The Mainstream Media Falls For Absurd GOP Rhetoric

Always leave it to the media to feed the false balance monster:

Washington Post: "In shutdown blame game, Democrats and Republicans united: It’s the other side’s fault"

"Even before the midnight deadline for a government shutdown, the players were already staking out their positions in the battle to come: the fight over who was at fault."

"President Obama argued that Republicans were to blame for using a budget bill as a means of extortion to roll back health-care reform. No, the GOP shot back, it was Obama and Senate Majority Leader Harry M. Reid (D-Nev.) who were responsible for refusing to negotiate."

It seriously doesn't take much scrutiny to see just how patently absurd this is. Both sides want to pass a Continuing Resolution to fund the government through the rest of the year. However, the GOP wants to add language to delay or defund a key law passed by the Democrats a few years back. The GOP is calling this a compromise since they originally wanted to repeal the whole law. I am just curious as to what practical definition of "compromise" this falls under. Let's ignore for a moment the fact that either of these options would effectively sabotage Obamacare, meaning it would be a repealed anyway*.  I see what Republicans both get and sacrifice in this supposed compromise. I also see what Democrats sacrifice. But I seriously have no clue what Democrats are getting. This is a necessary component of compromise to keep the word from being utterly meaningless. For example, it isn't a compromise for a thief to steal my TV set instead of my car.

What is even more absurd about this whole thing is the Democrats have already compromised on the CR's spending levels. I just seriously cannot understand how some in the media are so gullible to such obvious political spin. Democrats have a reasonable argument for why Republicans are to blame. But Republicans have nothing short of absurdities to justify blaming Democrats. The scary thing about this is that around half the country is still buying it. It isn't bias to point the finger at the culprit. It is objectivity.


*Republicans have not exactly kept this motivation secret, describing the efforts as the "last opportunity we're going to have to stop Obamacare" and a way to "stop the president’s health care law."


Update 10/2/13: Judd Legum also captures the absurdity of the GOP and mainstream media's definition of "compromise."

Further Reads:

 

Greg Sargent: "For GOP, a refresher on the meaning of the word `compromise’"

"In the “compromise” scenario Republicans are insisting on, then, only one side — Democrats — would be making concessions, and Republicans wouldn’t be giving up anything. Folks inclined to blame “both sides” for what’s happening here need to reckon with this basic imbalance."

Kevin Drum: "The Obamacare Fight Starts Tomorrow"

"For the past year or so, Obamacare has been the perfect foil for every corporation in America that's done something unpopular with its benefits package."

Kevin Drum:  "Here's Why the Public Blames Republicans for an Imminent Government Shutdown"

"This is why the public is likely to blame Republicans for a government shutdown: because Republicans have been very clear all along that they were deliberately stringing out the budget process so they could use a shutdown as leverage for their demands."

I don't share Drum's optimism the public will figure it out, at least not when most of the mainstream media seems to have largely ignored this extremely relevant piece of context...

Ezra Klein: "Don’t forget what the shutdown is really about"

"imagine if the Republican Party had won the 2012 election and Senate Democrats threatened to breach the debt ceiling and cause a financial crisis unless Republicans added a public option to Obamacare. Does anyone think a President Mitt Romney would find that position reasonable? Does anyone think that position would be reasonable."

Ezra Klein: "John Boehner’s ‘Plan C’ hurts Congress, hurts taxpayers, fixes nothing" 

This "Plan C" is politics at its worst. It's something that sounds good, but is still a terrible and utterly illogical idea.

"The idea behind this amendment, as Vitter explains it, is that Congress should live in the same health-care system its foisting on everyone else. But that's not what the amendment does. Obamacare doesn't force large employers to dissolve their health insurance arrangements and send their employees to the marketplaces. Congress is creating a worse version of Obamacare and applying it only to itself."

David Weigel: "No, Democrats Never Really Held the Debt Limit Hostage"

"To recap: Raising the debt limit always been unpopular, and tough to explain to voters. A few times, Democrats balked at raising it for a few days to make a point, then caved in. Many more times, they've just voted for the damn thing. John Boehner's Republicans have only ever agreed to raise the debt limit if they won major policy concessions from the president. Both parties don't do it. One party does it."

Greg Sargent: "John Boehner doesn’t have to let the Tea Party paralyze whole government"

John Sides: "Republicans and Democrats are treating the 2012 election like a mandate. They’re both wrong."

No, Obamacare Will Not Be Delayed or Defunded

The newest GOP hostage taking strategy in the continuing resolution and debt ceiling fights is to try and add language delaying Obamacare and/or the individual mandate. What is truly startling about this is just how unbelievably unlikely it is these strategies will ever succeed in delaying either. Before these bills can succeed, they must be approved by the Democrat-controlled Senate and signed by the President. However, this will almost certainly never happen. Ezra Klein and Sarah Kliff from The Washington Post's Wonkblog explain why (I will skip the whole "he will never do this to the signature achievement of his presidency" because it is just too obvious):

Why Senate Democrats will not delay the implementation of Obamacare or the individual mandate:

Klein: "Democrats point out that Obamacare's implementation schedule wasn't an accident. It was purposefully designed to begin in an off-year. That way there would be a year to work out the worst kinks, and by the time of the actual election, Democrats could point to millions of people getting insurance, running ad after ad highlighting constituents who now have coverage. If implementation didn't begin until October 2014, all voters would know about Obamacare would be the early glitches, as insurance coverage wouldn't begin until January 1, 2015."

Why Obama will not delay the implementation of Obamacare or the individual mandate:

Kliff: "A delay to the individual mandate – or the entire law – would also have a giant ripple effect throughout health-care industries, who have spent the past three years preparing for a 2014 launch. They've spent millions on marketing and outreach, writing business plans that hinge on a significant expansion of the health insurance market next year."

