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Old 11-17-2016, 08:13 PM
 
Location: Arizona
5,953 posts, read 5,307,586 times
Reputation: 17977

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Quote:
Originally Posted by Larry Caldwell View Post
It will be interesting to see how far Ryan gets with his plan to eliminate Medicare. Hospitals and docs will not take that lying down, and they represent 17% of the US GDP. Obamacare also meant that 20 million patients that they once had to treat for free now have insurance, so are not a drag on the system. Repeal Obamacare and eliminate Medicare and you will see the US health care system declaring bankruptcy. They hire lobbyists too. We'll have to see how this plays out.
You better be young or you won't even see how they start it let alone how it plays out. Anyone on Medicare now will probably be dead by the time the changes start.

 
Old 11-17-2016, 09:27 PM
 
Location: Metropolis IL
1,603 posts, read 1,893,637 times
Reputation: 2352
Quote:
Originally Posted by Ariadne22 View Post
The following illustrates what the world may become for the really ill. On another forum I had wondered how Ryan planned to address the high-cost Medicare beneficiary. Now we know - navigate the red tape to beg the govt for more money.So, the really sick would need to ask for premium support adjustment - instead of the no-questions asked now.

Indeed. All that howling a few years ago about death panels, well Ryan is proposing exactly that.

This is alarming. 74 y/o, I use very little medical care, but it's kind of nice to know that in retirement as I get older, should the worst happen, I don't have to worry about health coverage. Medicare will be there. Apparently, not without a lot of effort - when one is least in a position to advocate for oneself.
Before we sink any further into hysteria, it's important to read the entirety of Ryan's plan:

" If we act now, this can mean that traditional Medicare will continue for those currently on the program or near Medicare eligibility. It builds in a transition period such that workers in their 40's and 50's today—for whom Medicare enrollment and use is in the distant future— will have a health care program that looks more like what they are accustomed to using today."

The way I read this, is that the replacement plan for Obamacare, will continue on into what is now the Medicare years. Basically, it will be a lifetime healthcare plan, that younger people will already have adapted to financially and otherwise when they transition into their senior years. Folks currently 60 and older will still be under Medicare as it exist today.
 
Old 11-17-2016, 09:55 PM
 
Location: Living rent free in your head
31,083 posts, read 13,607,016 times
Reputation: 22142
Quote:
Originally Posted by BLS2753 View Post
Before we sink any further into hysteria, it's important to read the entirety of Ryan's plan:
" If we act now, this can mean that traditional Medicare will continue for those currently on the program or near Medicare eligibility. It builds in a transition period such that workers in their 40's and 50's today—for whom Medicare enrollment and use is in the distant future— will have a health care program that looks more like what they are accustomed to using today."

The way I read this, is that the replacement plan for Obamacare, will continue on into what is now the Medicare years. Basically, it will be a lifetime healthcare plan, that younger people will already have adapted to financially and otherwise when they transition into their senior years. Folks currently 60 and older will still be under Medicare as it exist today.
Here's a good summary of the various Republican plans to replace the ACA, they range from bad to worse. At this time there is no way to know which of these they will decide on, or if they will come up with something entirely different.

When Paul Ryan says that Medicare is going broke because of the ACA he is lying:

"Ryan tells Baier, “Because of Obamacare, Medicare is going broke.” This is false. In fact, it’s the complete opposite of the truth. The Medicare trust fund has been extended 11 years as a result of the passage of Obamacare, whose cost reforms have helped bring health care inflation to historic lows. It is also untrue that repealing Obamacare requires changing traditional Medicare. But Ryan clearly believes he needs to make this claim in order to sell his plan, or probably even to convince fellow Republicans to support it.
"

You know what really gets me about Paul Ryan...the guy forgot where he came from, he paid for his college education on Social Security Survivors benefits
 
Old 11-17-2016, 10:43 PM
 
Location: Living rent free in your head
31,083 posts, read 13,607,016 times
Reputation: 22142
Quote:
Originally Posted by BLS2753 View Post
Before we sink any further into hysteria, it's important to read the entirety of Ryan's plan:

" If we act now, this can mean that traditional Medicare will continue for those currently on the program or near Medicare eligibility. It builds in a transition period such that workers in their 40's and 50's today—for whom Medicare enrollment and use is in the distant future— will have a health care program that looks more like what they are accustomed to using today."

The way I read this, is that the replacement plan for Obamacare, will continue on into what is now the Medicare years. Basically, it will be a lifetime healthcare plan, that younger people will already have adapted to financially and otherwise when they transition into their senior years. Folks currently 60 and older will still be under Medicare as it exist today.
I sure didn't read it that way. Here is an explanation of the way the CBPP reads the Ryan 2015 plan:

"Chairman Ryan says that his premium-support proposal would not affect people aged 56 and older in 2014, but this claim is unlikely to be true. Under premium support, traditional Medicare would tend to attract a less healthy pool of enrollees, while private plans would attract healthier ones (as occurs today with Medicare and private Medicare Advantage plans). Although the proposal calls for “risk adjusting” payments to health plans — that is, adjusting them to reflect their enrollees’ health status — the risk adjustment process is highly imperfect and captures only part of the cost differences across plans that stem from differences in enrollees’ health.

