Don't Trust The Repuke TRUST Act: It Will Gut Social Security & Medicare On Top Of Leaving 55 Million Without A Covid Lifeline

"True to form, Republicans are trying to gut Social Security and Medicare in the middle of a pandemic. This bill doubles down on using secret, closed-door panels to undo these earned benefits. I will oppose any bill that includes a fast lane to cut Social Security and Medicare."
-----------------------------------------------------------------------

Sen. Ron Wyden's tweet above says it all.

As Jill Schlesinger noted last week when the last jobless numbers came in:

"That extra $600 a week was spent in the economy. So without a new package I think we are going to see the economy flatten out and that would create a really big problem in getting these millions of people back to work."

Let's cut to the chase:  

The Repukes  are trying to use the pandemic to cut  Social Security and Medicare benefits behind closed doors, using a bill with an Orwellian name—the TRUST Act.  The TRUST Act creates a closed-door committee to fast-track cuts to our earned benefits. And now, Sen. Mitt Romney (R-UT) and Sen. Mitch McConnell (R-KY) have put the bill on a fast-track of its own by including it in the Republican Covid-19 package known as the HEALS Act.

These vermin who are plotting to use this public health crisis as a vehicle to ram through cuts to  earned social insurance benefits, are fungal pond scum. The American people will never forget that they used the worst global cataclysm of modern times to try to rob millions of their Social Security and Medicare benefits. 

Most of the politicians pushing this dastardly plan are Republicans. Prominent Democrats are speaking out against it, including Sen. Ron Wyden (D-OR), the ranking member of the Senate Finance Committee and lead Senate negotiator on the relief packages.  He went on to explain:

The TRUST Act will result in far-reaching cuts to Social Security and Medicare—that is the intention of the bill. The legislation sets up closed-door commissions to fast-track the destruction of these programs. In 2010, a similar closed-door commission made cuts to the Cost-of-Living Adjustment (COLA); hiked the retirement age (which is an across-the-board benefit cut for all retirees); changed the Social Security benefit formula to reduce the amount people receive each month; and made cuts to Medicare that forced seniors and individuals with disabilities to pay more for drugs, doctor visits, and hospital care by increasing cost-sharing like co-pays.

The last thing struggling Americans need right now is a secret panel designed to slash their earned benefits and further undermine their economic security. It’s astonishing that attacking Social Security and Medicare are Republicans’ priorities at this moment, not protecting people’s health care or ensuring families can afford to stay in their homes and put food on the table.

Rep. John Larson (D-CT), lifelong champion of Social Security and chair of the Social Security subcommittee, condemned it with the strongest language possible:

This is a direct assault on Social Security benefits. The TRUST Act Commission would make it easier to fast track cuts, while ignoring the urgent needs to strengthen Social Security, especially during this pandemic. This would just kick the can down the road and ignore regular order. It’s Congress’s responsibility to do this correctly and vote! As Chairman Neal points out, we have seen this before with the 2010 Bowles-Simpson report, which proposed major Social Security and Medicare cuts. Instead, what we need to do is enact the Social Security COVID Correction and Equity Act to increase benefits, rather than cut them.

But a small splinter group of Democrats, publicly led by Sen. Kyrsten Sinema (D-AZ), supports the TRUST Act. They are the most reprehensible of all, for giving it bipartisan cover.

It’s not too late for politicians who originally supported the TRUST Act, when it was first introduced in January, to partially redeem themselves. They need to make it clear that even though they supported the bill, they do not support holding the pandemic response package hostage to jam it through behind the American people's backs.

We already know that Mitt Romney and his ilk are  holding personal protective equipment for nurses and doctors hostage so they can cut  Social Security benefits. What Krysten Sinema is doing is holding financial relief for millions of Americans who lost their job through no fault of their own hostage in order to cut Medicare benefits. It is sick, even by the gutter standards of the current reality with a deranged traitor scum as president.

Their justification for including the TRUST Act in the Covid-19 package is telling. They claim that with this coronavirus relief package adding to the deficit, we need the TRUST Act to "rein in the national debt." What they don't mention is that  Social Security doesn't add a single penny to the debt  because it had no creditors.  Even Ronald Reagan understood that!   At the same time Medicare is far more cost-effective than private insurance because it's administrative costs are 10 -15 times lower than private insurance.

This isn't really about the deficit. It's about achieving a long-standing right-wing ideological goal to gut senior Americans'  earned benefits—and using the Covid-19 catastrophe to do it. That's why even AARP, which rarely takes a stance on Social Security legislation, has come out against including the TRUST Act in the next pandemic relief package.

