Tuesday, December 11, 2012

Fwd: qotd: Means testing Medicare

Quote-of-the-day mailing list

-------- Original Message --------
Subject: qotd: Means testing Medicare
Date: Tue, 11 Dec 2012 12:20:28 -0800
From: Don McCanne <don@mccanne.org>
To: Quote-of-the-Day <quote-of-the-day@mccanne.org>

The Hill
December 8, 2012
Democrats warm to Medicare change that late Sen. Edward Kennedy opposed
By Elise Viebeck

Democrats in Congress are changing their tune on means testing in
Medicare, an idea the late Sen. Edward Kennedy (D-Mass.) resisted for

Leading Democratic lawmakers have suggested that raising premiums for
wealthy Medicare beneficiaries could be a matter of common ground with
Republicans in the ongoing deficit-reduction talks.

"I think that is reasonable and certainly consistent with the Democratic
message that those who are better off in our country should be willing
to pay a little more," Senate Majority Whip Dick Durbin (D-Ill.) said

The idea of affluence testing is not new — wealthy Medicare recipients
already pay higher premiums for doctor visits and prescription drug

But negotiations to avoid the so-called "fiscal cliff" open the door to
new measures that would make Medicare costs more progressive based on

Last week, Senate Finance Committee Chairman Max Baucus (D-Mont.) called
the idea "somewhat attractive" as a bargaining chip for talks on the
so-called fiscal cliff.

Sen. Claire McCaskill (D-Mo.) remarked that "Donald Trump may need
medication, but he certainly doesn't need the government to pay for it."

And Congressional Black Caucus Chairman Emanuel Cleaver (D-Mo.) called
means testing a good way to bolster Medicare's budget without cutting

"We already have a substantial amount of means-testing in the Medicare
program — most significantly, there is no cap on the income subject to
the Medicare tax," said (Rep. Henry) Waxman in a statement to The Hill.

"That is the right way to ask the better-off to pay more. And in fact,
we also have means testing now of the Part B and Part D premiums. It is
a mistake to go further."


Comment: Now that health care costs are unbearably high, Medicare must
be progressively financed since moderate- and low-income individuals can
no longer bear the full costs. A major step forward was the removal of
the cap on wages subject to Medicare taxes, so higher income individuals
pay more. The Affordable Care Act also added a new 0.9% Medicare tax for
incomes over $200,000/$250,000.

In addition, in order to help cover Medicaid expansion and subsidies for
the exchange plans, the Affordable Care Act also added a 3.8% tax on
investment income, again for those with incomes over $200,000/$250,000.
So we have already embarked on policies that make health care financing
progressive, though we need to do more, but only on the financing end.

Medicare benefits should be the same for everyone. We should eliminate
premiums and cost sharing, and we should expand benefits so that
administratively wasteful Medigap and retiree health benefit programs
are no longer necessary. Low income individuals should receive the same
standard of care as the wealthy, just as was the intent in enacting the
traditional Medicare program.

Introducing means testing, which we have already begun with Part B and
Part D premiums, reduces support of wealthier beneficiaries who are
annoyed by these additional charges. Once the principle of means testing
is established, the budget hawks ratchet it up, driving wealthier
individuals to look for private options, currently available as the
Medicare Advantage plans. It is only one small additional step to
introduce premium support - vouchers - where the wealthy will take their
money and run. Once you lose support of wealthier individuals who have a
strong political voice, then Medicare will descend down the path toward
becoming a welfare program, like Medicaid.

We cannot allow this bipartisan attack on Medicare to proceed. Mobilize
the forces!

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