Let’s make a scary assumption: You ran for office and won. You are a new member of Congress. Now you have the truly scary task of talking to constituents about things like Social Security and Medicare.
What do you do? Where do you start?
You get professional help. You call Milo Dupem, a senior partner at Obfuscate, Misleadum and Dupem, a Washington political advisory firm with a long and profitable history. Your meeting with Mr. Dupem goes like this:
“Mr. Dupem, how can I tell each voter what he wants to hear about Medicare and Social Security? Across the country we’ve got 10,000 people a day turning 65. Some days it seems that all of them are in my district. Some want to be reassured, no matter what. Others actually want to believe that both programs are doomed. How can I please them all?”
Dupem stares at you intently. “Congressman, it will take a while to understand government communications, but once you get the hang of it, you’ll have no problem making everyone happy. You’ll be able to tell them what they want to hear. You’ll be able to cite authoritative and complex sources that reflect your concern and deep understanding.
“You see, the most important government documents— like the Trustees Reports for Social Security and Medicare— are specifically written so that you can select items that will suit the occasion. They won’t be masterful sound-bites— that’s your job— but sound bites don’t cut it for serious background anyway,” Dupem said.
“How about an example?”
“Sure. How about Medicare? Do you remember that the program had massive unfunded liabilities only a few years ago?” Dupem asked.
“Yeah. Back in 2010, last time I looked, it was about $22 trillion.”
“Well, they’re all gone. No more problem. Clean bill of health, so to speak. One of the best disappearing acts in history.”
“What happened?”
“Congress changed the laws related to Medicare. And since the Trustees must report on the condition of Medicare based on everything that is built into those laws, the newest report says we’re pretty much good-to-go for a long time.”
“What’s the catch?”
“Hey, Congressman, I knew you were smart! The catch is that the law requires assumptions about future costs that have no relationship to history and likely future events. The Trustees are straight up about this. They even have a graphic on page 5, no less, showing the difference between spending under current law and spending under ‘illustrative Alternative Projections.’ By 2090, the gap is a whopping 3 percent of GDP!
“The report even says, on page 192, that “by 2040, simulations suggest that approximately half of hospitals, 70 percent of skilled nursing facilities, and 90 percent of home health agencies would have negative total facility margins, raising the possibility of access and quality of care issues for Medicare beneficiaries.” They also note that doctors may not be happy about Medicare reimbursements being a fraction of what private insurance pays.
“Of course, all that is in Appendix C, back on page 191,” Dupem adds.
“So what do I tell them?”
“No, dufus! You tell them what they want to hear. If they need good news, stick to the nice stats at the front of the book and laugh about the difference between law and a silly “illustrative alternative projection.”
“And if they are the other kind of constituent, the type that thrives on worry, well, you’re going to look pretty wise when you refer them to the CMS memo that explains why the good news figures are a legalistic fiction. That’s deep research, man. It shows you know.
“And, by the way, don’t tell them that CMS stands for Centers for Medicare and Medicaid Services! There’s nothing quite like an unexplained acronym to lend an air of familiarity and knowledge.”
“Wow, Mr. Dupem, this Congressman thing is starting to look like an easy gig! But one more thing, what about Social Security?”
“Oh, that’s even more simple. If you want to reassure people, just talk about the trust accounting for the Social Security Trust Fund and its trillions in assets and billions in interest income. That makes most people feel really good.
“And tell the curmudgeons about the federal budget accounting that shows Social Security is already in the hole.
“Once you get the hang of it— once you understand the sublime communication potential of government reporting— well, you’ll be in Washington for a long time,” Mr. Dupem said with a smile.
On the web:
John D. Shatto and M. Kent Clemens, “Projected Medicare Expenditures under and Illustrative Scenario with Alternative Payment Updates to Medicare Providers,” CMS, Office of the Actuary, 7/22/2015
Scott Burns, “The future of Medicare: Cheap, But Not Available,” 8/13/2010
http://assetbuilder.com/scott_burns/future_medicare_cheap_but_not_available
Scott Burns, “Social Security: It’s Still in the Woods,” 7/31/2015
http://assetbuilder.com/scott_burns/social_security_its_still_in_the_woods
2015 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds
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(c) A. M. Universal, 2015