Dems needs to fight like demons to insure no eventual compromise arises which contains this refuse buried inside it, akin to a Trojan horse.

See Also:

Economic Policy | Healthcare Policy | Social Security

Alert! Social Security and Medicare are in Critical Danger

by Dave Lindorff | August 11, 2020 - 5:09am | permalink

And:

Covid-19 | Economic Policy

Forcing People Back to Work in a Pandemic is Both Stupid and Immoral

Seniors "Running Up" Medicare and Social Security Tabs? In Fact, Too Many Risk Going Bankrupt

"Maybe Elizabeth Warren - a Boomer- will finally raise taxes on her generation which is running up the tab on Medicare and Social Security" -  Joseph Sternberg, WSJ, Sept. 13, p. 15A

"Yeah, I'm turning 65 next year.  Can't wait to go broke  trying to make ends meet with Medicare coverage. I worked 40 plus years paying into a system that will - at some point - kill me.  Yes, I can afford supplemental insurance at this point, but sometime in the future I may not be able to because of deteriorating health as I age."- Denver Post letter writer, Nov. 2, 'The Needs Of Our Seniors', p. 3K

It may stun many people to know that Medicare is by no means a "freebie" or entitlement. First, people have paid into it over a life time at the rate of 1.45%  in FICA taxes per paycheck. This is what appears on your W-2 tax form as "Medicare wages". It is that amount deducted from your pay for Medicare. Thus, it is most certainly not "welfare" and I'd even argue that it cannot be called an "entitlement". 

Second, no genuine "entitlement" would require a beneficiary to cover extra expenses like eye glasses and dental - two aspects that cannot be ignored and can come to thousands of dollars a year.  In addition, no entitlement makes increasing claims on one's budget  - as the Denver Post letter writer complained about - in regard to having to buy supplemental insurance. 

To fix ideas, my Medicare Part B supplemental (Part  B) insurance premium has just gone up to $144 a month.  This is in addition to my private supplemental insurance (which covers hospital procedures and tests Medicare B doesn't) which has now gone up another $30 a month to $273 a month. or $3,276 /yr.  At the same time Janice's private supplemental insurance has similarly gone up to $250/ month. So the total for both of for a year, with just supplemental insurance costs alone is now $5,004 + $4,728 =  $9, 732 for next year.  The Medicare supplemental insurance is offset by increasing the Social Security monthly payments in tandem, but all that means is that there is negligible benefit from any Social Security cost of living (COLA) increase, see e.g.

The Social Security cost-of-living increase is a cruel fraud ...

 

And:

The Mythical Social Security Cost Of Living Increa...


It is clear then, as the LA Times report notes, that current cost of living increases to Social Security are simply "cruel frauds" - i.e. if they can be wiped out with a simple offset.  "Here you go, sir, your Social Security increase for the new year....But...your Medicare supplemental (Part B) is being increased too - just  that amount -  so will be deducted from your COLA to pay for it!"

Lastly, one needs to enroll in a Medicare Prescription Drug Plan (Part D),  critical since you only get one shot getting lower cost access to prescription drugs. Even if you're not currently on any drugs per se, counselors assure you that the best bet is to at least sign into one, in case you have to rely on a prescription (say for blood pressure) later.  Right now I am on a blood pressure med (amlodipine besylate) and a statin (prevastatin) both of which I need to control a tendency to malignant high blood pressure, plus control the condition of hyperlipidemia - the tendency to collect too much fat in blood and liver.  

Fortunately, I can get both as generics so keep the total drug costs down to about $15 a month.  But at the same time, the plan provider (Humana) has now announced  the third monthly annual premium increase in a row - from what used to be ($18 / month), to now $60 a month.  Hence, the monthly premium is now four times what I pay for the actual meds. For Janice the factor is a bit smaller as she takes more meds, but the monthly increase is no less painful. So for prescription drugs alone we are talking about another $1,440 a year.  

Added to the cost of supplemental insurance - and leaving out the Medicare supplemental because it's offset by deduction from the Social Security COLA - that comes to: $7, 716 total.   But this doesn't include any dental or glasses etc. which easily adds another $2, 500 a year for both of us. That makes a grand total of $7,716 +  $2,500 =  $10, 216 a year in premiums and procedures etc. not covered by Medicare.  I show all this to also indicate what costs would be like for anyone who "buys into" Medicare.

Clearly, such proposals on offer from one or more Dem candidates need to be put into realistic perspective that people aren't just going to buy into the program and get a freebie. Not any more than those of us already in the Medicare program.  It can't be otherwise.  As for the 'Medicare for all' pipedream which claims all premiums can be wiped out for millions,  I will believe that when I see it. 

