Which Presidential Ticket Will Protect Medicare?
Watch this intense exchange between a leading House Democrat and Wolf Blitzer of CNN, and consider which party actually has the best interest of Medicare at heart. . . .
So what should we say about Medicare's future, given Pres. Obama's health system reform and the proposals by Romney/Ryan?
Here are some thoughts from some of my colleague Kevin Zeese, a health reform activist and lawyer:
I am no fan of Paul Ryan but isn't Ryan's Medicare plan -- a voucher system (or now renamed as premium support) -- virtually the same as Obama's health law? Obama gives subsidies to help people buy health insurance, and Ryan gives premium support (a subsidy) to buy health insurance. Actually Ryan is more liberal in two ways (1) you are not forced to buy insurance at the threat of a tax penalty and (2) you are given the option of buying into Medicare, a public option. I don't favor the Ryan Plan, but I also oppose Obama's health reform -- after-all, they are basically the same.
Here is how FactCheck.org scores the debate about whether Ryan proposes to "end Medicare as we know it" (http://www.factcheck.org/2012/07/no-end-to-end-medicare-claim/):
Democrats are still hammering an old, and since replaced, GOP proposal, claiming it would “end Medicare,” and cost seniors $6,000 more a year for their health care. The newest Republican budget, proposed by Rep. Paul Ryan of Wisconsin, keeps traditional Medicare — unlike his plan from 2011 — and the increased cost claim is no longer applicable to it.
The latest string of “end Medicare” claims comes from the liberal Patriot Majority, a 501(c)(4), a nonprofit advocacy group, that was founded by a Democratic strategist, and that does not have to disclose its donors. Its ads, which began airing June 18, support Democratic Reps. John Barrow of Georgia, Ben Chandler of Kentucky and Jim Matheson of Utah, as well as Republican Rep. David McKinley of West Virginia. Another late June ad, from the Democratic Senatorial Campaign Committee, echoes the Medicare theme, attacking Rep. Rick Berg, who is running for the Senate seat being vacated by Sen. Kent Conrad in North Dakota. The ad says Berg voted for “essentially ending Medicare.”
House members voted along party lines on the Ryan budget last year (which included the Medicare proposal), with all Democrats and only four Republicans, including McKinley, voting against it.
Battle-Tested Claims Never Die?
Democrats have jumped on Ryan’s budget proposal since he first presented it in 2011. His plan called for a massive change to Medicare — stopping the current Medicare system in 2022 for new beneficiaries and instead launching a so-called “premium-support” system, where seniors would pick from a choice of private plans on a new Medicare exchange with the help of government-provided subsidies. Claims that this would “end Medicare” — claims that were usually accompanied by images of elderly individuals — left the false impression that the Ryan plan would get rid of any kind of insurance program for seniors.
Furthermore, this plan didn’t pertain to the seniors pictured in the attack ads — they would remain on traditional Medicare, with only new beneficiaries in 2022 and beyond joining the private system. The claim made our list of the “Whoppers of 2011,” and so far, Democrats are making a good case for its inclusion in our 2012 list. A Democratic super PAC used the claim again in an Iowa congressional race in February, and now Patriot Majority and the DSCC are joining in.
The Patriot Majority ads say that “some in Washington want to end Medicare” and that the lawmaker featured in the ad “opposed those who’d increase costs on seniors by $6,000 a year.”
But the ads dig up that old claim about Ryan’s 2011 proposal. It’s true that an analysis from the nonpartisan Congressional Budget Office found that seniors on the private plans would pay more than they would under traditional Medicare. And the CBO analysis indicated that a 65-year-old in 2022 could pay about $6,000 more than he or she would for the year under traditional Medicare. The government subsidies would increase with the rate of inflation, which critics argued was not much when dealing with health costs that, for years, have risen much faster than the general inflation rate. Ryan did say that low-income beneficiaries would get more money from the government to help cover costs, but the details on how much and who would qualify were not yet fleshed out.
But Ryan’s new plan, released this year, is more generous in terms of what it would provide for subsidies, and it keeps traditional Medicare as an option for all beneficiaries, both current and future.
Here’s a quick rundown of the latest Ryan plan:
For seniors who are now in Medicare, nothing changes. They can stay with the traditional program as it is.
Beginning in 2023, 65-year-olds would have their choice of insurance plans — private and traditional — on a new Medicare exchange. A premium-support payment, like a subsidy, would be sent to the plan of their choice.
If the chosen plan costs more than the premium-support, the senior would pay the difference.
The Medicare eligibility age would be slowly raised to 67 by 2034.
All plans on the Medicare exchange would offer a base level of benefits, and they would be regulated by the Centers for Medicare and Medicaid Services.
The premium-support payments would be tied to the second-cheapest plan, which can’t grow more than gross domestic product plus 0.5 percentage points. If the cost does grow faster, Congress would be required to step in and take some action to keep costs down.
CBO didn’t conduct an analysis that shows what seniors might have to spend out of pocket under the latest plan. But it said that “beneficiaries might face higher costs,” adding that there was uncertainty in making such predictions. CBO said that both the Ryan plan and current law could lead to the same consequences — “reduced access to health care; diminished quality of care; increased efficiency of health care delivery; less investment in new, high-cost technologies; or some combination of those outcomes. In addition, beneficiaries might face higher costs, which could in turn reinforce some of the other effects.” And some of the effects would be greater under the Ryan plan because government spending is lower. But there was no estimate of seniors paying $6,000 more, or any other amount, under the latest GOP plan.
The ads ignore the updated Ryan plan, choosing instead to highlight an old, and misleading, claim. The ads feature images of seniors, who wouldn’t be affected by either of Ryan’s proposals — the changes to Medicare wouldn’t be put into place until 2022 or 2023, and would only affect new beneficiaries at that time.
The Patriot Majority ads also say these lawmakers “fought against raising the eligibility age for Medicare” and “prevented a new Medicare doughnut hole.” Those are both references to the Ryan plan, which raises the eligibility age and repeals the Affordable Care Act provisions that slowly closed the gap in Medicare prescription drug coverage, known as the “doughnut hole.”
‘Essentially’ Out of Context
The DSCC ad throws in the line that North Dakota Rep. Berg voted for “essentially ending Medicare.” But the line is a reference to an April 4, 2011, Wall Street Journal article, and it’s not the full quote from the newspaper.
The Journal actually said that the old Ryan plan “would essentially end Medicare, which now pays most of the health-care bills for 48 million elderly and disabled Americans, as a program that directly pays those bills” (our emphasis added). And that’s true of the old Ryan plan, which would end traditional Medicare for future beneficiaries (those who turn 65 starting in 2022). But as we explained above, the latest Ryan plan even keeps traditional Medicare as an option for future seniors.
Medicare as we know it is a bloated, inefficient, poor quality care system that will be bled by ObamaCare to feed the new support system for low income families purchasing mandated health (under)insurance policies. In other words, Medicare will be used to prop up the failed private health insurance business model. Ryan and Romney are no more correct about health system reform than is Obama, but let's not pretend that Obama is protecting Medicare, or reform our health care system. The sooner that ObamaCare is out of the way, the sooner we can go about improving the efficiency and quality, and therefore, the affordability of our health care system.
Dr. Joe Jarvis