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Why today's seniors object to the dissolution of Medicare

paul ryan photo
REUTERS/Gary Cameron
The ultimate goal of Ryan and his compatriots is to fully privatize health care in America; and given that objective, there is no reason to believe they will not attempt to do it sooner rather than later.

Recently, U.S. Rep. Paul Ryan, R-Wis., regurgitated his previously rejected plan to turn Medicare into a private insurance voucher program, and it is still part of the GOP budget plans. What is most interesting to me (as an 80-year-old senior) is why today’s seniors object to the plan, since it's not "our" ox being gored. In fact, to their credit, it was today’s seniors who led the fight to get this terrible plan set back when it was originally proposed (but sadly not forgotten).

For that I offer kudos to my peer group for the reasons below.

In presenting the plan, Ryan and other conservatives consistently made it clear: The plan would not affect today’s seniors who will remain on Medicare. That was an overt attempt to mollify today’s seniors and elicit their support. So then why would today’s seniors fight against a legislation that was not even relevant to them? Here are a few good reasons:

Legacy

American history is filled with the actions of groups who fight for causes that are more relevant to future generations than their own. In a sense that was part of the American Revolution. It is also true of union activism – with raises and rights that benefit future workers even more than those who battle for them. And it is always true of long-range social programs. To this end, I see today’s seniors as fighting not for a valued benefit (Medicare) that they enjoy, but showing a concern for their children and grandchildren who will face the health care challenges years ahead.

Making a statement

The seniors who now participate in Medicare desired to make a clear statement: This is a plan we like, we appreciate, and we use and is of value. The fact that we will continue to enjoy it also makes a statement to those who follow us, it is something you should have as well. And we will help you retain it.

Fear factor

As owner and manager of my own business for over 50 years, I early on noticed that it is unwise to castigate employees in front of others. The reason: When an employee sees you reaming out another one, the thought goes through their mind: “If this is the way he treats people, I could be next!”

So it is with the Ryan plan to disassemble Medicare. True, it is now only relevant to folks 55 and under, and would not take effect until 10 years from now. But having said that, today’s seniors also fear that once passed, the same people who are trying to eliminate Medicare might also then ramp up the timetable and make it effective sooner — or even now. After all, the ultimate goal of Ryan and his compatriots is to fully privatize health care in America; and given that objective, there is no reason to believe they will not attempt to do it sooner rather than later.

Patriotism

Finally, I like to attribute the best motives to my generation. And that would be that they see certain government programs (Medicare, Medicaid and Social Security among them) as being valuable components of a well run, fair, healthy, and secure society. Thus, the retention of Medicare for future generations means a better America now and in the future.

Final word

The motives of Ryan and his supporters are transparent. Under the guise of mitigating the deficit, they are attempting to make serious and significant social reforms in our country by eliminating government programs they dislike, and privatizing all that they are able to.  Medicare seems an easy target. Yes, it has some fiscal challenges, but the Ryan solution to destroy it in favor of a private program is not only less desirable to seniors but also had it own suspect cost projections; and it did not fly with those whom the program now serves.  Instead, today’s seniors bought into the better idea of not only preserving Medicare, but accepting tweaks and changes that would make it more fiscally viable for the future.

The failed plan does have some value for today’s seniors, however, because it gives a quick but highly instructive “peek” at the way some conservatives are striving to reshape America. And most seniors did not like what they saw. To that end, it may be a marker that seniors will use when going to the voting booth in future elections.

Myles Spicer of Minnetonka has spent his business career as a professional writer and owned several successful ad agencies over the past 45 years.

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Comments (34)

Right on, Myles

Medicare provides major cost savings. Its Diagnosis Related Groups control costs for every medical procedure. And its low overhead compared to private plans adds to those savings.

Some added facts...

Medicare administrative costs are about 6% (depending on various collateral costs that might be included); private health insurance can run as high as 20% for adiminstartaive costs, plus profit.

but you're not counting 25% fraud/waste/abuse

Your claim of 94% MLR for medicare does not take into account that the Medicare bureaucracy itself says there is 20%-30% fraud, waste and abuse

Fraud

Dennis, do you have some sources for those figures that you would care to share? I wasn't aware that fraud in Medicare was so rampant.

That and...

Put simply, seniors aren't as stupid as some people seem to think.

Amen

…to Rolf Westgard, Paul Udstrand, and Mr. Spicer.

