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Ethan Rome

Ethan Rome

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Republicans Want to Replace Medicare With Rationcare

Posted: 04/ 7/11 05:02 PM ET

The Republican "Path to Prosperity" proposed by House Budget Chairman Paul Ryan of Wisconsin eliminates Medicare as we know it. The nation's most efficient health insurance program would be turned over to the private insurance industry and seniors issued "ration cards" instead of Medicare cards. Seniors would pay more and get less care, while health insurance companies would make more billions in profits. This isn't reform - it's rationing. It's Republican Rationcare.

The Republicans would dismantle Medicare, trading seniors' guaranteed health care benefits for so-called vouchers that send hundreds of billions of dollars directly to private insurance companies. Beneficiaries would be forced to pay two to three times more than they would if the law remained unchanged. For someone turning 65 in 2022, the first year of the program, the voucher would be worth $8,000, which is less than the average cost per Medicare beneficiary today. The vouchers are deliberately underfunded and the result is that seniors would pay a staggering 68 percent of the cost of their medical care in 2030, compared to 25 percent if the law were unchanged, according to the Congressional Budget Office.

So on Day One of this Republican pipe dream, folks start out thousands of dollars behind. Then the voucher would lag behind the growth in actual medical costs because it would rise in step with the Consumer Price Index and as people's age and medical expenses rise. Using the CBO assumption of 2.5 percent annual inflation, the voucher would only grow to $9,750 by 2030. As a result, a person age 65 would be saddled with $20,700 in out-of-pocket medical costs. And that doesn't even count health care expenditures that aren't covered by Medicare. Welcome to the Republican vision of middle-class retirement. Americans can fill their golden years by juggling the challenges of rationed access to doctors and hospitals and the inability to put food on the table and pills in the medicine cabinet.

Adding insult to injury, the GOP is also hatching an appalling scheme to devastate America's seniors and families with $1.4 trillion in Medicaid cuts. This Republican plan would desert millions of children, people with disabilities and chronic diseases, and seniors who need help paying for long-term care. It would decimate the working poor and leave hospitals without enough money to provide lifesaving care.

So who benefits from the Republicans' Medicare scheme? Not you. The proposal would shift billions in health care costs onto seniors while making insurers even more profitable, making their overpaid CEOs, corporate lobbyists and Republican campaign contributors even richer. The health insurance industry will manage an estimated $863 billion in premiums this year. Under the Ryan plan, they'll get hundreds of billions of dollars more. To Republicans, this proposal makes all the sense in the world. After all, the GOP is a wholly owned subsidiary of billionaires like the Koch Brothers and global corporations that do business in America.

Insurance companies are well-suited to the task of rationing care for seniors. They have vast experience jacking up premium rates and denying care to the rest of the population. For the insurance industry it would be a seamless transition.

According to the private-market zealots at the Koch Brothers-funded Cato Institute, this will all be fine. Much of Medicare's spending is optional care that seniors would forgo if they paid a greater portion of the costs. Seniors "might even decide not to do the critical care" if it was too costly, Michael Tanner, Cato's health policy point man, told Politico Pro. If some of those costs were picked up by the individual, they might decide they wanted to save their resources for their survivors, Tanner said.

The pretense is over. The Republican plan is rationing. It's heartless. It won't be Medicare anymore. You can call it Medicareless or Republican Rationcare, but by any name, it would no longer be the guaranteed health care program that has served our nation so well since 1965.

 

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03:57 PM on 04/11/2011
The "Efficiency" number is another statistic that misleads. A claim for $1000, costs the same to process as a claim for $100,000. So, the payor of the $100K bill seems "more efficient" on a claim's administrative cost per dollar disbursed. Coincidentally, this is the method used to calculate Medicare's "Efficiency". Also, coincidentally, a Medicare supplement pays about $1000 for the first night in the hospital, Medicare pays for the rest. For every other dollar spent in the hospital, Medicare pays at least 80%, as well as all Doctor's office visits. Medicare is NOT more "efficient". In fact it has little oversight over claims and care, this alone gives rise to widespread fraud and abuse. And, they don't catch them all.
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11:35 AM on 04/09/2011
"according to the Congressional Budget Office, traditional Medicare spends less than 2 percent of expenditures on administrative costs, while private plans in Medicare Advantage spend approximately 11 percent on additional expenditures like profits"
http://wonkroom.thinkprogress.org/2011/04/05/ryan-fehbp/
01:00 PM on 04/08/2011
If these extreme capitalists and born again theocrats get their way America will become a very dark place where greed and ignorance dominate and economic decline is accelerated.
01:42 PM on 04/08/2011
Why can't we talk about the economics of Medicare instead of making value judgements? The average recipient will use more than $250,000 in lifetime benefits, a number rising every year. They have paid maybe 5% of that into the system, and the money was spent on something else anyway, never saved. The difference will come from the labors of their children and grandchildren, even the educations and healthcare of their great grandchildren and great,great grandchildren..

