Rep. Paul Ryan’s plan (and his 2012 update) would substitute a voucher system, and return us to the private sector for coverage of seniors.

The nomination of Paul Ryan for the office of vice president has again raised the specter of his “Path to Prosperity” plan as it relates to the future of Medicare. While the Republicans are trying to cast this plan as a way to “save” Medicare, in fact it will destroy it in the year 2022.

Ryan’s plan (and his 2012 update), as clearly articulated, would substitute a voucher system, and return us to the private sector for coverage of seniors. However, in presenting the plan, Ryan and other conservatives consistently make it clear – the plan would not affect today’s seniors, who will remain on Medicare.

That is an overt attempt to mollify today’s seniors and elicit their support. Why? They know how objectionable this plan really is to seniors (present and future). Thankfully, thus far, the plan has failed, but that did not assuage most of my senior contemporaries. In fact, to their credit, it is today’s seniors who are leading the fight to get this terrible plan set back (but unfortunately not now forgotten). As a 79-year-old senior myself who has enjoyed the benefits of Medicare for over a decade, I want to offer kudos to my peer group for its unflinching preservation of this excellent program as we know it today.

Meanwhile, since it’s not “our” ox being gored, why then is it TODAY’S seniors who are fighting the good fight to retain Medicare in the future? 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. Changes are needed, but not vouchers.

Making a statement

The seniors who now participate in Medicare desire to make a clear statement: This is a plan we like, we appreciate, we use, and is of signficant 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 45 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 his/her 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 it would not take effect until 10 years from now. But having said that, today’s seniors also fear that once it were passed, the same people who are trying to eliminate Medicare might also then ramp up the timetable and make it effective sooner to eventually affect them. After all, the ultimate goal of Ryan and his compatriots is to fully privatize health care in America; 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 other conservatives 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 its own suspect cost projections. Instead, today’s seniors would buy into preserving Medicare by accepting tweaks and changes that would make it more fiscally viable for the future.

Ryan’s original failed plan does have some value for today’s seniors, however, because it gives a quick but highly instructive “peek” at the way Romney, Ryan and conservatives are striving to reshape America. And most seniors do not like what they see, at least when it comes to their health care. To that end, it may be a marker that seniors will use when going to the voting booth on Nov. 6.

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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34 Comments

  1. The Question “Conservatives” Always Ask (behind the scenes):

    How can we “make a killing” by inventing (and making legal) new ways to extract resources from our fellow citizens,…

    thereby padding our pockets without going to the trouble of inventing anything, producing anything, providing anything of actual value to society, or doing any actual work, ourselves?

    They did it with banking and almost destroyed the world economy necessitating that those whose lifeblood they had already been relentlessly draining bail them out.

    (With a new bubble rapidly growing, now, because the problems which allowed the last to inflate and burst have not yet been fixed, I can’t help but wonder how the government which they have driven deeply into debt and deficit, through tax cuts and tax cheating which have befitted only themselves, will be able to bail them out AGAIN).

    Now they seek to change the Affordable Care Act in ways which will allow them to use health care as a vehicle by which to extract even more of the financial lifeblood from their fellow citizens. (After all, who makes an easier mark than a family whose beloved member is desperately ill and trying to survive?)

    If they gain sufficient power to pursue this course, they will eventually price medical care out of the reach of MOST Americans, impoverish all those who work in medical care (including the entire membership of the AMA), and bankrupt hospitals, geriatric care institutions, and pharmaceutical companies, nationwide.

    They’re hoping to do the same with fossil fuels as the world’s energy needs increase and fossil fuels grow more scarce, especially oil as used for transportation and in-the-home climate control. (Thus their desperate attempts to prevent alternative energy sources from coming online fast enough to cushion the public from the coming exponential price increases in energy costs from which they expect to profit in ways never before seen).

    What today’s “conservative” Republicans (together with some Democrats) and Wall Street are really all about is seeking to maintain and expand the give-us-everything-for-nothing gravy train by which they are currently able to (legally, by their own designs) rip off their fellow citizens, destroying those citizen’s lives and our entire nation for no other purpose but to selfishly pad their own pockets.

