Assuring Medicare
The reasons are wonky, but the concern is valid that Romney’s reform plan will undermine the program.
As the Obama campaign touted a nonpartisan study showing more than half of today’s seniors would pay more for Medicare under a voucher system, the Romney campaign underlined the authors’ caveat: This is not an analysis of the Romney-Ryan model. The two are much alike, though.
Kaiser Family Foundation researchers used the same benchmark set in the Romney-Ryan proposal, which is the same as in Rep. Paul Ryan’s budget plan: If the government cut seniors a check to buy private health insurance equal to the second lowest bid from a private Medicare Advantage plan in a given area, would it cover the cost of current benefits?
The answer was no for 59 percent of seniors on Medicare.
October 21, 2012 - 7:47 AM
I can see the need for reforms to Medicare and Social Security, but these are reforms that have to give much more than 10-15 years notice to people who are working at the low wage or bottom of the middle class wage scale and who have not been able to fully fund their retirement or their old age health care needs. For these people and the already dependent disabled people and the truly poor, there has to remain a guaranteed income and a guaranteed health care system. We simply cannot abandon that promise as soon as many believe we can. Any change needs to include a good 25-30 year window for the people who can to prepare for an alternative to Social Security or Medicare as we know them. Anything less is inhumane.
First, you assume present day economic conditions. Under those same assumptions, present M-care is also unsustainable. (Just about everything is unsustainable under present economic conditions, but I digress).
Second, you purposely mix up M-care & M-caid under the guise of:
“….the poorest and most vulnerable seniors” – who qualify for dual enrollment….”
By no means suggesting that such seniors be ignored, what is their percentage in the total pool, meaning, this can be adjusted for, & to use this as the norm is a red herring.
The states have shown they are better at efficiently using taxpayer money than the feds.
Neither Obama, the dems in general (or the RTEB) are suggesting any alternatives. Just pointing at the GOP (which is) and promoting scare tactics (and histrionics).
So now you want poor seniors to use Medicaid instead of Medicare? Is that what you are saying? I did not mention Medicaid, but it too has to remain in place for the poor and the working poor.
I “assume present day economic conditions” because graph after graph after graph shows very very little in gains for those who have been working the past 30 years and despite his promise to create “good paying jobs” even as he says government cannot create jobs, Romney cannot and would not improve the ability of the low wage workers to save for their retirement such that they can afford the hit that is coming.
The TP/R so called “plan” is objectionable, regardless of what it goes up against. Democrats have said they will work to secure and sustain Medicare and Social Security for these workers. That is the only fair thing to do.
#3 And, by the way Mrs. Saunders, many poor seniors already receive M-caid. As pointed out by the RTEB. My point was that although this is true, they still represent a relatively small number of seniors, M-care recepients & both (dual enrollment). As best I can tell less than 10%.
Thus, my point that this is managable within the GOP reform suggestions.
I said absolutely nothing about wanting poor seniors on M-Caid.
As to:
“Democrats have said they will work to secure and sustain Medicare and Social Security for these workers. That is the only fair thing to do.”
Yeah, they’ve said that. Please surmise their plan.
To #1 (Sandi) and #2 (Jim Lucas): Jim is correct. Present-day Medicare is already unsustainable, and the future only holds larger deficits:
http://www.npr.org/2011/04/30/135844222/medicares-math-problem-taxes-benefits-trouble
http://www.nationalreview.com/articles/296901/medicare-s-dirty-little-secret-douglas-holtz-eakin
Medicare was supposed to be self-sustaining, but the twin revenue streams of payroll taxes and beneficiary premiums cover less than half of Medicare’s actual spending. Something’s gotta change. Romney, Ryan, and the GOP have proposed vouchers, a scheme which definitely has issues. But Obama, Biden, and the Democrats have offered no plan at all.
So what is the Democrats’ plan? Hike the retirement age? Double (or even triple) payroll taxes and beneficiary premiums? Reduce payments to providers further, since the first $716 billion in savings is already earmarked for covering Obamacare insurance subsidies for younger people? Impose a cap on lifetime benefits?
We can’t afford to wait 25+ years for a fix, as we’d go belly-up Greece- or Japan-style long before then. The time for reform is now.
My #4 was preceeded by a post that pointed out that my #2 was not directed to Mrs. Saunder’s #1, but to the RTEB.
I do not believe that Medicare is already unsustainable, nor that is has to be in the future. I agree there needs to be reform, but it is simplistic to think shifting the costs to the elderly will fix the problem. Just as shifting the costs to the states will not fix Medicaid.
