Saturday, Republican nominee Mitt Romney announced his choice for Vice President -- Congressman Paul Ryan of Wisconsin. Ryan is most widely known as a proponent of a radical restructuring and privatization of Medicare. But beware the hyperbole on both sides. Ryan's plan would not necessarily "save" Medicare; nor would it necessarily destroy it.
I will write more on this as the campaign develops, but in the meantime here are a few things to think about:
1. If you are on Medicare now, the Ryan proposal will not immediately affect you. It is designed to phase in over time. If you are over 55, you may still have an opportunity to keep your current Medicare options, at least for awhile. It is not clear what the longer term impact of the Ryan proposal would have on Medicare as we know it now.
2. If you like the idea of private insurance, you will love the Ryan plan. He proposes to give seniors a voucher (or as he calls it "premium support") to go out and buy their own private insurance. The biggest threat to this idea is that the "support" part would be capped and limited, so that over time, if not adjusted well for inflation, you the beneficiary would pay more and more out of your own pocket. The premium support/voucher idea will be a major point of discussion. Read up on it here and here.
3. Medicare already relies heavily on private insurance, but when Medicare is PRIMARY (as it fits with supplmental/gap plans), it is able to exert considerable market power on your behalf when it chooses to do so. Turning Medicare over to the private sector would raise a number of critical questions -- would there be insurance reforms to be sure that private plans could not turn you down or "underwrite" you, or raise your premiums because of your pre-existing illnesses? How would these premiums be adjusted for the rising costs of health care? And if, as Ryan proposes, traditional Medicare would have to compete with the private plans, most think that the sickest people would stay in traditional Medicare, ultimately driving up costs and causing traditional Medicare to self-destruct.
4. Ryan will be telling us we have to do something about Medicare NOW (in the middle of Presidential campaign) because it is going broke. Mostly false. The Medicare Trustees report that Medicare will be solvent through 2024. That gives us the next 12 years to make the changes necessary to keep it solvent. Will that be easy at any time? Absolutely not. But will we get a decent debate in the heat of a partisan campaign? Not likely.
5. Is Paul Ryan's Medicare proposal "right wing social engineering" as Newt Gingrich labelled it? I have no idea what Gingrich was thinking or does think at any given time, but changing Medicare dramatically in the direction of a private sector that has profit at its driving force is certainly "engineering" of major proportions.
The median income of Medicare beneficiaries is $25,000 a year. Medicare already requires seniors to pay a considerable part of their income for their peace of mind. Most people feel a tremendous sense of relief when they turn 65, however, because they know that at least they cannot be turned down for insurance, and they will receive assistance from Medicare to pay their medical bills. Turning over the Medicare program to the private sector, especially without a number of safeguards and regulatory oversight (which Republicans tend to dislike) does not sound like the direction we ought to be going.
Your thoughts?
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Please Christians, consult your Jee-bus about this one
It's already happened with for-profit hospitals
this is the repubs idea of being a successful business man, make as much profit as you can with no regard to who you skay-roo in the process
Romney/Ryan 1040
Two young nurses came to my room one day with a portable Xray machine. They came in, did ONE chest Xray, wheeled the machine back out of the room and left, they were in my room for exactly 10 minutes, the charge for that ONE XRAY? was an ASTOUNDING $18.000 DOLLARS!, I almost had a heart attack when I saw that figure. I called my insurance to complain? you know what they said? "Oh yes we know Mr Taban they always charge that much, WHAT! I SAID, AND YOU DON'T CARE?. They just brushed ME AND MY COMPLAINT/ INQUIRY ASIDE, as if it was no big deal, go figure, :-(. The total cost after 30 days, and this was without the doctors surgery bill, was almost $300.000 JUST FOR THE HOSPITAL ALONE. $5000.00 PER DAY FOR A ROOM??