"This is especially true for health insurance companies, which decided months ago the prices they would charge consumers on the marketplaces. Those prices assumed that the law would have an individual mandate. Insurers would have likely set different prices if they didn't think the requirement to carry coverage would be in effect."

How the individual mandate is different from other parts of the law that have been delayed:

Kliff: "all the delays so far do have one thing in common: They erased political headaches for the law while barely denting the number of people that the health overhaul will cover in 2014. The delays Republicans are asking for now would cause major political and substantive headaches for the law while sharply reducing the number of people it covers."

"The Congressional Budget Office estimates that, without an individual mandate, 11 million fewer people would gain coverage next year."

"That would happen for two reasons. First, fewer people would buy health insurance coverage without a federal law requiring them to do so. Second, the people who signed up would likely be sicker people, who really thought they would use the coverage. That would cause premiums to spike, making the market a tougher sell for healthy people."

How the individual mandate is different from the employer mandate:

Kliff: "The individual and employer mandates often get lumped together as similar policies. They do, after all, both have the word mandate in their name – and both require certain entities to buy health insurance coverage. In practice though, they're significantly different. The individual mandate is a lynchpin policy, one that makes the rest of the Affordable Care Act work by bringing millions more people in the health-care system who don't currently buy coverage."

"The employer mandate, by contrast, is more of an extra nudge, aimed at encouraging companies to keep doing something they already do right now."

"The Congressional Budget Office estimates that with its [the employer mandate's] delay, a half-million fewer people gain coverage in 2014. This has a lot to do with the fact that most big employers already offer insurance right now, with no requirement to do so."

Make no mistake. A delay of Obamacare and/or the individual mandate is a political and practical impossibility. Delaying the individual mandate in particular would cause insurance rates to spike and insurance companies to flee the exchanges. It wouldn't just be a disaster for insurance companies, but also for the millions of currently uninsured people expected to gain coverage in 2013 (If Democrats are looking for a simple way to explain why they won't delay the individual mandate, try starting there).

Why Are The Washington Post Wonkbloggers Repeating A Romney Campaign Falsehood About Medicare?

The Washington Post’s WONKBLOG has been repeating the Romney Campaign's falsehood about Obamacare and Medicare. From their fact check of Bill Clinton's 2012 DNC Speech:

FALSE: [Clinton:]“Both Governor Romney and Congressman Ryan attacked the president for allegedly robbing Medicare of $716 billion. That’s the same attack they leveled against the Congress in 2010, and they got a lot of votes on it. But it’s not true.”

The Affordable Care Act did indeed cut Medicare spending by $716 billion, as the Congressional Budget Office wrote in a July 24 report. It does that by reducing payments to Medicare hospitals and doctors, essentially ratcheting down the amount they receive when they see a patient.

...these Medicare cuts do indeed exist.

However, all three major fact checkers have come to pretty much the opposite conclusion:

• FactCheck.org (here, here, and here) 
• Washington Post Fact Checker (here and here)
• Politifact.com (here, here, here, and here):

In my post on Ryan’s Medicare claim, I explained why this is the case using the findings of both FactCheck and The Washington Post Fact Checker (PolitiFact did an exceptionally poor job explaining the problem):

"Medicare payroll taxes go to pay for Medicare Part A. What revenue is left over goes into the Medicare Hospital Insurance trust fund. And that fund goes to finance shortfalls in Medicare Part A. As of late, there is not enough revenue coming from payroll taxes to cover hospital insurance for medicare beneficiaries. As a result, the trust fund is being drained and will eventually be empty, meaning Medicare Part A will become insolvent. To help mitigate the problem, the Affordable Coverage Act slows the amount of money coming out of the trust fund via reduced payments to hospitals. Obama can get away with those reduced payments to hospitals largely without causing them to drop out of the program because of a deal he stuck with hospitals, promising new patients through the ACA, more than making up for the lost revenue. This saved money stays in the trust fund (although it can be loaned out, more on that later). It does not go to cover the uninsured not currently in Medicare. In addition, Obama increases the revenue coming into the trust fund via a 0.9 percent tax "on earnings above $200,000 for single taxpayers or $250,000 for married couples."

The savings from Medicare that actually go into Obamacare come from Medicare Parts B, C, and D, and only from funds that come from congress (income taxes, corporate taxes, etc...) to cover outlays. This accounts for approximately 2/3 of $716 Billion in slowed medicare growth. Obama decreases the growth of money congress spends on Medicare from general revenue using the Independent Payment Advisory Board, which is incredibly limited in what it can target."

...a bill can both reduce the deficit and not be "paid for." This is because some of the revenue that comes in goes "into savings" instead of being used to pay the bills. And just like a bank uses savings accounts to make loans, so too can this Medicare money "in savings" be loaned out to pay for other programs. FactCheck explains:

"What happens in government accounting is that after Treasury issues a bond that it will have to pay later, it can spend the money it received on other things. And it often does, whether that’s coverage expansion, as called for in the health care law, or any number of things. The Romney spokesman said it was “a shell game.”"

But that doesn’t mean that the Medicare trust fund will be slashed or its “piggy bank” “robbed” or “raided,” or any other claim we’d put firmly in the category of “senior scare.” (emphasis mine)

Romney does have a point in essentially calling this an accounting trick. And he could spend time making that claim instead of a demonstrably false one. You can argue over whether or not the CBO was therefore wrong to say the ACA cuts the deficit. But you cannot say payroll taxes are going toward the ACA anymore than you can say your personal savings in the bank are going toward someone else's loan. Just like those savings are still legally yours, so are the trust funds still legally Medicare's. Any money that is borrowed from the fund has to be paid back.

I am not quite sure why the Wonkbloggers are doing this. And I can find no explanation as to why they keep coming to the exact opposite conclusion as these major independent fact checkers, including the Washington Post’s own Glenn Kessler. Could It be the double counting? Romney could certainly say Obamacare isn’t paid for, or that it adds to the debt (but not deficit). However, as Glenn Kessler has noted, that would open Republicans (including his own VP Pick) to criticisms of hypocrisy since those claims can be leveled at nearly any deficit reduction plan, including many of the GOP's own.

