A Workable Bi-Partisan Approach to Medicare
Dec 31st, 2011 | By Tim George | Category: Current Events, Politics | Print This Article
Working across party and capitol lines, Sen. Ron Wyden (D-Ore.) and Paul Ryan (R-Wis.) announced an extraordinary reform deal. This comes in spite of President Obama assertions that progress cannot be made with Medicare because of Republicans’ unwillingness to act.
The Washington Post reported: “Working with Democratic Sen. Ron Wyden (Ore.), the Wisconsin Republican is developing a framework that would offer traditional, government-run Medicare as an option for future retirees along with a variety of private plans.”
Wyden and Ryan revealed the following key elements of the bill:
- No changes for those in or near retirement. Americans currently over the age of 55 would see no changes to the structure of their benefits, although they would be free to opt into a private plan once the new Medicare Exchange was established in 2022.
- More choices for seniors, including a traditional Medicare plan: Starting in 2022, Medicare would begin offering seniors a choice among Medicare-approved private plans competing alongside a traditional Medicare plan on a Medicare Exchange.
- Premium support ensures affordable coverage: The plan would introduce a “premium support” system that would empower seniors to choose either a traditional Medicare plan or a Medicare-approved private plan.
- More help for those who need it: Low-income seniors who qualify for Medicaid would continue to have Medicaid pay for their out-of-pocket expenses, while other low-income seniors who do not qualify for Medicaid would receive fully funded savings accounts to help offset any increased out-of-pocket costs.
- Less help for those who don’t: Wealthier seniors who need help least would see their assistance reduced.
- Strong consumer protections to safeguard the Medicare guarantee: This reformed Medicare program would include some of the toughest consumer protections in American government:
- All health plans that participate in the Medicare Exchange would be required to offer benefits that are at least the actuarial equivalent of those provided by the traditional Medicare plan.
- Premium-support payments would be risk-adjusted to ensure that those with greater health needs are guaranteed affordable coverage.
- Participating plans cannot refuse coverage based on pre-existing conditions, nor can they charge discriminatory rates based on health status.
- Transparency and competition work as powerful cost controls: Program growth would be determined by the competitive bidding process — with transparency, choice, and competition forcing providers to reduce costs and improve quality for seniors.
- Cap on growth serves as a backstop: However, exceeding the cap would not trigger across-the-board bureaucratic cuts or higher premiums. Instead, Congress would be forced to do its job: Determine why the costs exceeded the cap and fix the problem.
Their press release also offered a glimpse into a workable bi-partisan health care reform plan. In a joint statement, the two, “Just as Medicare reform would give seniors more power to choose, reform is needed to free small businesses and individuals from restrictions that inhibit choice and control in health coverage.”
Other ideas suggested by Wyden and Ryan include:
- Any small business with up to one hundred workers would be able to offer its employees a free choice option so that they could use the amount that their employer contributes toward their health coverage to purchase their own health insurance.
- The cost of the free choice option would be fully tax deductible to the employer, just like employer-provided health coverage.
- Allowing individuals to keep one insurance product as they transition from their working years into retirement would ease seniors’ transition into Medicare while giving small businesses and their workers more choices and freedom.
Yuval Levin observed the proposed bill focuses primarily on Medicare while injecting it with many free-market elements:
The government would define the minimum insurance benefit it would seek to provide to all covered seniors, based on the level of coverage Medicare now provides, and then there would be a process each year in which the competing insurers would offer bids proposing to provide that (or a greater) benefit at the lowest cost they could. The level of the premium-support payment would be set at the level of the second-lowest of the bids. Seniors would then be able to apply that amount toward the purchase of any of the plans on offer. Thus, there would be at least one option that would cost less than the premium-support benefit, and seniors choosing that option would get the difference back; there would be at least one plan that cost the same as the benefit, so that seniors could obtain it with only the same out-of-pocket costs they have today; and there would be other plans that cost more (perhaps because they offered more, or because they failed to find ways to drive greater efficiency in their networks of doctors and hospitals) and for which seniors would pay an additional premium if they chose. Poorer and sicker seniors would get additional help, while the wealthiest seniors would get less.
Medicare has long been used as a tool to scare seniors and soon-to-be-seniors and keep votes in the President’s camp. Should this bill get legs, it will leave the Medi-scare crowd in a quandary. The plan is an obvious attempt to protect Medicare and to have the wealthy pay more.
For the Mitt Romney camp, this is a big plus. Spokeswoman Andrea Saul released a statement saying: “We are very pleased to see that Congressman Ryan has introduced a Medicare reform proposal that aligns so closely with what Governor Romney proposed last month. This bipartisan plan proves once again that Governor Romney has thoughtful, workable solutions to the looming entitlement crisis. It also underscores the absurdity of Speaker Gingrich’s repeated attempts to throw a serious reformer like Paul Ryan under the bus by calling his ideas ‘social engineering’ and ‘suicide.’ ”
Aside from politics, such a bill suggests that when the White House and its Congressional foot soldiers are left out of the mix, considerate Republicans and Democrats can craft reasonable and bipartisan solutions to long-term fiscal problems.
In spite of the value of this plan, many Democrats and those in the liberal media are already arming themselves for war against it. Consider these not-so-bipartisan remarks:
Sen. Sherrod Brown (D-Ohio) – “This is dressed up and looks a little pretty — a little lipstick on the pig here, but it really is not much different than Ryan number one. Ryan gets this reputation as being this thinker that’s got new ideas. It’s just the same recycled privatization stuff that Gingrich did in 1995 with Medicare.”
White House Communications Director Dan Pfeiffer – “We are concerned that Wyden-Ryan, like Congressman Ryan’s earlier proposal, would undermine, rather than strengthen, Medicare. The Wyden-Ryan scheme could, over time, cause the traditional Medicare program to ‘wither on the vine’ because it would raise premiums, forcing many seniors to leave traditional Medicare and join private plans. And it would shift costs from the government to seniors. At the end of the day, this plan would end Medicare as we know it for millions of seniors. Wyden-Ryan is the wrong way to reform Medicare.”
Guess it look like politics isn’t the sole property of one side of the fence after all.
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