Privatization / corporatization of health care in the U.S. is the reason why our health care is prohibitively expensive, and can boast of only mediocre outcomes, at best. Nowhere else in the industrial world do citizens find themselves going bankrupt over medical care, and most industrial countries achieve substantially better health outcomes, and at lower cost, than we do. All Mr. Ryan's plan will do is perpetuate our current dysfunctional system, with CEOs of health insurance companies being paid 7-figure salaries while nameless clerks deny coverage and the people they ostensibly "serve" find themselves having to choose between paying for food, or the mortgage, or clothing on the one hand, and paying off that hospital or doctor bill on the other, knowing that the "non-profit" hospital or physician may well take them to court if they choose to eat rather than pay for medical care.

Ryan is an Ayn Rand ideologue with no knowledge of the lives of most of his constituents and a mind set similar to Herbert Spencer of the 1880s. He is not a conservative. He's a reactionary, and a radical, dangerous one at that.

I'm not quite eligible for Medicare yet, but

I'm old enough to remember why it was instituted in the first place: insurance companies were either outright refusing to insure seniors or were charging such high prices that insurance was unaffordable. That's why, unlike some of the zealous younger Republican legislators, who were too young to remember or pay attention to the origins of Medicare, I know that it was needed and still is needed.

Yes, its finances are in bad shape, but mostly because it covers only the oldest and least healthy Americans. Raising the age of eligibility would actually make this problem WORSE.

If younger, healthier people were added to Medicare (say, lowering the age of ability by one to five years every year until everyone had it as their "public option"), they would pay premiums at the same rate as the seniors and yet use the services less.

The seamless answer...

Yes, if when we were deciding how to fix our health care system, we simply allowed anyone of any age to join the Medicare program, the actuarial tables with a younger component would have made the program far more solvent. Instead, because of ideology, we rejected single payer and a public option in favor of the comlicated and not well recieved Obamacare. We had our opportunity to really fix our healthcare system, and rejected the better ideas.

why Medicare's finances are bad and senior's finances worse

Medicare is terrible insurance. Wishing everyone was on it just shows no understanding of what Medicare covers. There is no catastrophic coverage (unless you choose Part C--which is basically teh Wyden/Ryan plan), there are no benefits for a lot of important health services (such as an annual physical), and there are very high co-pays and deductibles. Someone in their 40s today will pre-pay about $200,000 in premiums and also pay hundreds of dollars a month once retired. As a beneficiary, I would not wish Medicare on any younger people. Original Medicare is so bad that 95% of the people who subscribe to Original Medicare make some other further arrangements to make up for its obvious limitations, costing us much more money.

solutions

There are modestly inexpensive ways to mitigate certain weaknesses in Medicare: various Supplimental plans offered by all private insurance companies. But the cost of adding those, plus Medicare insurance is far less than full private insurance plans that seniors would have to seek under Ryan's plans.

I am not sure you are on Medicare -- if you are, you are well covered, if not ask virtually anyone who is on Medicare, and you will find almost universal satisfaction with the plan. Frankly, for me personally, it once saved my life.

I am on Medicare and you are wrong

Read my post again. You should not be so condescending to people. Or call me a liar.

I am on Medicare and you apparently do not understand what Medicare covers and does not cover. Most important -- I repeat -- it does not provide catastrophic coverage. That means there are lifetime limits if that meaning is not clear. That alone makes it terrible insurance. But it is otherwise so bad that according to the June 2012 MedPAC Databook, seniors on average are responsible for 54% of their out of pocket healthcare expenses. Medicare pays only 46% of those costs. Have you ever seen any insurance that only covered less than half a policyholder's losses?

In addition it appears that you have done no research into the Aaron/Reischauer/Rivlin/Ryan/Wyden Plan (I know you want to mislead people and call it the Ryan plan but it is basically a long-time Democratic Party concept). According to a study done by four Harvard researchers published in the Journal of the American Medical Association in August 2012, if the Wyden/Ryan plan had been in effect in 2009, the people who bid on Part C Medicare (which is like the Wyden/Ryan plan and Obamacare and the Federal Health Employee Plan) that year would have delivered Original Medicare to the government and seniors at 15% less than the government delivered it that year through the private insurance companies it contracted with to deliver Original Medicare.

Your obviously NOT privately insured

If you were, you still wouldn't have catastrophic coverage, you'd be paying 18% more for administration, you'd have huge co-pays, and access to one tenth the number of providers.

Huh?

