Why Would the AARP Support State-Sponsored Euthanasia?

[GaryC 7]

I really wouldn't mind paying for health care via insurance if the insurance did what it was meant to and I could understand what was covered, and get the things I want covered using an understandable, fair and predetermined set of rules and fees. That's not what is offered though and I don't like having to worry about not knowing if I could afford to pay if...that's the nightmare of this stupid system.

I agree with this 100%. My children are actually covered through their Dad's work. . But the rules and the double speak are ridiculous. My daughter was hospitalized 3 times last year so the deductible was met back in February. Ok so when she went to the hospital the 2nd time I get a bill for $704 for the Emergency room physician. I called and told them the deductible had been met and to rebill the insurance. I was told my insurance wasn't covering it. So I call the insurance.....the reason it isn't covered is because the doctor is OUT OF NETWORK. WHAT?!?! How can he be when it states right on Blue cross website that the hospital is a PREFERRED NETWORK PROVIDER??? This wasn't a doctor visit but an emergency in which my child was subsequently taken by ambulance to a special childrens hospital for 10 days. So I guess next time you are bleeding to death at the emergency room better make the doctor on call is IN NETWORK.

Anyone who doesn't think we need healthcare insurance reform hasn't had to really use the healthcare system much. IMO

I remember, almost twenty years ago, when my daughter was hospitalized for hypoplastic left heart syndrome. My company bought quite good insurance. I paid a portion of the premium. Fair enough. When we first went to hospital, the insurance company got to choose which hospital she went to and which doctors she saw. She had pretty good medical care, and everything she got was covered according according to the language of my employers contract. But CIGNA, in the end, really didn't want to pay. Their lawyers agreed with my employer that they had to pay, but they didn't want to. They were new to our state (Illinois) and had had bad luck "with lots of sick babies" and CIGNA of Illinois wasn't going to make a profit that year. My employers (a S&P 20 company, fortunately not a small one that CIGNA might have been able to push around) posture was, this is our contract with you, are you going to honor it? We got calls at all hours of day and night for months from creditors asking us to help them get paid by our insurance company. The last call woke me up in the middle of the night a year (to the day) after she died.

Our medical system in this country is broken because of the scum insurance companies that profit from our misfortune or lack of it. I wholeheartedly support the President's initiative. No one has ever called my mom or anyone in my family about a Medicare claim!

First of all, I am very sorry about your daughter. I am wondering about your story about the creditors calling you though. By law they cannot call you in the middle of the night. Again, I am sorry for your loss but in the end the insurance company did pay, no?

[mendeleev 68]

I really wouldn't mind paying for health care via insurance if the insurance did what it was meant to and I could understand what was covered, and get the things I want covered using an understandable, fair and predetermined set of rules and fees. That's not what is offered though and I don't like having to worry about not knowing if I could afford to pay if...that's the nightmare of this stupid system.

I agree with this 100%. My children are actually covered through their Dad's work. . But the rules and the double speak are ridiculous. My daughter was hospitalized 3 times last year so the deductible was met back in February. Ok so when she went to the hospital the 2nd time I get a bill for $704 for the Emergency room physician. I called and told them the deductible had been met and to rebill the insurance. I was told my insurance wasn't covering it. So I call the insurance.....the reason it isn't covered is because the doctor is OUT OF NETWORK. WHAT?!?! How can he be when it states right on Blue cross website that the hospital is a PREFERRED NETWORK PROVIDER??? This wasn't a doctor visit but an emergency in which my child was subsequently taken by ambulance to a special childrens hospital for 10 days. So I guess next time you are bleeding to death at the emergency room better make the doctor on call is IN NETWORK.

Anyone who doesn't think we need healthcare insurance reform hasn't had to really use the healthcare system much. IMO

I remember, almost twenty years ago, when my daughter was hospitalized for hypoplastic left heart syndrome. My company bought quite good insurance. I paid a portion of the premium. Fair enough. When we first went to hospital, the insurance company got to choose which hospital she went to and which doctors she saw. She had pretty good medical care, and everything she got was covered according according to the language of my employers contract. But CIGNA, in the end, really didn't want to pay. Their lawyers agreed with my employer that they had to pay, but they didn't want to. They were new to our state (Illinois) and had had bad luck "with lots of sick babies" and CIGNA of Illinois wasn't going to make a profit that year. My employers (a S&P 20 company, fortunately not a small one that CIGNA might have been able to push around) posture was, this is our contract with you, are you going to honor it? We got calls at all hours of day and night for months from creditors asking us to help them get paid by our insurance company. The last call woke me up in the middle of the night a year (to the day) after she died.