Adding up all these  Medicare -related costs up it is clear Joseph Sternberg (top quote) is talking twaddle when he claims seniors are "running up the tab".  In fact, the tab is being run up on us (including via the Medicare Advantage program which is bleeding traditional Medicare into insolvency.  All one need do is run the numbers to see, in fact,  that Medicare as we now know it fails to work for many retirees, leaving them in danger of going bankrupt.   The corporo-media tends to give that short shrift.  

Point of fact: . A study published this year by Gallup and West Health, a research organization dedicated to lowering health care costs, showed that people over 65 had withdrawn an estimated $22 billion from long-term savings accounts in the previous year to pay for health expenses Medicare didn’t cover.  This is why T. Rowe Price and other investment centers emphasize a retiree today needs at least $250k saved just to cover medical expenses.

Few may recall that Medicare Advantage is the privatized spawn of the  "Medicare Modernization Act" that Billy Tauzin and his Reepo criminal congress forced through back in 2003 - to the cheers of Big PhRMA.  It was no wonder that soon after it passed, Goldman Sachs estimated the benefit to PhRMA ( in terms of corporate welfare), would be over $13.7 b over ten years. It's probably even more now.

Indeed, another vile aspect of the 2003 law was that it barred Medicare from negotiating for lower drug prices like the VA does. The law actually left the negotiating to private insurance companies and pharmacy benefit managers. The very existence of this refuse denied Medicare the ability to drive down prices - and indeed control prices. 

But then many of us at the time suspected the Bushies were behind this recklessly expensive, bogus law as a means to rush Medicare toward insolvency - the better to privatize it. They even embedded a Trojan horse in the law called "Medicare Advantage" which is now spending $12b a year more than traditional Medicare.

Moreover, our money is daily being pilfered, "borrowed" from the Social Security Trust Fund to pay for military -defense spending, as well as other national budgetary incidentals.  The total now owed is estimated at $3.4 trillion.  So it is outrageous that Sternberg could even suggest higher taxes on Social Security beneficiaries.    But this is the skewed political landscape we inhabit now. 

 It's no surprise Sternberg would try to make a specious case to tax Medicare and Social Security given the 207 GOP tax cuts have sent deficits soaring.  So the Reep defenders want some way of replenishing the revenue lost by the reckless tax cuts. But no one with even  a normal intelligence is biting. 


See also:

10 Reasons Medicare Advantage Plans Will Never Meet Our Needs

Healthcare Policy | Insurance

http://www.smirkingchimp.com/thread/diane-archer/81747/10-reasons-medicare-advantage-plans-will-never-meet-our-needs


And:

Social Security

Dean Baker

Article Tools E-mail | Print Comments (0)

Social Security

A Bold Plan to Strengthen and Improve Social Security Is What America Needs

Trump-GOP "Miracle" Alternative To Obamacare? - HRAs Or Health Care For The Rich And Healthy

"We need to look at the German health care system!"

The latest scare that health care misers, i.e. conservatives,  are circulating is that all of the current medical "entitlements" will soon become insolvent unless a radical change is made so "medical costs drop".  And what is  the best way to lower medical costs? Well, either by implementing a wider basis for HSAs (health savings accounts, e.g. Scott Atlas, WSJ, June 7 p. A15) or via  HRAs or  'Health Reimbursement Accounts' (Laura Sanders,  WSJ, Exchange, June 21-22).

 In respect of the latter The Wall Street Journal editorial writers are absolutely giddy,  writing ('Trump's Healthy Tax Break',  July 2,  p. A14 ):

"The miracle is that the GOP has managed to find a political winner that doesn't reignite the debate over pre-existing medical conditions.  Republicans should spend time from here to 2020 telling voters that one party is thinking with  ingenuity about how to expand choice - and another is eliminating every option except government run health care."

But it's hardly a case of "ingenuity" when only the richest or at least the upper 3 percent of income earners will be able to afford this miraculous alternative the WSJ and many others tout.

In regard to the former WSJ piece, for example, we're informed by Dr. Scott Atlas (of the Hoover Institution) that "disclosing prices isn't enough" because patients don't care so long as "it's all covered by insurance".  In a sense this is correct, as I learned when I tried to make the case (in a prostate cancer support group) for halting further PSA tests for men in their mid- 70s or beyond. This was based on a UC Berkeley Health notice that found:  "The National Comprehensive Cancer Network recommending routine PSA screening for all but very healthy men with a significant life expectancy, who are most likely to benefit from detection of aggressive tumors."

