A Modest Medicare Proposal

Rep. Paul Ryan (R-Dreamland) has a problem.

He's been lauded by the conservative-loving media for weeks, because he had the "courage" to introduce a budget that is based on imaginary numbers and assumes actions by corporations that history and common sense both tell us will never happen.

He believes (or claims to believe) that tax cuts for corporations will spur hiring. The fact is that corporations have done just fine lately, even with reduced work forces, and they're sitting on tons of capital. The reason they're not hiring is (see above): They're doing just fine lately, even with reduced work forces.

Ryan seems to believe that putting more money into their bank accounts will magically cause them to change their ways--to put the interests of their country ahead of the financial interests of their stockholders. That's not what corporations do. That's not what they're supposed to do. And wishing won't make it so.

Where this becomes about Medicare is in the fact that another aspect of Ryan's budget would destroy Medicare, while putting in place another program that's called "Medicare," but isn't. News flash--if the president forcibly abolished Congress and declared himself sole ruler for life, but still called himself "President"--he wouldn't be. He would be a dictator. The name of something is not that thing. The thing is the thing, and what Ryan is pushing is not Medicare.

I doubt that he would admit it, but his plan shares some commonalities with President Obama's Affordable Care Act, which Ryan no doubt tries to dismiss with the pejorative "Obamacare." Contrary to the picture painted of the ACA by the right, it's not a socialist system, and it keeps the health insurance coprorations deeply involved in the health care of Americans.

Medicare (and the VA) are, in fact, much more socialistic in nature. Not that there's anything wrong with that.

What the ACA (And Mitt Romney's plan in MA, for that matter) included that Ryan leaves out is only the key component that makes ACA and Romneycare work. These plans force the insurance companies to accept everyone, regardless of preexisting conditions, but they make it financially plausible to do so by also pushing millions of healthy people into the system. The premiums from the healthy, who don't yet need expensive care, pay for the unhealthy who do.

Only in Ryan's plan, he simply wishes that insurance companies would be delighted to take on all those seniors, without the counterweight of a new healthy population to spread the risk. That won't happen. Medicare came about because insurance companies wouldn't insure seniors. There's nothing in Ryan's plan to make that change. See above: Corporations don't do things that are not in the financial interest of stockholders. Unless they're forced to. By government regulation.

So Ryan has offered a plan that will never get passed, and that most Americans polled deeply despise. Pretty soon the "courageous" tag will fall off, to be replaced by the "loser" tag. And anyway, if Ryan is courageous for offering an imaginary plan that doesn't address the real issues, then President Obama should be considered a superhero for finally taking on the one thing that will do the most to destroy the economy in the future--the growing cost of health care--and bringing millions of uninsured into the system.

There are two potential compromises here that would work to solve Ryan's conundrum.

1) He and the other Republicans could get over their knee-jerk, unrealistic opposition to the ACA, and instead work to expand it to also include age as a preexisting condition that insurance companies can't deny. The health insurance companies shouldn't be allowed to not insure seniors. Giving seniors vouchers or coupons is meaningless if a) insurance companies won't accept them, and b) the value of the vouchers and coupons is insufficient to provide meaningful health care. By expanding the ACA to include seniors, and keeping government regulatory eyes on them to make sure that seniors can get the care they need for the money they have available, Medicare could remain a guarantee of health care while having its financial structure changed.

That, however, is only the second-best compromise, because it still keeps insurance corporations in the mix. As long as they're part of the system, health care costs will be a problem, because money that should be going to care is instead going into profits for those corporations. And regulation or not, the way insurance companies increase profits is by taking in ever-higher premiums while paying out fewer claims.

So solution #2 is the better long-term option. This one also was kicked around during the health care debate of 2009, and it never went anywhere, but it truly makes the most sense.

2) Instead of expanding the ACA, expand Medicare to cover all Americans.

As with Social Security, we'd all pay into the program through payroll withholdings. But that would be counterbalanced by the fact that we'd no longer be paying into group health care plans as we are now. For most people, their paychecks would be a little fatter than they are now, because the cost of health care in this country--when it doesn't have to contribute to corporate profits and multi-million-dollar salaries, when the burden is shared by the healthy and the sick, when the poor don't have to wait until they're desperately ill and then seek care at emergency rooms--would come down significantly.

Those who could afford it could continue to buy their own private health insurance or pay direct costs for premium care if they wanted to, just as they do now. But they'd be paying into the system, too, and it would be there if they needed it. The desperately poor and long-term unemployed would get assistance to cover their medical needs. Most Americans would be taking home more pay, which would be good for the economy.

Okay, it's a little bit socialist. So what? Should we ignore the best options because of labels other people put on them? Or should the richest country in the history of the world turn its back on the health of its citizens, and its own long-term financial stability at the same time?

If Ryan was truly courageous, he would pick one of these--ideally #2--and run with it.

Comments

[Troy Smith]

Nuff said. I hope some people finally wake up to what Ryan and his bunch are trying to do, and that next year it bites them in the kiester big-time (Ryan et al, not America in general.)