The problem is what is underneath, a terribly over priced health care system that rewards service not outcomes and encourages rather than rationalizes expensive care. Privatizing the systems, leaving more on the states, or lessening our commitment to health care for the elderly poor, disabled poor, and working poor is not the answer IMO. You can agree with Jim Lucas all you like, that will never change my mind.
From your first link: “But when we’re talking about cuts in things like health care and elderly support programs,” Steuerle says, “we’re basically talking about cuts in a rate of growth.”
I believe that is precisely the reason that 716 billion dollars was cut from Medicare. We have to come at this from both ends. The reason most doctors to the elderly stack patients in their waiting room like cord wood is to increase their volume. With more and more “boomers” they will have all the patients they need and if one has to sacrifice…so does the other.
I do not have a checklist to offer but I already admitted reform is needed.
The shortfalls in your second link are the direct results of any attempts at controls being called “death panels”. Now who do we have to thank for that? It is the cold hard reality that has already been mentioned and rejected, but will have to happen. You cannot have unlimited life sustaining medical intervention for the last 40 years of your life. Medicaid certainly has limits, why not Medicare? It has to be done, but there are no grown ups in either room and you know that too. The “Romney Plan”, is not going to be welcomed by those needing votes either.
Just don’t say you weren’t warned.
To all posts on this thread. In association to a recent previous thread reference RTEB bias, etc.
The predicate editorial did/said/advocated nothing except to scare voters as to the GOP suggestions.
Two weeks before the election. Granny over the cliff.
7 – Sandi, I agree that health care is overpriced – enormously so – but what do you mean when you say it rewards service not outcome?
I mean it rewards doctors for how many things they can say they treated you for and how many things they can say they did to or for you, not for how well those items actually helped you.
http://www.dartmouthatlas.org/downloads/reports/Spending_Brief_022709.pdf
“Medicare spending in 2006 varied more than threefold across U.S. hospital referral regions… Research has shown that some of the variation is due to differences in the prices paid for similar services, and some is due to differences in illness; but even after accounting for these factors, twofold differences remain.
In other words, the differences in spending are almost entirely explained by differences in the volume of health care services received by similar patients.”
More:
http://www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareFinancingReview/downloads/07Fallpg59.pdf
http://www.healthcare.gov/law/resources/reports/nationalqualitystrategy032011.pdf
Thank you, Sandi. So what’s the solution? A board that prescribes a set regimen of treatments and medications for every illness, to ensure all receive equal outcome?
I do not believe that “A board that prescribes a set regimen of treatments and medications for every illness, to ensure all receive equal outcome” was even hinted at. Not by me and not by the links I offered. If you only want to play games, discuss the issue with someone else.
12 – Sandi, I asked you what your proposed solution to the problem you defined – that of a health care system that rewards service not outcome, and illustrated by you in post #10. I suggested the board…I ask you what YOU would propose.
If you don’t know, just say so, and save the self-righteously indignant histrionics.
To #12 (Sandi): That’s the problem, Sandi. You haven’t hinted at any specifics at all. Obama and Biden haven’t hinted at any specifics at all. Congressional Democrats haven’t hinted at any specifics at all. Without seeing actual policy proposals, people are reduced to guessing. Or coming to the conclusion that Democrats actually don’t have any solution at all.
I am a blogger. I am a bookkeeper. I am a mother. I am a wife. I take care of 4 dogs and a cat. I am not a policy maker and I am not under any obligation to waste my time formulating the intricacies of health care reform. And trust me, you would not want me to.
I do believe that the Obama administration has said similar things and that is the catalyst for the Medicare reforms offered in the ACA or “Obamacare”. We have to control the growth and the spending, and whether it meets your approval or not, that is the direction the ACA is going in.
No one, including Romney/Ryan can offer specifics. Yet.
I believe the studies and points I made are under consideration and an ongoing part of the Medicare reform but I have not studied that in depth, I only believe that from listening to the experts.
People who think “Democrats actually don’t have any solution at all”, should at the very least acknowledge that neither do the Republicans. I believe it is in the ACA and the goal of HHS. Are you saying it is not?
http://www.cms.gov/apps/docs/ACA-Update-Implementing-Medicare-Costs-Savings.pdf
There is no “one solution”, this is a complicated and ongoing process. I believe President Obama and the Democrats have laid out a good plan to begin to achieve our goals.
Can you share the Romney/Ryan plan for Medicare?
I wonder when honesty became “self-righteously indignant histrionics”? I told you what I thought would improve the system and save money. I offered you links to the same research confirmed POV, not partisan political opinion. Then I offered the ACA guidelines.
It is not me that is working “self-righteously indignant histrionics”, it is the person describing the ubiquitous “death panels” with sophistry. Or the person claiming there is no plan, when there clearly is.