The liberal Internet has decided to pile on this piece in The New Republic from William Galston of the Brookings Institute. Galston thinks that Democrats ought to lay off Paul Ryan, because demonizing his plans for Medicare might invalidate premium support as an option for keeping the program finances sustainable. I think Paul Krugman says most of what needs to be said here.
What’s wrong with this lament? How about the fact that Romney-Ryan actually is a plan to end Medicare as we know it? (And why the quotation marks? That’s what it is – replacing the system with fixed-value vouchers). It is also a plan for drastic cuts in food stamps and Medicaid, not to mention canceling the expansion of coverage under the Affordable Care Act, which would mean lost insurance for tens of millions of Americans – thousands of whom would, in fact, die as a result.
Yet pointing out these truths is, in the eyes of Very Serious People, “demagoguery.”
But as for invalidating premium support, let me join with Scott Lemieux in saying, “Good.” Medicare holds down costs better than any other health program in America, maybe with the exception of the more radically government-centered Veterans Administration plan. The reason is that it has a large risk pool, can bargain on prices, and bring those savings to the individual. And there are a number of demonstration projects on coordinated care and bundled payments that could work to drive costs down even more. The last thing you want to do in that case is to add another middleman into that process, with them taking their percentage off the top. We don’t have to guess about whether opening up Medicare to “competition” will spur lowered costs. We have a series of good examples of that kind of competition in action, and it doesn’t work. It didn’t work for Medicare Advantage, whose costs are far higher than Medicare as a whole.
Premium support plans merely shift medical costs to individuals. That’s the only way it makes money. The benefits of “competition” accrue only to the competitors. The plan subscribers get screwed, either denied coverage or forced to pay through the nose for it. And with the cherry picking of healthy seniors sure to occur by the private plans, premium support doesn’t preserve Medicare, it undermines it:
Under premium support, traditional Medicare would tend to attract a less healthy pool of enrollees, while private plans would attract healthier enrollees (as occurs today with Medicare and private Medicare Advantage plans). Although the proposal calls for “risk adjusting” payments to health plans — that is, adjusting them to reflect the average health status of their enrollees — the risk adjustment process is highly imperfect and captures only part of the differences in costs across plans that stem from differences in the health of enrollees.
Inadequate risk adjustment would mean that traditional Medicare would be only partially compensated for its higher-cost enrollees, which would force Medicare to raise beneficiary premiums to make up the difference. The higher premiums would lead more of Medicare’s healthier enrollees to abandon it for private plans, very possibly setting off a spiral of rising premium costs and falling enrollment for traditional Medicare. Over time, traditional Medicare would become less financially viable and could unravel — not because it was less efficient than the private plans, but because it was competing on an unlevel playing field in which private plans captured the healthier beneficiaries and incurred lower costs as a consequence.
Digby is right that plenty of Democrats would like to bring Obamacare to Medicare, and create an integrated system with private insurance companies in an exchange, with a government, or public, option on the menu as well. This would have improved the current private market for individual insurance, but it clearly degrades Medicare, on price and quality and everything that matters. The idea of scaling down Medicare to Obamacare is not nearly as appealing as scaling everything else up to Medicare.
So in this context, blowing the Ryan plan to end Medicare out of the water isn’t just a means to win an election, it actually is a means to make such an idea toxic. Because it would in fact BE toxic for senior citizens.




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Just get the insurance companies out of the mix totally! They add no value whatsoever.
Without Medicare Advantage, however, many doctors simply will NOT accept Medicare patients.
I think we may need a Governmental Medical Corps. More doctors, and perhaps give credits for medical care while reducing owed educational costs.
And, for gawd’s sake, a purposeful fraud-squad! I’ve called to report Medicare fraud and been totally ignored……..and those little electrical scooters are still being pushed to any old person under a tree in the park! Damn.
Please no. I think some people are stuck on the idea of profits and how well private companies and the “free” market can make things better. Gah!!!
Getting insurance companies out of the mix is what traditional Medicare does.
I’m not as up on Medicare Advantage (MA) plans as perhaps I ought to be. My parents are enrolled in the Kaiser MA plan, and are mostly happy with it. The only real problems came with Kaiser’s formulary: Mom did well on a drug that was restricted use in Kaiser’s formulary. She did not do well with the substitutes, so we had to jump through some hoops to get her the drug she needs. It worked as it is supposed to work.
I remember reading “What’s the Matter With Kansas” and thinking, jeez, don’t let that spread. Well the voting-against-self-interest just grew like an outta control fungus.
Perhaps if we’d have had a leader………… sigh.
As I’ve mentioned on another thread, my doctor of almost two decades said that I had to have an Advantage Plan (not just plain old Medicare) or I’d have to find another doctor. I was okay with that….costs me about $65 per month. As I understand it, though, doctor gets about $600 per month. I have no way to verify that……..but it does seem ‘odd’ to me since I rarely see my doctor and have no particular conditions that would cause him to have to work up a lather.