Inadequate risk adjustment would mean that traditional Medicare would be only partially compensa*ted for its higher-cost enrollees, which would force it to raise premiums to make up the difference. The higher premiums would lead more of Medicare’s healthier enrollees to abandon it for private plans, very possibly setting off a spiral of rising premium costs and falling enrollment for traditional Medicare. Over time, traditional Medicare would become less financially viable and could unravel — not because it was less efficient than the private plans, but because it was competing on an unlevel playing field in which private plans captured the healthier beneficiaries and incurred lower costs as a consequence."


and later in the same document:

For example, a frail elderly widow with income of only $11,700 — just above the poverty level — could be required to pay $400 more each year if the Part B deductible rose from $146 to $550, as some proposals would do.[9] Many such individuals likely would forgo some needed care as a result.
 
Old 11-17-2016, 11:36 PM
 
Location: Wisconsin
21,541 posts, read 44,028,155 times
Reputation: 15150
Default Some things never change...

Quote:
Originally Posted by 2sleepy View Post
Inadequate risk adjustment would mean that traditional Medicare would be only partially compensa*ted for its higher-cost enrollees, which would force it to raise premiums to make up the difference. The higher premiums would lead more of Medicare’s healthier enrollees to abandon it for private plans, very possibly setting off a spiral of rising premium costs and falling enrollment for traditional Medicare. Over time, traditional Medicare would become less financially viable and could unravel — not because it was less efficient than the private plans, but because it was competing on an unlevel playing field in which private plans captured the healthier beneficiaries and incurred lower costs as a consequence."
It's called "starve the beast." A back door way of defunding the program - similar to privatization of "part" of SS - undermines the entire program - in both cases. Typical GOP playbook.
 
Old 11-18-2016, 01:07 AM
 
Location: Eugene, Oregon
9,162 posts, read 3,010,297 times
Reputation: 13834
Quote:
Originally Posted by Serious Conversation View Post
From a purely philosophical perspective, yes, conservatism would want to end SS. Practically and electorally, absolutely not.

Practically, how are Republicans going to just yank it? The Boomers aren't even majority at FRA yet. If you just close up the shop, they deserve that money back, which means quickly printing more cash we don't have to cover the presumably one off lump sum payments to each contributor. Logistically, no, you can't just shut it down - it would take years to do an orderly phase out or shutdown, and by then, people would have voted Democrats in power, so they'd just undo whatever Republicans did. Not all Republicans would go along with it either.

It's one of those sacred cows I don't see being altered significantly anytime soon, but I may be completely wrong.
You've done a better and more realistic job of describing this issue than many others have, while they used a lot more words. The "not all republicans would go along with it, either", is the most hopeful part. I hope you're completely right. If there's just enough of them who either have some humanity left or are worried enough about their re-elections, to form coalitions with the Democrats in Congress, they can control what Trump and the others in their party want to do. If these sorts of alliances could muster veto-proof majorities, they could also block or remove parts of Trump's executive orders.
 
Old 11-18-2016, 01:15 AM
 
6,625 posts, read 3,752,330 times
Reputation: 13703
Quote:
Originally Posted by Larry Caldwell View Post
It was, during the Reagan administration. Almost all the deductions and tax breaks were cancelled, and everybody but the wheeler dealers got a big cut in the percentage of taxes they paid. I remember my federal income tax dropped by about 20%. Tax rates went down, and collections increased in one swell foop. Tax returns were one page. Then Congress got to work adding back the breaks for their buddies, until we have the impenetrable swamp we deal with today. It only took 30 years or so.
Reagan increased deductions and loopholes, and lowered marginal tax rates, as well.

But it was Reagan who reduced the deductions and loopholes almost immediately. Why? Because the debt went up significantly almost immediately.

So instead of raising taxes by raising the marginal rates, he put in increases in other ways...the loopholes he'd increased were removed, deductions decreased, other tax charges were added, so that some people ended up paying more in taxes AFTER Reagan's reform than before, even though their nominal rate was less.
 
Old 11-18-2016, 01:28 AM
 
6,625 posts, read 3,752,330 times
Reputation: 13703
Quote:
Originally Posted by Steve McDonald View Post
You've done a better and more realistic job of describing this issue than many others have, while they used a lot more words. The "not all republicans would go along with it, either", is the most hopeful part. I hope you're completely right. If there's just enough of them who either have some humanity left or are worried enough about their re-elections, to form coalitions with the Democrats in Congress, they can control what Trump and the others in their party want to do. If these sorts of alliances could muster veto-proof majorities, they could also block or remove parts of Trump's executive orders.
He is wrong.