If the contention of the GOP platform is to offer limited insurance to the segment (as in a voucher program), they would be the ones laying claim to the "death squads". Being a senior means needing care. We weren't designed to live that long, and most of us won't last long without available comprehensive care.
Even the wealthiest seniors would face physical and financial oblivion under that scenario.
I can't believe any parent's children (even the most radically conservative of them) would condone relegating them to such a fate...If for no other reason than their inheritance would be gobbled up by medical bills:)
We are already a socially bereft nation when compared to the rest of the world. Let's move forward please.
You don't know what you are talking about and my guess is that you are not yet Medicare age so don't try to speak for us. Wyden-Ryan is not a voucher program. Food stamps are a voucher program. Medicare today, employer insurance today and Medicare as proposed by Wyden-Ryan is a premium support program. There is nothing new or radical about this despite the left wing author's rant.
The idea of Wyden-Ryan is not to offer "limited insurance." Limited insurance is what Medicare is today with no catastrophic coverage, up to $6000 a year in admitted-inpatient hospital deductibles, 20% copays for observed-inpatient hospitalization and almost all other acute and preventative procedures as an outpatient or in a clinic, no drug/physical-exam/dental/aural/vision coverage and geographic restrictions. Wyden-Ryan will not fix all these problems but it will fix the biggest limit in Medicare, adding catastrophic coverage, removing the lifetime limit that is killing the guy in Miama who has used up his "Medicare days" (haven't heard about that; hmmm could be the mainstream media is burying that story)
Look up the data Louie before you rattle on
"(Ryan) proposes to give seniors a voucher -- or as he calls it "premium support" -- to go out and buy their own private insurance."
Actually that is totally incorrect, perhaps even possibly purposely misleading. The Wyden-Ryan proposal (I guess you can keep ignoring the other author if you are going to mislead people) does not give seniors anything. We seniors could go buy own private insurance I suppose, the way 55% of us already do today with retiree insurance and Medigap. but not with any government money. The Wyden-Ryan proposal is for an exhange that works the same way Medicare Parts C works today for 28% of us seniors. (Part D works similarly as well as the Federal Employee Health Plan.)
There is nothing at all radical about any of this.
(I don't understand what the rest of your comment has to do with vouchers vs. premium support. If you are answering my request earlier to name ANY econometric research that posits that those over 55 would be harmed by changes to Medicare caused by Wyden-Ryan, why are you referring to those under 55?
(Those under 55 are going to be harmed anyway. All economists -- especially the ones in the Medicare actuary's office -- already agree (and you mention this in your article) that the trust fund is no longer funded just when they reach Medicare age. But you want to kick the can down the road... again.)
"If you are over 55, you may still have an opportunity to keep your current Medicare options, at least for awhile."
On the word "awhile," the author links a Kaiser FAQ sheet that says explicitly no change to those over 55.
So why does the author say "you may have an opportunity to keep your current Medicare options, at least for a while? Does the author think no one will follow the link?
2. Part C effectively goes away under the Wyden-Ryan proposal (or the whole thing becomes like Part C if you prefer to look at it that way)
3. The known current Wyden-Ryan proposal for changing Medicare Parts A and B (assuming that's what you mean by "traditional Medicare") is fantastic. For the first time since Medicare began, it would have catastrophic coverage (per page 11 of the Wyden-Ryan proposal). Seniors would finally have the kind of coverage that everyone else has (for more on the implications, see the recent Miami Herald story about the heart patient who used up his "Medicare days"-- it's hard to find because the mainstream press buried it). If new improved Wyden-Ryan Parts A/B has catastrophic coverage, many seniors will not need supplemental coverage
Still, all of this is meaningless for anyone born before 1956. What is unclear about the left-wing Kaiser's fact check finding that there would be "no change for anyone over 55." If Kaiser thought that Wyden or Ryan were lying about this, don't you think they would have said so? Does "no change" mean "there will be changes" where you come from?
