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Paul Abrams

Paul Abrams

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Ryan Medicare Scheme Would Devastate Entrepreneurship, Jobs

Posted: 04/12/11 05:31 PM ET

When it comes to its Medicare scheme, the Republican (aka "Ryan") Budget is a total fraud, as will be explained in a more comprehensive article shortly.

But, it is also instructive to consider the Republican Medicare scheme's macro-effects beyond just the provision of health care for senior citizens alone.

It would devastate entrepreneurship (i.e., risk-taking) and, since new businesses are the primary source of new jobs, would kill job growth. If one believes Republicans' rhetoric and not their policies, these are the activities they claim to champion.

It is no accident that the era of entrepreneurship began soon after Medicare was passed. One of the primary drivers to passing Medicare in the first place was the potentially devastating financial impact on children (and thus on grandchildren) when a parent became ill. And that was in 1965 when the costs of health care were much lower because there was far less that medicine could do to manage illness, maintain wellness and reduce suffering. There were, for example, no MRI machines to search for potential causes of disease symptoms; there were no stents to keep clogged heart arteries open, and no bypass surgery to relieve angina (pain from inadequate oxygen to the heart). There were only a few drugs to treat cancer; bone marrow transplantation had not been invented.

That is, if the financial impact on his children of an elderly parent becoming ill were considered potentially devastating in 1965, imagine what it would be in 2011 when modern, but costly, technology is available to improve well-being and detect and treat diseases. Before the Bush Recession, had there been no Medicare, people might have considered a second mortgage on their homes as a hedge, but that second mortgage was already being used to fund college education, and buy 'big-ticket' items like an additional room, new appliances, new cars and so forth. Today, and probably for a very long time, one's home is at best a place to live, not a source of major cash.

The Ryan Medicare scheme would, after 2022, throw seniors out from a government guarantee and into the private health insurance system with vouchers to help pay premiums. The vouchers percentage of the premiums decline over time. What would premium costs be for a person previously covered under a spouse's employer's medical plan who has lung and heart problems? For a man who has prostate cancer, or a woman who has breast cancer? Could they even get insurance?

Since Ryan also wants to repeal President Obama's Affordable Health Care Act, there would be no prohibition against insurance companies denying insurance for pre-existing conditions or throwing a person off of coverage when they became ill, or re-impose annual or lifetime caps on coverage? Indeed, what would the impact be on insurance premiums in general if people over 65 were included in the coverage pool?

If the Ryan Medicare scheme became law, what would young families do, planning both for major financial obligations when their children were ready for college and their parents becoming ill? Risk-taking in one's career (working, say, for a start-up) or even pooling resources to do a start-up would not be high on the list. And, how would grandma feel about her illness costing her grandchildren their college educations?

Although a rise in the savings rate is usually good, it can also be overdone, and since the saved money is pre-ordained for future medical expenses, it is not "liquid", and thus not really available for investment or purchase of big-ticket items.

Although the Ryan Medicare Scheme is not the only place his budget raises society's insecurity and thus diminishes risk-taking, entrepreneurship and job growth, it is probably the single most threatening.

 
When it comes to its Medicare scheme, the Republican (aka "Ryan") Budget is a total fraud, as will be explained in a more comprehensive article shortly. But, it is also instructive to consider the ...
When it comes to its Medicare scheme, the Republican (aka "Ryan") Budget is a total fraud, as will be explained in a more comprehensive article shortly. But, it is also instructive to consider the ...
 
 
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HUFFPOST SUPER USER
Fourcents
All for One and One for All
10:02 AM on 04/22/2011
There are many "first world countries" that provide excellent healthcare for ALL their citizens. No one in our government talks about this.

If healthcare were not provided by other countries you know Republicans would shout it from the rood tops. If it comes up all Republicans can say it how those are socialist countries as if that is a bad thing.

Even corporations would gain from effective healthcare systems in the US. The world is full of succesfull governments that use taxes to lift the standartd of living for their citizens. Now convince me that a high standard of living is bad for business!

For businesses to sell things they need populations that can pay through higher standards of living. One For All and All For ONE should be our motto even if it is originally French. Why are Republicans determined to take us to the most primitive levels of government where war and security seem to have the highest priority?
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HUFFPOST SUPER USER
jabailo
(Participant) Texeme.Construct()
12:46 AM on 04/17/2011
So your argument is that Government should continue to fund a wasteful system since it takes in so much excess that can be used to fund technology...and that, in the past, this excess has allowed some good technology to arise.

I'd say, maybe, but the thing is it seems like medical technology plateaued 20 or even 30 years ago.

I mean back in the 60s it seemed like heart transplants would become an outpatient service and we would have of course licked cancer.

