Granny Bird Award: Paul Ryan

Today's Granny Bird Award, one given from time to time to those who actively seek to harm or impair the rights of elders, goes to Rep. Paul Ryan (Asshole-WI) for his proposed 2015 budget, re-introduced in the House Of Representatives just in time for 2014 campaign purposes.

Yesterday, I examined his proposed cuts to the safety net, with an emphasis on Medicare. Today Granny Bird wants to point out his deceptions and misrepresentations with respect to Social Security.  Michael Hiltzik quite nicely assists in that endeavor:

...what concerns us here is his description of the Social Security trust fund, which currently holds close to $3 trillion in U.S. Treasury bonds, all purchased with payroll tax income paid by working men and women since 1983.

The idea of building up this trust fund was to bank excess tax revenues against the looming wave of baby boomer retirements, which has now begun. But the trust fund is still growing, because Social Security's income streams--the payroll tax, interest on its bonds, and revenues from income taxation of benefits--still are sufficient to cover current benefits, and then some.

Ryan wants you to think different. Here's the passage in question, from page 66 of his plan.

"Any value in the balances in the Social Security Trust Fund is derived from dubious government accounting. The trust fund is not a real savings account. From 1983 to 2010, it collected more Social Security taxes than it paid out in Social Security benefits. But the government borrowed all of these surpluses and spent them on other government programs unrelated to Social Security. The Trust Fund holds Treasury securities, but the ability to redeem these securities is completely dependent on the Treasury’s ability to raise money through taxes or borrowing."  ...

...The money has been invested in U.S. Treasury securities, just as you might do by purchasing Series EE savings bonds, or TIPS. Why do people invest in T-bonds? Because they're the safest securities in the world. The U.S. has never, ever defaulted on them (although the Tea Party wing of the GOP seems to think that would be a good idea). The money isn't invested in corporate securities or anything else, because Congress hasn't allowed that.

The Social Security trust fund's bonds are backed by exactly the same commitment of the U.S.' "full faith and credit" as any other Treasury security. Keep your eye on that ball, because Ryan is going to try to palm it.

When one buys a T-bond, one is effectively lending the money to the government, which then uses it to do things. So, yes, Ryan is correct in stating that "the government borrowed all of these surpluses and spent them on other government programs unrelated to Social Security."

Right. On national defense. Two wars. Construction of roads, school buildings, courthouses. On the salaries of congressmen like Rep. Ryan. What of it?

Was this money wasted? Hardly. The U.S. economy has more than doubled in size (adjusted for inflation) over that time, in significant part because of the infrastructure and services provided by government--including with that borrowed money.

...there's no "dubious government accounting" involved here--the dubious accounting is all Ryan's.
The trust fund is indeed a real savings account, involving deposits and interest. Yes, the government borrowed the money, and it has paid interest on it every year (duly recorded and published, down to the last dollar, in the annual reports of the Social Security trustees).

And yes, "the ability to redeem these securities is completely dependent on the Treasury’s ability to raise money through taxes or borrowing." What Ryan doesn't say is that the Treasury's ability to raise taxes and borrowing is effectively unlimited.

The most important factor is the one that people like Ryan want you to forget: The money in the Social Security trust fund came directly or indirectly from the payroll taxes paid by millions of American workers--100% of it. It was paid by workers in the trust that the government would pay it back. Paul Ryan is hinting, pretty strongly, that he doesn't want to pay it back.   [Emphasis added]

I quoted the column extensively because Hiltzik's argument required it and I'd recommend you read it all.  His point (and mine) is that Ryan and his rich benefactors would be happier if we took our money and paid it into Wall Street brokers' hands.  And once we do that, we should just die.

Paul Ryan never met a rich campaign donor he didn't like and a "taker" elder he did.

How long, O Lord.  How Long.

 

Granny Bird Award: Medicare Advantage Plans

The Granny Bird Award is given from time to time to those who violate or in any way harm the rights of the elders, or who use the elders to rip folks off.  Today's award goes to the Medicare Advantage insurers who rip off our precious Medicare system.

Michael Hiltzig of the Los Angeles Times put these plans in his spotlight and explains just why they are a way for insurers to take advantage of government largesse in order to turn a buck.

Here's what he had to say in his March 26, 2014 column:

A big part of the argument made by enemies of the Affordable Care Act that the Act is hurting Medicare applies to a category of health plan known as Medicare Advantage. New evidence has just come in showing that Medicare Advantage is a ripoff that fattens the health insurance industry while scarcely helping its enrollees, all at public expense. ...

