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Paul Ryan's Medicare plan: the big oops
Aug. 15th, 2012 05:52 pmAs much as some GOPers might be jumping up and down with enthusiasm about Mitt Romney's pick of Paul Ryan as a candidate for VP, consider the following bit of op-ed concerning Ryan's entitlement "reform" plan from the Los Angeles Times' Michael Hiltzik:
Within hours of the Wisconsin congressman's anointing as Mitt Romney's vice-presidential running mate, the budget plan's salient features were being widely publicized: It would deliver a handsome tax cut to the richest Americans while eviscerating the programs and services the rest of the country depends on. These include healthcare services, banking and clean water regulations, road repair and education assistance.
Yet all the discussion has overlooked the real damage the Ryan budget would do to an important segment of the American public. We're not talking about the very poor and the near poor. Their lives would be made immeasurably worse, to be sure, by a budget that would shrink Medicaid and force cutbacks in food stamp, educational and law enforcement services, among so many other things. Ryan at least pays lip service to maintaining the national safety net, ineffective as his proposals to do so may be.
Now, you might think that all of this is just going to affect the working poor and indigent, right? Not quitet :
The more insidious assault on the middle class comes from program cuts. Most of the commentary on Ryan's budget has focused on his master plan for Medicare and Medicaid, both of which he would gut. But it's a mistake to think the burden would be shouldered exclusively, or even chiefly, by the poor.
Ryan would replace the existing Medicare system of guaranteed treatment (with a nominal individual premium) with one providing vouchers for service through private commercial insurance plans. By design, the vouchers wouldn't cover all costs, and because their value would rise in accordance with a standard inflation measure, not with medical inflation, the gap would widen over time.
The Kaiser Family Foundation calculated that in 2022, the out-of-pocket medical expenses of the typical 65-year-old would come to half his or her Social Security income — double the level under traditional Medicare. There are two reasons. First, private insurers would deliver benefits at a higher administrative cost, and second, the vouchers would low-ball the retirees' real costs.
As a device to reduce the growth in healthcare costs, which is the principal component in government spending going forward, this is pure sleight of hand. Costs will keep rising, and at a faster rate than before (Ryan would also repeal the healthcare reform act, including its cost-reducing provisions). Less of the increase would show up on the government's ledgers only because more would show up in family budgets. The average American would be poorer for it.
There's more, but short of posting the entire text of the Hiltzik piece, it'd be better to read the original.
On the other hand, try this piece from the usually Republican.leaning Chicago Tribune's David Lazarus on for size:
There's no question that reform of Medicare and Medicaid is necessary. The programs are simply unsustainable in their current form and with millions of baby boomers coming down the pike.
Points to Ryan for having the chutzpah to put something on the table.
But cutting back on Medicaid, or Medi-Cal as it's known in California, won't do much to improve things. The only alternative for many low-income people would be to show up at emergency rooms, which would result in higher rates and taxes for others.
As far as Medicare is concerned, I don't think there's much evidence that the private sector has the best interest of patients at heart. Ask yourself: Does your insurance provide the level of coverage you desire at an affordable rate? Are you confident your private insurance will meet your needs in the future?
Most other developed nations offer a Medicare-for-all program that spreads healthcare risks evenly among members of society. If Ryan's plan were to be adopted, the United States would move even further from a goal of universal coverage.
In that sense, if in no other, it's fair to say that it would end Medicare as we know it.
And I'm not sure that's an improvement.
Neither am I, but considering that politics is becoming more and more of a money- and advertising-driven monster that threatens to eat all genuine policy considerations alive before they're even superficially discussed, don't expect much of anything substantial from the talking heads that infest Sunday morning TV. That would, after all, require actual work.
Within hours of the Wisconsin congressman's anointing as Mitt Romney's vice-presidential running mate, the budget plan's salient features were being widely publicized: It would deliver a handsome tax cut to the richest Americans while eviscerating the programs and services the rest of the country depends on. These include healthcare services, banking and clean water regulations, road repair and education assistance.
Yet all the discussion has overlooked the real damage the Ryan budget would do to an important segment of the American public. We're not talking about the very poor and the near poor. Their lives would be made immeasurably worse, to be sure, by a budget that would shrink Medicaid and force cutbacks in food stamp, educational and law enforcement services, among so many other things. Ryan at least pays lip service to maintaining the national safety net, ineffective as his proposals to do so may be.
Now, you might think that all of this is just going to affect the working poor and indigent, right? Not quitet :
The more insidious assault on the middle class comes from program cuts. Most of the commentary on Ryan's budget has focused on his master plan for Medicare and Medicaid, both of which he would gut. But it's a mistake to think the burden would be shouldered exclusively, or even chiefly, by the poor.
Ryan would replace the existing Medicare system of guaranteed treatment (with a nominal individual premium) with one providing vouchers for service through private commercial insurance plans. By design, the vouchers wouldn't cover all costs, and because their value would rise in accordance with a standard inflation measure, not with medical inflation, the gap would widen over time.
The Kaiser Family Foundation calculated that in 2022, the out-of-pocket medical expenses of the typical 65-year-old would come to half his or her Social Security income — double the level under traditional Medicare. There are two reasons. First, private insurers would deliver benefits at a higher administrative cost, and second, the vouchers would low-ball the retirees' real costs.
As a device to reduce the growth in healthcare costs, which is the principal component in government spending going forward, this is pure sleight of hand. Costs will keep rising, and at a faster rate than before (Ryan would also repeal the healthcare reform act, including its cost-reducing provisions). Less of the increase would show up on the government's ledgers only because more would show up in family budgets. The average American would be poorer for it.
There's more, but short of posting the entire text of the Hiltzik piece, it'd be better to read the original.
On the other hand, try this piece from the usually Republican.leaning Chicago Tribune's David Lazarus on for size:
There's no question that reform of Medicare and Medicaid is necessary. The programs are simply unsustainable in their current form and with millions of baby boomers coming down the pike.
Points to Ryan for having the chutzpah to put something on the table.
But cutting back on Medicaid, or Medi-Cal as it's known in California, won't do much to improve things. The only alternative for many low-income people would be to show up at emergency rooms, which would result in higher rates and taxes for others.
As far as Medicare is concerned, I don't think there's much evidence that the private sector has the best interest of patients at heart. Ask yourself: Does your insurance provide the level of coverage you desire at an affordable rate? Are you confident your private insurance will meet your needs in the future?
Most other developed nations offer a Medicare-for-all program that spreads healthcare risks evenly among members of society. If Ryan's plan were to be adopted, the United States would move even further from a goal of universal coverage.
In that sense, if in no other, it's fair to say that it would end Medicare as we know it.
And I'm not sure that's an improvement.
Neither am I, but considering that politics is becoming more and more of a money- and advertising-driven monster that threatens to eat all genuine policy considerations alive before they're even superficially discussed, don't expect much of anything substantial from the talking heads that infest Sunday morning TV. That would, after all, require actual work.