I cannot understand this comment. I would be happy to answer you if you made it more clearly. "If I were" what?

I never said I was privately insured. I am on a public Part C Medicare health plan that provides catastrophic coverage, an annual OOP cap, low co-pays and deductibles, an annual physical, drug coverage, vision and dental coverage, ER coverage in Canada (important to me because I live near the border and enter Canada often) and many other features. None of the items I listed here are available in Original Medicare.

Medicare

It sounds to me like you just made a good case for improving Medicare, not getting rid of it. Turn it into a universal single payer health plan for the entire country with decent coverage and then we've got something to work with.

BTW

You are incorrect when you state Medicare does not cover "annual physicals"; sonce 2011 and the adoption of ACA (Obamacare), annual physicals (called annual wellness visits) are covered and important improvement to the plan.

Original Medicare does not cover physicals

Whomever moderates this blog's comments continues to let you post comment after comment of erroneous information about Medicare, possible seriously harming the health of senior citizens. I guess I should cut you some slack given your advanced age but the person who moderates the blog can't also be 80.

Your information about Medicare and annual physicals is incorrect. It has been highly publicized that Original Medicare does not pay for annual physicals. It has also been highly publicized that an annual wellness visit is not an annual physical. Please stop misinforming senior citizens with your left-wing opinions. The facts are readily available although I know they counteract your ideology

One of the things one

One of the things one discovers, on entering the post-65 age group, is that Medicare works. It works for us, rather than for health care insurance companies or even health care providers, whose charges are routinely and absurdly high. Medicare says, "No, you can't charge that ridiculously high fee for that service." And "That provider knows that you can't be charged for that--don't pay them!" I actually enjoy reading what Medicare calls "footnotes" on its reports to me, because it's like having a personal agent blocking for me!

I never knew Medicare was out there protecting subscribers/patients like that, until I got to be part of the system. Seniors have all discovered that, and we do, indeed, want Medicare for everybody.

Another way of underscoring your point.

Single payer works for the benefit of the insured, and Ryan's plan works for the benefit of health care providers and insurers !

Regardless of what these industries' PR and advertising says (even their mission statements, in the case of health care providers), they DO NOT respect the best interest of the public as a whole nor the patient in particular.

Of course Medicare has its problems - how could it be otherwise with such a massive program ? I would put at the top of the list of its readily solvable problems the illegal fraud and LEGAL fraud which accounts for hundreds of billions of dollars per year. I'm including "legal fraud" here because some of the business rules Medicare uses in determining what to pay are absolutely RIDICULOUS (Durable Medical Equipment has numerous fine examples), and cost all of us dearly.

How about extreme and severe criminal penalties for illegal fraud, and eliminating stupidity in the schemes of qualification for payment and amount of payment ? The current penalties and current level of commitment to enforcement will not do the job.

The stated mission..

of the private health care insurers (as it should be) is PROFIT. That is why they are in business. Their loyalties run (in order and in my opnion):

1. Their top executives who clearly look out for their own interests
2. Their shareholders who judge them solely on the growth an profitability of the company
3. Their employees, where motivation and retention are needed
4. Their customers -- who they are supposed to serve. If their customers were placed #1 -- the other mission goals would suffer. It is a clear confilict of interest, and the primary reason our health care costs are higher than any other inductrialized nation.

ideas please

Mr. Myles,
I think it is amazing how you attribute the best motives to yourself and your generation and reserve the worst motives possible to Mr. Ryan.

The truth is – these entitlements (Medicare, Medicaid and Social Security) are going broke. You offer no reforms or suggestion to save these entitlements. You offer no ideas on how to reform these programs to insure continuation. These programs are unsustainable in their current form.

Even the President realizes these programs are in desperate need of reform. However, he offers no ideas or is willing to commit the political capital to insure these programs continue in some form for future generations.

I applauded Mr. Ryan for new ideas. When you or your party offer no new ideas or even acknowledge the desperate state these programs are structured – whose motives need to be questioned?

Well, sir...

I believe you are worng on virtually every comment -- except the one concerning "the worst possible motives" to Mr Ryan. My view on"mostives" is that many of our congresspeople (of both parties) are too muc in the lap of lobbyists and campaign contributors.

From there, I would disagree SS is going broke. Fully one third of Federal revenues (over $800 billion) comes from SS taxes and payroll taxes. If it were not raided by congress SS could be quite solvent, and th U.S. owes the fund megabucks already. But that is another topic.

