Abramoff and Medicare

by John Holbo on January 22, 2006

I’m reading Off Center. Here’s something from p. 87:

When the debate over prescription drug coverage picked up in the late Clinton years, the pharmaceutical lobbying group PhRMA (Pharmaceutical Research and Manufacturers Association, pronounced “Farma”) went so far as to establish a faux grassroots organization that putatively represented the elderly: “Citizens for a Better Medicare.” Despite the lofty title, Citizens for a Better Medicare had few, if any, actual citizens on its rolls Its main activity was to spend millions of PhRMA dollars on slick ad campaigns supporting an industry-friendly drug plan. When Citizens for a Better Medicare came under fire, PhRMA switched its “grassroots” efforts over to the United Seniors Association, a conservative direct-mail organization that had cut its teeth with frightening scare letters to senior citizens. The United Seniors Association board included, among other GOP political operatives, Jack Abramoff

Greg Sargent and Kevin Drum have lately suggested that (as Kevin writes) “Dems might do well to tie the Republican corruption scandal to the broader theme of Republican addiction to special business interests.” Healthcare and the energy industry are the obvious places to start. But I haven’t yet seen anyone point out this fairly direct Abramoff/Medicare bill connection. Rather a useful factoid, perhaps, for purposes of converting the maddening complexities of this legislative boondoggle into damning talking-points. Medicare. It doth glaze the eyes over.

Mark Schmitt:

The backlash against the Medicare drug bill may or may not be a backlash against the people responsible for the Medicare drug bill. If it merely increases cynicism and deepens the sense that government can’t do anything right, then the ground remains fertile for the Republican anti-government message – even if it is Republicans themselves who betrayed their own anti-government message. Democrats have a very complicated (but absolutely true) story to tell here: They have to show that the Medicare bill was a guaranteed disaster from the start, that its consequences were not accidental but imtimately related to the corruption of the Republican majority, and that there is an alternative that would do more and cost less, and that Democrats would make it happen. We cannot assume that this story will occur automatically to people as they struggle with the program.



california_reality_check 01.22.06 at 10:41 am

People who know say this program was a disaster from the beginning and most likely will implode on 5/15/06. The most cynical say it was a plan all along to enrich drug companies while killing off the young, old, por, weak and ill. They are costing the US the most ,you see. I agree this is an opportunity for dems. This was a major failure of the thug party. However, the first goal is to save those lives that have already been compromised.


Steve LaBonne 01.22.06 at 11:57 am

Of course we’re making two rather far-fetched assumptions here: that we have a Democratic Party capable of making those arguments coherently, and a press that wouldn’t hopelessly mangle those arguments in the reporting even if they did. (I’m in an especially foul mood today about the current pathetic state of the news media, having seen Good Night, and Good Luck– a wonderful movie- last night.)


abb1 01.22.06 at 12:20 pm

Addiction to special business interests” is a silly phrase. They represent business interests, they’re simply doing their job.


Henry (not the famous one) 01.22.06 at 1:30 pm

And let’s remember that many of the Democrats in Congress held their nose and voted for it–just as AARP supported it–on the theory that as flawed as it was it was a first step in extending drug benefits to seniors. So we find ourselves in a more benign version of the Iraq War: “If you thought it was such a bad idea, then why did you vote for it?”


nihil obstet 01.22.06 at 7:10 pm

Simple message:
Medicare Parts A & B = liberal, Democratic program.
Medicare Part D = conservative, Republican program.


nick s 01.22.06 at 7:50 pm

The big thing about the Medicare story is that it’s one which doesn’t have to be directed from DC. Local media love health stories: there’ll be segments on every nightly broadcast, or in every local paper. Every small town will have its set of players: a ‘Granny Mabel’, who can’t navigate the bureaucracy and can’t afford her pills; kindly local pharmacist who is providing seven-day supplies to loyal customers; a jobsworth chain that can’t do it; doctors worried about what’s going to happen. Etc.

The Dems need to play a part in pinning Granny Mabel’s fate to the Republicans and lobbyists. Yes, there’ll be the kneejerk ‘playing politics with people’s lives’ response, but there are obvious rejoinders.

Dem challengers in districts where the local GOP rep. supported the bill need to start their campaigns right now.


Martin James 01.22.06 at 8:27 pm

My teenage daughter makes $ 6.50 an hour in her after-school retail job.

This is her first year to get and W-2 and fiel a tax return. I showed her her state taxes: $ 22.84. Don’t worry you’ll get that back. Federal taxes: $42.50, Don’t worry you’ll get that back.

