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Terry O'Neill

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The Romney-Ryan Budget: Turning Medicare Into a Boon for the Insurance Industry and a Bust for Seniors

Posted: 08/31/2012 8:55 am

This is Part 3 in a series. Find previous parts here.

At a July 11 press conference announcing NOW's endorsement of President Barack Obama, a reporter asked about Mitt Romney's message on the economy, and I suggested that the GOP candidate "bring it" -- that feminists are ready to have a substantive conversation about Romney's economic ideas and the impact they would have on women if he were elected.

Exactly one month later Romney did indeed bring it -- the pain, that is -- by choosing Rep. Paul Ryan as his vice presidential running mate and supply-side soul mate. Ryan is the author of the deeply unpopular House budget plan, now appropriately referred to as the Romney-Ryan plan.

I've already addressed what the GOP team has in store for women's health care, so now I want to talk about Medicare. A lot of confusing, contradictory information on the future of Medicare is being lobbed at us right now via the opposing campaigns, their surrogates and the media. So I'd like to get to the heart of the matter, to what women and their families will experience if Romney and Ryan get their way.

First off: Although the Romney-Ryan budget plan goes to some length trying to disguise it, the reality is that converting Medicare to a privatized voucher system is a key element of the Romney-Ryan scheme.

In other words, take health care coverage for retirees out of the hands of the U.S. government, where it has worked comparatively well, and shift it to the private market, which has proven to be a high-cost failure for most everyone else. Oh, and simultaneously repeal Obamacare, so the array of benefits that recently became available to seniors, often without co-pays or deductibles, disappears. Women especially should beware. Senior women's median annual income is shockingly low: just $15,282, compared with $25,877 for men. Where are senior women supposed to find the resources to pay the extra costs for their health care?

Remember, Medicare isn't designed to make a profit, while that is the main mission of private companies -- to produce lots of money for their investors. The health outcomes of seniors are secondary to private insurers. The reason Medicare was introduced in the first place is because, as we age, we have less income just as we start developing more health issues and needs. This is when we need stability, reliability and affordability most in our health coverage.

But the Romney-Ryan budget prods seniors into taking their chances in the private market, which is exactly where the right-wing always funnels public money whenever it can. And what a favor they're doing for retirees: Isn't that how all of us want to spend our golden years -- shopping for health insurance that won't break us financially yet will provide all the services we require (or think we will require, because we can't know in advance what health condition might emerge next).

One thing we do know is that older women's health care needs are greater than men's. That's partly because women are more likely than men to experience physical limitations and to suffer from chronic conditions like arthritis, hypertension and osteoporosis. Moreover, according to the National Women's Law Center, nearly half of women with Medicare report having three or more chronic conditions; just 38 percent of men do. These conditions require medications, so it's especially important for women to have drug coverage under Medicare. But the Romney-Ryan Medicare plan makes it harder for women to get the medications they need. Remember the "donut hole" -- the gap in drug coverage that requires seniors to pay out of pocket once their medication costs have reached a certain level? In 2007, 64 percent of those affected by the donut hole were women. Obamacare closes the donut hole. The Romney-Ryan plan, by repealing Obamacare, opens it right back up again.

Oh, and the Romney-Ryan plan also raises the Medicare eligibility age to 67, leaving millions of retired seniors high and dry -- without employer-based health care, relegated to the private health insurance market during the interim. And because the Romney-Ryan scheme repeals Obamacare, insurers would go right back to refusing coverage based on "pre-existing conditions," and wouldn't be required to cover life-saving preventive services like mammograms, bone scans and screenings for a range of conditions (heart disease, high blood pressure and cervical cancer, for example) without co-pays.

Imagine a woman in her 60s or 70s -- who may already have health conditions in need of consistent supervision and treatment -- laboring to discern what each private plan available has to offer. She has a government-issued voucher, or as Romney-Ryan now call it, a "premium-support payment," for a fixed amount of money. What information will she have to help her judge whether or not a private plan's rate is truly a good buy? The price might look right compared to her voucher, but what extra costs might pile up down the line?

Do we think for a moment that these companies are going to be completely forthcoming about what services their policies cover and what extra costs are involved, thereby allowing this woman to make a thoroughly informed decision? The sub-prime mortgage crisis offers an important lesson here: Big companies cannot be trusted to police themselves and act in the best interest of the consumer. The Romney-Ryan plan contains no failsafe to prevent analogous scams being run on future retirees.

