Stanley Feld M.D.,FACP,MACE
The need for effective Medicare reform is becoming increasingly apparent. Both the public and providers do not like Obamacare.
The cost overruns for Obamacare are hidden from the public but are becoming evident.
There is an ideological divide between policies that work and policies that don’t work.
President Obama believes the only policies that work are government policies that control providers, insurers, and consumers.
There are multiple examples that have shown that these policies have never worked. Government has never controlled spending for any projects for myriads of reasons.
What makes President Obama think his government can force the healthcare system to become more efficient and control healthcare costs?
Price controls and restriction of access to medical care will not work.
Entitlement programs have been fertile grounds for fraud and abuse by all the vested interests including government agencies.
Government should be of the people for the people.
Government should level the playing field so secondary stakeholders compete for primary stakeholders’ business.
I voted for President Obama because I thought he offered this hope. He fooled me as he has fooled millions of other Americans.
President Obama has a cool, seductive speaking delivery. He is general enough to make one think he believes in what you believe but his agenda is central government control over all areas of life.
The agenda is the opposite of the individual freedoms our country stands for.
None of President Obama’s policies have worked in the last 3.5 years.
He has snuck in higher taxes on the middle class for his healthcare bill and has not lowered healthcare costs. Healthcare costs have increased.
Americans are not dumb. They are beginning to realize they are on the road to serfdom.
President Obama is using every dirty trick known in American politics to attack Governor Romney and now Representative Ryan in order to keep from talking about his record on jobs, the economy, healthcare costs, the deficit and its meaning, our National Security, foreign policy, energy, and immigration.
For some reason the traditional media is on President Obama side. The result has been a loss of their audience by newspapers, magazines, and network television.
America is in a fiscal crunch. Entitlement spending is at the center of the fiscal crunch and must be reformed effectively.
“Medicare is at the center of our fiscal crunch, with outlays that have grown about twice as fast as the economy over the past decade, according to the Congressional Budget Office (CBO)”.
The fiscal crunch is only going to get worse as 76 million baby boomers retire in the next two decades.
The Medicare trust fund has been depleted by the federal government borrowing from the trust fund. Over time and as unemployment rises less Americans are paying into the fund. The government’s depletion of the fund has occurred since the beginning of Medicare.
The Medicare premiums paid by seniors for Medicare Part B is going to double in the next two years. This is a tax on seniors on fixed incomes that no one is talking about and few can afford.
President Obama is expanding an entitlement with Obamacare. It will accelerate the consequences of the fiscal crunch.
“Even if the substantial reductions in payments to health care providers included in the Affordable Care Act (ACA) are fully implemented and Congress allows the 27.4% reduction in physician payments required under current law to go through, Medicare spending will continue to grow at unsustainable rates.”
The Ryan plan can change the direction of Medicare and save it.
- No one over 55 years old is affected.
- People younger than 55 will have the option to choose between traditional Medicare or premium support from government to pay for competing private healthcare insurance plans.
- Traditional Medicare is a defined benefit plan. The government decides on the price it will pay for medical services.
- Ryan’s plan is a "defined contribution" plan. The government decides on an amount of money ("premium support") to provide to individuals to buy private insurance of their choice.
- Consumers will choose from an approved set of competing private insurance plans along with traditional Medicare.
- There is an open enrollment period each year, allowing people to choose either of the plans.
The goal is to force the healthcare insurance industry to compete for patients as well as give seniors the right to choose the most appropriate plan for their needs.
The Ryan plan allows competition among in the private sector which will increase efficiency and drive down costs.
President Obama is scorning this system as a “voucher system.”
Once again President Obama is obfuscating the truth with a sound bite.
Americans 55 years old and younger have paid into the system all their working life jus as senior 55 years and older have. The “premium support” is not a free give away as are food stamps.
Premium support is determined each year by the government calling for competitive bidding by the healthcare insurance industry.
“ The government would then provide seniors in each region of the country with a "premium support" equal to the second-lowest bid in that region, or one equal to the bid of the federal fee-for-service Medicare program -- whichever is lower”.
Seniors could choose the traditional Medicare, since the government would still contain a package of required benefits that would constitute its comprehensive insurance coverage, just as Medicare does today.
Seniors would be guaranteed freedom of choice. A private healthcare insurance option would equal the “premium support” payment.
The premium of the private insurance might even become cheaper than the Medicare premium seniors would have to pay.
The Ryan plan would allow the healthcare insurance industry to compete with Medicare.
The healthcare insurance industry could be forced to lower its net profit by the competition just like it has occurred in other industries. The competition could also force increase efficiency and quality of product.
Tort Reform and fraud and abuse are not addressed in the Ryan Plan yet.
The Ryan Plan is a good start to change from central control to individual choice. It I not there yet.
Presidential candidate Romney’s pick of Paul Ryan as running mate has made Romney the good guy in the Medicare issue.
“ It's President Obama who has put Democrats in the position of being the party that is cutting current seniors' benefits, rationing care (thanks to the IPABs), and letting the program collapse as it becomes unsustainable.”
If you're a senior now or in the future, Democrats are offering you nothing except a grim, mean, rationed future when it comes to medical care.
It's the Republicans who are offering hope for a sustainable Medicare future with freedom of choice.
The Wyden–Ryan proposal outlines a strategy for Medicare reform that harnesses market forces to control costs. It provides a real alternative to the top-down controls favored in the Obamcare.
Paul Ryan and Ron Wyden have defined the policy parameters that could be the basis for real Medicare reform in 2013.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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