I also disagree when you say the president, congressional leaders (and me) find Medicare and Medicaid unsustainable. Actually virtually everyone who can add knows these programs need some reform. I would not object ot that at all -- but to toss them out (as Ryan suggests) or come up with a nonesensical "voucher" plan in the heat of a time limited need to reduce revenues, is not a good way to get intelligent reform.

Actually I do propose a change in Medicare to make it more sustainable, and solvent. Let EVERYONE regardless of age, participate. with a younger, more healthy group, it would make it stronger; that is the basis of ALL insurance programs. Unfortuantely, Medicare only covers the elderly, and sickest of our nation -- and it amazing to me that it is doing as well as it has. Partly because it has limits on the cost of services; and if congress had allowed it to negotiate drug costs, it would have done even better.

Medicare is not going away, so let me accept your idea to find ways to make it stronger and more solvent. It can be done -- other countries cover all their citizens and do it without breaking the bank, American can -- and should be -- doing it too.

Entitlements?

"The truth is – these entitlements (Medicare, Medicaid and Social Security) are going broke." Technically these are entitlements, but I and my employer has paid specifically into Medicare and Social Security my entire working career. I don't really consider Medicaid or SSI in the same category as Medicaid, Social Security and SSDI because Medicaid/SSI you can draw benefits without paying in.

That being said, I think that Social Security is an easy fix, you can raise the age or lower the benefits until it is balanced. Medicare is a different can of worms. From what I understand from my parents and others, it pays about 80 percent of hospitalization and they need to purchase a supplemental policy to cover other medical needs. If you can't pay, you can be dunned for the remainder or spend down and go on Medicaid, which is for the poor.

With Medicare, I anticipate the consumer share after the earned benefit will continue to climb because of overall rising medical costs. That will just push more people onto Medicaid, the welfare side, sooner. Or we will spread the uncompenated costs to others through increased billing.

The real battle in this country will be to control overall medical costs.

Ryan's "new ideas" are hardly

New. A voucher program would simply be another Republican corporate welfare program to benefit the health insurance industry. The goals of that industry are exactly as stated in the comment above your comment.

Easy fixes to both medicare and SSI

I like the alternative of allowing anyone of any age to join medicare that will indeed drive down the average cost per patient.

I also like the idea of taking the income caps off the Social Security tax, which is now set at about $113,000.

http://www.socialsecurity.gov/pressoffice/factsheets/colafacts2013.htm

According to the AARP that would solve I believe it was 80% of any anticipated short fall.

A lighter note

As the comments seem to be ending, I like to recall the halcyon days of the Tea Party when they regularily disprupted meetings, and carried some pretty serious posters and signs. My favorite was: "No Pubic Option!" -- but close to it was: "Keep you damn government hands off my Medicare"

But will there be doctors?

Medicare doesn't pay what the services actually cost, which is why doctors, clinics, hospitals cap the number of Medicare patients that they will accept. The rest of their clients pick up the tab for the shortfall. Adding even more people to Medicare creates an even larger pool of people not covering the cost of their care.

The ACA should result in a government run single-payer system as more employers opt out of coverage and fewer insurers agree to be part of the exchanges. Private insurance plans will continue to exist for those people able to pay and not content with the public option.

Very bad information about Medicare

In addition to his insults and misleading information, the author of this blog post is just plain wrong. At 80 years old, he does not realize that those of us just turning 65 – not to mention those now 45 – do not get the free ride from Medicare (and near free ride from Social Security) that he got. He did not have to pay any Medicare tax until 1965, when he was in his mid 30s, and most likely had a cap on his Medicare tax probably through to his retirement. (And he probably paid a much lower Social Security tax than we pay most of his life, depending on when he retired. And was able to get “full Social Security” at an earlier age -- 65 instead of 67).

Someone who is 80 today probably got back $3 for every $1 he or she paid in to the two programs. Under today’s rules, someone just retiring now or in the next few years – if they live to 80 – will probably just break even. Those of you 45 or less, will pay in much more than you get out – if you get anything at all – unless the programs are reformed. Don’t be fooled by all of these left-wing lies.

(Aside from the financial aspect of these about to go bankrupt insurance programs, you younger people need to look into just how bad Medicare insurance is. Despite the praise in some of these comments, Medicare lacks catastrophic coverage, provides no benefits for a lot of important health services (such as an annual physical), and forces you to pay very high co-pays and deductibles. I would not wish it on any younger people. Original Medicare is so bad that 95% of the people who subscribe to Original Medicare – I am one and that probably includes Mr. Minnetonka -- make some other further insurance arrangements to make up for Medicare’s obvious limitations

One more thing...

