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Recursion

(56,582 posts)
Sun Oct 27, 2013, 06:35 AM Oct 2013

Entitlement spending I want to cut

Medicare Part C ("Medicare Advantage&quot , completely if possible
Many (but not all) classes of farm subsidies and crop insurance (feel free to ask; I have a whole position paper on this from back in my K street days)
Medicare Parts A, B, and D but not through benefits cuts within the existing coinsurance regime (see below)
Medicaid, but only through an extension of Medicare to people under 25 or a massive expansion of Federally Qualified Health Clinics (see below also)

I'd like to take a large part of those savings (but not all; some can go to deficit reduction, though I think the lion's share of deficit reduction should come from Defense and new revenues) and put them into a new TANF block grant, UI, SSI/SSDI, SNAP, and Section 8, though I'd like to seriously re-think how some of those are currently done (particularly TANF, Section 8, and SSI). Alternately, take all that money and enroll everyone under 25 in Medicare (which will lower the cost of private plans that currently keep children under 25 on them, as well as eliminating SCHIP and greatly reducing Medicaid rolls).

Medicare Parts A, B, and D I'd like to see move away from fee-for-service, and particularly I'd like to see the FQHC model expanded and given preference within the Medicare framework. In addition I'd like Medicare Part D to negotiate for drug prices like the VA does. I don't know that this would save money but I think it would and a lot of really smart people agree with me on that, but this is something we can experiment with (and the ACA has some experiments like that in its language, though HHS still has to implement them).

There's no particular long-term fiscal advantage to cutting Social Security (doing so could make some year-to-year deficits smaller, but it doesn't impact the actual debt), but as I've caught hell here for saying before, I'd be willing to means test benefits if the GOP could deliver something very good in return, which at the current moment they can't, so as far as I'm concerned it's a dead letter (this is also basically what Reid is saying).

There's a perfectly acceptable Democratic position that does a lot to cut entitlements and puts the onus on the GOP to sell the cuts to their constituents, without harming the poor, the elderly, and children, and without restricting growth too much. And, as always, the only good way out of a fiscal impasse is growth, not austerity. Nobody ever cut their way to prosperity.

Anyways, that's what I think about entitlement spending.

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