But that hasn't happened. Meanwhile, the costs of expensive measurement technology have come down largely through efficiencies in the general computing and software industries...not through any specific "medical" advances.
03:12 PM on 04/15/2011
Mr Abrams, another good piece of work - importantly, your wrighting continues to add to a general understanding of the issues.
The contrast of the Ryan proposal to the outline put forward by the President will form the logical basis for what is going to be a very important debate. I think it is clear that there is no possibility that Medicade and Medicare can go forward as is. With healthcare currently 16 to 18% of the GDP and running at an inflation rate of 4 to 7 times the other parts of the economy - healthcare might well become 1/2 of the whole economey in as few as 14 years. This result would be unacceptable and, both parties understand the math.
This debate will continue to shed marginal issues until it boils down to strategies of cost control - likely including: fraud control, co-payments (at some level) to keep the users involved with costs and a larger menu of higher co-paid elective add-ons to a basic level of service available to all.

As a part of this discussion there must be a strategy resulting in the rashening of expensive electives and exotic proceedures.

Interestingly, Ryan's private insurance voucher system might function if it began at birth for everyone. Then it would be a true insurance based on actuarial tables with quantifiable risks and could be competitively priced - leaving only 60 years of real problems to solve.

Your voice would be of great benefit in this discussion.
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rikster
buy the ticket-take the ride
08:25 AM on 04/15/2011
Mr. Ryan has no clue how a regular person lives. he surely is a creature of the wealthy. He is only seeking personal gain by making life miserable for the majority. a signature of the people who run this country via non-elected proxies (Lobbies)
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HUFFPOST SUPER USER
Sheila Whitehead
sheilababe
02:44 PM on 04/14/2011
Paul Ryan seems very animated in his facial and body motions. What we have heard coming out of his mouth is pure abortion for seniors and I am one! It would be the end of what we know as a secure medical system for Medicare receprieants. It's wrong and the last straw from the Republicans against people with needs and older people. What is their true mission? Is it to ruin our whole system or just muddy their party for the next presidential election? This does not have anything to do with the budget nor did the attack in Wisconsin on Union and Labor. They are trying to control by taking away entitlement programs. They do want people to think or have choices. I will never vote for any of the Republicans ever again.
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catcancook
Obama/Biden 2012
02:06 PM on 04/14/2011
"The Roadmap would give the most affluent households a new round of very large, costly tax cuts by reducing income tax rates on high-income households; eliminating income taxes on capital gains, dividends, and interest; and abolishing the corporate income tax, the estate tax, and the alternative minimum tax. As a result, despite its steep cuts in Social Security, Medicare, and other programs, the Roadmap would allow the federal debt to continue growing for decades to come."

From:

http://www.cbpp.org/cms/index.cfm?fa=view&id=3308
01:46 PM on 04/14/2011
Ryan and Boehner are trying to make a pyramid scheme out of Social Security and Medicare.

It would take demented people to beat us out of our retirement after we have all paid in extra since 1983.

The younger workers should get the same as we get without benefit cuts.

To quit subsidizin­g insurance companies in Medicare would help save money for Medicare.

Right now you can retire at 62 if you take a cut in your benefits. Republican leaders want to raise that early retirement age to 65.

I cannot help but worry about the 'Gang of Six'– Dick Durbin (D), Mark Warner (D-Va.), Saxby Chambliss (R-Ga.), Mike Crapo (R-Idaho), Kent Conrad (D-N.D.) and Tom Coburn (R-Okla.)

They are working on a fix to our programs and are said to be using a lot of the Bowles/Sim­pson plan. Conrad has always wanted to cut our programs. Today Dick Durbin said something to the effect he thought the programs had to be cut.
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HUFFPOST SUPER USER
Sheila Whitehead
sheilababe
02:45 PM on 04/14/2011
and what corportation get rich on this healthcare plan and voucher? Nerver never, the nerve of this party..................
HUFFPOST SUPER USER
JanusDaniels
01:29 AM on 04/14/2011
Duh. Republicans still promise that any startup, anywhere else in the industrialized world, still has this crushing advantage over their US competition.
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HUFFPOST SUPER USER
fgbouman
Curmudgeon & Designer
07:22 PM on 04/13/2011
Since there're no safe investments today, a health savings account is not only a gamble on the state of your health, it is a gamble on whether you'll have anything left in your health savings account to pay for it. Social Security and Medicare have probably done more to spur American entrepreneurship than any other activity of the government. The safety net they provide has allowed risk-taking that would have occurred no other way. But nihilists don't care about facts. They just want to destroy.
01:41 PM on 04/14/2011
I would not consider investing in the stock market if I didn't know I had Social Security.
04:12 PM on 04/13/2011
That was very insightful, you looked at an area that never really occurred to me, and I thank you!

Now how does one go about gaining a Professional Iconoclast designation? I had to look it up, as it wasn't necessarily in my vocabulary, and hadn't ever stopped to learn what it meant, when I heard it in conversation or read it. Surprisingly enough, I have always been one, I just didn't know to describe myself in such a manner.

Once again, thank you.
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HUFFPOST BLOGGER
Paul Abrams
11:32 PM on 04/15/2011
"Professional Iconoclast" is a great field because, among other things, one can appoint one's self. One does not need a rich daddy like "W" had to get him out of military service, or raise money for him among his friends. So, it is open to people like you and me. I say, "go for it"!
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DRaymond
Network administrator, voiceovers
01:40 PM on 04/13/2011
What shall we call this new animal?  It certainly isn't Medicare.  I suggest we call it Ryancare.

