Watch out for Republican "Ryancare" -- it destroys Medicare

Soon we'll learn specifics of the Republican plan to destroy Medicare.

Columnist E.J. Dionne has coined the term "Ryancare," since Congressman Paul Ryan is announcing the plan, and his Road Map for America's Future calls for moving health care for the elderly into a system where vouchers are used to buy private health insurance.

Ugh. No way. Keep your damn hands off of Medicare, Republicans.

I'll be eligible for Medicare in less than three years. I'm looking forward to this, being sick and tired of the bullshit our current private insurer, Regence BlueCross BlueShield of Oregon, regularly piles on us.

Denying my wife's medically necessary care in order to save money (a decision that was overturned by an independent reviewer after we appealed). Discouraging colon cancer screening for the same reason: higher profits for Regence.

Now it looks like Republicans are going to try to convince Americans that private insurance is a better way for seniors to get their health care. This makes essentially zero sense. Hopefully it'll backfire big time on politicians with an "R" after their name come election time.

As Nobel prize winning economist Paul Krugman says, "Privatizing and voucherizing Medicare does nothing whatsoever to control costs."

Absolutely true.

In fact, it will increase costs for senior health care, since Medicare currently has very low administrative costs, being a single payer system. (Isn't it interesting that all those Tea Party types who have been screaming about how they want to keep Medicare as-is are proclaiming their love for single payer government-run health care financing?)

The vouchers that form the foundation of Ryancare would end up supporting marketing, advertising, claim denying, and other private insurance costs. Money available for actual delivery of health care would shrink, not expand.

Seniors would get screwed. To learn how, read an excellent article in Kaiser Health News, "Analysis: Medicare and Medicaid Get Squeezed in Ryan Plan."

If seniors are worried about doctors dropping them because of crappy reimbursement, and if health care providers are equally worried about how to care for sick seniors when medical costs keep rising faster than payments, they should be super-concerned about Ryancare.

Here's some excerpts from the article:

Capping expenditures is central to cost-control in the Ryan plan, which is essentially the same plan that he co-authored with former Congressional Budget Office director Alice Rivlin during the fiscal commission deliberations. The plan limits the annual growth in the amount earmarked for either premium support or block grants to one percentage point more than gross domestic product (call it GDP+1).

...But just because the government slowed its spending doesn’t mean that old people and the poor wouldn’t have the same health care bills they had before. Health care for these vulnerable populations absent some other force in the marketplace would continue growing at rates significantly faster than the Ryan plan’s GDP+1 formula, just as it has for decades.

Who would pick up the costs that once were picked up by the government? Under the existing system, doctors and hospitals already complain bitterly about the insufficient fees that Medicare pays for the services they provide seniors.

...One option for physicians and hospitals under a capped Medicare premium support system would be to step up what they have always done when faced with inadequate Medicare reimbursement. They could shift even more costs to private, non-Medicare payers, that is, employers and their covered employees. For working stiffs and their bosses, higher taxes would be replaced by higher insurance premiums.

Another option would be for insurers to begin making skimpier plans available to seniors, who would have to make up the additional costs out of their own pockets. Co-pays would rise. Deductibles would rise. Fewer services would be covered.

Our current health care system really is a non-system. Ryancare would only perpetuate the problems of what we have now: rapidly rising costs, rationing based on ability to pay, poor health outcomes compared to European social democracies and Canada.

What's the solution? Well, the article says that we're already on the road to it: the Affordable Care Act, a.k.a. Obamacare.

There is one way to avoid these negative outcomes. The government could set minimum standards for the insurance plans sold to seniors and the poor and set up exchanges, perhaps in the states, to enforce those standards. It could also guarantee that the premium support was adequate for poorer seniors (about half live solely on Social Security) to purchase those plans.

There’s a precedent for this approach. Republicans call it “Obamacare.” Democrats call it health care reform, which also included an Independent Payment Advisory Board that every year after 2015 is going to recommend to Congress cuts in Medicare anytime expenditures go over GDP+1. Republicans want to repeal this measure, along with the rest of the bill.

Yes, Medicare needs improving. But we shouldn't go backwards and return control of senior health care to the private insurance companies that are doing such a poor job of providing services to the under 65 folks.

My prediction is that Ryancare is going to get a big Thumbs Down from Americans. And that Republicans are going to pay the price at the ballot box come November 2012, helping Obama to be elected to a second term.

Comments

[Rain]

Maybe on Obama but Ryan could not get through this Medicare destruction without Obama signing off on it as so many other things. Will he hold the ground on this or is he going to do what he just did on civil trials for accused terrorists-- wimp out? Supporting him doesn't seem it will guarantee us anything and with so many Americans clueless that they are impacted by entitlements, I don't have a lot of hope on any of this.

[Blogger Brian]

Here's an excellent Daily Kos post on this topic:
http://www.dailykos.com/story/2011/04/05/963631/-GOP-unveils-plan-to-eliminate-Medicare,-press-neglects-to-ask-about-it

I like the questions posed for, so far, an unquestioning press corps:
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This plan would save money by limiting the rate of increase in subsidies, but it wouldn't control health care costs. If, as is likely, the cost of health insurance rises faster than subsidies, how will seniors be able to afford health care coverage?

Health care costs are higher for seniors than any other age cohort for obvious reasons. Before Medicare, private insurers didn't want to provide coverage to seniors because end-of-life care can be phenomenally expensive—there's no outliving old age. Why should we expect things to be any different now?

Under this plan, subsidies for private insurance would be means-tested. Wouldn't that turn the subsidies into a welfare program, subject to the the budget axe just like Medicaid?

You claim that eliminating Medicare and replacing it with subsidized private insurance will save costs without lowering the quality of or access to health care for seniors, but you also say that you won't actually eliminate the current system before 2021. If your plan is such a good idea, why wait so long to implement it?

This proposal replace Medicare with a health insurance marketplace nearly identical to the health insurance exchanges in the Democratic health reform bill, yet you oppose those vigorously. Why do you oppose health care exchanges for younger Americans but support them for seniors who will face much higher health care costs and are much more difficult to insure?

During the 2010 campaign you accused Democrats of cutting Medicare by $500 billion, but now you are proposing its elimination in order to save trillions. Isn't that hypocritical?

[Sandy Greenleaf]

What about those of us who are disabled and under 55? I need joint replacement and was told I wouldn't even be considered for it until I'm at least 55. By that time, I will have been out of the workforce for 12 years, at least. Who will give me a job at that age? At 43 I was diagnosed and wanted them to fix me so I could go back to work and they told me no, we don't want to have to do it twice..that's their argument for making me wait until I'm at least 55, and perhaps not then. This makes no sense.