  2. Final words

    “I see today’s seniors as …showing a concern for their children and grandchildren”

    So how’s that $15 Trillion dollar debt working out for ya? You’ll excuse me if I remain skeptical of leftist protestations regarding the well being of future generations whilst they suss out every remaining farthing that can be begged, borrowed or stolen.

    1. Debt

      Lets be clear. The debt is entirely a function of failing to collect taxes from current taxpayers for current expenses and passing the bill on the future taxpayers. This has been the result of something pitched as “tax cuts” by the proponents, but were in fact simply tax increases on future taxpayers for the benefit of the folks getting the immediate “tax cut”.

      There is no such thing as a “tax cut”. Any cut in taxes for one person means someone else has to pay more. The only way to reduce taxes for everyone is to reduce spending. But for all their talk, the proponents of a balanced budget have been unwilling to actually pass one.

      I don’t think we need to balance the budget, but we need to stop pretending that by cutting taxes we are cutting government. The real issue is not a balanced budget, but how the money gets spent. To the extent we are investing in the future its perfectly appropriate to ask future taxpayers to share the cost. To the extent we are simply spending money for the benefit of current taxpayers, we should be the ones paying the bills. But right now we are cutting spending on things like educating future generations in order to reduce the taxes so people can buy themselves luxuries.

      1. Let’s be clear….

        Let’s be clear, our national debt is from spending too much! Federal spending is at 24% of GDP while it has been historically at 17-18% of GDP.

        47% of Americans pay no federal income tax and 35-40% of Americans actually receive transfer payments from the 53% that actually pay federal income taxes.

        The top 1% pay 37% of all federal income taxes. The top 5% pay 59% of all federal income taxes. The top 10% pay 70% of all federal income taxes. The top 25% pay 87% of all federal income taxes. Federal income taxes are more progressive than Europe’s income taxes.

        We need more informed voters than Ross Williams since we are on an unsustainable path towards Spain and then Greece!

      2. Interesting hypothesis, Ross

        “Lets be clear. The debt is entirely a function of failing to collect taxes”

        Perhaps you can go into a bit more detail on how debt is accrued without having spent anything.

        I always find leftist financial theory fascinating.

        1. Hey, Mr Swift

          It’s your side that’s responsible for 80% of the current National Debt. Almost all of it has been run up under the last 3 GOPer presidents and their policies.

          When Clinton left office in 2001, he left a surplus. With projections of the entire Debt being paid off in 10 years. Which would have been only the second time in the country’s history we had no Debt(the other was in the 1830s).

          But NO! We had to have two huge tax cuts, two unpaid for wars, an unpaid for Medicare drug program, No-Child-Left-Behind, a huge new government agency Homeland Security, policies that led to a near Depression, a bank bailout, etc.

          But when questioned by Bush’s Sec. of Treasury about the exploding Debt and deficits, VP Cheney said, “Reagan proved it, deficits don’t matter.”

          Or maybe like all “conservatives”, they only matter when a Democratic president inherits them

    2. This is not about “debt”

      Nice diversion, but irrelvant to this discussion. The economics of continuing Medicare are complex and mostly unrelated to the causes of our debt issues. But this much is certain; the cost of administer the government run Medicare program for our seniors — now and tomorrow — are far less than those racked up by the private insurance companies. That was the basis of the current law limiting them to 20% overhead and profit (remember the $1 billion golden parachute given the CEO of
      United Health?). Current Medicare administrative costs are estimated to be between 3-6%. No…I really do not want to damage my children’s health care with a phony voucher system.

      1. I’m sorry, Myles…

        …perhaps you’ve not heard. Our national debt, driven to $17 billion during Obama’s single term, is having negative effects on Medicare:

        “Debt deal puts Medicare, Medicaid up for cuts”

        http://www.cbsnews.com/2100-250_162-20086779.html

        The federal government believes hospitals and doctors will gladly provide their services for even less than the cost to them of providing them….perhaps Obama believes he can barter with government cheese.