So under Ryancare,  Seniors, if they can manage to get health insurance at all, will get a small fraction of the cost being covered by the federal government.  The rest of the cost will be whatever the insurance company wants to charge for as little actual coverage as it wants to give.  Also no doubt it will include another favorite insurance priority of the Republicans, allowing your insurance company to relocate to whichever state has the weakest regulations.

But let's be honest, when the date comes and one brother gets Medicare and another gets Ryancare and one family sees their parents get Medicare and another get Ryancare, even though they have paid the same taxes, they will say 'oh well, I was born just a little too late, shucks'.  No, they will demand fairness, which the Republicans will respond by making Ryancare cover rates until they almost fully taken care of.  In other words no real budget savings but huge payouts to the insurance companies.
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HUFFPOST SUPER USER
Sheila Whitehead
sheilababe
02:48 PM on 04/14/2011
This should not be compaired to Obamacare, because the Presiden'ts package even with the Republicans taking away most of the funding for it to work, is still a benefit for families with kids and no insurance. It's working......so please do not express the two and the same
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DRaymond
Network administrator, voiceovers
06:35 PM on 04/14/2011
But at the same time we shouldn't let the Republicans get away with just presenting this as some sort of 'reform' or 'fix' to Medicare, which is what they are trying to do.

This is something entirely different than Medicare, both in philosophy and result.
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HUFFPOST SUPER USER
ReadMyLipstick1
It can't be that hard.
01:29 PM on 04/13/2011
Excellent article, Mr. Abrams! No question in my mind about the authenticity of the issues you address. Historically, families took care of their elders, took care of special needs children, neighbors and each other. They educated their children, and this generally happened without both parents working. Most people today barely bring enough home in their paycheck(s) to pay their regular bills – mortgage/rent, utilities, automobile payments, food and healthcare. The shortage of money isn’t due to them living beyond their means, (in most cases), it just costs what it costs for the basics. Now with gasoline soon approaching $5./gal., people are not going to be able to afford to drive to work, and other costs will sky rocket due to the gas cost. Today most people can’t afford to do anything beyond the basics. The 545 people who so haphazardly run our lives and control our destiny need to find a way to come to understand what we are going through out here in Middle America, and come down off their high horses, and get this country back to basics.
iridium53
Semper Fi
12:27 PM on 04/13/2011
Good points.

Canadian-like healthcare and other social nets free individuals from their corporate dependence and allow small businesses to thrive because they no longer have a disadvantage in accessing employees because of their buying power and because it reduces their individual risk.

It matters not at all to me whether I pay the government for healthcare, as with Canada or I pay health insurance - one way or another, I pay. The difference is that with government healthcare I have someone on my side administering healthcare, an elected official (however remote) whereas otherwise I have an employer that will limit healthcare rules to fit their needs - not mine.

No corporation, except mine for me, has my interest in mind - only theirs.

I strenuously object, however to the Affordable Healthcare Act. A healthcare system that leaves healthcare insurance in the middle, taking at least 20%, to administer and profit, from my healthcare - enforced by a government protection racket - is absolutely unacceptable. The worst possible outcome.
11:48 AM on 04/13/2011
It is ironic that the party who claim to be for the American spirit of free enterprise are also the party who crush that free enterprise through their short-sighted health policies
09:10 AM on 04/13/2011
This is health care rationing, when you become and no longer profitable the rich and corporate types don't care if you die. As far they are concerned senior citizens with their social security and medicare are a drag on the economy. They have no regard to human life.
04:27 PM on 04/13/2011
And or they are attempting to get out of the obligations that they and their predecessors have already looted, due to the rarely discussed fact that Social Security is still to this day, funded 100% year in and year out, by taxes coming into the government coffers, which are used to buy, as have all the previous deposits, U.S. Treasury Bonds. Let us not forget, The U.S. Government has never failed to pay for any U.S. Treasury Bond that has been returned for payment.

As far as Medicare is concerned, yes it is paid for and has been paid for by working individuals ever working day of their lives. There are so many huge disparities in the program that need to be addressed such as fraud & the higher cost of Medicare Advantage plans compared to basic medicare. For those of you unaware, the Advantage plans get approx. 15% more from medicare than the cost of the basic plan, because they handle the claims and pay their own doctors, it is an HMO, and if you don't have any pre-existing conditions, and or need to see a doctor who isn't in their plan, it normally a pretty good deal for the recipient as well. The over riding costs is the issue, and it appears as though the President is prepared to address that disparity, according to his comments in his announced budget deficit agenda today.
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HUFFPOST SUPER USER
Sheila Whitehead
sheilababe
02:51 PM on 04/14/2011
buddyo you got it so wrong. s/s has been paid in by me. since I started working. thus my s/s card..........as for medicare, so much is automatically deducted from s/s check because I opted to take plan d for prescription and hospital drugs coverage. .....without this, I could not afford to live....so dry up