No Paul Ryan, Payroll Taxes Are NOT Going Towards ObamaCare

Paul Ryan has been LYING about Obamacare and payroll taxes.

During a campaign stop at Miami University in Ohio, Paul Ryan made the claim that payroll taxes will now be used to fund the Affordable Care Act:

"Ryan slightly reframed the attack by arguing that Obamacare is effectively taking hundreds of billions from payroll taxes. “Take a look at your paycheck next time. Look at that line on your paycheck that [reads] payroll taxes," Ryan said. "You see our payroll taxes from our paychecks are supposed to go to two programs--Social Security and Medicare period. Now because of Obamacare they’re also going to pay for Obamacare." The crowd booed." (emphasis mine)

One problem with this: It is completely false. And the Romney campaign knows it.

Earlier this week, FactCheck.org released probably the best article on Mediscare claims since they began resurfacing after the Ryan VP pick. This article is an absolute must read for anyone wanting to understand how Medicare works, as well as what Romney, Ryan, and Obama each plan to do about Medicare's fiscal problems. The article begins with explaining the troubles Medicare faces down the road, mainly focusing on insolvency (which is different from bankruptcy). The article then summarizes the history of Medicare, as well as the different "Parts" of Medicare (A,B,C, and D). Understanding this is crucial for understanding the Ryan, Romney, and Obama Medicare plans (Obama has already passed his plan as part of the ACA). Here is a basic summary of what each Part of Medicare covers:

• Medicare Part A: Hospital insurance
• Medicare Part B: Insurance for doctor visits
• Medicare Part C (Medicare Advnatage): Combines both Part A and B but uses a private insurer.
• Medicare Part D: Prescription Drugs

The article also debunks the claims from both the Obama and Romney campaigns about how each candidate plans to cut benefits and push the cost of healthcare further onto seniors. I will not spend any time in this post talking about whether or not either campaign's arguments hold water (See my previous post and Roundup from last week for that). This post will be dedicated to understanding why Paul Ryan is lying about payroll taxes going to fund the Affordable Care Act (Obamacare, PPACA, ACA).

One area where FactCheck's article falls a bit short is on explaining why Paul Ryan's claim mentioned above is wrong. The article is a bit vague and inconclusive. However, a campaign speech by Paul Ryan finally motivated FactCheck to get more detailed and help explain specifically why Paul Ryan's claim is wrong (the article also debunks Medicare bankruptcy claims). This article is another absolute must read. I will summarize and expand here:

Medicare payroll taxes go to pay for Medicare Part A. What revenue is left over goes into the Medicare Hospital Insurance trust fund. And that fund goes to finance shortfalls in Medicare Part A. As of late, there is not enough revenue coming from payroll taxes to cover hospital insurance for medicare beneficiaries. As a result, the trust fund is being drained and will eventually be empty, meaning Medicare Part A will become insolvent. To help mitigate the problem, the Affordable Coverage Act slows the amount of money coming out of the trust fund via reduced payments to hospitals. Obama can get away with those reduced payments to hospitals largely without causing them to drop out of the program because of a deal he stuck with hospitals, promising new patients through the ACA, more than making up for the lost revenue. This saved money stays in the trust fund (although it can be loaned out, more on that later).³ It does not go to cover the uninsured not currently in Medicare. In addition, Obama increases the revenue coming into the trust fund via a 0.9 percent tax "on earnings above $200,000 for single taxpayers or $250,000 for married couples."

The savings from Medicare that actually go into Obamacare come from Medicare Parts B, C, and D, and only from funds that come from congress (income taxes, corporate taxes, etc...) to cover outlays. This accounts for approximately 2/3 of $716 Billion in slowed medicare growth. Obama decreases the growth of money congress spends on Medicare from general revenue using the Independent Payment Advisory Board, which is incredibly limited¹ in what it can target.

So it should be pretty clear Paul Ryan's claim is false. But remember I accused Ryan of more than just telling him a falsehood. I accused him of lying, meaning he knew what he was saying was false. What is my evidence? Besides Ryan's work on the medicare program (meaning he should know this Medicare 101 knowledge) and acceptance of Obama's ACA Medicare savings (he should know what he is accepting), when FactCheck asked Romney's campaign about their claims, the campaign responded this way:

"When we asked the campaign how it could argue that Obama’s spending reductions didn’t extend the life of the trust fund, a spokesman replied that it didn’t extend the fund “unless the administration is ready to admit their law blows a huge hole in our deficit.”"

So essentially they are accusing Obama of double counting the savings from hospital insurance. If that money has to be put into the trust fund, it can't also cover the non-Medicare related Obamacare expenses. Fact Check explains (from their original article):

"The fact is that CBO and the guardians of the hospital trust fund say Obama’s health care law does both extend the life of the trust fund and reduce the deficit, but can’t be also counted as paying for the law’s added spending."

This may sound a bit confusing. It essentially comes from the fact that a bill can both reduce the deficit and not be "paid for." This is because some of the revenue that comes in goes "into savings" instead of being used to pay the bills. And just like a bank uses savings accounts to make loans, so too can this Medicare money "in savings" be loaned out to pay for other programs.² FactCheck explains:

"What happens in government accounting is that after Treasury issues a bond that it will have to pay later, it can spend the money it received on other things. And it often does, whether that’s coverage expansion, as called for in the health care law, or any number of things. The Romney spokesman said it was “a shell game.”"

