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9/8/2010
Jeremy Shown: Time to take Ryan's Medicare Roadmap seriously
As most in these parts know, Wisconsin congressman Paul Ryan has developed a proposal to reform America's entitlement programs which he calls A Roadmap for America's Future. It has elicited no small amount of outrage from Ryan's opponents on the left. New York Times columnist Paul Krugman went so far as to call Ryan a "flim-flam artist". While there are serious critiques of Ryan's plan to be made, the arguments against Ryan's Medicare reforms are unconvincing and seem to be predicated on contradictory notions held by those on the left.
For future Medicare beneficiaries now 55 or younger (those who first become eligible on or after 1 January 2021), the proposal creates a standard Medicare payment to be used for the purchase of private health coverage.
Medicare beneficiaries would use the resulting vouchers to purchase health coverage. The plans themselves would still be certified by Medicare, but this would greatly reduce the practice of the federal government making detailed decisions about healthcare prices and coverage. In other words, instead of the government making decisions about health coverage, individuals would receive dollars from the government in the form of a voucher which would be used to purchase the health coverage that is right for them.
Sound familiar? It should. The idea of giving our elderly citizens the monetary wherewithal to meet their basic needs is at the heart of one of the government's most popular programs, Social Security. It's true that Social Security is not strictly a voucher. It's even better - it's cash. Cash, of course, can be used to purchase the necessities of life such as food and shelter.
But what about the fact that Ryan's proposed voucher does not cover the full cost of average health insurance? The average Social Security benefit for retired workers is about $14,000 a year while for those over 65 the average household expenditures on just food and shelter is about $18,000. That the voucher doesn't cover the full cost of health insurance is no reason to oppose Ryan's idea. If you are one who believes we owe our elderly citizens health insurance at no cost to them, then find a way to make up the difference or argue for a bigger voucher – but don’t oppose the Roadmap.
Many of those opposing Ryan's Roadmap are the very same people that hold up the current Social Security program as the model of a successful government run social welfare program. Yet these same advocates will argue that Ryan's approach to Medicare is a bad idea. This line of reasoning simply doesn't hold up under even a moderate amount of scrutiny since Ryan's plan appears to reshape Medicare more along the lines of the current Social Security program.
All Americans interested in creating entitlements that meet basic needs while maximizing freedom and flexibility for beneficiaries should take Ryan's idea more seriously.
Jeremy Shown blogs at Rhymes with Clown and frequently hits on politics and economics in Wisconsin and the U.S.
COMMENTS
And the exact savings and improvements in Medicare costs would be what? The the average overhead in our medical system is 31% for private insurance and 3% for Medicare. Medicare negotiates the price of procedures significantly down from the outrageously high prices that private insurors pay (but still much higher than the rest of the world). Medicare provides a fair system that is easier to deal with than private insurors. So what is the reason for change? I see this is nothing more than the mantra that "private industry is always better at something than government". That mistaken philosophy is especially ignorant of the facts about our health care system in the US. No, privatizing our Medicare system would be about as efficient ad medicare part B, huge costs that benefit the providers, lots more paperwork and confusing "choices"
dave allen (Wed Sep 08 06:55:13 2010)
Look, Ryan wants to privatize social security and Medicare because private entities can give campaign contributions and public entities cannot. To add 20% to their costs (in profits and CEO salaries and bonuses) is cruel and absolutely stupid. To force geezers to stay in a tight jobs market for an additional two years is equally stupid, and will only drive the elderly into taxpayer-funded food stamps.
All to feed the Fat Cats that fund the elections.
Can you imagine what would have happened to your retirement account had Bush gotten his way and privatized social security?
Jack Lohman (Wed Sep 08 08:50:40 2010)
Although some of Ryan's Roadmap bears discussion and consideration, this Medicare voucher business does NOT. All it amounts to a transfer of money from MC to private insurance companies who already have an inordinate amount of power over legislation. This idea is cracked, I'm afraid.
JeanMarie (Wed Sep 08 08:56:57 2010)
Jack, that's ridiculous.
Jo (Wed Sep 08 09:10:10 2010)
JeanMarie, your are absolutely correct. Actually, a Medicare-for-all single payer would have made the most sense. It would have covered 100% of the people, cost $400 billion less, and allowed those not happy with it to buy a Gold plan the good, old-fashioned, free-market way... with cash dollars. But it also would have provided a bare-minimum "floor" of coverage, and SAVED businesses of this cost and attracted more of them to stay in the US.
But we found out that the D's are as corrupt as the R's. They've just been better at hiding it over the years.
Jack Lohman (Wed Sep 08 09:13:21 2010)
And Jo, what's ridiculous? What part of political bribes are not effective? They are given because they work, and they buy elections. And Ryan is not beyond being bought. Did I miss anything?
Jack Lohman (Wed Sep 08 09:16:37 2010)
Jack said:
Can you imagine what would have happened to your retirement account had Bush gotten his way and privatized social security?
Hmmm..., might it have started to be operated like the Wisconsin Employee Trust Fund - nearly 100% funded instead of being broke?
Duke (Wed Sep 08 10:51:18 2010)
Here's the part I don't understand -- if the fiscal situation is as dire as Ryan claims, why not implement the reforms sooner rather delaying the first dollar of savings until 2021.
I'm 49 years old, just below Ryan's cutoff. If his plan is good enough for me, it's good enough for someone born six years earlier than me.
Northern Pike (Wed Sep 08 14:36:54 2010)
Duke are you somehow under the impression that SS is broke? Maybe in about 50 years.
Dean Weichmann (Wed Sep 08 15:58:07 2010)
You've got to be kidding, Duke. Did you not have a 401(k) over the last 3 years?
Jack Lohman (Wed Sep 08 16:25:48 2010)
It struck me that maybe more people should be grandfathered and grandmothered in if benefits are to lessen. 55-year-olds already have their incomes and financial plans pretty well set according to the current programs. If we start health savings accounts controlled and owned by people earlier, the gov. would not need to kick in so much, in general. Though I am conservative, I am concerned with changing things in a way that leaves a segment hanging.
Soapbox Jill (Wed Sep 08 17:11:34 2010)
Real conservatives should demand big savings on these programs now, not projected 10-year savings that can easily be changed and delayed by a future Congress.
So, come on conservatives -- man up!!
Privatize Social Security -- NOW.
Implement the Medicare vouchers -- NOW.
Unless you think some people are more entitled than others.
Northern Pike (Wed Sep 08 18:55:41 2010)
Northern Pike, nobody "deserves" more than anybody else. For roughly 50 years I've paid into Medicare and Social Security and am now on both. Probably just like your parents.
But we do need to increase the intake by eliminating the cap and means testing both. They ARE underfunded, and when I was a company owner and had a project that was underfunded, I INCREASED funding. Duh.
Jack Lohman (Thu Sep 09 08:42:10 2010)
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