Our medical system in this country is broken because of the scum insurance companies that profit from our misfortune or lack of it. I wholeheartedly support the President's initiative. No one has ever called my mom or anyone in my family about a Medicare claim!

First of all, I am very sorry about your daughter. I am wondering about your story about the creditors calling you though. By law they cannot call you in the middle of the night. Again, I am sorry for your loss but in the end the insurance company did pay, no?

After my employer threatened to take them to court, they finally paid.

By fact, they did call in the middle of the night. By fact, CIGNA would not have paid unless they had been up against another big company with adequate resources to bring them to honor their commitments. This system is broken. Very substantial reforms are needed. I support the President's inititatives, although they probably don't go far enough.

My elderly mom is covered by an effective, hassle-free single payer system (called Medicare). It isn't perfect. Its just far, far better than what the private sector delivers.

[Sofiyya 1,687]

All those, regardless of income, who refuse to carry health care, or to be forced into Obama's plan, would be levied a "tax penalty" for exercising their right to refuse such a demand.

Excerpt from a Joint Committee on Taxation meeting re Barry's plan:

Edited August 8, 2009 by Sofiyya

[Sofiyya 1,687]

[Sofiyya 1,687]

Obama: Need a pacemaker? Take a pain pill. This from the same man who vigorously opposed life-saving efforts for newborns who survived abortions and who doesn't want his daughters punished with a baby.

However, he requires empathy in his Supreme Court appointees . . .

Edited August 8, 2009 by Sofiyya

[GaryC 7]

I really wouldn't mind paying for health care via insurance if the insurance did what it was meant to and I could understand what was covered, and get the things I want covered using an understandable, fair and predetermined set of rules and fees. That's not what is offered though and I don't like having to worry about not knowing if I could afford to pay if...that's the nightmare of this stupid system.

I agree with this 100%. My children are actually covered through their Dad's work. . But the rules and the double speak are ridiculous. My daughter was hospitalized 3 times last year so the deductible was met back in February. Ok so when she went to the hospital the 2nd time I get a bill for $704 for the Emergency room physician. I called and told them the deductible had been met and to rebill the insurance. I was told my insurance wasn't covering it. So I call the insurance.....the reason it isn't covered is because the doctor is OUT OF NETWORK. WHAT?!?! How can he be when it states right on Blue cross website that the hospital is a PREFERRED NETWORK PROVIDER??? This wasn't a doctor visit but an emergency in which my child was subsequently taken by ambulance to a special childrens hospital for 10 days. So I guess next time you are bleeding to death at the emergency room better make the doctor on call is IN NETWORK.

Anyone who doesn't think we need healthcare insurance reform hasn't had to really use the healthcare system much. IMO

I remember, almost twenty years ago, when my daughter was hospitalized for hypoplastic left heart syndrome. My company bought quite good insurance. I paid a portion of the premium. Fair enough. When we first went to hospital, the insurance company got to choose which hospital she went to and which doctors she saw. She had pretty good medical care, and everything she got was covered according according to the language of my employers contract. But CIGNA, in the end, really didn't want to pay. Their lawyers agreed with my employer that they had to pay, but they didn't want to. They were new to our state (Illinois) and had had bad luck "with lots of sick babies" and CIGNA of Illinois wasn't going to make a profit that year. My employers (a S&P 20 company, fortunately not a small one that CIGNA might have been able to push around) posture was, this is our contract with you, are you going to honor it? We got calls at all hours of day and night for months from creditors asking us to help them get paid by our insurance company. The last call woke me up in the middle of the night a year (to the day) after she died.

Our medical system in this country is broken because of the scum insurance companies that profit from our misfortune or lack of it. I wholeheartedly support the President's initiative. No one has ever called my mom or anyone in my family about a Medicare claim!

First of all, I am very sorry about your daughter. I am wondering about your story about the creditors calling you though. By law they cannot call you in the middle of the night. Again, I am sorry for your loss but in the end the insurance company did pay, no?

After my employer threatened to take them to court, they finally paid.