Medicare Advantage plans differ from traditional Medicare by offering its enrollees ostensibly better care and sometimes broader services--free eyeglasses, even gym memberships--in return for reimbursements from the government that are 14% higher than traditional Medicare reimbursements, or more. And yes, the Affordable Care Act aims to pare the government's reimbursements for Advantage plans by a total of about $200 billion over 10 years. ...

Critics have long argued that the extra reimbursements for Advantage plans are a waste of money, just a handout to the insurance industry. A new paper by three Wharton School economists gives the critics powerful new ammunition.
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The authors, Marc Duggan, Amanda Starc, and Boris Vabson, found that only about one-fifth of the extra reimbursement gets passed through to patients in the form of lower premiums, better care or more services. Where does the money go? Insurers pocket much of it as pure profit. Some they spend on advertising--to attract more Advantage members, so they can claim more of the enhanced reimbursement, which they use to advertise to get more members...you can get dizzy following this daisy chain. ...

You shouldn't be surprised that the health insurance industry is leading the charge against Advantage cuts, terming them "devastating for seniors." Devastating to the insurers' bottom lines, they mean to say. It's important to remember that the money comes from premiums paid by non-Advantage enrollees in Medicare, and from taxpayers. 

Republicans love to portray themselves as guardians of the public purse. Yet here they are, lining up to protect one of the most wasteful claims on government resources of all. What could account for that?   [Emphasis added]

I wish I'd had this information when I turned 65 and promptly signed up for my Medicare Advantage Plan.  It even included a Part D to cover my pharmaceutical expenses.  It turns out that it only pays a fraction of the two drugs I take not covered by the hospice people, and those two drugs are expensive.  Unfortunately, I signed up again with the same plan and I'm stuck with it until the end of the calendar year (if I live that long).  Trust me:  I won't make that mistake again!

Once again, Mike Hiltzig does his job well as a consumer columnist, and for that I am grateful.

Granny Bird Award: Those Who Treat All Elders As Children

The Granny Bird Award is one given from time to those who impair or harm the rights and well-being of elders.  This edition goes to those who assume the gray hair and/or a cane or walker is a sign of idiocy and incompetence.

For example, the grocery store employee who says "here, mama, lemme get that for you" instead of  "Ma'am, can I help you with that?".  Or the campaign worker who assumes that you are so old, decrepit, and senile that you won't possibly understand any of the issues so instead just says, "Sorry to have disturbed you."

 Or, as in my case, a doctor who changes or adds a prescription without explaining why the change is necessary and what it will involve.

Some backstory is necessary.  As many of you know I now live in an assisted-living facility (the "Cuckoo's Nest") because I have end-stage COPD and congestive heart failure.  My medications are provided through a hospice organization.  This hospice group has been wonderful to me with visits at least once a week by the nurse case manager and other visits from a spiritual adviser and a physical therapist.  The group has also provided me with a wheel chair, a room oxygen supplier, and a portable oxygen device, all without cost to me.

A while back, a nebulizer suddenly appeared in my room.  The med-tech here said it was from hospice.  When my nurse-case manager showed up for her weekly visit, I asked her about it.  She said it was for a breathing treatment whenever I needed it.  That sounded OK to me, but I didn't figure I'd need it because my current regimen of O2 and my emergency inhaler worked just fine.

What she didn't tell me is that there would no longer be an emergency inhaler for me -- that was what the nebulizer was for.  So what's the big deal?  Well, the inhaler (which I only use first thing in the morning to clear my lungs and last thing at night to facilitate sleep) takes 3 to 4 seconds to use.  The nebulizer treatment takes 10 minutes!  Hey, given my remaining life span, 10 minutes is a big deal!

Not only that, the nebulizer treatment isn't as effective as the inhaler and leaves me with an aching chest.  That may very well be caused by my resentment at having this change being forced on me without any explanation, any warning, or any assurance that if I was unhappy it would be changed. I will cop to that.

But here's the kicker:  the doctor who prescribed the change hadn't examined me (not ever), just signed off on a report from the nurse.

So, when the nurse shows up this week, I'm going to give her an earful, using language much less reserved than that used in this post.

Stay tuned.

UPDATE:

I was victorious.  Not only will my inhaler arrive this afternoon,  I also got an apology. She promised to always explain any changes and, just as important,  she promised never to treat me as a a child again.