Thursday, August 23, 2012

Medicare

My column this week in the Sky Hi Daily News
Mitt Romney's pick of Rep. Paul Ryan for VP risks losing some seniors'votes. Ryan had authored a controversial plan that altered Medicare. Until Ryan was picked, Romney had one goal: to repeal Obamacare. A GOP strategy was to frighten seniors by claiming an Obamacare panel would pull the plug on them or would cut their benefits. Romney now says his plan is like Ryan's, but fear not: no one over 55 will see any changes. Horsefeathers.

Ryan's plan is part of his deficit reduction proposal. The President's plan to save Medicare is a part of Obamacare. The major difference is that the Ryan plan to save Medicare will cost current and future seniors out of pocket money and Obamacare puts more of the burden on service provider hospitals, doctors, and insurers.

The Ryan plan partially privatizes Medicare, changing Medicare from a fee for service system to a subsidized purchase of private insurance, though seniors could choose traditional Medicare. Both Ryan/Romney and Obamacare set the same limits on future spending growth.

Here is how Romney/Ryan plans will impact us already on Medicare:

Romney's more recent mediscare infers Obama will steal $716 billion from Medicare benefits. Ironically, Ryan's plan keeps the same $716 billion in cuts but Romney said he would restore them. Romney/Ryan would repeal Obamacare. Romney had been vague on a replacement until last week when he embraced Ryan's plans. By repealing Obamacare, Romney/Ryan would immediately raise the cost of drugs to seniors by re-opening the donut hole, make seniors pay cancer screenings and wellness checks co-pays, and shorten the life of our current Medicare system.

Obamacare cuts no benefits. Much of Obama's cuts to Medicare will be taken from subsidies for insurance companies to administer Medicare Advantage; the rest result from vigorous prosecution of fraud and efficiencies required of the providers such as elimination of duplicate tests and reducing reimbursement to hospitals. Medicare Advantage is a combined Medicare and supplemental plan that is continuing successfully this year without prospects of a subsidy. Insurers just became more efficient. The participating private insurers had tacked on 14% more than what it would cost the government to administer Medicare themselves. These savings are already being used this year to close the donut hole which will be phased out completely by 2020, to eliminate co-pays for cancer screenings and check ups, and to extend the life of Medicare for eight years, making it solvent until 2024 instead of going broke in 2016.

GOP talkers still scare seniors by claiming an appointed panel would make decisions about limiting coverage. The Obamacare law prohibits that from happening. Any reference to end-of-life counseling was deleted from the law and included was a clause forbidding the panel from “any recommendation to ration health care … or otherwise restrict benefits or modify eligibility criteria.”

Ryan would also cut Medicaid by 30%. Hit hard would be poor seniors who depend on Medicaid as a supplement to Medicare and for nursing home care .

So what would my 40 something children expect when they retire? The Congressional Budget Office (CBO) could not estimate by how much co-pays would rise because Ryan's newest plan lacks details; his first plan tripled co-pays from the current 25% to 68% because costs would rise faster than funding. AARP also warns of higher co-pays .

By repealing Obamacare, Ryan throws out cost savings measures imposed on providers. He claims competition within exchanges that provide the private plans would be enough to lower costs, but this is no free market. It regulates prices of the participating insurers, limiting competition.

And the deficit? Per the CBO, the Ryan budget plan would increase it and keeping Obamacare would reduce it. For neutral information sources, see www.kaiserhealthnews.org , http://money.cnn.com/2012/04/23/news/economy/, www.factcheck.org, and www.politifact.com

 


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