By fact, they did call in the middle of the night. By fact, CIGNA would not have paid unless they had been up against another big company with adequate resources to bring them to honor their commitments. This system is broken. Very substantial reforms are needed. I support the President's inititatives, although they probably don't go far enough.

My elderly mom is covered by an effective, hassle-free single payer system (called Medicare). It isn't perfect. Its just far, far better than what the private sector delivers.

I agree that some changes need to be made, no doubt of that. I am just worried that we will be trading one tyrant for another.

Re: medicare, my father has medicare, he must carry supplemental insurance for the 20% not covered and he must have another to cover his drugs. Medicare does help but my insurance through my company is much better than that.

Oh, if a creditor calls you after 9PM you can sue them for breaching the fair credit act. That shouldn't happen and you do have recourse for it.

[GaryC 7]

'End-of-Life' Counseling Intensifies Health Care Debate

A provision in the House health care bill would provide Medicare coverage for an end-of-life consultation, leading some to believe that the Obama administration is looking to save money by pressuring insurers to provide less coverage to seniors in the later stages of their lives.

A provision in President Obama's health care reform bill encourages "end-of- life" counseling for seniors -- sparking euthanasia fears among some of the legislation's critics and leading others to believe that the White House is looking to save money by pressuring insurers to provide less coverage to seniors.

The provision, tucked deep within the House bill, would provide Medicare coverage for an end-of-life consultation every five years, and more frequent sessions if a person is suffering a life-threatening disease.

Health providers would be required to explain to seniors the end-of-life services available, including "palliative care and hospice."

"This provision may start us down a treacherous path toward government-encouraged euthanasia if enacted into law," House Minority Leader John Boehner, R-Ohio, and Rep. Thaddeus McCotter, R-Mich. said in a statement last month.

But the sessions are not required, as President Obama reassured seniors last week at an AARP town hall meeting, when one woman said she'd been told that the policy requires everyone of Medicare age to be visited and told they have to decide how they wish to die.

"Nobody is going to be forcing you to make a set of decisions on end-of-life care based on, you know, some bureaucratic law in Washington," the president said.

Obama encourages people to create living wills, but it's not clear if he supports Medicare reimbursement for "end-of-life" counseling.

A Harvard study released earlier this year directly linked end-of-life counseling with lower health care costs and better quality of life for patients with advanced cancers.

Researchers, who interviewed 603 advanced-cancer patients about whether they had end-of-life conversations with their physicians, found that patients who did had an estimated average of $1,876 in health care expenses during their final week of life, compared with $2,917 for those who didn't. Patients also associated higher costs with a worse quality of death during their final week and typically did not live longer if they received intensive care.

"As the nation looks to ways to improve patient care and reduce costs of health care, end-of-life conversations should be considered, " said the study's senior author, Holly Prigerson, a professor of psychiatry at Harvard Medical School.

"Policies that promote increased communication, such as incentives for end-of-life conversations, may be cost-effective ways to both improve care and reduce some of the rising health care expenditures."

White House aides acknowledge it's a sensitive issue.

A quarter of all Medicare spending takes place in a patient's final year of life, and studies show most people facing a terminal illness or simply very old age prefer less medical intervention to more. That suggests the potential for savings.

Last fiscal year, the government spent $455 billion on Medicare -- 15 percent of the federal budget -- to cover 46 million Americans. Medicare spending is projected to skyrocket to 20 percent of the budget by 2019 as baby boomers increasingly become eligible for the program.

In 2010, 40.2 million seniors 65 years and older will be eligible for Medicare. That number is projected to rise to 54.8 million in 2020 and 88.5 million in 2050, according to the U.S. Census Bureau.

But Medicare's program for hospital stays is already spilling red ink. A report earlier this year showed that because of rapidly declining revenues, the Medicare trust fund for hospital expenses since last year has been collecting less in taxes and interest income than it pays out in benefits.

The fund's reserves will be exhausted by 2017, making it insolvent two years earlier than the trustees predicted last year. Medicare's total unfunded obligations, including its programs that use general revenues to pay for doctors' fees and prescription drugs, have reached $37.8 trillion.

When the Bush administration expanded Medicare reimbursement to cover hospice care, which is less expensive than hospital care, hospice use grew 240 percent. Studies show people prefer hospice care but officials are concerned about people outside a patient's family or doctor influencing the decision to give up on curative care.