But that doesn’t mean that the Medicare trust fund will be slashed or its “piggy bank” “robbed” or “raided,” or any other claim we’d put firmly in the category of “senior scare.” (emphasis mine)

Romney does have a point in essentially calling this an accounting trick. And he could spend time making that claim instead of a demonstrably false one. You can argue over whether or not the CBO was therefore wrong to say the ACA cuts the deficit (see Update 8/28/12). But you cannot say payroll taxes are going toward the ACA anymore than you can say your personal savings in the bank are going toward someone else's loan. Just like those savings are still legally yours, so are the trust funds still legally Medicare's. Any money that is borrowed from the fund has to be paid back. The Romney campaign knows this and it is reasonable to assume Ryan does as well. So he knows payroll taxes will not fund the ACA, yet he still makes that claim. It is a lie.

¹ Most of what the IPAB targets is the extra money paid into Medicare Advantage (Part C,except for hospital insurance), making costs from the expensive program fall into line with traditional Medicare. You can argue this will indirectly affect benefits, but the program is forbidden from directly cutting benefits. Romney and Ryan, on the other hand, give congress practically unlimited power to save money however they desire, including through benefits (and we all trust congress, don't we). As Ezra Klein and others have repeatedly noted, ObamaCare and Ryan's plan call for approximately the same-sized reductions in future medicare growth. The difference is in how it is implemented. Without a doubt though, Romney's plan to avoid the $716 in slowed growth is the worst. It will actually hasten insolvency.


Update 8/28/12:

For the last few weeks, the Washington Post Fact Checker has been on vacation. So he as not been posting fact checks on this issue since the Ryan VP pick. Today he finally posted a response to readers' questions on Medicare Cuts, bankruptcy, and cost shifting. Overall, the post was not all that impressive compared to FactCheck's posts. However, he did link to an old article talking about the "double counting" issue mentioned above. This article is another absolute must read for anyone interested in this issue. It turns out double counting has been an acceptable practice for both parties for the last few decades. That's right, Republicans use this as well:

"When President Bill Clinton signed the Balanced Budget Act of 1997, then House Speaker Newt Gingrich (R-Ga.) was one of the speakers. “On Medicare, we came together and we saved the system for at least a decade,” he declared. How could he make this claim? Through the same double-counting that Republican now decry. The

Fact Checker especially frowns on hypocrisy, and Republicans should acknowledge that they have gladly played this game before, including under President George W. Bush." (emphasis mine)

However, playing the "you did it too" game is not a good excuse for doing something potentially harmful. But it does turn out this practice isn't really that bad, since it increases gross debt without increasing public debt. The Fact Checker explains:

"Some argue that the increase in the gross debt is evidence of double-counting but the CBO has said that focusing on the health care law’s impact on the gross debt is not very illuminating: “That measure of debt conveys little information about the federal government’s future financial burdens and has little economic meaning.” (emphasis mine)

This may explain why the Romney campaign has avoided this line of argument and instead chosen a demonstrably false line of argument. He would be open to criticisms that both parties do this and could put the reputation Reputation of congressional Republicans in 1997 in jeopardy. It is much easier to tell a simple lie.

Note: Just to head off a potential criticism, Ryan cannot say that he was talking about Medicare funds being loaned Obamacare when he said payroll taxes were being used to fund Obamacare. If he had meant it in this way, he would have to admit payroll taxes also fund national defense, congressional pay, the war on drugs, and most any program funded by congress through general revenue. However, his statement started by claiming that payroll taxes only fund Medicare and Social Security. So either way, he was lying.

² I reworded this to make it clearer. It used to say "However, as with any "savings account", that money is available for other uses when it's not being spent"

³ I added the qualifier in parenthesis to make it clear that this money can still be loaned out, even if it still belongs to the trust fund. It has to be paid back.

The Roundup

Best Thing to Happen to The Internet Since Al Gore! ... Here is a cat singing the theme from Game of Thrones (Thanks to The Washington Post):

Yet another reason to subscribe to Ezra Klein's RSS...

Steven Novella: Nocebo Nonsense

"Chopra’s article was inspired by a New York Times article by researchers into nocebo effects. The researchers, however, make very different points from Chopra. They review the scientific evidence, which is pretty clear. People will report negative side effects even when taking placebos. If they are warned about a particular side effect, they are more likely to report that one. Again – there is no reason to think this is anything other than subjective reporting. Stress is the one factor that can cause real physiological consequences, and therefore illnesses that significantly respond to stress (like heart disease) can be affected by anxiety or hopefulness. This is not true, however, of most diseases." (emhpasis mine)

The Solyndra Standard
A MUST READ on the GOP's hypocrisy in the Solyndra case. Stephen Lacey puts the case in context:

"And here’s the really astonishing disconnect: While supporting tens of thousands of jobs, the loan guarantee program is expected to cost $2 billion less than Congress budgeted for, according to an analysis from Herb Allison, John McCain’s former National Finance Chairman.

Meanwhile, amidst the Solyndra saga, we casually accept a $300 million aircraft failure without batting an eye. No outrage. No sustained political campaign. It’s just another day testing our military toys.

Why? Because we don’t often see programs like this as a “failure” in the political arena. We would never use one failure as an excuse to abandon investment in new technologies. Most politicians accept losses in military R&D expenditures because the long-term gains are potentially so important for national defense and for eventually developing technologies for civilian use.

We should always strive to make programs as efficient and cost-effective as possible. But a few bankrupt clean energy companies representing a fraction of the program’s budgeted cost is no excuse for abandoning federal investments in clean energy — a strategically important sector that is becoming one of the largest drivers of business this century." (emphasis mine)

Will the Fed’s efforts to boost the economy only benefit the wealthiest?
Thanks to the inaction of congress, quantitative easing may be one of the last options to help stimulate the economy. It effectively lowers the value of debt using inflation, which could help tackle the crippling deleveraging that is keeping consumer demand down and slowing the recovery (particularly in the housing market). But there is a price. That price is increased income inequality.

