About Those Medicare Vouchers

Kaiser Family Foundation is a respected, non-partisan, nonpolitical think-tank focused on medical research. The Foundation has just released its analysis of Paul Ryan’s plan to “reform” Medicare; the high (or low) points of that analysis are instructive. According to Kaiser,

• Nearly six in 10 Medicare beneficiaries nationally could face higher premiums for Medicare benefits, assuming current plan preferences, including more than half of beneficiaries enrolled in traditional Medicare and almost nine in 10 Medicare Advantage enrollees. Even if as many as one-quarter of all beneficiaries moved into a low-cost plan offered in their area, the new system would still result in more than a third of all beneficiaries facing higher premiums.
• Premiums for traditional Medicare would vary widely based on geography under the proposed premium support system, with no increase for beneficiaries living in Alaska, Delaware, Hawaii, Wyoming and the District of Columbia, but an average increase of at least $100 per month in California, Florida, Michigan, New Jersey, Nevada and New York. Such variations would exist even within a state, with traditional Medicare premiums remaining unchanged in California’s San Francisco and Sacramento counties and rising by more than $200 per month in Los Angeles and Orange counties.
• At least nine in 10 Medicare beneficiaries in Connecticut, Florida, Massachusetts and New Jersey would face higher premiums in their current plan. Many counties in those states have relatively high per-beneficiary Medicare spending, which would make it more costly to enroll in traditional Medicare rather than one of the low-bidding private plans in those counties. In contrast, in areas with relatively low Medicare per-capita spending, it could be more costly to enroll in a private plan.

Ryan insists his plan would save money. And it would. It would save the government money, by shifting the costs of medical care back to the people the program was supposed to help–the elderly, and especially the low-income elderly.

This is Ryan’s basic approach to fiscal responsibility. His central insight (big thinker that we keep being told he is): We can save the government lots of money by eliminating or greatly reducing programs like Medicare. We can privatize social security and send Medicaid back to the states where it would almost certainly die (approaches Ryan favored until the campaign ixnayed that talk), saving taxpayers–especially rich ones–billions. (Of course, we could also cut defense spending, but that’s sacred under the Romney/Ryan approach). Or we could take the approach favored by Grover Norquist, and just get rid of government altogether. Drown it in a bathtub.

What pisses me off isn’t that some people, including Ryan, reject the very notion of a government that provides a safety net. People are entitled to their political positions, just as I am entitled to mine. What pisses me off is that they lie about it.

Ryan knows his “remake” of Medicare would cost seniors more money. If it is such a great idea, he should be able to explain why we should embrace it. Instead of lying about it, Mr. Serious Thinker should have the balls to defend it.