There your in my iPhone 3 (not gs)
Starner Jones, MD
notes Not that bright don't see professionally
Healthcare is already a giant mess; more than twice as expensive (and growing) as the rest of the industrialized world with tens of millions having no coverage at all. Now Ryan and Romney seek to introduce the same to seniors as well.
Conservative Christians have a profound choice (free will) to make in this short life. Jesus (King of social justice) said, "you can either follow God or Mammon (Prince of greed), but you can't have two masters. To love one is to despise the other."
Republicans would never agree to this level of government interference.
So the plan is unworkable.
Dear Mr. President:
During my shift in the Emergency Room last night, I had the pleasure of evaluating a patient whose smile revealed an expensive shiny gold tooth, whose body was adorned with a wide assortment of elaborate and costly tattoos, who wore a very expensive brand of tennis shoes and who chatted on a new cellular telephone equipped with a popular R&B ring tone. While glancing over her patient chart, I happened to notice that her payer status was listed as "Medicaid"! During my examination of her, the patient informed me that she smokes more than one costly pack of cigarettes every day and somehow still has money to buy pretzels and beer.
And, you and our Congress expect me to pay for this woman's health care? I contend that our nation's "health care crisis" is not the result of a shortage of quality hospitals, doctors or nurses. Rather, it is the result of a "crisis of culture", Heaven forbid, purchase health insurance. It is a culture based on the irresponsible credo that "I can do whatever I want to because someone else will always take care of me."
Once you fix this "culture crisis" that rewards irresponsibility and dependency, you'll be amazed at how quickly our nation's health care difficulties will disappear.
Respectfully,
STARNER JONES, MD
•Nothing changes for current seniors or those nearing retirement
•Medicare is reformed as a premium support system, meaning that existing spending is repackaged as a fixed-amount benefit to each senior that he or she can use to purchase an insurance plan
•All insurance plans must offer coverage at least comparable to what Medicare provides today
•If seniors choose more expensive plans, they will have to pay the difference between the support amount and the premium price; if they choose less expensive plans, they can use any leftover support to pay other medical expenses like co-pays and deductibles
•“Traditional” fee-for-service Medicare will be offered by the government as an insurance plan, meaning that seniors can purchase that form of coverage if they prefer it; however, if it costs the government more to provide that service than it costs private plans to offer their versions, then the premiums charged by the government will have to be higher and seniors will have to pay the difference to enroll in the traditional Medicare option
•Lower income seniors will receive more generous support to ensure that they can afford coverage; wealthier seniors will receive less support
•Competition among plans to provide high quality service while charging low premiums will hold costs down while also improving the quality of coverage enjoyed by seniors
Did you ask the lady if she had paid for the tattoos herself, or if they were paid for by friends or boyfriends.
Many tattoo parlors will give free tattoos for singers and athletes, even local ones. I knew a bass player who was in a number of small bands got many tattoos for "free" this way.
Were any of the tattoos fresh. Could they have been purchased before she say lost her job in the recent recession. Maybe you heard about that. Well if they slash Medicaid and Medicare I am sure you will hear about it.
As for the phone, as someone who doesn't have car, I can tell you a cell phone with GPS and internet can be an absolute lifesaver when missing the last bus, or walking down the wrong street can be the difference between life or death. You see the phone as a luxury. But in reality it can be part of a much lower cost replacement for having a car.
As for the shoes, again maybe you haven't thought it through. Many women have many different pairs of shoes. If you can only buy one pair of shoes that you are going to wear on long walks from your house to the bus that takes you to the hospital and then to go to stores and businesses where people may already be ready to deny you service then you may spend a little more for the best shoes you can.
Period, end of story.
Anybody expressing any opinion otherwise is either being willfully obtuse and disingenuous, or lacks functional intelligence.
When you're old and sick the last thing you want to deal with is a health insurance company and health suppliers whose best interests are in direct competition with yours.
Old people will be helpless at the hands of private insurance.