[Cnsieler]

First of all have you read the Ryan Bill?

http://thomas.loc.gov/cgi-bin/bdquery/D?d112:1:./temp/~bdnVxu::|/bss/|

H.CON.RES.34
Latest Title: Establishing the budget for the United States Government for fiscal year 2012 and setting forth appropriate budgetary levels for fiscal years 2013 through 2021.

I will post a summary
Lists recommended budgetary levels and amounts for FY2012-FY2021 with respect to: (1) federal revenues, (2) new budget authority, (3) budget outlays, (4) deficits (on-budget), (5) debt subject to limit, and (6) debt held by the public.

Lists the appropriate levels of new budget authority and outlays for specified major functional categories for FY2012-FY2021.

Lists recommended budgetary levels and amounts for FY2030, FY2040, and FY2050 as a percent of the federal gross domestic product (GDP) with respect to: (1) federal revenues, (2) budget outlays, (3) deficits, and (4) debt held by the public.

And so on....
I highlighted the key words

This would have to pass the senate and be signed by the president for it to become a "law". (Look again at the key words above)

So why is he the anti-Christ? Nothing is going to happen on this bill.

[Cnsieler]

Because a Donald Chump I bolded everything above. Recommended. that is the key word.

[Cnsieler]

Because I am a Donald Chump bolded everything above. Recommended. that is the key word.
I will go get something to eat.

[Jeff Mariotte]

I know the Ryan bill isn't going to become law--this year. But the Republican establishment has rallied around it like it's a blueprint to a better world. It's not--it's more of the same, giving everything to the already wealthy at the expense of the rest of us. It's exactly what we don't need. It would kill jobs, not create them. It would destroy Medicare and Medicaid. It would be bad for the country.

The trouble with it even existing now is that the Republicans in Congress will take it as a starting point for negotiations. Nothing will get done without Democrats and Republicans arriving together at some kind of compromise. If your starting point is a dangerous, foolish, extreme bill, then it becomes harder to reach a compromise that works in the best interests of the country. We need people who are willing to deal with reality, and this is a document based in fantasy.

[Cnsieler]

Why be extreme? It makes no sense. It really does not. No one will provide coverage to a high risk group. It makes no sense.

My position is to try to not be draconian.
My Father in Law is much better with facts and figures. But here goes

Medicare tax rates are around 1.45 % ( Plus employer match.

From IRS tables
The 2011 employee tax rate for social security is 4.2%
(amount withheld). The 2011 employer tax rate for social security is 6.2% (10.4% total). The 2011 wage base limit is $106,800, unchanged from 2010.
The 2011 employee tax rate for Medicare is 1.45%
(amount withheld). The 2011 employer tax rate for Medi-care tax is also 1.45% (2.9% total). There is no wage baselimit for Medicare. tax; all covered wages are subject to Medicare tax.

My first question is why are not both programs self financing?
The answer is the Social Security in theory is and in fact collected a surplus last year. So my first proposal is hand off the Social Security trust Fund.

So in my little dream world hand off of Social Security. It will take care of itself.

Now medicare....

[Cnsieler]

I noticed everything is in bold now...
Their are parts of ACA I want to keep. For example I am saving money and I have my children on my plan. ( Remind me I need to write my Senators that fact).
That was and is a good idea.

Just because the other side thought of it does not mean that "all" of it is a bad idea.

Also when this diabetic old fat man ( Mr. MOSS Bear)turns 65. Who is going to provide me with an opportunity to buy health insurance, in other words I will be a high risk.

So you are correct I can't get rid of Medicare. You win.

So now My question is I posted the rates above. All pay those rates with an employer match. So my question why do we have shortfall in medicare funding?

How much revenue are we collecting?

Doing research.....

[Jeff Mariotte]

Just imagine if we had universal Medicare, and didn't have to buy yachts and mansions for the CEOs of health insurance companies. If we could work to control medical costs and spending while applying most of our dollars directly to care instead of to the middlemen at private insurance companies. The Affordable Care Act works toward making Medicare more efficient, but Republicans have to let it work (and keep tweaking it to work better, instead of trying to kill it). And while it's hard to compare Medicare administrative costs with private company costs, by any measure those costs are much lower with a single-payer system. http://voices.washingtonpost.com/ezra-klein/2009/07/administrative_costs_in_health.html

Is our health really something that has to serve as a profit center for private industry? Aren't we better served with more focus on health and less on profit, in this case?

[Cnsieler]

The research I did says that less than 2 percent of Medicare costs are for administration. It is also the the biggest insurer on the block at 30 percent of the population. The other said thing I found is that like Social Security was set up to be self sustaining, and it's trust fund was raided by Congress and they left IOU's. So tell Congress to keep their hands off of it.
I hate private medical insurance companies. But right now we need to make sure we can pay for what we have.
It is all or nothing with privatization or single payer. Having experienced Socialized medicine in New Zealand, I prefer the good ole United States every time but with some compromises.