But, but……..if there is no Advantage Plan, how will I find a doctor who will accept plain old Medicare?
I worked with people who could not find a Medicaid doctor who would accept them…….and, thus, back to the ER for medical care.
Our health “care” system is totally f*cked up.
I wish someone with knowledge of managed care plans would do a write up on them. I know several people who have one and they swear by them.
I don’t have one of those plans, just medicare and a very high deductible plan (which pays nothing till now anyway). I visit a whole squad of doctors for various conditions and not one of them has rejected me – - yet.
I am fearful that once Romney gets in office, medicare will disappear rather quickly and we will all have to buy some sort of private advantage plan. I also think the cost will go up quickly. Can’t prove any of that, but once you privatize something, cost goes up. That and the supreme court appointments are two reasons I find it hard to dump Obama, much as I dislike him.
If I could afford to move to Santa Barbara, I certainly would. My dad is getting outstanding care using Medicare. I live in a less affluent area, and there are many doctors who just don’t want to deal with Medicare or Medi-Cal.
What I’ve observed is that when people feel ‘troublesome and unwanted’ they tend to avoid doctors………and end up in the ER when things get bad.
This is, in my humble opinion, NOT good medical “care.”
That is pretty strange. Physicians tend to be pretty good about taking care of patients they have long-established relationships with.
The exception to that would be if your physician changed his practice into a real HMO (like Kaiser-Permanente). In that case, he would give up his private practice. But again, when physicians do that they tend to explain what has happened to their patients.
If you want to check on the $600/month thing, you need to see what capitation payment is from the MA plan to the physicians. You should be able to get that information from the plan itself.
Agree. Sadly.
Before I “got old”, I was paying almost $12,000.00 for health insurance per year. If I had not been employed, I probably would not have been able to buy into any insurance plan anyhow. It’s friggin’ crazy!
I think Alan Grayson was telling the absolute truth. It cost him, but I still admire that he told the truth.
Thanks for the info on how to find out what the MA plan is paying. I’ll follow up.
My doctor is a nice enough guy, but he’s been around a long time and has a lot of old patients……..and he’s not getting rich as a general practitioner. It may be that Medicare really does not pay enough under the regular plan.
Me too. He fell to the crazy right wing. So many people vote against themselves. Alan had it right. Anthony Weiner did too but he got hold of a camera.
Is that generally true or your experience? My doctors, and I’ve had, at one time or another, at least a half dozen different, have never balked at Medicare.
The whole healthcare dust up is a perfect example the whole phony “2 party” bullshit. Romney pisses on Obamacare, which is Romneycare gone national. Then Obama pisses on the Ryan plan, which is Obamacare gone Medicare.
The cherry on this sundae is nobody in the GOPocrat uniparty favors single payer, the only rational solution.
I reported an online fraud and Medicare did get around to it. Not right away, but, then, it was really penny ante. However, it was fraud and they did respond. Had a nice conversation, in fact, with the woman who called.
Studies have been done and the quality of care doesn’t correlate with people’s satisfaction. I find that interesting, but maybe it’s just the human condition: we’re an emotional species and that’s how we make decisions. We certainly vote on emotion, why not medical care.
It may just be my experience with my own doctor…..I just know that I was kind of shocked to be told “do this or you are out.”
My brother and my dad have had no problem finding Medicare doctors in Santa Barbara.
Oxnard is a funny place….. a big town with small town behaviors.
I’ve had more experience with Medi-Cal clients who have been my clients. Hard to find doctors who will accept Medi-Cal.
I think that as the govt. pulls back on Medicare and Medicaid, it will be harder to find doctors who will accept lower payments. But, hey, the Big Boys don’t really believe that people should receive “entitlements” anyway.
was just telling someone about a woman i know who has no health insurance and thinks Ryan is “brilliant”; she also thinks private chafrity can take the place of—- everything
How old is she?
Medical school costs are outrageous, amounting to multiple six figures, and discourage many qualified and interested students from becoming doctors. A good plan would be to subsidize medical school costs in exchange for an agreement by a student to work for a government-sponsored program modeled after the Veterans Administration or the British National Health Service following graduation. This program could provide services to low-income persons, Native American reservations, at-risk children, etc.
The sub-text of the health care discussion is the decay of the profit driven system. It goes way beyond health care, and there are two obvious paths we can take. One will enrich a small cadre of CEOs, Investors, and others who compose the financial aristocracy at the expense of everybody else. The other will lower their incomes to maybe 7 figures a year and provide more efficient service to everyone.
Medicare For All would deliver about 95% of the money paid in to actual health care. Obamacare gives private insurance a 15% profit, for doing nothing that Medicare can’t do cheaper.
State banks, like North Dakota, would provide banking services that don’t require trillion dollar bailouts from taxpayers.
Putting tax money into employment, rather than unemployment benefits, would
get badly needed work done in infrastructure upgrades, while upgrading the incomes and living conditions of the workers who were previously expected to sell themselves for whatever the “Job Creators” want to pay.