By all means, have them pay 50% of the cost themselves, that's maybe $400 a month. They will clamor for a low cost alternative, yes, one with fewer options, but using a British model of a National Health Service, the care will still be very good and much more sustainable for the country we all love. BTW, I'm 56 years old and a primary care doctor.
itolduso
lateral thinker
12:13 PM on 04/08/2011
KEEP YOUR TEA-PARTY HANDS OFF MY GOVERMENT HEALTHCARE!
mm3264
Volunteer Of America, Occupy Wall St
10:15 AM on 04/08/2011
If you ask Rivlin, what they worked on had little to do with what Ryan claims was a partnership. She doesn't even want her name on it. The reason the Republicans put Rivlin first is because they want the ignorant to believe it was Bi-Partisan
09:35 AM on 04/08/2011
Medicaid let me introduce you to how MEDICAID works that is covered by the States - not the Federal Government that is run at State Level - the Federal Government gives the States only a small percentage of the money for Medicaid and Welfare and never provides enough and has crazy rules for coverage and the States are bleeding money out because of the strain of Medicaid & Welfare. So just the same the States will be getting the Federal Government pay into their Medicaid system but the State will be in charge of how it will dispense the benefits and who will be eligible and for how much. The responsibility for paying for Medicaid is at State level now they will be able to control it at State Level.
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dacohenz
09:11 AM on 04/08/2011
Typical dark side politics, give to the rich and take from the poor, Sheriff of Nottingham style.
09:10 AM on 04/08/2011
WOW more people that do not know what they are talking about and write an article - not surprised the Medicare part of the Ryan Budget plan is not a VOUCHER system heck it isn't even all of Ryan's baby it is the Rivlin-Ryan plan and it is far better than stinking Medicare that makes you pay rent for items that are cheaper if you buy them out right. Undercuts payments to Doctors and Hospitals so the private insured people have to take up the slack. But the Rivlin-Ryan plan is that you will get to choose your insurance provider - you cannot be denied - the Federal Government pays your monthly premiums -as they do now out of your SOCIAL SECURITY monthly income and the more money you personally have the less the Federal Government will pay toward your premiums especially if you are in the top 10% so billionaires will not be eligible for Medicare. There you go tax the Rich and no return for them. The poor will be totally covered - just as Medicare gives you 80% coverage now that will not change. Except that Warren Buffet and Bill Gates will not be receiving government paid for benefits they will have to pay their entire premium.
09:59 AM on 04/08/2011
'Tax the Rich and no return for them.'

Anyone else notice that Rich is capitalized here...just like we do with the word God or Jesus?

It really is heartbreaking to think of Warren and Bill having to pay an entire insurance premium in their elder years. How little they have received from this society. It's really just a shame that the two wealthiest men in the world will receive nothing back from the society that made them so rich...oh I'm sorry Rich.

Would they have become this rich without a public school and university system to provide them with employees? Would they have become this rich without the roads, bridges and utilities (price regulated) to power their offices or factories? Would they have become this rich without consumers (read the poor rabble) to buy their products and services?

