Stanley Feld M.D.,FACP,MACE
since 1965, the Democrats have been able to use the Medicare hammer to bash
Romney and Paul Ryan have co-opted the Medicare issue from the Democrats in
this election cycle. Medicare has been a
popular entitlement program with seniors that has always been unsustainable.
that a huge number of baby boomers are becoming eligible for Medicare coverage is has become more
realize that Obamacare is unpopular. Over 60% of Americans disapprove of the
even realize that the passage of Obamacare had cost them the 2010 midterm
Republicans are using Obamacare as a rallying call to defeat President Obama in
his re-election effort.
knows that Medicare is almost bankrupt because the government has depleted its
also know that President Obama has lied, dissembled the truth or has ranted
about the Republicans on the issue of Medicare during his re-election campaign.
Obama cannot change a basic truth. Obamacare was designed to destroy Medicare.
and Ryan are trying to save Medicare without withdrawing the promise of
Medicare coverage for seniors over 55 years old.
Obama can try to defend Obamacare, a new entitlement, which will bankrupt the
nation and destroy Medicare.
can disavow Obamacare but he cannot do both.
plan is to try to confuse everyone into thinking that he can have it both ways.
“ 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”.
year the nation’s healthcare cost was $2.5 trillion dollars. This year the
quoted healthcare system costs are $2.8 trillion dollars. An increase in $300
billion dollars a year for ten years is $3 trillion dollars.
have been blamed for the increase in costs. However, each year physicians have
received reimbursement cuts not increases. President Obama is ignoring the real
causes of the increases in cost.
article in the New England Journal of Medicine stated that the Romney Ryan Plan
could work. Paul Ryan (R) and Ron Wyden (D) stimulated this article submitted
to the NEJM. The NEJM seems a most unlikely place to have this article
assume the NEJM is feed up with President Obama’s rhetoric. The Wyden-Ryan is
an alternative to traditional Medicare.
is a premium support plan. It could shift Americans, under 55 years old, from
traditional Medicare coverage with the total government totally controlling their
healthcare choices by the Independent Physician Advisory Board (IPAB) to a
system of choice by individual seniors controlling their own healthcare decisions.
“Will this premium-support proposal based on
full competition among private plans and traditional Medicare work?”
President Obama is
afraid the government will lose control over the healthcare system and seniors.
He is arguing that the premium support system is a voucher system. It simply shifts the
cost of care to seniors without improving the efficiency of care.
He makes vouchers sound
like a dirty word.
Traditional Medicare has been shifting the cost of care over to
seniors in the last 4 years by increasing the deductible seniors have to pay
annually. The basic deductible for any hospitalization is now $1300.00 up from
$500.00 in 2007.
The basic premiums are now $109.00 a month up from $96.00 in
2008. The premium is scheduled to increase to $239.00 a month per senior in
Medicare premiums are means tested so the premiums for seniors
earning more than $110,000.00 per year by any means including dividends,
capital gains, sale of a home, retirement fund payments or any source of income
will increase the premiums markedly.
The means testing is done by CMS having a direct connection to the
IRS and seniors’ tax return each year.
Medicare premium payments for seniors are significant especially when less
than 50 cents of every dollar is going to direct medical care.
“President Obama’s argument would be true only if there were no
room to improve health care efficiency or if private plans ignored
opportunities to cut costs, increase market share, and improve their bottom
Ryan and Romney believe
government has no business telling private individuals and employers how much
they can budget for healthcare.
A consumer driven plan can force
the market to improve efficiency and quality.
“Under a premium-support system, each additional test or
procedure would not generate additional reimbursement from the government. Most
Medicare beneficiaries live on fixed incomes and are not in a position to pay
more in deductibles or premiums.
That reality can force
health plans and providers to coordinate patient care and find other
efficiencies rather than perpetuating the current fragmented system.
The Wyden–Ryan proposal for people 55 and younger offers this safety
valve. It converts Medicare to a defined contribution plan from a defined benefit plan. It gets the government out of
the insurance business puts consumers in charge. It saves Medicare.
If President Obama is correct, traditional Medicare with its
price controls and government regulations, will be the low-cost plan in every
market and seniors will shift back to traditional Medicare when the cost
differences become apparent. The
competitive market place consumer driven healthcare experiment will be declared
“One should not be fooled. If the alternative to market
incentives is price controls wielded by the IPAB, access to necessary services
will inevitably be limited, as providers (physicians, hospital and insurance
companies) seek more lucrative business.”
Price controls have never worked.
President Obama is also ignoring the serious fiscal problems
facing this country. The real threat is that America’s creditors will refuse to
lend us more money.
America must slow the growth of Medicare. Increasing entitlement spending of any kind is
no longer an option.
The only question is how to do it.
“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 Obamacare.”
The NEJM article recognizes that Paul Ryan and Ron Wyden have
defined the policy parameters that could be the basis for real Medicare reform
President Obama is starting to realize Obamacare’s problems.
Seniors are realizing that President Obama is doing more harm to
Medicare with premium increases and rationing care than Paul Ryan.
President Obama is the one throwing grandma off the cliff not
Obama has also been successful at faking out Americans with his trick plays.
next trick play is to look like he is rebooting Obamacare to eliminate the
He has put together a group led by Neera Tanden, who was a senior member of the White House team that
helped pass the health law.
The group includes Peter Orszag (former budget
director), John Podesta (transition director), Donald Berwick (first Medicare
chief), Ezekiel Emanuel (Orszag's health policy guru), Joshua Sharfstein
(former No. 2 at the Food and Drug Administration) and Tom Daschle, D-S.D. (former
Senate Majority Leader and Healthcare advisor).
“Call it Healthcare Overhaul, Version 2.0. Their
biggest idea is a first-ever budget for the nation's $2.8-trillion healthcare
system, through negotiated limits on public and private spending in each state.”
Another diversionary sham.
So far the group’s proposals include additional
ideas, such as a malpractice liability shield for doctors who follow best
clinical practices and competitive bidding for all Medicare supplies and lab
tests, not just home health equipment.
This group wrote the Obamacare law. It views cost
controls as unfinished business.
imposed control over individual freedoms does not work!
let him fake us out again! I won’t.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
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