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Frequent Social Butterfly

Re: GOP CUTS TO MEDICARE & SOCIAL SECURITY

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Message 31 of 85
I have seen all the headlines today about what the GOP is going after in 2018, and it will be "entitlement reform." Now if by "reform" you mean cuts to these, then I am very worried, but if you want to make these programs stronger to be able to be there for loved ones down the road, when it's their time, and if you work with the Democrats to that end, then I will have an open mind. Only if "reform" means strengthen and preserve mind you.My concern is that it does not.
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Valued Social Butterfly

Re: GOP CUTS TO MEDICARE & SOCIAL SECURITY

76 Views
Message 32 of 85

@myexper

 

You asked:

"So what happens to those who are NOT nearing retirement or retired"

 

They will adjust just like we did when changes were made by President Reagan and Speaker Tip O'Neill to save the SS system back in 1983. 

 

From the:

2017 Social Security Trustee Report on Social Security and Medicare Summary

 

Conclusion

Lawmakers have many policy options that would reduce or eliminate the long-term financing shortfalls in Social Security and Medicare. Lawmakers should address these financial challenges as soon as possible. Taking action sooner rather than later will permit consideration of a broader range of solutions and provide more time to phase in changes so that the public has adequate time to prepare.

 

As the CBO often puts it - you can raise revenues or cut benefits - most likely a fix solutions will have to consider both.

 

Look at some of the legislative proposals made by both Democrats and Republican to fix the current system of Social Security - a little of both is included. 

Social Security Admin. - Proposals Affecting Trust Fund Solvency

Some changes mathematically help more than others, some want to make some (current) changes which would cost the system more or less, and if those are acceptable then other revenue has to be adjusted too for a good overall Social Security reform which should last for many many years into the future, hopefully.

 

Do you really want to wait until insolvency and have the results forced upon current beneificiaries by law (the current law) - automatically reducing benefits - per the SS Trustees in about 2034 with an automatic reduction of about 23%.

 

 

 

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Valued Social Butterfly

Re: GOP CUTS TO MEDICARE & SOCIAL SECURITY

76 Views
Message 33 of 85

GailL1 wrote:

john258 wrote:

  


Well if as you say the states are the ones who control Medicaid, and sign up the providers now it would seem by your report that the states are the problem. Could be we need the Feds to set standards for the entire US then allow the states to run that program. Could be we need to require all providers. to accept all forms of Insurance that meet Fed rules for costs. We could help fund the costs a person has for schooling if they spend time in PC. We see in IHS specialists also acting as PC for people. I think you are overblowing the shortage in providers to some extent. It is not that bad where i am in the private sector, or IHS. You seem to be saying we medicare for all approach would be a good starting point. This is the second time you have seemed to approve that approach. I have a feeling the would be the approach we should look at as it does work.


The Feds do set the criteria for who is covered.  The income eligibility % of the FPL is set by the state's too with the Feds determining a minimum - except for the ACA expanded Medicaid income % which is defined by the PPACA (Feds).

Why did you think this went to the SCOTUS - which gave the state's the ability to opt out?

 

The state's % of matching funds for Medicaid is determined by the number of people in need in the various states - 

Number of people on various assistance programs like

  • SSI
  • TANF or whatever they are calling welfare these days
  • elderly who are on various help programs in Medicare determined by income
  • etc

States with a higher % of these populations get a higher % of matching funds from the Feds.

 

I have no idea where you are getting that I support any form of Medicare for All - quite the opposite - I want state's to have lots more control in health related plans but of course, the Feds have to have oversite and influence over things like the number of doctors in primary care - they have to incentivize doc's to go into primary care - a good place for tax incentives - we use this method for everything else.  

 

But then the states have to do their part to lure them into their state.  Perhaps by paying down student loans, state tax incentives, or they may just have to bribe them in some other way to go and work in certain areas.

 

Take a look at the Commonwealth Funds comparison of International Healthcare systems, we are far down on the list of primary care physicians number as compared to population.

 


Please do not waste your time giving me  articles you have found on the web as they have little if no use as they only cover what are national rules, and for the most part are not what is going on so have no use in discussing a subject except to point out they really mean little in most cases. This is the United States so that means with large problems you have to use all states so that means there has to be National Standards or nothing works. That you see in Medi Care and it works. The States should be part of the health care system, but sadly a number of the States will not make an effort to help. Just look at Texas and the big storm. It did little to get ready for such a storm. Would not follow what the Army C wanted, allowed bad zoning, did not push flood insurance etc. Storm hits and state goes to Feds so we all can pay for the damage. The same happens in health care unless you have overall rules. Everything you have been pushing requires over all rules. We even see the far right R. wanting uniform gun laws across all states. Now that could be because the rules they want will kill more people. So I would suggest you sit down and really look at the subject of health care and learn about the total picture.

