Health
Care Reform Update: Republican Voucher Plan for Medicare
by Alta Price, M.D.During an interview with Katie Couric during the pre-game Super Bowl show, President Obama announced plans for a televised half-day summit to be held at the White House on February 25 to go through Democratic and Republican health care reform proposals. I sure hope it will be a replay of the Q & A session with the House Republicans!
To get ready for the summit, let’s examine a subset of health care, Medicare. I am sure Blog for Iowa readers are savvy enough to know that Republicans were opposed to the creation of Medicare back in 1965. In fact, the patron saint of the Republican Party, Ronald Reagan, recorded an LP (remember those?) for the American Medical Association in an effort to defeat Medicare. My favorite quote from the LP is his dire warning that if Medicare passes, "We are going to spend our sunset years telling our children and our children's children, what it once was like in America when men were free."
And Republicans have been trying to kill (or privatize) Medicare ever since.
One way they have tried to kill Medicare is by ignoring the fact that Medicare will soon run out of money – the Medicare trust fund will be depleted in 2018. The Republicans tried to scare everyone into privatizing Social Security, even though it will be solvent for many years past the time Medicare goes broke. At the same time they ignored Medicare’s problems, or made them worse by passing the Medicare drug bill without paying for it. (Did you know the Medicare drug bill, passed under reconciliation and added to our national debt with no attempt to pay for it, costs as much over ten years as the current health care reform bills passed by the Democrats?) And of course the Medicare Advantage plans (which were part of the Medicare drug bill) were part of a Republican plan to privatize Medicare. Medicare Advantage plans cost the Medicare trust fund 14 % more per enrollee and are designed to attract only the healthiest seniors.
To deal with Medicare and bring down deficits, Republicans want to give seniors a voucher to purchase private insurance in the individual market. The government would no longer directly pay for health care services for Medicare recipients.
The most current and detailed Republican health care reform proposal is part of the “Roadmap for America's Future". The chief architect of the plan is Representative Paul Ryan, ranking Republican member of the House Budget Committee. Jonathan Cohn, Senior Editor for The New Republic writes about the Roadmap in an article “Yes, let’s talk about those Republican ideas”:
The health care portions of the plan, though, really would reduce what the government spends on health care. And they would do so, primarily, by extracting money from Medicare. Instead of continuing to provide coverage directly, the government would issue vouchers that seniors could use to buy private insurance. The value of the vouchers would rise far more slowly than Medicare spending is expected to grow if nothing changes.
The bills passed by the Democrats in the Senate and the House also cut Medicare spending over time. But they don’t do it by giving seniors a voucher inadequate to pay for private insurance. From the article again:
This is a critical difference. If you simply reduce the money flowing into Medicare, relying only on the wits of beneficiaries to figure out how best to spend what’s left, seniors are bound to end up with less care. That's the Republican method. But if you also introduce system-wide changes that reward more efficient care and force down provider prices, the dollars in the program really might go farther--so that spending less doesn't always mean getting less. That's the Democratic approach.
And what about seniors with pre-existing conditions? There are no insurance reforms in the Roadmap, so insurers can charge the sick more or refuse to cover them. You’ll be happy to know that the Roadmap envisions state high-risk pools for the sick elderly. That way it will be up to each state to decide if they want the financial burden of providing health care for the sick elderly who used to be covered by Medicare or if they will just let them die.
I just stumbled across some great analysis of the Roadmap health care proposal by someone (Baseline Scenario) on a financial blog, of all places. I highly recommend both part one “The Republican Plan, I: People Will Die” and part two “The Republican Plan, II: You’re On Your Own”.
Alta Price is a physician practicing Pathology in Davenport, Iowa. One of the original Deaniacs, she stays involved with Democracy for America, Iowa, and the Quad Cities. She advocates for quality, affordable health care for all, primarily as a volunteer with Progressive Action for the Common Good (Health Care Reform Issue Forum). Watch for Dr. Price's Health Care Reform Update every Tuesday here on Blog for Iowa. E-Mail Alta Price
