Why not defund Medicare Part D instead?

[Recursion]

I'm straw polling my conservative friends on this via Facebook, and this seems to have a little traction.

When all is said and done with this fiasco, conservatives are going to need a scalp. If they don't get one, they'll make one up. Nothing is wrong with just having them make one up, of course, but then there's Medicare Part D.

To liberals, it's a giant giveaway to drug companies that uses government money but refuses to use government purchasing power to use that money sensibly. To conservatives, it's an embarrassing reminder of how they got duped by Rove and company into expanding rather than decreasing entitlement spending.

Like the ACA it's a Federal intervention into healthcare. Unlike the ACA, it increases the deficit over the next decade. Repealing it would be one of those rare things that lets both parties shore up their outside flank a little bit, and scores well with CBO.

[Gravitycollapse]

1. So your genius plan is to take away prescription coverage for 30 million Americans?

[Recursion]

8. Insurance is not health care

I've been told that a million times here.

[Gravitycollapse]

9. Whoever believes that is a fool. When costs are prohibitive, denial of payment is denial of service.

[Hoyt]

13. Exactly. Access to insurance, or outright poverty (essentially Medicaid), is all but required

for anything but minor conditions that resolve themselves or we learn to live with (opposed to die with).

[Warren Stupidity]

2. Oh that's a great idea. How about we just concede 2014 now instead?

What is with people on our side thinking we have to cut existing programs? How about increasing benefits? Huh?

[leftstreet]

3. Why not just defund Medicare? n/t

[BlueCheese]

4. I think the two plans are rather similar.

Both of them use government money to help people buy health insurance/care from private companies. This isn't surprising, since they both came from center-right principles.

The funny thing is Democrats were overwhelmingly opposed to Medicare Part D but overwhelmingly in favor of the ACA, while Republicans were the opposite, almost as if whoever gets the credit is more important than the actual content.

[Recursion]

10. Also interestingly...

... Medicare D does it through an explicit tax (which is generally the liberal preference) and ACA does it through a tax code provision to incent a private purchase (which is generally the conservative preference).

Are we through the looking glass yet?

[FarCenter]

12. The individual can choose not to buy and be covered by Medicare Part D

You are encouraged to buy, even if you aren't on prescription drugs, because if you do not carry Part D coverage until you need prescription drugs, there is a "late signup" penalty, which can be pretty stiff.

However, there is no annual penalty for not buying Part D.

So the way that Part D is made "mandatory" is quite different than Obamacare.

[Recursion]

14. No, the "penalty" is that you're paying for the subsidies whatever you do

Part D takes money from the general fund, which means you're paying for it. That was also the hook that got states into Medicaid: you're paying for it anyways, you might as well benefit from it. In both cases, there are still costs to participate, but even if you refuse your money is still going to it.

And that's what I'm getting at. Part D was (badly) implemented by Republicans along usual Democratic lines of collective payment as an inducement for participation. ACA was (possibly badly?) implemented by Democrats along the usual Republican lines of using tax policy to give people an incentive to behave in a particular way we want.

This kind of just struck me so I'm still not sure where to go with it.

[Hoyt]

5. This is one liberal who gives credit to bush for two things, not obstructing Part D and

dodging shoes. I paid for my mom's drugs before 2003, and can't imagine how she and other elderly managed.

However, I do agree there should have been tougher negotiating power in the legislation.

[ProSense]

7. That was the biggest flaw and scam with Medicare Part D

It prohibits the government from negotiating drug prices.

[ProSense]

6. Better idea:

have the Government negotiate drug prices.

The health care law increased the Medicaid drug rebate percentage to 23.1 percent.

http://www.medicaid.gov/AffordableCareAct/Timeline/Timeline.html

The President has proposed the same rate for Medicare (http://www.democraticunderground.com/10022670043 ), which would save even more than the Senate proposal (http://www.democraticunderground.com/10022725266), $164 billion to $141 billion, respectively.

[pnwmom]

11. No. No scalps for them AT ALL. They must be totally humiliated by this

or they will just try it again next time.