And just how easy will it be for this woman to move from one plan to another until she finds one that suits her budget and health needs the best? Will her doctors accept all of the competing plans, or will she need to switch providers as well? Romney and Ryan use terms like "empowering" and "the power of choice" to describe this process, but it sounds exhausting and is in fact risky and cost-inefficient. Please note that according to the Romney-Ryan plan, the competition factor is what would drive down health care costs, so their system only works if seniors flock to insurers that do a good job and drop ones that aren't delivering. Not that this approach has ever worked to contain costs in the larger health care market, but don't mind that small detail.

Now wait, you ask: Doesn't the Romney-Ryan plan include an option for retirees to stick with the tried-and-true "traditional" Medicare? The answer is that the option to stay with Medicare is set up to fail. In other words, after the huge blowback against Ryan's original plan to voucherize Medicare, this most recent version now gets there in several steps rather than in one giant leap. But the end result is the same. After all, the GOP platform tells us in black and white just what the wizards are up to -- moving Medicare (and Medicaid) to the private market.

The Romney-Ryan plan claims this major Medicare overhaul would not go into effect until 2023, so that people 55 and over wouldn't be affected, but that turns out to be not quite true: Despite the delayed implementation, if this plan were to be enacted along with repeal of Obamacare during a Romney-Ryan administration, out-of-pocket costs for all people on Medicare would start going up almost immediately.

Here's another clue that these guys' pants are seriously on fire: Surely you've seen the Romney TV ads charging President Obama with viciously cutting $716 billion from Medicare in order to fund health care reform. Romney promises to restore those funds, but what the ads don't tell you is that Obama's cuts don't affect benefits, only over-payments to insurers, providers and hospitals. The president's cuts responsibly address inefficiency and waste. The New York Times reports that repealing those cuts would "immediately add hundreds of dollars a year to out-of-pocket Medicare expenses for beneficiaries."

Finally, don't be fooled into thinking that a privatized Medicare with seniors paying for more of their health care is needed to somehow control rising health care costs. The truth is, the Romney-Ryan budget plan undermines Medicare -- and many other essential social programs -- in order to pay for increased military spending and enhanced tax breaks for millionaires and billionaires. No meaningful reduction in the federal budget, and certainly no reining in of runaway health insurance costs are included.

In my first post in this series, I introduced Linda and her daughter Emily. Linda retired with no savings, no 401(k) and no pension. She didn't save much from the low-wage jobs she worked, and today she relies on Social Security for more than 90 percent of her monthly income. Without traditional Medicare, she would not be able to afford health coverage, and Emily would be exhausting her own savings and salary helping out her mother. That is exactly where the Romney-Ryan plan would leave Linda and Emily: stuck in a cycle of economic insecurity that gets passed from one generation to the next.

When President Lyndon Johnson signed Medicare into law in 1965, he said: "No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime."

Our nation has the ability to protect and enhance President Johnson's vision of health care for all. But the Romney-Ryan plan to convert Medicare to a private voucher system takes us in exactly the wrong direction.

Next time: What the Romney-Ryan budget plan's scheme for Medicaid means for women.

 

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This is Part 3 in a series. Find previous parts here. At a July 11 press conference announcing NOW's endorsement of President Barack Obama, a reporter asked about Mitt Romney's message on the economy...
This is Part 3 in a series. Find previous parts here. At a July 11 press conference announcing NOW's endorsement of President Barack Obama, a reporter asked about Mitt Romney's message on the economy...
 
 
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HUFFPOST SUPER USER
Wayne Caswell
Consumer Advocate & Founder of Modern Health Talk
09:28 PM on 09/11/2012
"Money in politics is making our nation sicker." So is INSURANCE in healthcare. I believe that the key to reforming our "sick care" system is getting the incentives right and getting private insurance companies out of BASIC health care entirely. Their profit motive gives them an incentive to increase costs, knowing that higher costs = more insurance customers paying higher premiums. What I propose instead is a hybrid public/private model that capitalizes on contrasting incentives, eliminates the need for health insurance, and saves over $1 trillion per year. Read about & comment on the proposal at http://www.mhealthtalk.com/2012/08/hybrid-model/.
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HUFFPOST SUPER USER
John David Payne
godisimaginary
07:38 PM on 09/11/2012
I would like to see independent verification that women at the same age as men are suffering from more chronic conditions and notice how it is expressed ..women, almost half, what is or was the exact percentage, men only 38%. How many of these women who are suffering from chronic conditions are married and have additional support from their husbands, or are we expected to beleive they are all living in drafty shacks with no heat and little food. And lastly, this trip around, can anybody tell me when momograms have specifically saved anyone's life? Be careful here because if the info is paid for by any support group and is not verifiable by independent medical opinion, it is worthless
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E4B32787
US Gov: The best that money can buy.
02:01 AM on 09/08/2012
The voucher system would make sense if it lowers the costs of Medicare. But, we have a voluntary voucher system called Medicare Advantage that involves private insurance, and it cost 14% more per patient than traditional single payer Medicare.

