The article quotes my mother in law, Judith Stein. Our politics could not be more different. Nevertheless, I rather agree with her that these changes are not good ones. If people are going to be dependent on government (me: bad; her: good), at least the interface should be fair and people should have the maximum amount of power to ensure that they are not being mistreated. Such appeal rights ENHANCE the power of the individual as against the state. That's what we conservatives want, right? I don't see what conservative agenda this accomplishes, other than insignificant savings here and there.

The point is to make the program both more efficient from a taxpayer standpoint and less desirable from a dependent standpoint.

Unfair way to accomplish those ends -- better to reduce promised benefits or, better yet, to enhance personal control/choice in the operation of the entitlement, as with HSAs, which you are rightly enamored of for just those reasons.

Once an entitlement is granted under law, one is really and truly owed the benefit conferred. One of the bad effects of the dependency created by entitlements is that the individual is at the mercy of the state to follow through on the commitments that the individual has been induced to incorporate into his planning. Administrative apeals give the individual power to force the government to follow through. These changes make the entitlement "less desirable" in ways that run counter to the conservative concern for the power of the individual versus the state.

rds:

The Supreme Court has ruled otherwise with respect to Social Security (on owning 'your' entitlement), and Medicare would have to follow.

But I wouldn't be surprised to see angry seniors whacking the nearest HHS official, a Congressman out for a walk, or even Charlie Schumer with their umbrellas. Telephone hearings seem especially cruel.

No one ever changed things by being fair.

cruel?

Those are understandable macro-level goals, but accomplished in a way that runs counter to liberty on a micro-level.

Once an entitlement is granted under law, one is really and truly owed the benefit conferred. One of the bad effects of the dependency created by entitlements is that the individual is at the mercy of the state to follow through on the commitments that the individual has been induced to incorporate into his planning. Administrative apeals give the individual power to force the government to follow through. These changes make the entitlement "less desirable" in ways that run counter to the conservative concern for the power of the individual versus the state.

It is not necessary to think of it this way to agree with my take on the matter, but a benefit legally conferred can be seen as a form of property. I know I'm not going to get any argument from you about the importance of enabling individuals to enforce property rights. Granted, this change isn't really going to materially effect people's right to appeal all that much, but nevertheless I don't think this advances any good conservative aim.

If benefits are over-gernerous, it is better to reduce them or, better still, to enhance personal control/choice in the operation of the entitlement, as with HSAs, which you are rightly enamored of for just those reasons.

In any case, Medicare is one of the least objectionable federal entitements, in my view -- although I am mindful that it should not be overgenerous. The private market would have to be humming like a Rolls Royce to provide well for the care of the very old and very poor. Not impossible, but not assured, either.

sorry about the multiple postings. I expanded my thought a little in the third one -- apparently one should not click "stop" while the site takes forever to post your comment, and then revise it. It will all be posted.

Jim Hamlen: If I recall correctly from law school, you don't own your entitlement in that you can't prevent administrators from taking it away. That is -- no entitlement is permanent. That is why these procedural changes are legal. But what I am saying is different -- you are entitled to what you are entitled to until the entitlement is changed, and procedures should permit you to enforce your right to the maximal extent. Inadequate appeals procedures only enhance the power of the state vis a vis the individual.

It would be cruel for an 80 year-old supplicant to lose an appeal because of a 'bad' connection, or a hang-up at a crucial moment. Which we both know will happen, much more frequently than we would like to believe. At least with video, one could see the "arbiter".

Given the way Medicare's finances are going, I wouldn't be surprised to see Congress eliminate the appeals process altogether. That would make for some interesting campaign trips, now wouldn't it?