Ryan-Wyden Medicare Reform Approach - Worth a Serious Look
Among the most hypocritical aspects of certain purist Democrats who call themselves liberals is their willingness to attack any Democrat who veers even slightly from liberal orthodoxy.
Sadly, their attacks almost always turn personal, substituting name-calling for thoughtful analysis of the facts.
Oregon Democratic Sen. Ron Wyden is one of the Senate's leading progressives, with a voting record on every major issue defining liberalism that is second to none.
Yet he has also been a target of attack by purist liberals -- because he has shown a willingness to mix liberal approaches (relying on government to assure social equity) with conservative principles (relying on private market competition and individual choices) to achieve traditional progressive social goals.
In 2010, Wyden introduced the Healthy Americans Act (HAA), co-sponsored by Utah conservative Sen. Bob Bennett.
It combined a commitment to national healthcare coverage and the individual mandate with allowing everyone to cash out their employer-provided insurance to exercise their choices to purchase insurance among competing private insurance companies.
The bill quickly attracted broad bipartisan support from leading liberals and conservatives in the Senate.
Had President Obama and the House and Senate Democratic leadership supported that bill, it was estimated it would have attracted 70 or more votes in the Senate and overwhelming bipartisan majorities in the House.
But it never gained traction among the liberal base of the Democratic Party, and the Obama White House never seriously considered it.
Now, in recent months, Wyden has joined with conservative Republican Rep. Paul Ryan (Wis.) to come up with a Medicare reform proposal that reflects a similar mixture of liberal and conservative principles.
It combines the "Medicare Guarantee" -- ensuring all seniors access to Medicare as we know it -- with providing seniors an option to purchase private Medicare policies that would compete for their business.
In short: If you want to keep your Medicare, you do. If you want to shop and, with some federal subsidies, purchase private insurance, you can.
What could possibly be wrong with that?
Here are just a few facts about the Ryan-Wyden approach:
• Unlike a voucher program that would give seniors a fixed amount of money to purchase health plans -- the original Ryan plan -- Ryan-Wyden would adjust premium support payments each year to reflect the actual cost of health insurance premiums and still give seniors the option of being on Medicare.
• All participating private plans will be required to offer benefits that are at least as comprehensive as traditional Medicare. Cherry-picking healthier seniors -- the key criticism by liberals of giving seniors a private alternative to Medicare -- will be made unprofitable by a robust risk-adjustment mechanism that would be policed by Medicare administrators.
• Low-income seniors choosing private options will receive additional benefits to cover out-of-pocket costs -- ensuring that seniors will have the same choices regardless of income.
• Seniors will have access to a catastrophic benefit that does not exist in traditional Medicare.
• The Ryan-Wyden Medicare Exchange, where private insurance options will be listed and forced to compete in a transparent fashion, will operate under strict federal oversight to ensure a level playing field.
Here is the ultimate fact that liberal ideologues who have attacked Wyden's proposal fail to address:
Unless something is done to control costs, according to the Congressional Budget Office, the Hospital Insurance Trust Fund that finances Medicare hospitalization coverage will be out of money by 2022.
The result -- seniors will likely be forced to endure more cost-shifting and arbitrary cuts until they are left with a program that doesn't guarantee much of anything.
Of course, there are concerns that the private options might be so successful as to swallow up "Medicare as we know it."
But as Wyden wrote recently in the Huffington Post,
Doing nothing is also a direct threat to the Medicare Guarantee. Congress must pass meaningful reform within the next few years, and since it is highly unlikely that Democrats are going to win a supermajority of seats in both the House and the Senate this year, the only way to pass legislation upholding the Guarantee is for Democrats and Republicans to work together.
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Mr. Davis, a Washington, D.C. attorney specializing in legal crisis management, served as Special Counsel to President Bill Clinton in 1996-98 and served as a member of President Bush's Privacy and Civil Liberties Board in 2006-07. He currently serves as Special Counsel to Dilworth Paxson. He is the author of the forthcoming book, "Crisis Tales - Five Rules for Handling Scandal in Business, Politics and Life," to be published by Simon & Schuster.