I suggest you go to a country that has no public schools, pesky health programs or public roads and see how much money you make starting a business there. Should be great, based on your premise that as little government as possible will make business thrive! I think the Ivory Coast needs a coffee shop - there's a good start for ya.
12:59 PM on 04/08/2011
You have got to be kidding you are freaking out because I capitalized rich - it happens to be your number enemy number.1. This continual joke about how they owe society because society made them rich. Really as for public schools, roads, bridges who pays for those - oh yeah the Private sector the TAX PAYER the revenue maker the job creator - not the public sector they create the dept and the PRIVATE SECTOR pays the freakin bill. Public sector employees do not create revenue into the Government only the Private sector can do that. So who actually pays for all of those things not only does the Private sector pay for all of those things even if they send their kids to private school they still pay for the public school. Are you honestly that jealous of people that are personally successful? Do you have to buy Microsoft products NO - do you pay Warren Buffet for making wise investments NO !!! But they owe you some how ... Both Warren Buffet and Bill Gates are Liberals and give plenty of money to charities. Warren Buffet will complain that he thinks he should pay more taxes but he doesn't he can no one is stopping him from doing so you can gift as much money as you want to the Federal Government. By the way Indiana now has private tollways and they are far better than when they were public.
itolduso
lateral thinker
12:12 PM on 04/08/2011
OOOOh! "But the Rivlin-Ryan Plan is that you get to choose your insurance provider...." Well, ya know what? I CHOOSE MEDICARE...which lets me choose my DOCTOR
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susandiane
Despite everything, I am still a proud Virginian
08:39 AM on 04/08/2011
and us gen-xers are frigged over again!
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citygirl1832
Life is supposed to be good
07:58 AM on 04/08/2011
Republican Death Panels!!!
07:35 AM on 04/08/2011
Is it, as the commercial indicates better to have a bureaucrat in whose boss is accountable to voters oversee healthcare.

Or

Is it better to have a Manager who is sitting on a yacht with his boss the CEO extolling the latest profit figures. Complain about lack of service here and there is either a promotion or a raise.

Distasteful as it may be. I tend to think the best value for my dollar is in Washington.

Single Payer Health Care

Less paper work. Streamlined service. Allow for private insurance if desired.
09:08 AM on 04/08/2011
Absolutely...single payer is the way to go...
07:12 AM on 04/08/2011
Before Medicare became law, pre-1965, 14% of seniors had medical insurance because few insurers would authorize premiums for them due to their being high risk. Now, over 99% of seniors have medical coverage. This alone accounts to the increase in life expectancy.

Medicare not only provides a safety net to seniors, the cost of the administration of Medicare is 4% and decreasing, whereas private insurance administration is nearly 17% and increasing. These costs are passed on to consumers.

The vouchers to be issued will be wholly inadequate to purchase like coverage from private insurers, if you can get coverage at all.
06:59 AM on 04/08/2011
I find the concept of smaller Government perplexing. I understand about the GDP and all (kinda) But If there were more product would not that ratio be reduced?
As for health care. Why is it that people always talk about Insurance as if it were health care? It really is not. All insurance can be summed up easily. It is a financial institution that collects money to be distributed for services rendered. For some spastic reason. This is done at a huge profit. The beneficiaries of this method. Not the doctors. Not the patients. Not the hospitals. Yup you guessed it.
The old people that can not afford the care provided them. Are they to be left on the side of the road? Who will pay for the treatment they receive? I will in higher costs. You will in higher fees. We all will in a lowering of life expectancy.
I for one find it distasteful to hand over money to an insurance sector that craves indulgence. So that some people can claim they care about America when in fact they care only about how they look to Americans.

End Trans.
09:10 AM on 04/08/2011
So true...actually, ins goal is to minimize expense and maximize profits...that's why I wanted single payer...
04:48 AM on 04/08/2011
The whole idea is to transform what is now Medicare and Social Security for all to Medicare and Social Security for the rich only. It's just another transfer of wealth and income inequality from poor to rich under the guise of "getting spending under control" or "balancing the budget." Take your pick. And people are falling for it.
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contrariandy
Progressive Capitalism created the Middle Class.
05:51 AM on 04/08/2011
And notice how the Repo Men continue to shift numerous tax and expense burdens from the Rich to the Middle Class. That's been part of the plot for many years - Keep increasing the regressive tax burden on the Poor and Middle Class so that they can be tricked into being Angry Republican Taxpayers.
09:11 AM on 04/08/2011
Yep, I wonder if AARP has wrapped around this yet...
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weathergirl
loved politics as a little girl!
12:46 AM on 04/08/2011
The voucher system does not work for schools and it will not work for Medicare! The "death panels" that the GOP claim were in "Obamacare" were be realized! Vouchers will never cover the needs of senor citizens. We really need a single payer system so that we do not have to pay for the 2nd and 3rd vacations homes and the private jets of the CEOs of HealthSouth, Blue Cross, Blue Shield, CIGNA, etc. Right now in our private health care system we have rationing by the companies paying minimum wage earners to check a box and deny coverage! Right now, doctors have to spend most of their money and time on millions of different insurance forms so their patients might be covered for the consultation and so they can get a living wage from the compensation that the insurance companies deem is fair. Of course, the insurance companies are "for profit" and in the business to deny coverage so that way they will make more money!