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Wendell Potter

Wendell Potter

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Ryan's Medicare Plan Would Be a Windfall for Insurance Companies

Posted: 04/21/11 08:32 AM ET

Rep. Paul Ryan's plan to privatize Medicare would accelerate a trend started several years ago by corporate CEOs and their political allies to shift ever-increasing amounts of risk from Big Business and the government to workers and retirees.

If enacted, the Ryan plan would represent a windfall of unprecedented proportions for insurance corporations and other businesses.

For millions of average Americans, many of whom already are finding it impossible to save for retirement, it would represent financial calamity. The nation's middle class would pay dearly for Ryan's proposed shredding of the social safety net that Medicare currently provides.

Ryan, chairman of the House Budget Committee, wants to dismantle the Medicare program and replace it with a system of vouchers. Starting in 2022, the government would give the average 65-year-old Medicare beneficiary $8,000 a year to buy coverage from a private insurer. That's the amount health care analysts estimate will be what the Medicare program will spend on every 65-year-old in 2022 if the government doesn't turn it over to private insurance companies.

While that might sound fair on the surface, it would actually be a very bad deal for people who turn 65 that year, compared to those who turn 65 in 2021. That's because commercial insurance plans are much more expensive, and operate far less efficiently, than the current Medicare program.

The amount of money commercial plans actually spend to pay medical claims has been declining rapidly over the past several years while the amount they spend on administrative activities such as marketing and underwriting -- and to pay executives and reward shareholders -- has been increasing. That's why Congress included a provision in last year's health care reform law to require insurance firms to spend no more than 20 percent of their policyholders' premiums on overhead. By contrast, the current Medicare program spends just 3 percent of its budget on administration.

The nonpartisan Congressional Budget Office says the $8,000 voucher won't be nearly enough for seniors to buy comparable coverage from private insurers and pay the additional out-of-pocket costs that those insurers would require them to pay. The amount the average 65-year-old would have to shell out to buy private insurance in 2022, according to the CBO, will actually be $20,510. Seniors would have to pay the difference -- $12,510. If Medicare is not privatized, the difference would be $6,150.

Here's why this would be a dream-come-true for the insurance industry: The more health plan enrollees have to pay out of their own pockets, the less insurers have to pay for medical care. The money that insurers avoid paying out in claims goes straight to their bottom line -- and into shareholders' pockets.

Insurers have been shifting more and more of the cost of care to their policyholders over the past several years by enticing -- or pushing -- them into plans with ever increasing deductibles. This trend is part of what Yale professor Jacob S. Hacker called "the personal responsibility crusade" -- making people more responsible for the management and financing of the major economic risks they face -- in his 2006 book, The Great Risk Shift.

This crusade has been led by Republicans and insurance company executives who have been saying for years that the best way to control medical costs is for Americans to have more "skin in the game." That's an expression that former Aetna CEO Jack Rowe used often before he retired in 2005, the year he made $22.2 million. It was also a sound bite favored by the CEO I used to work for, CIGNA's Ed Hanway, before he retired in 2009. Hanway's total compensation that year was almost $111 million.

The problem is, most Americans have far less skin to put in the game than CEOs like Rowe and Hanway or even Rep. Ryan, who makes $174,000 as a member of Congress. The median household income in the United States was just $49,777 in 2009, which was down $335 from 2008.

That decline, by the way, was the continuation of another trend that began as the Clinton era was ending and the George W. Bush era was beginning. Median household income in the United States peaked in 1999 at $52,388 (adjusted for inflation). It fell more than $2,000 during the eight years of the Bush administration.

During that time, health costs rose dramatically. According to the Kaiser Family Foundation, the average annual health insurance premium for family coverage increased from $5,791 in 1999 to $13,770 in 2010. The average amount that workers contributed out of their own pockets for family coverage increased from $1,543 to $3,997.

With household incomes declining, Americans have had far less money to put into retirement. According to a recent survey conducted by Opinion Research Corp. for America Saves and the American Savings Education Council, less than half of current workers are saving enough to have a "desirable standard of living in retirement."

If workers are having this much difficulty saving for retirement, where in the world will they find the money to pay what Rep. Ryan would make them pay for Medicare coverage when they turn 65?

Ryan's "blueprint" is one that will take America back to the pre-1965 days when senior citizens were losing their homes and their farms to pay for medical care. They were becoming destitute -- and dying much earlier than they are today -- because insurers would not sell them coverage because they were too much of a risk to insure, and there was no safety net for them.