So, the question has to be asked, how does the private insurance approach save Medicare if Medicare Advantage costs 14% more?

The Republicans don't want to save Medicare, they want some corporations to extract profits from the monies we spend on Medicare. That's why they're complaining to cuts to Medicare that would reduce per patient costs for Medicare Advantage to that of traditional Medicare.
12:15 PM on 09/03/2012
Romney pollster Neil Newhouse said, "We won't let our campaign be dictated by fact checkers." The Republican National Convention was testament to that as lie after lie from the mouths of Mitt Romney and Paul Ryan continued down the totem pole.

Vice presidential nominee Ryan declared in his speech that President Obama "raided" Medicare of $716 billion to fund Obamacare when actually it rid the program of fraud and waste.

Carefully avoiding the words "privatize" and "voucher," he pledged that he and the new president would "strengthen and protect" Medicare and Mr. Romney would repeal Obamacare.

"I'll take freedom any day over the supervision and sanctimony of the central planners," he said. "Our rights come from nature and God and not from government"; emphasizing his scorn of entitlements, "Nobody should have to settle for a country where everything is free but us."

Did he mean freedom to scramble for an affordable insurance company whose premiums won't continously and relentlessly spiral? Did he mean the right to die when such a company proves nonexistent and urgent care is unobtainable?

If the candidates attain office, will they be able to explain the omission of those key words "privatize" and "voucher" to the voters who elected them?

While concealing their disdain,
Could they possibly explain
To the millions in despair
Why they had to mess with their
Obamacare and Medicare?

Elizabeth Gerteiny
Author of The President Of War
www.bushandcompany.org
05:00 PM on 09/14/2012
I like this post! Two thumbs up
HUFFPOST COMMUNITY MODERATOR
Veneita
If trolls had minds, they wouldn't be trolls
10:14 PM on 09/02/2012
If their plans are so good, ryan ought to put his mom on it
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E4B32787
US Gov: The best that money can buy.
09:35 PM on 09/02/2012
Changing to a voucher system would make sense if it could deliver comparable care at a lower price. But we already have a private insurance alternative to traditional Medicare called Medicare Advantage and it is more expensive.

So I can't see changing Medicare in its entirety to what amounts to mandatory Medicare Advantage. It simply adds an intermediary party, the insurance company that costs more than any savings insurance can manage to obtain from medical care providers as demonstrated by Medicare Advantage.
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JstDarla
Gone Fishing
08:55 AM on 09/01/2012
Are they going to drop us a check for all the money we paid into it all these years from our paychecks?
08:04 AM on 09/01/2012
I live in Australia, and here we have free healthcare to ALL, and at the same time we our healthcare system costs less than the U.S system.

Here in Australia, we have a choice, we can choose the public healthcare (where we are guranteed treatment and free doctors visits), or we can pay extra out of pocket to purchase private insurance (where we can get better treatment).

My father was diagnosed with Cancer, and had treatment that was paid for by the state, he eventually succumbed and passed away a year and a half later, BUT throughout that whole time (with numerous doctors appointments, hospital stays and even home treatment) we never had to pay out of pocket.

All the above, and our healthcare system is still cheaper than the U.S.
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HUFFPOST SUPER USER
Nomccain
08:54 AM on 09/01/2012
As one of, if not THE only remaining country to treat health care on a for profit basis, is both greedy and immoral. The Republicans don't want anything to change unless it's privatized where profits can be made higher and higher. In frequent visits all over Europe, we are viewed as a greedy, self serving, incompassionate nation where health care is concerned. They couldn't be more right.
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HUFFPOST SUPER USER
lNSCOUT
07:17 AM on 09/01/2012
darling you're 30 years late reporting this story.....the Republican Party has been at war with the Government of the United States for the past 30 years! it's policy of starving the beast is mean to bankrupt the country so that all of the services the government performs can be privatized......a boon? it would be the largest transfer of wealth from the public sector since W's friends privatized the army.....how has that worked out? FOR PROFIT INSURANCE ABD FOR PROFIT HOSPITALS ARE NOT A GOOD IDEA FOR THE WELFARE OF THE PATIENT. .......The government isnot a corporation.
06:07 AM on 09/01/2012
Y'all can whine, whinge, and wail all you want, regardless of who is elected president and or the party in charge changes must and will come to SSI and Medicare, and that is all there is to it.