OASDI and Medicare, $ 125.31. You don’t get that back; that pays for the pensions and medicare for your grandparents.

She says “That’s crap!”

The median voter in the USA is a middle aged, suburban, married white female, with family income of about $50,000 a year.

I just don’t think trying to sell Medicare Part D as a disaster is a big winner.

1. Most people have exactly the same coverage.

FEHBP, Tricare, those with retiree employer coverage applying for the RDS, and most of those on Medicare Advantage.

2. How long do you think it will take the States to get the 6 million on Medicaid figured out, 3 months, 6 months, a year? Its a transition problem not some permanent barrier to coverage. They’ll still get cheap or free drugs. Why all the crabbing about the insurance companies in medicar Part D? Doesn’t anybody remember “managed competiton” and the Clinton plan, its the nearly the same damn thing.

But if you want conspiracy theories, have you looked at the fine print of what MMA did to Medicare part B premiums? They are means tested with higher income retirees paying a greater and greater percentage of the premium over time.

This will be the first area where the baby boom effect will hit the government budget for the following reason: Medicare Part B ( and the new Medicare Part D) is not funded by FICA payroll taxes, it is paid out of general revenue. There are no big balances in the trust fund.

So ask yourself, why did the supposedly, friendly- to-the-rich Republicans include tax increases to wealthy in the form of higher Part B premiums?

Why indeed, if not to get my daughter and my dad thinking the same way about Medicare?


joejoejoe 01.22.06 at 8:31 pm

You don’t bribe people to pass legislation that is popular.

That’s what Democrats should say every time Abramoff comes up. NOT negotiating the lowest prices for Medicare drugs and placing ‘Made in the USA’ labels for Chinese goods assembled in the Marianas Island are two examples of the Abramoff school of government. Republican voters are opposed to these provisions as well as Democrats. Get the ugliest provisions of that have been made law in the past few years into the light – the stench of the law is worse than any free golf trips.


nick s 01.23.06 at 4:07 am

The median voter in the USA is a middle aged, suburban, married white female, with family income of about $50,000 a year.

Highlighting the median, though, points to the distribution. Seniors vote in larger percentages than twentysomethings. And your median voter most likely has parents, and doesn’t want to share an increasing burden of their healthcare, particularly given that the American system spends most of its money on the last years of life.

How long do you think it will take the States to get the 6 million on Medicaid figured out, 3 months, 6 months, a year? Its a transition problem not some permanent barrier to coverage.

To point to an issue raised here quite often, the French heatwave of August 2003 lasted one month and killed thousands. The Chicago heatwave lasted one week and killed over 700.

It’s pretty damn glib to dismiss as a ‘transition problem’ something that may well kill people, or at very least place a greater strain on the health system by sending them to the E.R.

Oh, and right now, the states aren’t going to be reimbursed. That’s going to be a fun knock-on.


Barry 01.23.06 at 8:39 am

Martin James, the only reason that your daughter won’t get Social Security is because people like you let the GOP steal it.


Martin James 01.23.06 at 12:57 pm


More over-reaction.

First, I think she will get her social security.

Second, if she doesn’t, do you really think the ONLY reason she won’t is that people like ME let the GOP steal it? Flattering, but exaggerated.

Your figures are also incorect on the percent of health care spending in the last year of life. For the over-65 population the estimates are 22% to 30% are for the last year of life. For the total population, its 7 to 10%. That’s a lot, but its not most.

You can do the math yourself. According to Health Affairs, total health spending in 2004 was $1.9 trillion. Take 50% if you want to say its most. Divide that out over about 2.5 million deaths. You get an AVERAGE cost in the last year of life of $380,000. Sorry, didn’t happen.

Using the more accurate number 7% you get $53,200.
Still a lot, but its a closer fit to the facts.

I’m not glib about the transition problem being a problem. I just think most of the Medicare Part D complaints are overblown.


JR 01.23.06 at 5:30 pm

“Factoid” is not a synonym for “fact.” “Factoid” was invented by Norman Mailer, in his biography of Marilyn Monroe, to describe falsehoods (typically about a star’s background or romantic life) that were planted in the press by Hollywood publicists and were soon taken as universally known truths. E.g., Lana Turner was discovered at the counter of Schraft’s drug store.

It’s a shame that the word has lost this meaning. The Bush administration is the champion of the factoid- from “Saddam caused 9/11” on down.

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