted.
mistermix & Kevin Drum : J’accuse!
NCSteve
@wrb: And I think people who profess to be equally outraged by white people on unemployment or disability who they don’t think “deserve” it are following a more abstracted, more genteel form of the norm that made looking down upon and reviling “white trash” a mandatory part of the segregationist social code.
Maybe being raised in the South makes one’s ear more highly attuned to this kind of thing. But, down here, it was always an important, and very explicit, part of the segregationist creed that whites who conformed to the stereotypes of blacks as being no account, thieving, lazy, sexually immoral degenerates were to be looked down upon as being “worse than n****rs.” And especially when compared to the “good” n****rs–the ones who worked hard and knew their place and yada yada yada (i.e. the black people the racists knew personally). “White trash” were to be reviled even as they were granted all of the legal and social benefits conferred upon members of the superior race. Indeed, you see precisely that ethic at work in “To Kill a Mockingbird,” both from Atticus and the sheriff on the one hand and from the jurors who convict Tom Robinson even though they know he’s innocent on the other.
The existance of a few white people who could be denounced as “white trash” was critical to the validation and justification of the segregationist social code. Reviling white trash enabled whites to assure themselves that they were fair-minded, and thus their prejudices, and the social system based upon them, were likewise fair. And equally important, the fear of being categorized as “white trash” made hard working poor whites even more virulently racist, and harder working, than whites who were better off.
In an age where overt racial prejudice is socially unacceptable, having specific whites who can be condemned as being just as bad as unknown blacks and Mexicans who are hypothosized into existence by stereotypes and confirmation bias is even more important to the protection of the subconscious attitude from conscious scrutiny.
Triassic Sands
Of the 15.3% FICA tax, only 2.9% goes to Medicare. Social Security gets more than four times as much.
The cap on wages should be removed. Not raised; removed.
One of the beauties of Mitt Romney’s 1040s, and something we can know without seeing his tax documents, is the fact that he makes tens of millions of dollars and not a dime of his investment income is subject to FICA.
dance around in your bones
@dr. bloor:
Took the test: result?
Congratulations!, You are either Human, or are a Replicant that has learned empathy. Go about your business like this never happened.
I don’t know what to think about that.
I’m pretty sure I’m a Human and not a Replicant, however. I’ve always been a big fan of empathy.
Paul in KY
@BGK: God bless your mom.
Paul in KY
@WereBear: The problem is that many elderly folks just don’t have the ‘umph’ or gumption or whatever you call it to say ‘Hell no, he/I aren’t having that surgery’.
That is why, IMO, it is vital for them to have an adult child with them, involved in the process, who can be their advocate.
dance around in your bones
My 85 yr old landlord used to make this same argument. When we ‘talked about’ Obama and ACA he’d just keep repeating “where’s the money going to come from?” Like no one else was deserving of medical care, or there was NO WAY to increase revenues.
I didn’t want to say increase taxes on rich
dudes like yourself or raise the cap on Social Security income… because I kinda loved the house he was renting to me and I wanted to stay there. I was such a coward….plus, I liked the guy, even if he was a dick about ‘entitlement’ programs, which only applied to himself and people like him.
Paul in KY
@NCSteve: That’s a true post, Steve.
Paul in KY
@NCSteve: That’s a true post, Steve.
Groucho48
@Downpuppy:
Exactly! A version of this chart was posted on another forum I visit and I made the same point.
What they’ve done to get the figures for a person’s contributions to SS and Medicare is, as a comparison, to assume that your payroll taxes, over your 40 year working career, were placed into an investment that ALWAYS grew at an annual rate of inflation +2%.
Using that assumption, yes, the top income folks paid in more than they get out. But, if your assumption is inflation + a tiny bit less than 2% and you get more out than you paid in.
And, it also treats SS as an investment instead of an insurance policy. With SS, if something bad happens and you or your spouse have to start collecting much earlier than expected, SS will be there. That imaginary investment will only be there for a few years and then be gone.
Medicare is different. As long as it keeps growing at a rate well above inflation, it is always going to be in trouble.
But, for SS, this is just another attempt to make it seem as though SS is welfare, not insurance, and that should be treated as the lie it is.
Yes, that means you may have to concede this one point to your crazy uncle who collects SS while railing on about freeloaders. But, much better that, than for the right to convince all the rest of us that SS is a Ponzi scheme. Which they have been trying to do since it was instituted.