"And that's where a lot of people fear that some of these ideas in these bills lead you to and that's unethical as far as I'm concerned," Sen. Charles Grassley, R-Iowa, said.

Charmaine Yoest, president and chief executive of Americans United for Life, said in a blog post that health reform "must respect life, and not contain provisions that mandate or encourage the withdrawal or curtailment of effective life-sustaining treatment to the terminally ill, the chronically ill, or the permanently disabled."

Lawmakers say making end-of-life decisions ahead of time is a good thing -- and it should be done early.

"Think about it when you're 50 years old instead of when you're 85, what sort of care you want," Grassley said.

The White House says even though Medicare would reimburse for the counseling sessions, it wouldn't conduct them.

"These decisions will be made by doctors and patients," White House spokesman Robert Gibbs said.

And Gibbs accused critics of misrepresenting that part of the health reform bill.

"I think there are people that have knowingly spread inaccurate information to hold up progress on health reform," he said.

http://www.foxnews.com/politics/2009/08/06...-reform-debate/

[Sofiyya 1,687]

Rahm Emmanuel's brother, Dr. Ezekiel Emanuel, is an advisor to the Obama administration on health care issues. He and his brothers were interviewed on Charlie Rose, yielding this snippet. The relevant information starts about 2 mins 11 secs into the clip.

[Mr. Big Dog 10,747]

Re: medicare, my father has medicare, he must carry supplemental insurance for the 20% not covered and he must have another to cover his drugs. Medicare does help but my insurance through my company is much better than that.

Your father just needs to get a job with good insurance, then.

[Mr. Big Dog 10,747]

'End-of-Life' Counseling Intensifies Health Care Debate

...

A Harvard study released earlier this year directly linked end-of-life counseling with lower health care costs and better quality of life for patients with advanced cancers.

...

In 2010, 40.2 million seniors 65 years and older will be eligible for Medicare. That number is projected to rise to 54.8 million in 2020 and 88.5 million in 2050, according to the U.S. Census Bureau.

But Medicare's program for hospital stays is already spilling red ink. A report earlier this year showed that because of rapidly declining revenues, the Medicare trust fund for hospital expenses since last year has been collecting less in taxes and interest income than it pays out in benefits.

The fund's reserves will be exhausted by 2017, making it insolvent two years earlier than the trustees predicted last year. Medicare's total unfunded obligations, including its programs that use general revenues to pay for doctors' fees and prescription drugs, have reached $37.8 trillion.

So end of life counseling not only reduces cost but also betters quality of life for people with advanced cancers. What's the issue?

As for the funding, again, Medicare contributions have been 2.9% for the past 20 years. Private insurance premiums, on the other hand more than doubled over the last decade alone. It is quite obvious that the more seniors we have, the more of a funding requirement there will be. Try and have private insurers do what Medicare does: Cover more people longer with ever more treatment options on a funding inflow that remains stagnant relative to wage growth over two decades. Good luck with that.

Edited August 8, 2009 by Mr. Big Dog

[GaryC 7]

'End-of-Life' Counseling Intensifies Health Care Debate

...

A Harvard study released earlier this year directly linked end-of-life counseling with lower health care costs and better quality of life for patients with advanced cancers.

...

In 2010, 40.2 million seniors 65 years and older will be eligible for Medicare. That number is projected to rise to 54.8 million in 2020 and 88.5 million in 2050, according to the U.S. Census Bureau.

But Medicare's program for hospital stays is already spilling red ink. A report earlier this year showed that because of rapidly declining revenues, the Medicare trust fund for hospital expenses since last year has been collecting less in taxes and interest income than it pays out in benefits.

The fund's reserves will be exhausted by 2017, making it insolvent two years earlier than the trustees predicted last year. Medicare's total unfunded obligations, including its programs that use general revenues to pay for doctors' fees and prescription drugs, have reached $37.8 trillion.

So end of life counseling not only reduces cost but also betters quality of life for people with advanced cancers. What's the issue?

As for the funding, again, Medicare contributions have been 2.9% for the past 20 years. Private insurance premiums, on the other hand more than doubled over the last decade alone. It is quite obvious that the more seniors we have, the more of a funding requirement there will be. Try and have private insurers do what Medicare does: Cover more people longer with ever more treatment options on a funding inflow that remains stagnant relative to wage growth over two decades. Good luck with that.