Paul Ryan has a bill already drawn up. He presented it to the House of Rep once before, if I remember correctly.

His plan is to partially privatize Social Security, with the intent to increase the privatization over time.

They'll still call it Social Security, but what privatization, even partial privatization, does is kill Social Security. Once there is no pool, it crumbles on its own. It's the pool aspect that makes it work.

A plan that is privatization of Social Security is something we already have. It's called 401k. So the privatization of SS would seem to me to be just increasing the amount you can contribute to your 401k. I don't know if Ryan's plan still requires the payroll tax by the employers, which would also be in your new 401k.

Ryan has said this is a top priority. I expect they'll get this done within the first few months. I also expect the people to go along with it, since Trump's supporters will still be in the honeymoon phase and more apt to believe what they're told then than later.

Ryan has a plan to privatize Medicare, as well, through the use of vouchers.

All this will be handled at the same time they "repeal" Obamacare (looks like Obamacare will merely be reformed, though, and not repealed, as promised). They'll sell it as all three things need to be done together, because Obamacare screwed everything up, they'll shout. Many people will believe that, too. Because many people are stupid.

Trump is in favor of partially privatizing Social Security. Don't know how he feels about Medicare. But I'm guessing Ryan and others can dance around Trump, since Trump doesn't know much about things like that or how government works. If it's early on, Trump will still be trying to get his sea legs.
 
Old 11-18-2016, 02:08 AM
 
Location: Eugene, Oregon
9,162 posts, read 3,010,297 times
Reputation: 13834
Quote:
Originally Posted by bpollen View Post
He is wrong.

Paul Ryan has a bill already drawn up. He presented it to the House of Rep once before, if I remember correctly.

His plan is to partially privatize Social Security, with the intent to increase the privatization over time.

They'll still call it Social Security, but what privatization, even partial privatization, does is kill Social Security. Once there is no pool, it crumbles on its own. It's the pool aspect that makes it work.

A plan that is privatization of Social Security is something we already have. It's called 401k. So the privatization of SS would seem to me to be just increasing the amount you can contribute to your 401k. I don't know if Ryan's plan still requires the payroll tax by the employers, which would also be in your new 401k.

Ryan has said this is a top priority. I expect they'll get this done within the first few months. I also expect the people to go along with it, since Trump's supporters will still be in the honeymoon phase and more apt to believe what they're told then than later.

Ryan has a plan to privatize Medicare, as well, through the use of vouchers.

All this will be handled at the same time they "repeal" Obamacare (looks like Obamacare will merely be reformed, though, and not repealed, as promised). They'll sell it as all three things need to be done together, because Obamacare screwed everything up, they'll shout. Many people will believe that, too. Because many people are stupid.

Trump is in favor of partially privatizing Social Security. Don't know how he feels about Medicare. But I'm guessing Ryan and others can dance around Trump, since Trump doesn't know much about things like that or how government works. If it's early on, Trump will still be trying to get his sea legs.
Yours is the doom and gloom version. But I think that there are enough republicans with the good sense to derail that, if it ever comes to a vote. Will all the Democrats vote in a block to support their dissent? Let's hope so. The part of this about the Medical Profession joining in loud protest over ending or damaging Medicare/Medicaid has to be expected and considered as a major roadblock to the wrecking crew.

It is hard to believe that an ordinary-looking guy like Ryan, who generally passes for normal and regularly gets re-elected in a state that swung to Obama, could have so much evil and malice wrapped up in him. Why would he be that way? What would he gain from it? He'd really have to be crazy to be plotting all the things people are attributing to him. Trump has the franchise for that kind of behavior.
 
Old 11-18-2016, 03:43 AM
 
Location: Myrtle Creek, Oregon
12,268 posts, read 12,511,970 times
Reputation: 19430
Quote:
Originally Posted by Steve McDonald View Post
Yours is the doom and gloom version. But I think that there are enough republicans with the good sense to derail that, if it ever comes to a vote. Will all the Democrats vote in a block to support their dissent? Let's hope so. The part of this about the Medical Profession joining in loud protest over ending or damaging Medicare/Medicaid has to be expected and considered as a major roadblock to the wrecking crew.

It is hard to believe that an ordinary-looking guy like Ryan, who generally passes for normal and regularly gets re-elected in a state that swung to Obama, could have so much evil and malice wrapped up in him. Why would he be that way? What would he gain from it? He'd really have to be crazy to be plotting all the things people are attributing to him. Trump has the franchise for that kind of behavior.
Ryan is left brain, and has realistically evaluated the situation:

Given the current programs, and
Given that tax increases are impossible
Then the programs willl collapse.

As boomers enter Medicare, it will eventually consume the entire federal budget. SS is just a matter of moving the trust fund from "not really national debt" to "really national debt." It's just a matter of selling a bunch of bonds to pay for the ones they are buying back. Medicare will be a lot more expensive, and there isn't much of a trust fund to pay for it. The money will have to come out of other programs, and the Republicans do like their empire.
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