Great hyperinflation episodes in history — and what they tell us about the Fed
A MUST READ:
A look at historical cases of hyperinflation point to why it is absurd to suggest it will happen in the US any time soon:

"none of the most severe instances of hyperinflation appear to be triggered by a central bank simply trying to inject money into a basically intact economy in order to reduce the unemployment rate." (emphasis mine)

Conservative Group Plans to Push Republicans Toward Action on Climate, Cleaner Energy

"Leading members of the Christian Coalition and the Young Republicans on Monday will launch nationwide the Young Conservatives for Energy Reform, a grassroots group aimed at engaging Republicans on the goals of cutting oil use, backing alternative energy and clean-air regulations, and fighting climate change."

Can these groups pull the GOP away from the propaganda of the fossil fuel industry?

The politics and philosophy of racism
Two points:

1. Turns out racists aren't necessarily more likely to be republican than democrat. 
2.  Libertarianism will not sure racism for essentially the same reason free markets work: individual cases of racism are "spontaneous orders—of phenomena that are the product of human action, but not of human design" 

2013 may be the year of Austerity. Isn't that what the GOP wanted so badly back in 2010?

Poll: Republicans Really Aren't Big Fans of Arabs or Muslims

Brutal Attack On Palestinian Met With Near-Universal Rebuke among Israelis

On the Progressive Consumption Tax and What it means for people like Romney.

Very good story about the debate over the minimum wage.

Quote of the Day: Early Voting a Bad Idea Because it Makes it Easier for Blacks to Vote

NPR debunks the myth of the "independent voter".

Healthcare for Freedom Lovers

Socialized healthcare in the Heritage Foundation's Index of Economic Freedom Top 10.

Amidst the abundant rhetoric surrounding the passage of the Affordable Care Act, one message seems to be incredibly popular among those on the right, socialized healthcare is unsustainable socialism. Indeed this idea is not new. Ronald Reagan once claimed socialized medicine was a "short step to all the rest of socialism." The bottom line is simple: If America wants to continue being a free nation, it must reject the idea of socialized healthcare.

Yet today, nearly all wealthy nations provide some form of socialized healthcare. Are all these countries on their way to socialism? Are they even close? To answer this question, I decided to take a look at the top countries on the conservative Heritage Foundation's 2012 Index of Economic Freedom. The United States currently ranks number 10. It has fluctuated since the creation of the index in 1995, once achieving a rank as high as 4. At least some of this fall has been attributed to the ACA:

"A 2010 health care bill that greatly expanded the central government’s reach has been under challenge in the courts"

Naturally, since the United States was dinged for government involvement in healthcare (its socialized healthcare program), I was curious just how the 9 countries above fared on the issue of government involvement in the healthcare system. 

Indeed every country listed in the top 10 contains some form of socialized medicine (except for the United States, until recently). However, their methods of implementation are different. Singapore has compulsory savings and price controls resulting in a largely private system. Canada has a hybrid system of public and private insurance and hospitals. New Zealand is almost completely public. One of the best ways to gauge government involvement in healthcare is to find out just how much of the total healthcare spending in a given country comes from the government: 

1. Hong Kong:¹ The overwhelming majority of Hospitals in Hong Kong are public, managed by the Hospital Authority. In 2007, the government accounted for 49.9% of all healthcare spending.
2. Singapore: In 2010, the government accounted for 36.3% of all healthcare spending. Since 1995, this number has been as low as 29.8 in 2007 and as high as 54.1 in 1998.
3. Australia: In 2010, the government accounted for 68% of all healthcare spending. This number has stayed fairly constant, never dipping below 65% GDP since 1995.
4. New Zealand: In 2010 the government accounted for 83.2% of all healthcare spending.This number has stayed fairly constant, never dipping below 77% GDP since 1995.
5. Switzerland: In 2010 the government accounted for 59% of all healthcare spending. This number has stayed fairly constant, never dipping below 53% GDP since 1995.
6. Canada: In 2010 the government accounted for 70.5% of all healthcare spending. This number has stayed fairly constant, never dipping below 69% GDP since 1995.
7. Chile: In 2010 the government accounted for 48.2% of all healthcare spending. Since 1995, this number has been as low as 36.6 in 1996. 2010 is the highest year since then.
8. Mauritius: In 2010 the government accounted for 41.7% of all healthcare spending. Since 1995, this number has been as low as 33.9 in 2007 and as high as 54.7 in 1995, 1998, and 2004.
9. Ireland: In 2010 the government accounted for 69.2% of all healthcare spending. That year was the lowest on record. Between the years of 1995 and 2009, this number has been as low as 71.5% in 1996 and as high as 77.4 in 2004.
10. United States: In 2010 the government accounted for 53.1% of all healthcare spending. That year was the highest on record. Between the years of 1995 and 2010, this number has been as low as 43.1% in 1999 and as high as 47.7% in 2004. In addition, separate estimates predict a 3.8 percentage point increase² by 2015 as a result of the ACA and future Medicare beneficiaries.  

¹ I could not find the standard WHO format statistics on healthcare spending for Hong Kong. I instead used an available WHO profile with data from 2007. 

² Remember that all these numbers are statistics and are thus subject to a margin of error. As a result, some estimates are going to be slightly different from others. The 3.8 percentage point number comes from a study with slightly different estimates for government healthcare contributions.

And which of these countries appeared to have been dinged by Heritage Foundation for having too much government involvement in healthcare? Other than the US, just two: Singapore and Canada. Nothing on Australia, New Zealand, Switzerland, or Ireland, four countries where the government contributed significantly more to healthcare than the US. Nothing on Hong Kong or Chile either, two countries that contributed approximately the same amount as the US to healthcare. In fact, the country with the lowest government contribution to healthcare was one of the few dinged for it.

