…On â€œMeet the Pressâ€ the other day, I asked Rachel Maddow if she supported the $700 billion in cuts, and she simply wouldnâ€™t say. Here was the Oxford-educated pride of liberal punditry professing to have no opinion on a primary means of funding what she considers a glorious legislative achievement.
Others pooh-pooh the significance of the cuts. They supposedly hit only â€œnonessential services.â€ This may be the first time in the debate over entitlements that Democrats have deemed anything related to Medicare â€œnonessential.â€
What Democrats mean is that $156 billion of the cuts fall on the Medicare Advantage program. They have always hated this feature because it gives seniors access to private-sector coverage options. But seniors like it.
The Obama cuts also rely on grinding, year-after-year reductions in payments to doctors and other providers. This is a way to maintain that there are technically no changes in â€œbenefits,â€ though access to and quality of care inevitably will be affected.
No one concerned with the health of Medicare would go about it in this fashion. But â€œObamacareâ€ was helter-skelter legislating, a desperate attempt to make the numbers temporarily add up.
Medicareâ€™s actuaries consistently sound the alarm about the consequences. A May 2012 report by the Centers for Medicare and Medicaid Services said, â€œThe large reductions in Medicare payments rates to physicians would likely have serious implications for beneficiary access to care.â€
It also noted the punishing effect on hospitals, nursing facilities and home-health agencies, which â€œwould have to withdraw from providing services to Medicare beneficiaries, merge with other provider groups or shift substantial portions of Medicare costs to their non-Medicare, non-Medicaid payers.â€
Oh, is that all? If a Republican president had done this, The New York Times would have called for impeachment proceedings.
Is the Republicansâ€™ counter-assault on Medicare hypocritical? No. How â€” not whether â€” to restrain Medicare is the question. The Democratic approach, now and in the future, is blunt-force price controls. Republicans want to get savings through competition and choice.
This is how the popular Medicare prescription-drug program works. The cost of the program is 40 percent below projections, as James Capretta of the Ethics and Public Policy Center points out, and the $30 per-month premium is only $6 more than in 2006…