  The issue being that given over $2 b is spent each year on the initial PSA testing and followup biopsies, other tests (e.g. MRIs), it's a significant chunk of change. Nearly all the respondents, however,  accused me of being a shill for drug or insurance companies.   Some of the blowback:

"What are you a politician running for office? An insurance company agent? I am sick of you guys coming in here and trying to tell us to try to control costs and not to get these tests!"

"I'm in no position to contradict medical science on this, but 70-75 seems a bit young. Yes, it leaves a "life expectancy" of 10 years (in 2018, living in the U.S., given today's technology), but healthy people with good genes and healthy  lifestyles routinely live well into their 90 "

Of course, the latter guy's claim is wrong as it's now been learned that barely 7 % of longevity is accounted for by "good genes".  Anyway,  they were going to get their tests come hell or high water, even if it meant ultimately leading to draconian treatments.  Usually ADT or androgen deprivation therapy- for which recent stats show more patients die from heart attacks (owing to complications from treatment, upsetting the hormone balance) than the cancer.

Where Atlas is right is that under the current systems - including Medicare - the insurance (i.e. supplemental plans) minimize the patient's share of costs. Hence, most advanced prostate cancer patients won't bother to comparison shop given what ever they need (Lupron, Casodex etc.) will be covered anyway.  He has a point in respect of this issue.

Where he is wrong is in claiming that HSAs are the ticket to better medical care for everyone, lower insurance premiums, and better access for all.   To make sure we grasp these entities, they are savings vehicles in which the person sets aside money tax-free for health expenses.  Atlas' argument is that patients will be more careful in how they use health care if they have to use their own dollars.  Else, if insurance companies are the providers, the "consequences are inflated prices, overuse of health care and unrestrained spending."

The problem with his argument is that even most middle class people in this country can't save enough to have viable HSAs.  The proof? The Federal Reserve's recent economic survey and analysis which found that up to 40 percent of the putative middle class is unable to save even $400 for an emergency.  Raise the amount to $1,000 and the proportion translates to a majority (65%) of citizens.

So let's say a guy gets prostate cancer and needs surgery or radiation therapy. We are looking at an amount in the range from $60,000 - $85,000 to be paid for treatments which means the HSA must have that kind of money to use it.  Clearly most middle class folks newly diagnosed with this cancer will be out of luck. They simply won't have the money to cover the expenses of care unless they're in the upper 1-2 percent.

Now, related to the HSA is the HRA being touted by the WSJ in its editorial yesterday as the GOP miracle alternative to the ACA and any other Dem proposal. The HRA stands for the health reimbursement account. and in many ways is similar to the HSA.  According to the WSJ Exchange piece cited earlier:

"Beginning Jan. 1, 2020, companies can provide employees with tax free dollars can purchase an individual policy rather than offer a group health plan."

Sounds like a bonanza. Is it? Nope.  It's the Trump- GOP' cheapo alternative to the ACA or Obamacare.  Or any single payer permutation, including the public option, the Dems might offer. The employer will give you tax free bucks (maybe $400 a month) and you can then use the money to stash until you need medical care. But what if you're faced with the prostate cancer diagnosis mentioned earlier?  Well, again, you'll be out of luck if those tax free dollars aren't commensurate with the medical treatment costs.  This will be the case if your income is middle class ($50,000- 85,000) as the Fed defines it, or below.

Also, even if you're better off than that, what if employers only raise the HRA payments with inflation (now 2%)?  While we know health care costs typically rise faster than inflation.  For example, the cryotherapy I received in 2017 which cost $55,000 than - according to the CMS Summary sheets- would cost nearly $75,000 now.  That would include the costs of the 3D biopsy, plus the cryo proper and the two anesthesia administrations.

Basically then, what Atlas and the Conservative-Corporate HRA promoters are hawking merely continues a barbaric and regressive health system for most Americans.  When the earlier cited WSJ editorial claims "this is good news for workers" - well, yeah, if those workers are earning $100,000 a year and up!  Or, as the same editorial admits: "the young and wealthy who don't consume many services."  But would any intelligent person really want to roll the dice on that?

Incredibly, it seems to be only nurses who grasp the U.S. health care system is regressive, even at times barbaric and grafting to the point patients consider killing themselves. This as opposed to heaping huge medical bills, debt on their families. Just look at all the Type I diabetics now having to travel to Canada to get their life-saving insulin (say for $100 for a month's supply) instead of shelling out $700-800 a month in the U.S.

Let me, however, agree also that one other area that Atlas is correct is in averring that the "supply of medical providers needs to increase" and vastly!   This is just basic math and common sense, which as I will show in a future post, also underlies the housing shortage and crisis. That is, no one seems to be taking into account the exploding population - which has increased in the U.S. by 45 million since 2001. The number of medical care providers, especially RNs - has not kept pace.

