Grading PolitiFact *Liberal*-Style: RyanCare--Pay or Die!

There was quite a “liberal” uproar over this PolitiFact (PF) ruling on the claim made by a Democratic Congressional Campaign Committee TV ad on Paul Ryan’s proposed “Path to Prosperity” to change Medicare from a defined benefit to defined contribution plan, as well as raise the eligibility age from 65 to 67. And of course, leave it as is for the most important Republican voting bloc, the “screw-everybody-but-me” baby boomers.

Steve Benen of the Washington Monthly (which appears to be a sort of counter to the conservative Washington Examiner) headlines his criticism "When PolitiFact Becomes PolitiFalse."

Josh Marshall at Talking Points memo: “Knowledge Counts”-- “This is why Republicans are spinning this issue so hard and bamboozling folks at places like Politifact.”

“PolitiFact has Pants on Fire in their rating of Democratic Claims about Medicare” says David Dayen of FireDogLake.

Finally, Brian Beutler at Talking Points Memo makes a mild claim, “PolitiFact Insists Republicans Don't Want To End Medicare”.

I’ve listed these links first as part and partial to linking from the “Guide to PolitiFact Detractors” page because it adds a lot to the “liberal” PolitiFact critics who think PolitiFact leans right.

Careful reading of what “RyanCare” offers, as noted above, is its re-structuring of the Medicare program from a defined benefit, government as single payer to defined contribution, consumer-driven plan. And once all the baby-boomers die, should this program as defined by Paul Ryan actually come to pass, there would be no Medicare as we know it today. Medicare would simply be an individual subsidy program.

This is how Tony Carrk at American Progress.org describes it:

Medicare as we know it would end for new beneficiaries in 2022 under the House Republican budget proposal. It would be replaced with a government voucher (although Ryan does not define it as such) that would be paid directly to private insurance companies. This system would double costs to seniors. The nonpartisan Congressional Budget Office, or CBO, concluded that “most elderly people would pay more for their health care than they would pay under the current Medicare system.”

Seniors would pay more for two reasons. First, the Ryan plan forces future beneficiaries out of the traditional Medicare plan into a more expensive private plan. In 2022 65-year-olds would be forced to pay twice as much for care than they would under Medicare: $12,500 compared to $6,150. The same holds true for 65-year-olds in 2030. They would be forced to pay $20,713 compared to $9,138 under Medicare… [see graph below]

PolitiFact’s reason for ruling this Pants on Fire is based on four points (1) “it seems intended to frighten those who are currently enrolled in Medicare.” (2) This is only a budget proposal which has not passed congress, while the ad says “Republicans [already] voted to end it.” Writer Angie Drobnic-Holan also feels that the DCCC should have included the qualifier (3)“as we know it.” Lastly, she states (4) the $12,500 that the ad claims seniors would be forced to pay was actually half the amount.

(1) Holan does have a point here. Fear-mongering is played by both sides of the aisle: from government take-over (the PolitiFact Lie of the Year) to the end of Medicare as we know it, it goes to both extremes.

But if you were the beneficiary, which would you prefer? I’m guessing you’d have reason to be more fearful if Medicare were to end, even with a qualifier. I suppose that supports what Holan says, but such a drastic re-structure would have reason to invoke a little fear.

(2) As far as RyanCare not having been voted in yet, it should be kept in mind that the political betting market Intrade.com says that currently the Senate has a 66 percent chance of going to majority Republican in 2012. If Obama can’t get re-elected, RyanCare has a pretty good chance of becoming law….along with the repeal of Affordable Care Act ("Obamacare").

(3) Is ending Medicare any different than it ending “as we know it”? I guess the impression Holan believes is given is that Medicare will end without being replaced. But assuming people, particularly seniors, understand the ramifications of the Republican plan, they would know what was meant.

Let's look ahead here.  If you were 55 years old this year, by the year 2056, assuming RyanCare passed as is and nothing changed, what would Medicare look like?  Most of the boomers would have passed...and there might be an announcement in the "future news" that the last person using single-payer Medicare has passed away.  What would it be then?

(4) And yes, in 2022, the amount seniors would have to pay would be the difference between what they would have had to pay between Medicare ($6,150) and RyanCare ($12,500), or $6,350. However, if you look at the numbers for 2030 in the chart below, the burden increases for seniors to $11,575, which is not far off from $12,500.  In the PF Mostly True world, that is less than 10 percent off.

Cost sharing to patient will go from $6,350 in 2022 to $11,575 in 2030.  Beyond that?

My final point is about something stated in the CBO analysis of the Ryan Proposal:

…costs to individuals (beyond those covered by the premium support payment) would be higher under the proposal than under traditional Medicare, and some individuals would therefore choose not to purchase insurance … the number of older Americans without health insurance would be higher.

The Ryan proposal is a VOLUNTARY program. So…what’s to keep elderly people from not buying insurance and just going to an emergency room if they get sick and claiming indigency? This is part of what is driving insurance costs higher today…and he wants to keep it?

The Republican “healthcare” scheme is a 3-1/2 page proposal designed more for deficit reduction than it is a serious healthcare-for-elderly insurance plan which tries to contain costs (for the elderly). And it does end Medicare: end Medicare, and end Medicare as we all know it.

It should be noted that my conservative counterpart has nary a peep to say about this Pants on Fire claim, even with a special article by PolitiFact concerning the many complaints linked at the beginning. The closest he has is one review about a ruling on Mike Pence where he gloats over errors by PolitiFact, although he makes an error (or more likely, misrepresentation) himself on his report from sources on how the premium supports are indexed for inflation.  He had no comments at Facebook on the original ruling; his comments on the second article, called "Medicare Mailbag--mixed metaphor edition" were only to attack me on a fallacy, but he would not answer when I asked him if my supposed fallacy invalidated my argument (that the company I worked for did something similar to save costs, so this proposal was not "new").

But this is not Pants on Fire material. There’s a glimmer of truth in the message of the ad although “the available evidence is insufficient to establish it as either true or false.” There is a fairly strong likelihood that the Republicans may soon have the power to end Medicare (as we know it) and Seniors, in time, (estimated to be by 2030) may have to find up to $12,500 of their own funds to cover their annual healthcare costs. Compare that to the PolitiFact claim investigated “Seniors will have to find $12,500 for health care because Republicans voted to end Medicare." There’s really not much difference.