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Valued Social Butterfly

Re: GOP CUTS TO MEDICARE & SOCIAL SECURITY

98 Views
Message 34 of 85

rk9152 wrote:

myexper wrote:

rk9152 wrote:

mandm84 wrote:

As long as you got yours it's ok rk9152 ?


Did you miss the words  "our" safety net accidentally or on purpose?


The "our" refers to people on or nearing retirement.

 

So what happens to those who are NOT nearing retirement or retired rk?

 

Did you "miss those words accidentally or on purpose"?

 

The comment to you "as long as you got yours it's OK" does indeed apply to yourself rk .... as it has in all the government assistance programs that you regularly condemn!

 

 


You seem unable to comprehend the difference between an earned retirement package be it government, union, or private and an unearned program based on need. They are really two separate entities and should be discussed separately.


No rk .... I completely "comprehend" your evasion from the fact that you believe "as long as you get yours it's OK"!

 

You stated "Any proposal I've ever seen has exempted anyone on or nearing retirement age. So, "our" safety net is safe." ....... And in THIS DISCUSSION rk .... and relative to Social Security and Medicare rk!!!

 

So you are not concerned about those NOT currently nearing retirement or NOT in retirement.  So long as you believe that you'll "get yours" .... it's no problemo!!!!

 

 

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Valued Social Butterfly

Re: GOP CUTS TO MEDICARE & SOCIAL SECURITY

130 Views
Message 35 of 85

myexper wrote:

rk9152 wrote:

mandm84 wrote:

As long as you got yours it's ok rk9152 ?


Did you miss the words  "our" safety net accidentally or on purpose?


The "our" refers to people on or nearing retirement.

 

So what happens to those who are NOT nearing retirement or retired rk?

 

Did you "miss those words accidentally or on purpose"?

 

The comment to you "as long as you got yours it's OK" does indeed apply to yourself rk .... as it has in all the government assistance programs that you regularly condemn!

 

 


You seem unable to comprehend the difference between an earned retirement package be it government, union, or private and an unearned program based on need. They are really two separate entities and should be discussed separately.

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Gold Conversationalist

Re: GOP CUTS TO MEDICARE & SOCIAL SECURITY

124 Views
Message 36 of 85

myexper wrote:

NOTHAPPENING wrote:

mandm84 wrote:

http://theweek.com/speedreads/740454/gop-senator-says-tax-cuts-must-followed-by-structural-changes-s...


From your link, GOP didn't say:"cuts to SS and Medicare" in fact the statement was made by Marco Rubio who said:" that cutting taxes needs to be followed by cutting spending on popular federal programs."


The GOP Budget already indicates a $400 Billion cut to Medicare and a $1 Trillion cut to Medicaid NOTHAPPENING!!!


Yeah, that is not happening when we respond by flooding and jamming the phone lines of our local Senators, Representatives, Congresspeople, .etc by calling and contacting them to tell them to vote 'NO' on any and all bills that will do this or to demand they immediately resign from office.

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Valued Social Butterfly

Re: GOP CUTS TO MEDICARE & SOCIAL SECURITY

137 Views
Message 37 of 85

NOTHAPPENING wrote:

mandm84 wrote:

http://theweek.com/speedreads/740454/gop-senator-says-tax-cuts-must-followed-by-structural-changes-s...


From your link, GOP didn't say:"cuts to SS and Medicare" in fact the statement was made by Marco Rubio who said:" that cutting taxes needs to be followed by cutting spending on popular federal programs."


The GOP Budget already indicates a $400 Billion cut to Medicare and a $1 Trillion cut to Medicaid NOTHAPPENING!!!

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Valued Social Butterfly

Re: GOP CUTS TO MEDICARE & SOCIAL SECURITY

130 Views
Message 38 of 85

rk9152 wrote:

mandm84 wrote:

As long as you got yours it's ok rk9152 ?


Did you miss the words  "our" safety net accidentally or on purpose?


The "our" refers to people on or nearing retirement.

 

So what happens to those who are NOT nearing retirement or retired rk?

 

Did you "miss those words accidentally or on purpose"?

 

The comment to you "as long as you got yours it's OK" does indeed apply to yourself rk .... as it has in all the government assistance programs that you regularly condemn!