Did you read what you quoted? Medicare has a 37.8 TRILLION unfunded obligation. If this is an example of efficiency and a well managed program then I just don't know what to say. That is the GDP of the entire planet! Now you want to add everyone else to this program and expand that shortfall even more! I would say we would pay much less if we just dispensed with the government option all together and went with a total private system. We can't cover that kind of money.

[Mr. Big Dog 10,747]

'End-of-Life' Counseling Intensifies Health Care Debate

...

A Harvard study released earlier this year directly linked end-of-life counseling with lower health care costs and better quality of life for patients with advanced cancers.

...

In 2010, 40.2 million seniors 65 years and older will be eligible for Medicare. That number is projected to rise to 54.8 million in 2020 and 88.5 million in 2050, according to the U.S. Census Bureau.

But Medicare's program for hospital stays is already spilling red ink. A report earlier this year showed that because of rapidly declining revenues, the Medicare trust fund for hospital expenses since last year has been collecting less in taxes and interest income than it pays out in benefits.

The fund's reserves will be exhausted by 2017, making it insolvent two years earlier than the trustees predicted last year. Medicare's total unfunded obligations, including its programs that use general revenues to pay for doctors' fees and prescription drugs, have reached $37.8 trillion.

So end of life counseling not only reduces cost but also betters quality of life for people with advanced cancers. What's the issue?

As for the funding, again, Medicare contributions have been 2.9% for the past 20 years. Private insurance premiums, on the other hand more than doubled over the last decade alone. It is quite obvious that the more seniors we have, the more of a funding requirement there will be. Try and have private insurers do what Medicare does: Cover more people longer with ever more treatment options on a funding inflow that remains stagnant relative to wage growth over two decades. Good luck with that.

Did you read what you quoted? Medicare has a 37.8 TRILLION unfunded obligation. If this is an example of efficiency and a well managed program then I just don't know what to say. That is the GDP of the entire planet! Now you want to add everyone else to this program and expand that shortfall even more! I would say we would pay much less if we just dispensed with the government option all together and went with a total private system. We can't cover that kind of money.

Did you bother to read my response?

[GaryC 7]

'End-of-Life' Counseling Intensifies Health Care Debate

...

A Harvard study released earlier this year directly linked end-of-life counseling with lower health care costs and better quality of life for patients with advanced cancers.

...

In 2010, 40.2 million seniors 65 years and older will be eligible for Medicare. That number is projected to rise to 54.8 million in 2020 and 88.5 million in 2050, according to the U.S. Census Bureau.

But Medicare's program for hospital stays is already spilling red ink. A report earlier this year showed that because of rapidly declining revenues, the Medicare trust fund for hospital expenses since last year has been collecting less in taxes and interest income than it pays out in benefits.

The fund's reserves will be exhausted by 2017, making it insolvent two years earlier than the trustees predicted last year. Medicare's total unfunded obligations, including its programs that use general revenues to pay for doctors' fees and prescription drugs, have reached $37.8 trillion.

So end of life counseling not only reduces cost but also betters quality of life for people with advanced cancers. What's the issue?

As for the funding, again, Medicare contributions have been 2.9% for the past 20 years. Private insurance premiums, on the other hand more than doubled over the last decade alone. It is quite obvious that the more seniors we have, the more of a funding requirement there will be. Try and have private insurers do what Medicare does: Cover more people longer with ever more treatment options on a funding inflow that remains stagnant relative to wage growth over two decades. Good luck with that.

Did you read what you quoted? Medicare has a 37.8 TRILLION unfunded obligation. If this is an example of efficiency and a well managed program then I just don't know what to say. That is the GDP of the entire planet! Now you want to add everyone else to this program and expand that shortfall even more! I would say we would pay much less if we just dispensed with the government option all together and went with a total private system. We can't cover that kind of money.

Did you bother to read my response?

Of course I did. You keep going on about how the contribution has only been 2.9% and insurance companies raise premiums have doubled. Well, the result of the governments mismanagement by not raising premiums have cause this huge shortfall that we cannot possibly recover from. Wrap this number around your head, 37.8 TRILLION dollars. That is what is needed just to break even. Can you imagine what kind of tax rate we would need to cover that? Sorry man, I just don't see a well managed system there.