This is the mainspring driving the whole fandango, and at some point the music is going to stop..
So the “low-income persons, Native American reservations, at-risk children, etc.” get the rookies, perpetually? Not a sound practice idea.
Well, considering that what they have now is a 200 mile drive to the nearest clinic where they can wait 5 hours to see an overworked nurse practitioner or if they are lucky a physician-assistant-certified who has an actual doctor on skype ……
Not bashing N-Ps or PACs, cuz I know some that are pretty fantastic and are better than some actual MDs that I also know.
But the state of actual doctor distribution – especially for family practice docs – is horrid. And getting people to go into family practice is bad because of the pressure to pay for the education. The bills for tuition are so huge and many med students see a specialty as the only way to possibly manage getting that load paid off sometime in their lifetime if they want to ever have a family and a life not drowning in debt. So having a family practice becomes untenable as a financial decision – not as a matter of what they really want to do. And where they practice is even more so.
i live in northern NJ, about 30 miles from Manhattan. I tried to find out how the fairly limited number of Medicare Advantage programs would work for my situation, which includes having cancer which is, as of now, in remission. No signs of any problems, knock on wood, etc.
However, while I spent about 2 months trying to get answers from these insurance companies as to what exactly would be covered, what would or would not have co-pays ($30 per doctor’s visits was pretty clear, but the other stuff seemed to open to interpretation) — pretty basic questions and to me they seemed like something which should be known by the company and they should have been able to give me accurate answers. Nothing was highly exotic.
But, one rep would say one thing, next rep something else; same with supervisors.
I finally figured out they simply did not want someone with cancer, or at least they weren’t going to make my decision making easy or based on facts.
I ended up with Plan F Supplemental through AARP, which kind of worries me because of the political stands and backroom deals AARP leadership tends to make. Also, FYI to everyone looking at their rates: If you begin at 65 with AARP’s supplemental, through United Healthcare, your rate increases a fixed percentage each year as you age (right now I’ve forgotten how many years. I found this out when the rate increase mentioned the that the discount decreases annually. I don’t recall getting this information either from AARP or United Healthcare.
I am glad I can also use doctors and facilites in NYC, or anywhere in the country, if necessary. With the MA, I could only get emergency care out of area and had a higher co-pay for that, iirc. From what I understand, the fact the MA’s tend to limit the kind of care people can get if out of area makes it difficult for any who do any traveling or visiting out of state.
While I had no back issues when I joined, I did develop a rather nasty issue with what I thought and my GP diagnosed as sciatica. After over a year of working on this issue, it’s been narrowed down to primarily a sacroiliac-hip joint problem. My next step is to get an anlysis of what looks like squeezed nerves inside my spine and herniated discs may be contributing.
I am very glad to have the freedom to choose my doctors, especially for my cancer which has to be monitored carefully annually. Since it involves the thyroid, it also means working to find the best dose to inhibit any growth of remaining cancer cells and to ensure bone strength and energy.
But, several MA plans offered free gym memberships, dental, and vision, none of which I can afford on my own. The formularies, however, didn’t cover all my medications
But I’d gone through the HMO hell of trying to get answers as to coverage, referrals, the whole mess, always having to double and triple and quadruple check answers I was given. I am so glad I don’t have that worry and hassle any more.
I have one doctor who doesn’t take Medicare’s regular payments, but I can still go to him and my supplemental covers the extra percentage he can demand. The only inconvenience is that I have to send the check sent to me by United Healthcare directly over to the doctor (if I can’t afford the balance that month).
One spine center I contacted wanted to operate on me, but they didn’t take Medicare. They would have, however, given me a discount on the $65-100K for the surgey. (About 10%, iirc. Oh, yeah, like I can handle that!)
I’d also been completely tapped out savings-wise by having to buy health insurance on the private market. Another year or so would have left me without insurance for quite awhile. As it was I went only two months without coverage and felt incredibly nervous about that.
Medicare is the best birthday present I have ever received. Thank you, LBJ~ And FDR, TR, all the many activists who worked for national healthcare and at least got Medicare going.
Either Obama or Romney are going to give most of us a lot to worry about during the next 4 years. I trust neither one of them. They’re both saying whatever they think will get them elected; Obama has proven he’ll forget his campaign promises in a NY second. Romney will say anything to gain power.
In nothern NJ suboonia, I was paying $12,000 up to $18,000 per year, with co-pays, deductibles, 50% co-pays for prescriptions. If rate increases were really high close to elections in the state, then then the regulators tended to step in and demand reductions in the huge increases. Otherwise, they didn’t much bother the private insurers.
Gave me a hell of a deduction for Federal and state taxes!
Also, wiped out my savings.
I click edit and reply comes up. Hhhmm. Also said there a database error.
But, high rates are necessary to make execs of private for-profit insurance companies multi-millionaires. So, there’s that.