 

 

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Valued Social Butterfly

Re: GOP CUTS TO MEDICARE & SOCIAL SECURITY

141 Views
Message 39 of 85

john258 wrote:

  


Well if as you say the states are the ones who control Medicaid, and sign up the providers now it would seem by your report that the states are the problem. Could be we need the Feds to set standards for the entire US then allow the states to run that program. Could be we need to require all providers. to accept all forms of Insurance that meet Fed rules for costs. We could help fund the costs a person has for schooling if they spend time in PC. We see in IHS specialists also acting as PC for people. I think you are overblowing the shortage in providers to some extent. It is not that bad where i am in the private sector, or IHS. You seem to be saying we medicare for all approach would be a good starting point. This is the second time you have seemed to approve that approach. I have a feeling the would be the approach we should look at as it does work.


The Feds do set the criteria for who is covered.  The income eligibility % of the FPL is set by the state's too with the Feds determining a minimum - except for the ACA expanded Medicaid income % which is defined by the PPACA (Feds).

Why did you think this went to the SCOTUS - which gave the state's the ability to opt out?

 

The state's % of matching funds for Medicaid is determined by the number of people in need in the various states - 

Number of people on various assistance programs like

  • SSI
  • TANF or whatever they are calling welfare these days
  • elderly who are on various help programs in Medicare determined by income
  • etc

States with a higher % of these populations get a higher % of matching funds from the Feds.

 

I have no idea where you are getting that I support any form of Medicare for All - quite the opposite - I want state's to have lots more control in health related plans but of course, the Feds have to have oversite and influence over things like the number of doctors in primary care - they have to incentivize doc's to go into primary care - a good place for tax incentives - we use this method for everything else.  

 

But then the states have to do their part to lure them into their state.  Perhaps by paying down student loans, state tax incentives, or they may just have to bribe them in some other way to go and work in certain areas.

 

Take a look at the Commonwealth Funds comparison of International Healthcare systems, we are far down on the list of primary care physicians number as compared to population.

 

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Valued Social Butterfly

Re: GOP CUTS TO MEDICARE & SOCIAL SECURITY

146 Views
Message 40 of 85

GailL1 wrote:

erikm219989 wrote:

john258 wrote:

GailL1 wrote:

Well keep trying to keep them out of the ER even if they have Medicaid, extended Medicaid.  There is a doctor shortage specifically because Medicaid has grown by leaps and bounds and there are not enough primary care doctors who accept Medicaid to take care of the demand - which is also way, way up.

 

So they can't get a doctor or their wait is long to see a doc, so what do they do - Go To The ER for every little thing

 

Mercury News 06/21/2017 - Emergency Room Visits by Medi-Cal patients SOARING, state data shows

 

Expecting physicians to see and treat these patients for pennies on the dollar never works.


Well what is your plan to solve the problem?


It could be the vote out all the Republicans so that the Medicaid system can get fixed instead of taxes being cut for the 1% or the Super Rich.

 

The fix has to be at the state level.  States do their own Medicaid rate setting, they are the ones that sign up the doctors into the Medicaid program.

 

The Federal government can increase or decrease the amount which they pay as a percentage in special circumstances like waivers or at certain periodic times. This was done in the 1st few years of Obamacare - the Feds increase the % rate they paid for Medicaid providers in order to increase the number of them but this only lasted for a few years since the Feds thought that when this federal increase ended, states would pick up the slack.  Some states did, mine did - but some states didn't, so Medicaid providers did not renew their commitment.

 

Actually, we have a whole lot fewer primary care physicians in this country than elsewhere in the world, industrialized nations.  Other healthcare systems rely heavily on primary care physicians but here med students seem to prefer specialties rather than primary care.

 

On a related note - the number of specialist which participate in the Medicaid program is even slimmer in availability.

 

So, this Medicaid primary physician shortage problem begins at the state level but we do need to develop some incentives to encourage more med students to go into primary care along with PA's and NP's to work along side of them.

 

Years ago there was a legislative proposal which said that if a physician accepted MEDICARE, then they would have to accept MEDICAID.  Medicaid rates are lower than Medicare rates.  What do you think this might do - help Medicaid?  Harm Medicare?  Cause even more financial problems in some states?

 

Working on the overall cost of healthcare would help everybody.  

We can even take some of these cost controls from other countries.

 

 


Well if as you say the states are the ones who control Medicaid, and sign up the providers now it would seem by your report that the states are the problem. Could be we need the Feds to set standards for the entire US then allow the states to run that program. Could be we need to require all providers. to accept all forms of Insurance that meet Fed rules for costs. We could help fund the costs a person has for schooling if they spend time in PC. We see in IHS specialists also acting as PC for people. I think you are overblowing the shortage in providers to some extent. It is not that bad where i am in the private sector, or IHS. You seem to be saying we medicare for all approach would be a good starting point. This is the second time you have seemed to approve that approach. I have a feeling the would be the approach we should look at as it does work.

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