That's exactly the same place future senior citizens would find themselves if Ryan's plan to privatize Medicare ever becomes public policy.

 
 
 

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HUFFPOST SUPER USER
Archie1955
08:52 PM on 04/22/2011
Doesn't the prognosis detailed in this article suggest something? How about, that all intelligent American voters cease voting for Republicans and therefore against their best interests. Of course, that presupposes that there is such a thing as an intelligent American voter.
03:01 PM on 04/22/2011
You should tackle Medicare fraud first, and then begin discussions about lowering benefits. But leaving the elderly to foot their own healthcare bill is unrealistic.
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Jerry Aripez
Retired Union Carpenter
12:04 PM on 04/22/2011
It doesn't take a rocket scientist to know that Ryan works for the BIG Corporations and not for the people.....it is as plains as Jimmy Durante's nose....

http://www.youtube.com/watch?v=iauLtTRlfnE&feature=related
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HUFFPOST PUNDIT
TRex86
Enjoying life in West Ohio
12:01 PM on 04/22/2011
America already spends enough on health care to cover everyone and have hundreds of billions left over. At 17% of GDP we spend twice per capita what European countries spend--and get worse outcomes. Of course so long as we run much of the money through for profit companies we'll get what we should expect, a huge amount of money leaks out of the system and doesn't get to the bedside. Overhead costs of private insurance range from 25% to 40 percent. The obvious conclusion is to consolidate healthcare with Medicare for all. Private insurance could still contract with Unicare (without the current bonuses), sell supplemental policies, and Cadillac plans. Insofar as private companies wish to continue health insurance for their workers they could do so, but Unicare would function as a public option for those who want a different plan and wish to pocket the cash (using it for deductibles and co-pays).
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HUFFPOST SUPER USER
netman714
I used to be disgusted, now I'm just amused
12:30 PM on 04/22/2011
Thanks for the post - I agree with your obvious conclusion and it is amazing that our 535 Congressional Members can't see this as well.
Of course, the only reason they can't see it is they've been blinded by lobbyists' donations.
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HUFFPOST PUNDIT
TRex86
Enjoying life in West Ohio
02:36 PM on 04/22/2011
Thanks. I used to believe that a pluralistic system would suffice, but the for profit greedfest has persuaded me that only a federalized solution will address our needs. It seems to have been forgotten that our health insurers began as non profit public benefit agencies. They were granted exemption from anti-trust since they were bound by their charters to put the premium dollars into health care not their CEO's pocket. Allowing them to convert to for profit status was a disaster. Now we have a stratospherically expensive--at best mediocre--system that leaves 50 million Americans out in the cold. Have we no sense of decency?
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HUFFPOST SUPER USER
Guitarsandmore
devoted father, community activist, musician, reti
11:50 AM on 04/22/2011
All of the other developed countries already have some form of universal health care coverage which is funded mostly by tax dollars collected by and distributed by government.

http://en.wikipedia.org/wiki/Universal_health_care
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HUFFPOST PUNDIT
jmpurser
See My micro-bio
10:48 AM on 04/22/2011
"Ryan's Medicare Plan Would Be a Windfall for Insurance Companies"

Just as Obama's "Health Care Reform" law was.  It's a rigged game and the insurance industry is the only one who can't lose big.
letsbepeaceful
oh no, my micro-bio is now full...
11:19 AM on 04/22/2011
Except that the Affordable Health Care law DOES put restrictions on insurance companies - they have to use 80% of premiums for health care, more than they currently do, and not use them for those huge CEO salaries and shareholder payouts. For-profit health care is an abomination, IMO.
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HUFFPOST PUNDIT
jmpurser
See My micro-bio
11:37 AM on 04/22/2011
AND requires all of America to go shopping for insurance from those companies.

