Saturday, September 22, 2012

Obama vs Romney: Medicare

Here is the Obamacare claim on Medicare Advantage:
    "Today, Medicare Advantage is stronger than ever. Premiums are 16% lower and enrollment is 17% higher than it was before the Affordable Care Act passed.

    Any senior that wants a Medicare Advantage plan can chose one - and when they do, they'll always be promised every single one of Medicare’s guaranteed benefits.

    Before Obamacare, the government overpaid the private insurance plans in Medicare Advantage. The Medicare Trustees said those extra payments  - resulted in higher Medicare costs overall and higher premiums for all Part B beneficiaries, not just those enrolled in Medicare Advantage plans. Everyone paid higher prices so Medicare could give subsidies to private insurance companies.

    All the health care law did was get rid of those extra subsidies - saving $156 billion over 10 years, according to the CBO. Because of this and other reforms, people with Medicare will save $4,200 over a decade."

This is actually better than I thought. Medicare Advantage was started with the hopes of seeing cost savings by outsourcing Medicare to private insurers (unlike the rest of Medicare). As it failed miserably with this, I'd have thought they'd have canceled it outright.

Meanwhile, the Ryan plan (which Romney endorsed) would double the costs for future enrollees in Medicare, turning the whole program into a voucher plan for private insurance that provides less assistance than current Medicare. So, while both the "Obama" and "Romney" plans actually "cut" about the same amount from Medicare (reportedly $716 billion). The Obama plan does so by cutting waste and by predicted savings (which may or may not pan out) while the Ryan plan does so by actually reducing benefits (which the first one doesn't). While current seniors wouldn't be affected by the latter, it would harm future seniors like myself.

Read More: A Primer on Paul Ryan's 2011 Medicare Plan

A Demonstration Program Conspiracy?

Some people claim there's something sinister about a "demonstration program" being run by the Obama Administration on Medicare. They say it's keeping Medicare prices steady, in order to fool people, only until Obama is reelected. Well, here is the official claim:
"The three-year demonstration project by the Department of Health and Human Services, which began this year, is intended to speed up quality improvement in Medicare Advantage plans as called for under the 2010 health reform law.

HHS Secretary Kathleen Sebelius said Monday that before the new health care reforms were passed, Medicare overpaid private insurers to the tune of 114% above Medicare rates, and lacked any power to assure the care was high quality.

She said that, with the program, Medicare is overpaying private insurers by 107% and more beneficiaries have been switching to higher-rated plans.

"With the demonstration, we're on track to reduce ovepayments," Sebelius said. "I think it's a basic win-win-win situation. We've got lower rates, we've got better-quality plans, and we're on track to reduce the overpayments in the long run."

The demonstration project would cost $8.35 billion over 10 years, according to the Government Accountability Office (GAO) report. GAO is the "investigative arm of Congress charged with examining matters relating to the receipt and payment of public funds."

GAO disagrees with the demonstration project and says it would be better to use the quality measures defined under Obamacare. The program hardly sounds sinister. Also if it was started in 2012 and lasts for 3 years, it won't end until 2015, not coinciding with the current election. Even if it did coincide, it wouldn't seem sinister. In fact, GAO says they think costs would be less without it.

So, GAO says the Obamacare quality measures for Medicare are better than the demonstration project.

Keeping Medicare Efficient and Viable

Denise Early of the Tuscon Citizen writes: 
"So insurance companies keep investing billions of dollars to expand their Medicare Advantage business - while Mitt Romney says Obamacare is killing this option for seniors.   As I see it, smaller Advantage plan companies will find it difficult to find enough efficiencies to handle lower payments from Medicare. But the big players will get bigger, and they know they can still make profits with less money from Medicare."

The other option of continuing the overpayments so that many smaller insurers keep swarming around Medicare like sharks and raising Medicare costs for everyone seems like the wrong tactic.

More links on the subject:

"According to the Kaiser Family Foundation, about 25% of Medicare recipients (12 million) are enrolled in Medicare Advantage.

But the reason why the program saw cuts in the 2010 health-care law is due to its shortcoming: It's not as cost-efficient as traditional Medicare.

Under Medicare Advantage, the Kaiser Family Foundation says, Medicare ends up paying the private plans MORE per enrollee -- about 7% more -- than the fee-for-service program does."

It sounds very wasteful and inefficient. Nobody would want to continue it, right?

"The plan that I've put forward is a plan very similar to Medicare Advantage. It gives all of the next generation retirees the option of having either standard Medicare, a fee-for-service-type, government-run Medicare, or a private Medicare plan," Mitt Romney told reporters 8/16/2012.

Breaking Sam
Under the Republican plan, this parade goer will have to sell his Uncle Sam costume on eBay to afford the higher Medicare payments and won't be able to leave the costume to his kids. He'll also have to start selling Meth.

Part of the Republican Plan to Eliminate Medicare Once and For All

I want to point out that Paul Ryan's plan of changing Medicare to an entirely voucher-for-private-insurance based system is in keeping with the Republican plan to eliminate Medicare once and for all. When all Medicare does is give you back less return on your own money to buy private insurance, it won't make any sense for you to pay tax dollars merely to get that money back and have to use it to buy private insurance. The point of Medicare is that it's a massive program that doesn't discriminate due to age. Because it's so large, health providers lose out on tons of business if they reject it. So, they don't reject it. This means seniors can get medical insurance.

Unless part of the Republican plan is to keep around Obamacare, don't bet on having an easy time finding someone to insure you in your senior years.

Paul Ryan: ‘We Need’ A Man Who Thinks Medicare Is Unconstitutional ‘In The United States Senate’

 "Mourdock mocked the very idea that Medicare, Medicaid and Social Security are constitutional at a Tea Party rally last May. You can watch the man Paul Ryan begged GOP donors to send to the Senate ridiculing the idea that Medicare is constitutional here:"

GOP Rep. Todd Akin Thinks Medicare Is Unconstitutional, Runs Medicare-Based Attack Ad Regardless

A Conclusion

Seniors who vote for Romney/Ryan based on the GOP Medicare claims are selling out their kids and future generations because of false claims made about their own Medicare security.

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