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The issues with that plan are what about the people who can't afford that? Are we as a country okay with just accepting that people with money have "good/high quality" health outcomes and everyone else has "bad/poor quality" health outcomes? That used to not be the case, but in today's environment it seems much more acceptable to a majority of citizens.
Further - for young people, they can do some things to adjust their retirement savings to account for that (though it would still be a small % of people that could self fund $18,000 per year in health insurance expenses in retirement) - but what about older persons? Like current medicare recipients? What will they do?
If you start to subsidize the costs for lower-income/savings individuals - it becomes "Welfare" and the 1/2 of the country that is against welfare will also be against those vouchers (just as they are against SNAP and WIC and every other welfare program).
I'm 20+ years away from this affecting me, and I doubt that I'll be able to save enough to offset the destruction of medicare (if that is what ends up happening). Few people make enough to be able to afford to put away $20k+ a year towards retirement expenses. If you have to double that to account for lack of medicare .... that's going to be an impossibility for most folks.
Especially if you add in changes to Social Security. And if they change medicare substantively, there's certainly nothing to stop them from cutting Social Security.
This is all very simple.
Rich people pay most of the taxes. With Medicare and Social Security, they own the stock in the corporations that pay the employer half of all taxes. Rich people don't need Medicare or Social Security and would be delighted to kill it off. You have people like Rupert Murdoch creating Fox News to get half the country to vote against their economic interests. They focus on "they're gonna take your guns", abortion rights, flag burning, and all the other fringe issues that don't matter. It's a brilliant strategy that only benefits the richest 0.1% of the country.
The economic reality is that 75% of the country is going to hit 60-something with no pension and low net worth. When they have their health event where they can't work, all they have is Social Security and Medicare. The best we can hope for is that everybody screams when Paul Ryan and the Republican right working on the behalf of rich people try to kill those programs. The next 12 months are going to be interesting politics.
Medicare reform was going to happen eventually no matter who is elected. Today's program is not viable. For many years, I've had $10K per year penciled in as my best guess for what my individual retiree medical insurance would cost me to get the kind of coverage I'm used to. If you don't have the $1,000/month, you're going to get pretty lousy coverage. That's probably 75% of the late-Boomers. I'm now wondering if I've underestimated the cost? If it's $1,500/month, I'll pay it.
Of course it's viable, Ryan is spewing a lot of nonsense and he knows it...
"The 2016 report of Medicare’s trustees finds that Medicare’s Hospital Insurance (HI) trust fund will remain solvent — that is, able to pay 100 percent of the costs of the hospital insurance coverage that Medicare provides — through 2028. Even in 2028, when the HI trust fund is projected for exhaustion, incoming payroll taxes and other revenue will still be sufficient to pay 87 percent of Medicare hospital insurance costs.[1] The share of costs covered by dedicated revenues will decline slowly to 79 percent in 2040 and then rise gradually to 86 percent in 2090. This shortfall will need to be closed through raising revenues, slowing the growth in costs, or most likely both. But the Medicare hospital insurance program will not run out of all financial resources and cease to operate after 2028, as the “bankruptcy” term may suggest." Medicare Is Not
Medicare reform was going to happen eventually no matter who is elected. Today's program is not viable. For many years, I've had $10K per year penciled in as my best guess for what my individual retiree medical insurance would cost me to get the kind of coverage I'm used to. If you don't have the $1,000/month, you're going to get pretty lousy coverage. That's probably 75% of the late-Boomers. I'm now wondering if I've underestimated the cost? If it's $1,500/month, I'll pay it.
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If you don't have the $1,000/month, you're going to get pretty lousy coverage.
If you don't have the $1,000/month, you're going to get pretty lousy coverage AND you'll be unable to cover the out-of-pocket expenses.
If you don't have the $1,000/month, you're going to get pretty lousy coverage.
If you don't have the $1,000/month, you're going to get pretty lousy coverage AND you'll be unable to cover the out-of-pocket expenses.
How does that work?
It doesn't. Which is his point. If you can't come up with the premium cost (after voucher subsidy) plus extra money for deductibles/copays/coinsurance and other out-of-pocket, you have no coverage except charity care and Medicaid - if your state makes it available to you. The red states, in general, are very stingy with Medicaid. If you have no coverage, you go to the ER and charity clinics, but followup care, rehab, long-term anything isn't available to you. It comes down to never getting the correct/best care and/or dying.
Medicare now is affordable. Part A (hosital, skilled nursing, hospice) is free. Part B (docs/labs) is $109/mo. in 2017 deducted from the SS benefit. Part D offers drug coverage. Advantage plans combine A, B, D. If you're low-income, there are programs which pay the Part B premium and provide extra help with Part D - so that you pay virtually nothing for medical care.
The voucher program destroys that because there is no way the value of the vouchers will keep pace with inflation of medical costs, government is out of the health care business, and you're left to the mercy of the private, for-profit health insurer at the most vulnerable time in your life. Never a good place to be.
It doesn't. Which is his point. If you can't come up with the premium cost (after voucher subsidy) plus extra money for deductibles/copays/coinsurance and other out-of-pocket, you have no coverage except charity care and Medicaid - if your state makes it available to you. The red states, in general, are very stingy with Medicaid. If you have no coverage, you go to the ER and charity clinics, but followup care, rehab, long-term anything isn't available to you. It comes down to never getting the correct/best care and/or dying.
Medicare now is affordable. Part A (hosital, skilled nursing, hospice) is free. Part B (docs/labs) is $109/mo. in 2017 deducted from the SS benefit. Part D offers drug coverage. Advantage plans combine A, B, D. If you're low-income, there are programs which pay the Part B premium and provide extra help with Part D - so that you pay virtually nothing for medical care.