It was written behind closed doors with the insurance industry lobbyists.  It was done to preserve a broken system profiting a parasitic industry.
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HUFFPOST SUPER USER
RandyK100
Retired Info Tech
09:20 AM on 04/22/2011
The liars campaigned in JOB JOB IOB creation. Not one word about it in ryans piece of crap. Just doom and fat profits to his donors---ins. co's.
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blinkthink
Tax Wall Street Trades Now
11:31 AM on 04/22/2011
Boehner passed that ball to Ryan with the myth than more tax cuts the rich get, the more they create jobs. Now we know what he meant by "job creation."
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HUFFPOST SUPER USER
RandyK100
Retired Info Tech
11:56 AM on 04/22/2011
Ye olde trickle down
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HUFFPOST SUPER USER
dee50
Vouchercare-No Way!
08:38 AM on 04/22/2011
I guess if your under 55 you are screwe* but if you are over 55 the good times are hear again!
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HUFFPOST PUNDIT
jmpurser
See My micro-bio
10:56 AM on 04/22/2011
No.  If you're over 55 you get to keep your cat food.  If you're under 55 you have to fight the cat for it.
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blinkthink
Tax Wall Street Trades Now
02:27 PM on 04/22/2011
F&F. Per the GOP, blame the cat.
08:30 AM on 04/22/2011
Another result of this bill would be the virtual end of the nursing home/assistive living system. The system as it stands now is strange but it does work. Almost no family can actually afford to pay for their parents to live in a nursing home. Most nursing homes require that you sign over to them any property you own to them as payment. The system that has morphed out of this is that seniors who are facing this give their house or any other property to their children so they have no assets and are only covered by Medicare and/or Medicaid. The nursing homes know this but have always just accepted the fact that they make their money from Medicare. But, then again, so do most doctors and hospitals. Anybody think private insurance companies are going to foot the bill for long-term care? The "voucher" payment doesn't even come close to what the cost of a year's stay in a nursing home is.
letsbepeaceful
oh no, my micro-bio is now full...
11:21 AM on 04/22/2011
True - but you have to give it away at least 5 years before yo uenter a nursing home to be covered by Medicaid. Otherwise they can and do 'claw back; the value from your heirs.
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smalljaws
It can't happen here.
07:53 AM on 04/22/2011
Ban all pharmaceutical advertising on television. Why should consumers pay for big pharma's billion dollar advertising budget through ever increasing rates? We are well aware of the side effects of taking gopinol and conservanex.
HUFFPOST SUPER USER
bobWal
07:43 AM on 04/22/2011
Once a again the Republican/Tea Parties consist of two factions-millionaires and suckers. The clowns in their three corner hats and Gasden flags are the suckers. The millionaires are chuckling at them (and us) as they get away getting us to argue with each other as they rob the nation.
HUFFPOST SUPER USER
robert horwitz
07:38 AM on 04/22/2011
Wendell you don't have to sell me. I figured this out long before this latest health care debate. There is one thing that has always puzzled me. Though it has always been obvious to me why many of our elected officials always stand against the best interests of the folks who elected them and do their best to convince these folks to vote against their own best interests. I even understand how they do it. What has always puzzled me is how we can elect so many people who have no conscience.
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HUFFPOST SUPER USER
RandyK100
Retired Info Tech
09:16 AM on 04/22/2011
I marketing it's called bait and switch. And the switch is very painful.
10:20 AM on 04/22/2011
The no conscience thing comes from the Ayn Rand school of thought. If these ignorant people only knew what the f was going on.
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HUFFPOST PUNDIT
Chris1962
NYC
07:35 AM on 04/22/2011
>>>Ryan's Medicare Plan Would Be a Windfall for Insurance Companies>>>

Like Obama's quid-pro-quo with the insurance lobbyist wasn't? http://www.youtube.com/watch?v=5PwqSCJmbxk
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HUFFPOST SUPER USER
Talmageb
Shameless liberal
08:23 AM on 04/22/2011
It was modeled after Romneycare in MA. Has the same cost controlling methods and a draconian claw-back provision for any american getting subsidized health care. MA insurance premiums are highest in the nation and rising the fastest of any state. they are trying to put cost controlling methods in now...five years later...no sign of that happening to CHR at the national level. F&F
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HUFFPOST SUPER USER
Big Jake
11:11 AM on 04/22/2011
Another Google one in a million outlier... Color me unimpressed!
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Sneakers1
Animal Lover
07:18 AM on 04/22/2011
At this rate, the US will only attract immigrants from the poorest countries - no one in their right mind will want to live in the US - I for one, will be returning to my home country of Canada before retirement.

What civilized country has a voucher system for healthcare?

I have a better idea, put the military on a voucher system!
10:01 AM on 04/22/2011
Put Congress on the same voucher system, too! Then don't raise how much they get for the voucher and let their wages stagnate. They deserve all the problems they get from this.
HUFFPOST SUPER USER
davegstein
05:48 AM on 04/22/2011
Insurance Companies will profit?...well yeah...DUH!!! So either oppose it,or convert all your assets into insurance stock.....