Look, if populations are continually growing that logically  means  sick conditions (as well as serious accidents) and diseases must grow with them. Even the healthiest person following a rigorous diet  can get cancer or be injured in an auto accident - and then what? Go into bankruptcy or massive debt after accessing needed care?  It is evident we need not only a more rational health care system but also more providers (doctors and RNs) to work within it.

In  a recent NY Times account one beheld the vile scope of profit over patient care in full view as told by  the caring RNs that oversee such care.  For example:

"Renelsa Caudill, a Washington, D.C.-area cardiac nurse, remembers being forced to pull a cardiac patient out of the CT scanner before the procedure was complete. The woman had suffered a heart attack earlier that year and was having chest pains. The doctor wanted the scan to help him decide if she needed a potentially risky catheterization, but the woman’s insurance, inexplicably, had refused to cover the test."

And:

"Karla Diederich, also from California, remembers saying a final goodbye to her friend and fellow intensive care nurse Nelly Yap in their hospital’s parking lot. Ms. Yap was dying of metastatic cancer. She was scheduled for another round of chemotherapy, but the hospital had changed owners while she was on sick leave and she’d lost her job — and insurance — as a result. “Nelly spent most of her life taking care of other people,” Ms. Diederich says. “And when she needed that care herself, it was not there.”

Perhaps that’s because they see so much time and money wasted by the bureaucracy of the current system. By most estimates, the administrative costs of American health care surpass those of any other developed nation. Or maybe it’s because of the innumerable avoidable medical crises they constantly find themselves confronting. Patients go into heart failure because they can’t afford blood pressure medication, or gamble with their diabetes for want of insulin, then turn up in the hospital needing care that’s far more expensive than any preventive measure would have been.

Nurses, who encounter the system daily for years or decades, have hundreds of experiences, and they know better than most how brutally such stories can end.  Ms. Diederich, quoted in the Times piece, asserts: “It’s barbaric. Crucial medical decisions are being made by businessmen whose primary goal is to make a profit. Not by medical professionals who are trying to treat their patients.”

It comes as no surprise that both HSAs and HRAs fit into this model.  As the author of the WSJ Exchange piece notes in respect to the coming of HRAs in January:

"What's clear about this landmark change is it will make a complicated process more complicated."

And what will be the result of that? Well, what the wonks call "adverse selection".    A concept in economics, insurance and risk management  describing a situation where buyers and sellers have different information which is known as "asymmetric information." 

Thus those who avail themselves of HRAs will possess vastly lower information than the businesses, employers who offer them.  The net result? They are bound to lose - in their finances, as well as quality of care.

This elicits the question of whether there is a better, more rational system - say which allows those who wish to keep their private insurance, but also doesn't bankrupt millions who can no longer afford it.  The answer, to me, would be the German health care system which has the following key features the Democrats might wish to examine:  

-All workers contribute 7.5% of their salary each week which is matched by their employer.  The money goes into a public health insurance pool ensuring everyone gets coverage.

- When a German is hospitalized no bill is sent to his -her address afterwards.  The money will have already been deducted from the income to over the amount of the procedure will be known beforehand - no surprises (see next item).

- The system imposes strict limits on out-of-pocket costs  so there is no such thing as a "surprise" medical bill which seems to be the norm in the U.S.

- Germany regulates drug prices and medical costs through an independent agency. This system applies realistic and rational standards so Germans do not have to choose between buying food, keeping heat on, or buying meds.  The independent agency is comprised of doctors, insurance companies, patients and lawmakers. Hence, there is input from all stake holders.


The clueless may well scan the preceding attributes and conclude the system can't be as good as the U.S. hodge-podge, but they'd be totally wrong.  As my long time German friend Reinhardt has said:  "I would wager we are a much better system than the one Americans have. In fact, if I were in the U.S. I'd likely have been dead years ago because of the unaffordable costs of drugs, treatments."  Point taken and WHO and other stats support his claim.

Let's also acknowledge the Germans have the oldest health care system in the world so they must be doing something right.  The U.S. - both sides, red and blue- could learn from it. And look, anything we find has to be better than the HRAs pushed by the finance and 'zero government' input mavens.

See also:

Congress | Healthcare Policy

Congress Loves Socialized Health Care — For Itself

And:

Healthcare Policy | Insurance

Are You Sure You Actually 'Like' Your Private Health Insurance?

by Dr. Sanjeev K. Sriram | June 13, 2019 - 6:16am | permalink

And:

Big Pharma

Why Aren’t the Democrats Talking About Ending Patent-Financed Drug Research?