    3. Ask Bush

      I dunno – ask Dubya and Darth Cheney why they launched two wars without paying for them. Ask them why they told Americans to go shopping rather than contribute during a time of national emergency. Ask them why they gave tax cuts to the rich even while they were piling up debt (where are all those jobs those breaks for the rich were supposed to produce, anyway?) Ask them why they blew the balanced budget and projected surpluses Clinton handed them.

      Repubs. Hypocrisy with no shame. What are we gonna do with ’em?

  3. Yeah, I agree about that debt…

    Especially the debt that was created by the unfunded immoral Republican war in Iraq, and the debt that has been created by Reaganomics (i.e. reducing tax rates increases tax revenues), the debt created by all the investor loopholes in the tax laws (speaking of stealing), the debt created by reduced revenues due to removing regulation on banks and investment houses, the debt created by overfunding of the military. You are right, Swift, people today care more about themselves than they do about the future of our country.

  4. Mr. Swift your comments are a bit late don’t you think?

    The folks who sussed out the last farthing were the folks who supported the Iraq war and the unregulated bankers.

    Were you hollering equally loudly when Regan ran on balancing the budget and then never submitted a balanced budget? Deficits are caused by two things too much spending and not enough tax revenue. People need to start paying their fair share of taxes on their income regardless of source. Even a return to Regan tax rates would help. So if you are concerned about the deficit start yelling about raising taxes and adopting fairer tax policies.

    Did you pay an effective 13% on your federal taxes last year like Mr. Romney? My widowed 90 year old mother payed more than that on a whole lot less income.

    1. I agree 100% Jody.

      ” People need to start paying their fair share of taxes on their income regardless of source.”

      The 46% of our fellow citizens that pay absolutely no income taxes need to be brought into play, without delay.

      1. Of course you include the poor in your complaint, right ??

        I.e., the 46 million who at last count, in 2011, were at or below the poverty line.

        While it’s true that a minority pay most of the taxes (actually quite a small minority), yet those are the very folks who have benefited most from the opportunities given here in the U.S. – AND these are also the people who can AFFORD to pay. The idea that these people should get more breaks while placing an unbearable burden on the poor cannot be found in American ideals.

        (According to the U.S. Census Bureau, based on 2010 census data summarized as of September 2011, the nation’s poverty rate rose to 15.1% – or 46.2+ million Americans)

        1. Everyone should pay something.

          Carrying your own weight is not only found among American ideals, the country was built upon it.

          We’ve come to a place where we can shoulder some of the burden for those that are physically, or mentally incapable of doing so, but no one should expect their neighbors to haul their wagon through life.

          Even if it’s just $10, *everyone* should pay into the commons, Steve.

  5. How about nothing

    With the enrichment of our elected “representatives” paramount in their own minds, is it any wonder that they find medicare, and Social Security as well, a tremendous bother. Forget that the reason social securiity is in trouble because it’s funds were stolen by our “representatives” to cover “other things,” and had it been left for it’s intended purposes it would be fine. (Similar to all those “underfunded” pension funds). Perhaps what we need to do is just establish a completely unregulated, no holds barred free for all where we can buy and sell snake oil if we want, or tracts of land on the moon. Regean’s legacy is coming into maturity, and it’s pretty ugly for the nation, but great for the so-called “one percent.”

  6. The fact is that the current and ACA-modified Medicare will face significant financial issues between 2016 and 2022. The assumptions in the ACA with respect to provider costs may be unrealistic, but the ACA will delay the problems somewhat from a relatively near 2016 to a further out 2022.

    The next president WILL have to face the impending depletion of the fund and MAKE Medicare policy. Failure to do so is extreme dereliction of duty.

    A position of head-in-the-sand until 2022 isn’t feasible. A program of repealing the ACA simply returns the Medicare problem to the nearby 2016.

    No matter what is repealed or left in place, the Medicare problem IS NOT solved by either the ACA or the Romney/Ryan 2022 plan. More changes in the near future are required.

    To pretend that ANY solution to the Medicare issue will not affect current retirees (or people at 55 or older) is simply wrong. Medical care costs are rising too fast, there are too many people arriving at Medicare age, and they come with much more serious conditions due to a lack of health care in their later working (or unemployed) years.