[Mr. Big Dog 10,747]

'End-of-Life' Counseling Intensifies Health Care Debate

...

A Harvard study released earlier this year directly linked end-of-life counseling with lower health care costs and better quality of life for patients with advanced cancers.

...

In 2010, 40.2 million seniors 65 years and older will be eligible for Medicare. That number is projected to rise to 54.8 million in 2020 and 88.5 million in 2050, according to the U.S. Census Bureau.

But Medicare's program for hospital stays is already spilling red ink. A report earlier this year showed that because of rapidly declining revenues, the Medicare trust fund for hospital expenses since last year has been collecting less in taxes and interest income than it pays out in benefits.

The fund's reserves will be exhausted by 2017, making it insolvent two years earlier than the trustees predicted last year. Medicare's total unfunded obligations, including its programs that use general revenues to pay for doctors' fees and prescription drugs, have reached $37.8 trillion.

So end of life counseling not only reduces cost but also betters quality of life for people with advanced cancers. What's the issue?

As for the funding, again, Medicare contributions have been 2.9% for the past 20 years. Private insurance premiums, on the other hand more than doubled over the last decade alone. It is quite obvious that the more seniors we have, the more of a funding requirement there will be. Try and have private insurers do what Medicare does: Cover more people longer with ever more treatment options on a funding inflow that remains stagnant relative to wage growth over two decades. Good luck with that.

Did you read what you quoted? Medicare has a 37.8 TRILLION unfunded obligation. If this is an example of efficiency and a well managed program then I just don't know what to say. That is the GDP of the entire planet! Now you want to add everyone else to this program and expand that shortfall even more! I would say we would pay much less if we just dispensed with the government option all together and went with a total private system. We can't cover that kind of money.

Did you bother to read my response?

Of course I did. You keep going on about how the contribution has only been 2.9% and insurance companies raise premiums have doubled. Well, the result of the governments mismanagement by not raising premiums have cause this huge shortfall that we cannot possibly recover from. Wrap this number around your head, 37.8 TRILLION dollars. That is what is needed just to break even. Can you imagine what kind of tax rate we would need to cover that? Sorry man, I just don't see a well managed system there.

What time frame is the basis for this 37.8 trillion figure? What other assumptions have been made to arrive at that number? Once we know that, we can take a look at what kind of raise in the medicare rate it would take. I'm almost certain, however, that the system would remain in good shape if the rates would be raised half of the rate raises that the private health insurance has pushed through. In other words, raise the rate 50% over the next decade and I think we'd be looking a lot better. Alternatively, open the system for a premium below the private insurance rates to people that are net payers - young folks - and the picture will change dramatically for the better w/o the need for dramatic rate increases.

[GaryC 7]

What time frame is the basis for this 37.8 trillion figure? What other assumptions have been made to arrive at that number? Once we know that, we can take a look at what kind of raise in the medicare rate it would take. I'm almost certain, however, that the system would remain in good shape if the rates would be raised half of the rate raises that the private health insurance has pushed through. In other words, raise the rate 50% over the next decade and I think we'd be looking a lot better. Alternatively, open the system for a premium below the private insurance rates to people that are net payers - young folks - and the picture will change dramatically for the better w/o the need for dramatic rate increases.

I am not sure you really understand just how bad of a mess Medicare and Social Security are really in. Both of them are on the edge of total collapse. It is why I react to your assumption that the government can do it better. They are the worst possible managers of our health care. As bad as the insurance companies are they would seem like the pillar of efficiency compared to what it would be like under the government. Do a google search for "medicare unfunded liability". Do the same for Social Security. You will see why I am so strongly against the government take over. This is one hit that seems credible. If it isn't then click on any of the hundreds of hits.

Social Security and Medicare Projections: 2008

by Pamela Villarreal

The 2008 Social Security and Medicare Trustees Reports show the combined unfunded liability of these two programs has reached $101.7 trillion in today’s dollars! That is more than seven times the size of the U.S. economy and 10 times the size of the outstanding national debt. The unfunded liability is the difference between the benefits that have been promised to retirees and what will be collected in dedicated taxes and Medicare premiums. Last year alone, the size of the debt rose by $11.5 trillion. If no other reform is enacted, this funding gap can only be closed in future years by substantial tax increases, large benefit cuts or both.

The rest of the story is here