Of the 9 countries that ranked above the United States, only two countries' governments contributed significantly less to healthcare than the US. And of the countries that contributed as much or more, only one was dinged for that fact. So it sounds like the government's role in healthcare is much less a factor for measuring freedom than many conservatives like to imagine. In general, this index is very subjective in nature (is the recent excess in government spending really a sign of a lack of freedom, or the automatic reaction to the recession that was a product of pre-existing programs), so there is only so much that one can conclude from this analysis. However, there is one thing that can be concluded: Socialized healthcare does not keep these countries from being free, even in the eyes of conservatives. So why can't they say the same for the United States?

UPDATE 1/12/2013: Think Progress expands on this a bit.

Debunking Romney (Part 3): Medicare Claims

This post is part three of a three part series debunking a few central claims that have been made by the Romney campaign this year. The first part deals with Romnay's tax policies, the recent Tax Policy Center study, and Romney's response to that study. The second part deals with the white paper Romney's advisers wrote to attempt to justify his plan. Finally, the third part deals with Romney's recent Medicare claims, as well as his impossible promises on the subject. 


From Ezra Klein of The Washington Post:

I’ve got a modest proposal: You’re not allowed to demand a “serious conversation” over Medicare unless you can answer these three questions:

1) Mitt Romney says that “unlike the current president who has cut Medicare funding by $700 billion. We will preserve and protect Medicare.” What happens to those cuts in the Ryan budget?

2) What is the growth rate of Medicare under the Ryan budget?

3) What is the growth rate of Medicare under the Obama budget?

The answers to these questions are, in order, “it keeps them,” “GDP+0.5%,” and “GDP+0.5%.”

Let’s be very clear on what that means: Ryan’s budget — which Romney has endorsed — keeps Obama’s cuts to Medicare, and both Ryan and Obama envision the same long-term spending path for Medicare. The difference between the two campaigns is not in how much they cut Medicare, but in how they cut Medicare.

...

These plans get at the basic disagreement between Democrats and Republicans on Medicare. Democrats believe the best way to reform Medicare is to leave the program intact but vastly strengthen its ability to pay for quality. Republicans believe the best way to reform Medicare is to fracture the system between private plans and traditional Medicare and let competition do its work.

...

But it’s simply a conservative myth that the White House hasn’t put forward a Medicare reform plan. What that line really means is that White House hasn’t put forward some variant of Ryan’s plan, which in many Republican circles, has come to be seen as the only policy change that counts as “entitlement reform.”

But Obama’s plan is, without doubt, far more detailed than anything Romney has put forward, and Republicans are well aware of its existence." (emphasis mine)

Ironically, Romney has attacked Obama for these cuts to Medicare growth. It should be noted that, of all the ways Medicare growth can be cut under Obama's plan, there is one area that is protected: benefits:

"It’s worth noting that there’s one area these cuts don’t touch: Medicare benefits. The Affordable Care Act rolls back payment rates for hospitals and insurers. It does not, however, change the basket of benefits that patients have access to." (emphasis mine)

In the time since this article appeared, Romney has declared he will not keep Obama's cuts to future Medicare growth, despite the fact that these cuts would keep the Medicare trust fund solvent through 2024 (without them, they could lose solvency as soon as 2016). However, this will also make his budget promises practically impossible. Ezra Klein explains:

"Consider what Romney has promised. By 2016, he says federal spending will be below 20 percent of GDP, and at least 4 percent of that will be defense spending. At that point, he will cap federal spending at 20 percent of GDP, meaning it can never rise above that level.

All that’s hard enough. Romney will have to cut federal spending by between $6 and $7 trillion over the next decade to hit those targets. As my colleague Suzy Khimm has detailed, those budget promises already require cuts far in excess of what even Paul Ryan’s budget proposes.

But Ryan’s budget includes more than $700 billion in Medicare cuts over the next decade, Romney’s budget won’t. And Romney promises that there will be no other changes to Social Security or Medicare for those over 55, which means neither program can be cut for the next 10 years. But once you add up Medicare, Social Security and defense and you’ve got more than half of the federal budget. So Romney is going to make the largest spending cuts in history while protecting or increasing spending on more than half of the budget."

...

"Consider what the Romney campaign, then, is saying: If Romney is elected, then by his third year in office, every single federal program that is not Medicare, Social Security, or defense, will be cut, on average, by 40 percent. That means Medicaid, infrastructure, education, food safety, road safety, the postal service, basic research, foreign aid, housing subsidies, food stamps, the Census, Pell grants, the Patent and Trademark Office, the FDA — all of it has to be cut by, on average, 40 percent. If Romney tried to protect any particular priority, it would mean all the others have to be cut by more than 40 percent.

That’s not even remotely plausible. The consequences would be catastrophic. The outcry would be deafening. And Romney has shown no stomach for selling such severe cuts.

...

And yet Romney, who has never released the specific cuts that would make his numbers add up, repeatedly touts it on the campaign trail, and the media dutifully reports his promises to cut federal spending by more than $500 billion in 2016, and in fact to balance the budget by the end of his second term, which would require far larger cuts than what I’ve outlined here, despite the fact that everyone basically knows these cuts aren’t credible and will never happen.

I’m not sure what alternative there is, exactly, except to say, as clearly as possible, Romney’s budget plan is a fantasy, and it will never happen." (emphasis mine)

But what about Ryan's plan. Isn't it supposed to be a bipartisan option? To answer this question, Ezra Klein interviewed Sen. Wyden (D-OR), then man for whom the "bipartisan" label is referring to:

"Ron Wyden: My view is that the policies that were adopted by the Republican House majority and the Romney campaign do not preserve the Medicare guarantee. And that’s what the [Ryan/Wyden] white paper was all about. It was a set of options for improving on the existing Medicare system with public and private choices, beefing up consumer protection, adopting a new way to control costs and put Medicare on a budget so you can protect the guarantee.