    So the issue becomes, will the next administration shrug their shoulders and turn the problem over to the tender mercies of the free market or not.

    1. We are aware

      I think you would find most seniors today are aware (and would concede) that tweaks and modifications, and other changes are needed to continue a valued program. Most entitlement programs are kind of “living” programs, which change with the times and demographics. So it will be with Medicare. The real issue is that conservatives and the far right, given their goals, really want to dismantle all these entitlement programs, and today’s seniors are the ones to lead the charge against that effort.

      1. My point exactly.With

        My point exactly.

        With Romney/Ryan, if they are elected and repeal ACA, the Medicare become a problem that must be acted on by 2016.

        I have no doubt that they will bring forward the finest “free-market solutions”– the basic “free-market solution” is “if you can’t afford it, you don’t get it”.

        It is another “fiscal cliff” at that time.

        With Obama, the problem is pushed out further, allowing more time to further turn the ship from the shoals. But more changes will be required because there is legitimate doubt whether the price controlling measures are inadequate against the power of the healthcare industry.

        So the over-55’s who blithely vote for Romney/Ryan with the assumption that the “sacrifice” will be the future generation, will find it theirs in 4 years.

  7. By the way, the continued railing about deficits and the responsibility to future generations are oddly given mostly by those who typically do not give a damn about the environmental deficit and climate change heritage that we are leaving our children and grand-children.

    What happens with countries that have an actual debt crisis? Well, in a decade or so, virtually all the effects have vanished in the changes, revisions and write-downs.

    What happens in planets that have an environmental crisis? Well, in a couple of millenia, all of the effects have vanished in the extinctions and flourishing of a new form of life.

    Which is more irresponsible to disregard?

  8. Well said, Mr. Spicer…

    Having survived for a dozen years without health care coverage at all – every expense came out of my not-especially-deep pocket – I’m very happy to find myself under the Medicare umbrella for the past couple years. Medicare’s financial issues exist in large part because health care has been transformed by “privatizers” from a public service model to a corporate model, and while the Supreme Court may cynically define corporations as “people,” thinking humans know that corporations have neither soul nor feelings, and exist only to make money.

    When profit is what’s driving health care, both health care and actual health suffer. Should the despicable Ryan “plan” for Medicare and health care in general be enacted, we’ll be returning to those halcyon days of 1880, when poor people didn’t worry about health care because they didn’t get any – they just died, as seniors will do in large numbers when those vouchers buy them virtually nothing while corporate profits in the medical field continue to rise.

    As an old, broken-down history teacher, the idea of a legacy from one generation to another resonates with me, and a legacy that says “Screw you” isn’t one, I’d argue, that the nation’s founders would endorse.

  9. Those of us who are old enough to be on Medicare are old enough to remember when it didn’t exist. And how the elderly had no medical insurance, no medical care, and died horrendously with it.

    Medicare was created to provide health care for the elderly, so they wouldn’t have to choose between food or a doctor’s visit or a medicine. It works! Medicare actually reduces health care costs, by fighting–on its insureds behalf–with providers who charge extraordinary amounts for office visits and procedures.

    And the elderly, whose bodies are breaking down no matter how they eat or exercise, will get sick. Ever sicker. To death. What insurer will want to provide them with health care? That’s the very problem the Affordable Health Care Act means to address for the general population: if you are or have ever been sick, health insurers don’t want to talk to you. Covered by insurance and then get suddenly sick? The insurer has you out the door! and you’re on your own.

    Folks, those retirees of us who know how good Medicare is–and that it is there as health care, that we’ve paid for and still pay premiums and deductibles for–must tell our younger friends about it. And that vouchers are a way to completely return to private health insurance in old age–if you can get it!

    1. If you’re old enough to remember

      then you’re old enough to remember when Hubert Humphrey stood on the floor of the U.S. senate and argued against those who said we’d never be able to keep our obligations and said “If this program ever costs more than a hundren million dollars I’ll eat the paper it’s written on.”