For all the love liberals and Democrats have over a single payer health care system the Romney-Ryan plan gets there at least with Medicare. Tomorrows seniors would have the exact same benefits they are received under the current plan, the only difference is they would have to make a choice.

http://www.nationalreview.com/corner/315635/classic-krugman-yuval-levin

By and large American women, especially those from certain socio-economic circles are the most mollycoddled and protected species on god's green earth. They constanty claim a desire for independence and or to be treated as equals, yet much of their sex still argues for protections that treat them as if they are children who do not know their own right minds.

The female sex for various reasons consumes much of the healthcare dollars, so it stands to reason when (not if) changes are made to the Medicare system everyone is going to have to give up something.
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HUFFPOST SUPER USER
lNSCOUT
07:19 AM on 09/01/2012
actually most of healthcare spending is made in the last year of life...prolonging for two or three months the lives of 98 year olds....THAT IS IMMORAL.......All life is precious, yes....but we are not immortal.
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HUFFPOST SUPER USER
John David Payne
godisimaginary
07:29 PM on 09/11/2012
And if you are correct and you are to a certain degree, when will the doctors begin deciding who lives and who dies. I see from your perspective that if you are 98 it is immoral for you to survive any longer, I imagine if it is taking away that survival from someone younger, then it is immoral according to you. What would your attitude be if you were faced with the decision to pull the plug on yourself? Fortunately you are not totally correct. There is certainly a higher cost to health "care" as we are living longer and that will be an ethical challenge in the years to come. Regardless of which party wins the election the funding of care will go up every year and by 2035 it will consume about 45% of your GDP or more. How many of your friends will have the plug pulled on their loved ones as the price escalates, or will the doctors have a cost mandated point where the decision is made for them?
11:40 PM on 09/03/2012
Failed relationships are that-a-way ====>
05:42 AM on 09/01/2012
Looks like NOW is still telling women how they should vote.
calidesigner
Progress Wins
03:41 AM on 09/01/2012
Well said. These are facts every American needs to know and comprehend. How so many people can vote against their own best interests to further enrich the insurance and health care industry executives is beyond comprehension. Wake up folks. The Republican plans for the future will not balance the budget, they will bankrupt the country, plunge millions more into poverty and poor health. A vote for the 1%er party alias Republican party is not conservative, it is reactionary and destructive and will plunge this nation into disaster.
05:20 PM on 09/14/2012
I was blogging on the Huffington Post and read this blog and wanted to share it. I agree with this one more than any other.
12:54 AM on 09/01/2012
What they mean by "works well" is provides seniors with health care thus extending their life and improving their financial situation.
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moviefantastic
The truth shall set you free
09:35 PM on 08/31/2012
The title says it all: The Romney-Ryan Budget: Turning Medicare Into a Boon for the Insurance Industry and a Bust for Seniors

Seniors, ask yourselves, what do you want? A guarantee, or not. The voucher is a big "not."

Did you really think that the insurance industry has a swell deal for you? They want your money. And Romney/Ryan will give it to them. But the bucket. The security you once had, will be gone.

Romney/Ryan should be ashamed of themselves. They're not. It's the money. They were paid handsomely to deliver, and they will.
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HUFFPOST SUPER USER
Anne Towsley
03:54 PM on 08/31/2012
If you would like to use an example of what really happens to healthcare if you switch to Voucher all you have to do is look at " MANAGED CARE/HMO s. When this great idea was introduced by Nixon to cut Health care costs here came the old bait and switch plan like putting lobsters in a pan and turning the heath up. We didn't see it coming when the first level was affordable P.P.O. or the cheaper HMO much more affordable but OK service .POOF away went affordable P.P.O now all you had was your HMO at a higher price and lowered services
Now lets see who made out on that deal? Why C.E.O. s made leaps and bounds with perks salaries plush offices while they cut services and denied healthcare to many . Oh and look at who didn't go for that why it would be our congress and senate Beware of wolves in sheep clothing
calidesigner
Progress Wins
02:30 PM on 09/15/2012
Excellent comparison. Even the name managed care implies some one else is controlling your health care. I'll believe congress has our best interests in mind when they refuse their supreme health care package, or the same one for the rest of the country.