After re-reading your comments, I really feel compelled to respond once more. In them you have suggested I am "insulting", "condescending", and selling "left wing lies".

I do not intend or desire to "insult" anyone -- the gist of my article is simple: most seniors LIKE Medicare, and have shown a desire to protect it. That's it. Period.

I do not feel that is "condescending" in any way. Clearly, you disagree, but I sincerely feel your views are in the minority of the senior community. I do not see that as "condescending", merely an opinion...backed by numerous polls.

As for "left wing lies"...Medicare is totally non-partisan. It was passed by huge majorities of both parties. Seniors of whatever stripe, generally like the program, want to keep it, and see it at the present time as the best alternative to having health care protection.

I do want to thank you for cutting me "some slack due to my advanced age" as you noted in a previous comment. Fortunately I have been lucid enough to have run several successful businesses for over 50 years up to last August; however, I will take your observation under advisement.

Very bad information indeed

Sir,your facts are incorrect -- both as to me personally, and the programs you discuss.

First me. I actually paid into SS up to 2012 (I retired just last Aug at 79 when I sold my company. So whole I was drawing SS, I was also paying into and had no complaints.

Sure I may get back more than pay in -- no unlike private plan annuities do if you live long enough.

If you doubt SS is not popular,I would challenge you to ask seniors who totally depend on it to survive -- you obviously do not know the lives of seniors before Social Security took place; the choices we either abject poverty or hope some family member would take them in.

Yes, I did pay less into the fund years ago...and also earned less. It is all relative to the times and inflation, which will likely be true in years to come.

Of course many of us have supplementary insurance (and the private insurers love it too) - Medicare never was supposed to cover every dollar of every illness for everyone forever and ever. But is is a fine program that gives our senior citizens some peace of mind, and better health, just as it is designed to do. And oh yes, you are wrong about annual physicals; they have been included in the program since 2011 as annual wellness checkups.

Mr. Byron you are always free to not use medicare just opt out

You sound like the fellow who is getting a free lunch of sirloin and complains that it's not lobster.

Someone enrolled in what

Someone enrolled in what Dennis Byron calls "Medicare Plan C"--his option, he says-- is really enrolled in a private health insurance program previously called Medicare Advantage. He is not part of the original Medicare, and thus has only an indirect knowledge of its terms and how to reform it without killing it.

Medicare Advantage plans get a special [taxpayer] subsidy from the federal government to take on the entire Medicare-related health care of a retired person. UCare, for example, is a Minnesota Medicare Advantage program or plan. You sign up, and you personally never, ever deal directly with Medicare again. You deal with your plan. Your plan has a nice incentive to keep you healthy: what the government gives them to insure you reverts to profits if you're not in dire straits or the hospital.

Medicare now provides an annual physical (it didn't used to, except when one signed on, the "initial" visit). There is an annual deductible of $140 or less in 2013, for Part B, and about the equivalent of one day in the hospital for Part A. We all pay premiums, and mine was just upped by 54% for 2013 because my income was not at poverty level last year (that's called means-tested premiums). We can keep diddling both Medicare and Social Security, and keep them solvent, as we

Republicans have been trying to get rid of Social Security since the 1930s. Anyone with any brain and sense of history can see that Mr. Ryan is again attempting to privatize what is not an investment plan: it's a social insurance plan, a safety net to avoid disaster.

Amen!

and Amen again!

GOP Plans

My impression is that today's GOP plan isn't to get ride of Medicare (and other government programs), but rather to turn it over to private entities like they've done with schools and the military. Their objective is to turn these programs into a cash cow for businesses, with whom they then hope to get a job with after their term in Congress ends.

All the rhetoric about eliminating programs is red meat for their constituents to keep them angry and voting. Ooo, somebody's cheating the system? Heck, no one likes a cheater! Get mad and vote for me and I promise I'll fix the system and get those cheaters off the doles! In the meantime it's used as a guise to water down government regulations so big businesses can do what they want at a lower cost. Environmental regulations or worker safety regulations are just the big government telling you what to do. They would much rather dump pollutants into the river, air, or ground. If a worker gets injured it's cheaper to pay her off with a small sum and get a new body in there than implement safety standards.

And again...

Amen!