The voucher program destroys that because there is no way the value of the vouchers will keep pace with inflation of medical costs, government is out of the health care business, and you're left to the mercy of the private, for-profit health insurer at the most vulnerable time in your life. Never a good place to be.
Yep. And if you think Medicare is lined up to get gutted, seniors vote. Poor people don't vote. Medicaid is really going to get hammered. The ACA Medicaid expansion? Gone. Big cuts to state reembursement. A ton of expensive things won't be covered.
Their is always a quid pro quo for campaign contributions, donors fully expect that the palms they greassed will legislate in a way that benefits them. Tom Price is going to be the new head of HHS, here is who helped elect him:
Price has received $596,825 in federal campaign campaign donations from pharmaceutical and health products companies, as well as $3.56 million from doctors, pharmacists and other health professionals, according to the Center for Responsive Politics, which tracks campaign donations.Trump Picks Tom Price to Lead Health and Human Services - Bloomberg Politics
"Seema Verma will run the centers on Medicare and Medicaid, she designed the Indiana medicaid program which among other things asks covered people to make a small monthly payment to access health insurance. A missed payment can result in six-month lockout from insurance coverage." Seema Verma, Who Helped Remake Medicaid In Indiana, Picked For CMS : Shots - Health News : NPR
While working as a paid consultant to Indiana, Verma was working for a division of Hewlett Packard: Verma's work has included the design of the Healthy Indiana Plan, a consumer-driven insurance program for low-income Hoosiers now being touted nationally as an alternative to Obamacare. In all, Verma and her small consulting firm, SVC Inc., have received more than $3.5 million in state contracts. At the same time, Verma has worked for one of the state's largest Medicaid vendors — a division of Silicon Valley tech giant Hewlett-Packard. That company agreed to pay Verma more than $1 million and has landed more than $500 million in state contracts during her tenure as Indiana's go-to health-care consultant, according to documents obtained by The Indianapolis Star. Verma's dual roles raise an important question: Who is she working for when she advises the state on how to spend billions of dollars in Medicaid funds — Hoosier taxpayers or one of the state's largest contractors?http://www.indystar.com/story/news/p...sses/14468683/
Of course it's viable, Ryan is spewing a lot of nonsense and he knows it...
"The 2016 report of Medicare’s trustees finds that Medicare’s Hospital Insurance (HI) trust fund will remain solvent — that is, able to pay 100 percent of the costs of the hospital insurance coverage that Medicare provides — through 2028. Even in 2028, when the HI trust fund is projected for exhaustion, incoming payroll taxes and other revenue will still be sufficient to pay 87 percent of Medicare hospital insurance costs.[1] The share of costs covered by dedicated revenues will decline slowly to 79 percent in 2040 and then rise gradually to 86 percent in 2090. This shortfall will need to be closed through raising revenues, slowing the growth in costs, or most likely both. But the Medicare hospital insurance program will not run out of all financial resources and cease to operate after 2028, as the “bankruptcy” term may suggest." Medicare Is Not
Nope. When you kill ACA, you also kill the rich people tax Obama added. 0.9% on income above $250k and 3.8% on investment income over $250k. Part A then has big negative cash flow. That comes out of the general fund. Part B and Part D costs are already growing rapidly and those are funded out of the general fund and premiums. They have nothing to do with the so called Medicare Trust Fund.
It's not sustainable. With the Republicans in control of both houses of Congress and the Presidency, there are going to be big changes that mostly benefit the very rich. They may grandfather current retirees but the deal is going to change for younger people.
Yep. And if you think Medicare is lined up to get gutted, seniors vote. Poor people don't vote. Medicaid is really going to get hammered. The ACA Medicaid expansion? Gone. Big cuts to state reembursement. A ton of expensive things won't be covered.
Yep. Seniors vote.
and a *lot* of them voted for the new administration, that is lining up people hostile to medicare and by voting in a republican trifecta - have essentially voted for Medicare privatization.
While some junior members of congress may not be willing to cast votes that could cause issues with their reelection - many senior members (who can count on their congressional pension and will easily move to lobbying or other lucrative positions) may be happy to vote for gutting the social safety net - because if they don't do it now (with both the executive and legislative branches of the government in Republican control) - there may not be another time.
It is always possible that Democrats will be voted back in in 2, 4, 6, or 8 years.
And if you dismantle Medicare now (and Medicaid, obviously Medicaid will be gutted) - it will be much harder to put it back together. i.e. it could take 20+ years to undo the harm.
I'm many years away from retirement, and while not prosperous, my projections were solid. Destruction of medicare will definitely affect that. I'll be interested to see what happens in the next year.
Nope. When you kill ACA, you also kill the rich people tax Obama added. 0.9% on income above $250k and 3.8% on investment income over $250k. Part A then has big negative cash flow. That comes out of the general fund. Part B and Part D costs are already growing rapidly and those are funded out of the general fund and premiums. They have nothing to do with the so called Medicare Trust Fund.
It's not sustainable. With the Republicans in control of both houses of Congress and the Presidency, there are going to be big changes that mostly benefit the very rich. They may grandfather current retirees but the deal is going to change for younger people.
The deal is also going to change for older people. Ryan's plan calls for an equal amount of funds to be made available for both the premium support plan and Traditional Medicare. (I actually read the plan. LOL) IOW, older retirees can indeed choose Traditional Medicare but it will immediately cost them a lot more. But, in all fairness to Ryan and Trump, the additional cost does not actually change the plan itself.
I think the immediate concern for many retirees should be the reopening of the prescription drug donut hole. I doubt that most retirees know that it was the ACA that partially closed that gap.
I don't like the plan proposed by Ryan but I agree the current program is simply not sustainable.
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