Probably the two most significant specific differences between what Governor Romney is talking about and the white paper is, first, that the Romney campaign and the governor would repeal the Affordable Care Act. To lay a foundation for putting together a program to protect the guarantee and protect the budget, you need the changes the Affordable Care Act makes to Medicare, like bundled payments and moving the system towards pay-for-quality. Without it, you can’t move to premium support.

The second difference is that the Romney approach completely pulls the rug out from under the poorest and most vulnerable seniors. In the white paper, protections for so-called dual eligibles, the people in both Medicare and Medicaid, are bulletproof. There’s no way to throw them under the bus. Gov. Romney says he’d block grant the Medicaid program and push those cuts onto the people, which would do enormous harm to those people whose protection was at the center of the white paper." (emphasis mine)

Indeed there has been little attention to Ryan's proposals for cutting government healthcare spending outside of Medicare. And these cuts are no small thing. For instance, Sen Wyden mentions Ryan's Medicaid cuts, which total $800 Billion. Of course there will be impacts:

"The Urban Institute estimates that between 14 million and 27 million people would lose coverage because of Ryan's spending restrictions."

No wonder this plan isn't really bipartisan. So you have the presidential candidate passing off a nearly impossible solution as serious budget talk, and you have his VP proposing draconian right wing measures and calling them bipartisan. Both are accusing Obama of having no plan for Medicare reform, yet Obama has the most serious and detailed plan of all three. And then they attack him for the plan they claim he does not have! What is going on?! Some conservative pundits actually possess the cognitive dissonance to buy into this. But will the American people?

The Roundup: 

Mediscare Edition

Private-Market Tooth Fairy Can’t Cut Medicare Cost

"The bottom line is that, if anything, Medicare Advantage bids are above, not below, traditional Medicare -- once you do the analysis correctly, on an apples-to-apples basis. So regardless of whether you use the CBO analysis of Ryan 1.0, or the evidence to date with Medicare Advantage to analyze Ryan 2.0, the conclusion is the same.

We don’t want to put all our chips down on the health-care competition tooth fairy."

And yes, he notes that the CBO analysis is of Ryans 2011 plan:

"I focused on the 2011 plan because that is the only one that CBO has evaluated in terms of total, not just federal, cost.

The difference in the new version of the Ryan plan is that traditional Medicare would coexist with private plans. To suggest that this would change everything is to make an odd argument: Moving entirely to private competition would not generate big savings, but moving partially would."

The Morning Plum: Romney and Ryan muddy the Medicare waters
Great read!
Greg Sargent goes over the various back and forth blows from the Obama and Romney campaign. Both campaigns think they will carry the medicare message. However, Democrats may need to explain whats really going on here between both campaigns' plans for Medicare:

"The difference is not over whether to do something about Medicare over the long haul; it’s over how to do it. The true nature of this difference is what Romney’s strategy is designed to obscure" (emphasis mine)

Paul Ryan and the Problem With Competitive Bidding

"Private corporations all rely on competitive bidding, and it just hasn't done much to hold down costs. That's because the real source of America's high medical costs is the fact that we simply pay more than other countries for everything we get: more for doctors, more for procedures, more for hospital stays, more for drugs, and — yes — more for insurance. If you really want to hold down costs, you have to hold down costs at the source, and Paul Ryan's Medicare plan has no mechanisms for doing this. It relies solely on competitive bidding, and there's very little chance that this alone can keep Medicare costs from outpacing his "fallback" growth cap. It's a near certainty that his growth cap will be the real mechanism for reining in costs."

PolitiFact: Do Mitt Romney and Paul Ryan want to turn Medicare into a voucher program?
After bitching about the 2011 lie of the year, democrats are finally getting it together and making accurate statements about Ryan's Medicare plan:

We agree that in the world of policy wonks, there are distinctions between "vouchers" and "premium support," having to do with the type of inflation adjustment used and the degree of marketplace regulation imposed. Compared with his original plan, Ryan’s most recent plan does move closer to fitting the definition of pure premium support. But substantively, it’s still somewhere in between the two approaches.

But the Romney-Ryan approach pretty much matches the dictionary definition of "a form or check indicating a credit against future purchases or expenditures." We think that describes the general way Ryan's plan would work. For a political discussion aimed at voters rather than policy wonks, we think Obama’s use of the term "voucher" is close enough to earn it a rating of Mostly True. (emphasis mine)

David Frum: Paul Ryan Declares Generational War
Paul Ryan's criticism of Obamacare and the $700 billion in Medicare savings essentially amounts to a generational war:

"The talking point isn't even about changing Medicare, its about keeping the entitlements for the old, and not spending any of that money on the young. You could title this speech: Entitlements for Me, Not for Thee. Spending money on 'deserving' old people is good, spending on anyone else is a waste."

PolitiFact: Ryan's plan includes $700 billion in Medicare "cuts," says Stephanie Cutter

"Cutter said that Romney attacked Obama for cutting $700 billion out of Medicare, but "Paul Ryan protected those cuts in his budget." Again, with this item we are not addressing whether they are cuts, but simply whether she is correctly characterizing Ryan's plan.

Cutter is correct that the Ryan budget plan included cost savings that were part of the future health care law. Just recently, the Romney campaign backed away from that play, saying Romney’s plan would restore the spending that the health law is set to curtail, such as extra funding for private insurers under the Medicare Advantage plan." (emphasis mine)

As PolitiFact has noted before, these are not technically cuts. The reason they assigned a "true" rating is because it is of no consequence to cutter's speech. Cutter is essentially saying that what people are protesting in the Obama law, these "cuts," are preserved in the Ryan plan. So they should not criticize Obama for it without also criticizing Ryan.

Romney's Health Care Plan Freaks Out Utah Republicans

"When asked what they thought should be done to fix health care, Love and McCain offered up an unintentional endorsement of some of the very laws that they've been campaigning angrily against for the past two years, Obamacare and the federal stimulus package." (emphasis mine)

Mitt Romney: Paul Ryan Medicare Plan And Mine Are The Same, 'If Not Identical' 

A possible unintended consequence of the Ryan plan?

