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Old 11-30-2016, 08:40 PM
 
Location: Baltimore, MD
3,745 posts, read 4,222,880 times
Reputation: 6866

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Quote:
Originally Posted by 2sleepy View Post
Why is it the current plan not sustainable? And if the intent is to provide an equivalent amount of money to both medicare and Ryan's premium support plan...how does that save 'medicare'? I think we have every reason to not only be 'worried' but to assume they will try to do this.

This bright shiny thing they are trying to sell us is nothing more than a big wet kiss to pharma, insurers, and this time to doctors because under Ryan's plan they would no longer have to 'suffer through' a fee schedule as they do with medicare, they will be able to charge whatever they want.

I hope that everyone will stay on top of the details as they are released and contact your congressional reps. If we call them & write letters in large enough numbers they will think twice before they vote for this Machiavellian scheme.
First, look at Figure 7 on this linked summary. The Facts on Medicare Spending and Financing | The Henry J. Kaiser Family Foundation

As Geoff previously suggested, the ACA extended the life of the Medicare Trust Fund. (This is Part A only). In 2009, pre-ACA, the Fund was predicted to be insolvent in 2017. It is now predicted to be insolvent in 11 years + 1 month. I do not consider a Fund that will be insolvent in 11 years to be sustainable. Nevertheless, without the ACA, the trust fund will surely be insolvent in less than a decade.

Once the Trust Fund is depleted, we will not have enough wage earners to support the number of seniors who will be receiving Medicare benefits. Social Security has the same problem and it has been suggested that the fix could be an "across the board" cut in benefits. Similarly, Ryan's plan will save money by providing an equal but reduced amount of funds (per capita?) to the Traditional Plan and the Voucher Plan. That is why I suggested seniors choosing to keep the Traditional Plan will see an immediate increase in their premiums.

Yes, Ryan's plan sucks but I believe his constituents knew about his plan and decided to vote for him anyway. I cringe every time I hear Ryan talk about how his plan will give seniors choices while "saving" Medicare. I agree that seniors who are interested in this topic need to pay attention and may need to contact their Congressional critters now. IMO, waiting until the deals are made is too late.

 
Old 11-30-2016, 09:08 PM
 
Location: Chesapeake Bay
6,048 posts, read 3,876,928 times
Reputation: 3502
Quote:
Originally Posted by lenora View Post
First, look at Figure 7 on this linked summary. The Facts on Medicare Spending and Financing | The Henry J. Kaiser Family Foundation

As Geoff previously suggested, the ACA extended the life of the Medicare Trust Fund. (This is Part A only). In 2009, pre-ACA, the Fund was predicted to be insolvent in 2017. It is now predicted to be insolvent in 11 years + 1 month. I do not consider a Fund that will be insolvent in 11 years to be sustainable. Nevertheless, without the ACA, the trust fund will surely be insolvent in less than a decade.

Once the Trust Fund is depleted, we will not have enough wage earners to support the number of seniors who will be receiving Medicare benefits. Social Security has the same problem and it has been suggested that the fix could be an "across the board" cut in benefits. Similarly, Ryan's plan will save money by providing an equal but reduced amount of funds (per capita?) to the Traditional Plan and the Voucher Plan. That is why I suggested seniors choosing to keep the Traditional Plan will see an immediate increase in their premiums.

Yes, Ryan's plan sucks but I believe his constituents knew about his plan and decided to vote for him anyway. I cringe every time I hear Ryan talk about how his plan will give seniors choices while "saving" Medicare. I agree that seniors who are interested in this topic need to pay attention and may need to contact their Congressional critters now. IMO, waiting until the deals are made is too late.
The problem is that many people on Medicare (likely the majority) have a difficult time paying for their medical insurance today. Forget about immediate increases. They simply can not pay it.

Given the cost of market based health insurance, even with vouchers, people can not and will not pay. They will opt for ER until those shut down.

Basically, Ryan's plan is DOA. Along with the insurers, hospitals, healthcare providers if his plan is passed.

Last edited by Weichert; 11-30-2016 at 09:21 PM..
 