      Last year Medicare cost over 5,000 times that. In 1967 long-run forecasts estimated that Medicare would cost about $12 billion by 1990. In reality, it cost more than $98 billion that year. Today it costs $500 billion.

      And don’t tell me about “inflation.” If you want to raise the cost of something, get the government to subsidize it. Econ 101.

  10. Hindsight…

    would suggest that a better alternative to the ACA would have been to allow all citizens to get on Medicare as a public option. That would have been a boon to younger citizens, and provided a better (younger component) to Medicare for actuarily purposes. But…as was the case, it was opposed by the same folks whoo would like to disassemble the program altogether.

  11. hurray for medicare

    Long may it last and may it expand. Paying for the multiple corporate shell game management concept is worn out and has been proven to be too expensive. If all the facts are examined the truth is in front of you unless you are blinded by the dinosaurs. Faith and economics are a desperate reality. I can’t pay the doctor bills with faith.

  12. One way out of this trap is to simultaneously offer Medicare for all. You can’t reform Medicare because to do so is an attach on seniors, which they will fight. You can’t means test Medicare because middle class seniors (the ones who vote the most) know that they will be paying more. But if you offer Medicare to all, reform is absolutely essential, and it will be harder for the seniors to argue about means testing when the young are paying 80% of the premiums and the old are taking 80% of the services.

    So if you are a conservative, you start by offering Medicare to all. You make the annual dues for young people astronomical for the full plan, so you offer them cheaper versions of Medicare which are not fee-for-service, or high deductible and co-pay, and/or run through private insurers. Then you tell the seniors that they have to move to the cheaper versions of Medicare if they want to avoid fees, fees which are means tested. This will take a decade or more, but if we don’t pursue a path like this, the politics become impossible.

    The takeaway lesson is that you can’t privatize or otherwise reform Medicare unless you make it universal, first.

    1. Adding younger people to Medicare

      even at the same rates, would help balance its accounts. The reason Medicare is in trouble is that it covers ONLY the oldest, sickest Americans, which is why private insurance companies were refusing to cover this age group in the 1960s.

      If Medicare were opened up to younger, healthier people, even the many unemployed and under-employed 50+ crowd, those new enrollees would use many fewer services than than those over 65.

      Medicare is a popular program. If Obama had been a good tactician, he would have proposed gradually opening Medicare to younger people, perhaps refusing the age of eligibility by 5 years every year, thereby initially freeing the insurance companies of clients they don’t want anyway, and giving more people an affordable option for medical care.

      1. Sanity in your comment Karen

        Our society provides a huge subsidy to private insurers by relieving them of insuring those over 65. With Medicare Advantage they were given an opportunity to skim the cream even from that population. But let’s state reality: without Medicare, we’d have seniors in continual bankruptcy, probably homeless, and denied care left and right. In plain words, a lot more of our grandparents dying earlier and with less dignity.

        Seems to me even the Libertarian contributors to this site must concede this.

        But to oppose opening Medicare to all citizens, free market proponents must cry that private industry can’t compete against a very successful government program. To that I say so what? If government can do something better and more efficiently than private industry it should be in the business of doing so. By its nature privately insured health care isn’t sustainable since the goal of profit is 180 degrees opposed to the goal of health. Let’s stop subsidizing that absurdity.

        Open Medicare to all of us and let us choose. Private insurers can continue their focus on the boutique market and most certainly they’ll do just fine.

  13. Dissolution

    It does not matter which party tries to implement some “plan”.
    The insurance industry is making sooooo much money, they will lobby either party to their favor.
    We the people have been screwed for many years.

  14. our children and grandchildren

    If cutting Medicare and Social Security will help our children and grandchildren then it makes sense to cut it all. What would happen is the children and grandchildren would again become financially, medically and literally the caretakers of parents and grandparents. Large institutions would need to be built for those without children and grandchildren. Our country would go back to the care of the 1800’s unless the 1% is generous and helps someone. Their care would not keep the Mayo Clinic open.Maybe each of the 1% could have their own doctor while the children and grandchildren watched their loved ones suffer while under their care.

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