Update 8/21/12:

David Cutler: Hey Republicans! Stop Misusing My Medicare Study!
Supporters for the Ryan/Romney Medicare plan misrepresent a study on the effects of premium support healthcare systems.

David Brooks Badly Misrepresents the Romney/Ryan Medicare Plan
 
Update 8/26/12:

Ezra Klein: The problem with Romney’s Medicare chart: It’s not true

"You could take one of two views on this. You could say that Ryan’s and Obama’s plans put Medicare on a sustainable fiscal path, while Romney’s doesn’t, because that’s pretty much what the CBO will say, and they’re the folks who judge these things. Or you could say that none of the plans really make Medicare solvent — that they’re all just theory and prayer. What you can’t say is that Romney has released a plan that makes Medicare solvent." (emphasis mine)

Post ObamaCare Ruling Roundup

Some good reads on the recent decision by SCOTUS to uphold almost all of the Patient Protection and Affordable Care Act:

Update 7/12/12

Why Won’t Obama Sell His Health-Care Plan Now That It’s Been Upheld?

A new Washington Post/ABC News poll shows that the legislation is now viewed less negatively than it was before the court ruling, with 47 percent supporting the law and 47 percent opposing it. In April only 39 percent backed the Affordable Care Act while 53 percent opposed it, suggesting that voters are beginning to connect the dots of positive health-care benefits—such as keeping adult children on their policy until age 26—with the new law.(emphasis mine)

I really like the idea for a new ad:

"Simplicity is the key, says Melody Miller, Ted Kennedy’s spokeswoman for much of his long crusade for health-care reform. She proposes an ad with two hands, one that ticks off finger by finger five reasons to support the law; the other a fist that unfolds to reveal “Obamacare, health-care security for all,” written on the palm. “The truth” about Obamacare, says a narrator:

• (1) can’t be denied coverage for preexisting conditions; 

• (2) no cap, you won’t get cut off or lose your home if you have costly medical bills; 

• (3) reduces the deficit, according to the nonpartisan Congressional Budget Office; 

• (4) you can keep children on until age 26; 

• (5) you can keep your own doctor and choose your own coverage from a variety of plans, just like members of Congress."

Attempting to explicitly debunk the many many outrageous falsehoods (and outright lies) spread by the GOP about ObamaCare may be too complicated and ultimately put Democrats on the defensive. A simple attractive commercial like this can both introduce people to the benefits of ObamaCare and implicitly debunk some of those GOP-created falsehoods.

Many Americans still don't know what's in new health law

Americans are still highly misinformed about what is in the healthcare law.

WP Fact Checker: "The health law, if it works as the nonpartisan government analysts expect, will provide more tax relief than tax burden for middle-income Americans."

GOP Health Care Plan Is Still a Dud

Again, tort reform will not significantly decrease healthcare costs.

Original Post

Greg Largent: Republicans support Obama’s health reforms — as long as his name isn’t on them

The new Reuters-Ipsos poll finds that Obamacare remains deeply unpopular; 56 percent of Americans oppose the law, versus only 44 percent who favor it. The poll also finds that strong majorities of Americans favor the individual provisions in the law -- the hated individual mandate excepted, of course. What’s particularly interesting about this poll is that solid majorities of Republicans favor most of the law’s main provisions, too.(emphasis mine)

The One-Sided War Against Obamacare

In all, about $235 million has been spent on ads attacking the law since its passage in March 2010...

By contrast, only $69 million has been spent on pro-Obamacare ads, most of it bland public-service spots from HHS. Add to that the fact that most Democrats seem petrified of actually defending the law, and it's no surprise that the Fox News portrayal of Obamacare has been steadily gaining ground. That's what happens when you slink into a corner when the other guys declare war.(emphasis mine)

WP Fact Checker: Sarah Palin, ‘Death Panels’ and ‘Obamacare’

 Palin is seizing on a completely different entity to justify her provocative use of the phrase “death panel” three years ago. But the IPAB in no way resembles the “death panel” that she claims would decide whether her parents or her baby with Down Syndrome are worthy of care. Instead, it is a tool—subject to oversight and approval by Congress—to try to rein in the soaring cost of Medicare.

Did Scalia Scare Off Roberts?

"Any objective legal observer would tell you (and I'm trying to be one here) that the dissent's treatment of the severability issue is detached from 200 years of constitutional law. It's unsupported legally and it's a mess logically. It also includes a citation to a quote that Harry Reid gave to the New York Times in Janauary 2010 concerning the bill --- this from at least two justices (Scalia and Thomas) who routinely say that any use of legislative history is a sham because it's necessarily incomplete. One wonders what a quote not uttered on the floor of Congress but to a journalist would constitute in that case? In any event, rather than holding the mandate costitutional and those portions of the bill inextricably linked with it (guaranteed issue/community rating), four members of the Court were primed to throw the whole bill out. That level of judicial activism, in a context like this one, would be nearly unprecedented."(emphasis mine)

The GOP has once again chosen two mutually exclusive complaints about ObamaCare.


"Well, the Supreme Court said today that the health care mandate is ok.  I am no constitutional scholar, but from what I can tell from the news reports, the Court's logic is similar to mine in this old blog post." - Greg Mankiw, Advisor to Mitt Romney

Politifact: Limbaugh, GOP have it wrong: Health care law is not the largest tax increase ever

 

 

Politifact: Fact-checking claims about the individual mandate

 

 "The vague claim of cutbacks in Medicare forcing patients off dialysis is not connected to any reported event in Tennessee or anywhere else in the real-world United States."

 

 Scalia shows how conservatives have completely reversed themselves on the concept of judicial restraint.

FactCheck:Romney, Obama Uphold Health Care Falsehoods