Old 11-30-2016, 09:23 PM
 
13,969 posts, read 7,441,074 times
Reputation: 25522
Quote:
Originally Posted by lenora View Post
Once the Trust Fund is depleted, we will not have enough wage earners to support the number of seniors who will be receiving Medicare benefits. Social Security has the same problem and it has been suggested that the fix could be an "across the board" cut in benefits.
This kind of dances around the root problem. Medicare is sustainable with a combination of coverage cuts and tax increases. The problem is that the ACA tax to prop up Medicare was only paid by rich people. You kind-a have to be rich to have $250K of investment income or $250K of earned income. Rich people bought and paid for the extreme right wing news sources that swung the Presidential election to Trump. Their agenda is to reduce their taxes and reduce regulations on the corporations they own. If you ditch the Medicare taxes brought in with ACA, Medicare crashes. Social Security is the same thing. The bipartisan commission recommended a fix that is largely a tax on rich people. Bump the employee side from 6.2% to 7.2%, bump the employer side (rich people) from 6.2% to 7.2%. Lift the income cap on both the employee (rich people) and employer sides (rich people).

The first world social democracies tax their middle class much more heavily. Compared to Europe and Asia, it's astounding how little tax the median household pays. If you want social democracy programs like pensions for the elderly, health care for the elderly, the middle class that benefits from it needs to bear more of the burden of paying for it.
 
Old 11-30-2016, 09:43 PM
 
Location: Chesapeake Bay
6,048 posts, read 3,876,928 times
Reputation: 3502
Quote:
Originally Posted by GeoffD View Post
This kind of dances around the root problem. Medicare is sustainable with a combination of coverage cuts and tax increases. The problem is that the ACA tax to prop up Medicare was only paid by rich people. You kind-a have to be rich to have $250K of investment income or $250K of earned income. Rich people bought and paid for the extreme right wing news sources that swung the Presidential election to Trump. Their agenda is to reduce their taxes and reduce regulations on the corporations they own. If you ditch the Medicare taxes brought in with ACA, Medicare crashes. Social Security is the same thing. The bipartisan commission recommended a fix that is largely a tax on rich people. Bump the employee side from 6.2% to 7.2%, bump the employer side (rich people) from 6.2% to 7.2%. Lift the income cap on both the employee (rich people) and employer sides (rich people).

The first world social democracies tax their middle class much more heavily. Compared to Europe and Asia, it's astounding how little tax the median household pays. If you want social democracy programs like pensions for the elderly, health care for the elderly, the middle class that benefits from it needs to bear more of the burden of paying for it.
Well, there's vastly more of us (poor) than them (rich). If it comes down to that, so be it.

And believe me, that could happen. There isn't the discontent level of the 1930s, not yet anyway. But keep pushing and ???
 
Old 11-30-2016, 09:49 PM
 
Location: Retired
648 posts, read 498,737 times
Reputation: 1057
Obamacare will be eliminated through budget reconciliation. Medicare and Social Security benefits would only be reduced if Democrats go along with Republicans, as Democrats can still filibuster in the Senate. Unless McConnell changes the rules for the filibuster.

Trump realizes cutting Social Security or Medicare would be highly unpopular, and he wants to be popular. But the Affordable Care Act overall is unpopular, so it will get the ax.
 
Old 11-30-2016, 10:27 PM
 
29,809 posts, read 34,894,042 times
Reputation: 11730
Quote:
Originally Posted by Weichert View Post
Another reason. Life happens. Things like accidents, illness, divorce, job loss.

Happens to many people. I know that from personal experience. And can be very difficult to get past sometimes, many can not.
Sure and that is a reality and often gets acknowledged here. Not by all but by many.
 
Old 11-30-2016, 10:29 PM
 
29,809 posts, read 34,894,042 times
Reputation: 11730
Quote:
Originally Posted by Weichert View Post
The problem is that many people on Medicare (likely the majority) have a difficult time paying for their medical insurance today. Forget about immediate increases. They simply can not pay it.

Given the cost of market based health insurance, even with vouchers, people can not and will not pay. They will opt for ER until those shut down.

Basically, Ryan's plan is DOA. Along with the insurers, hospitals, healthcare providers if his plan is passed.
At any rate along with DOA will be DOP' Death On Poverty
 
Old 11-30-2016, 10:31 PM
 
29,809 posts, read 34,894,042 times
Reputation: 11730
Quote:
Originally Posted by Graywhiskers View Post
Obamacare will be eliminated through budget reconciliation. Medicare and Social Security benefits would only be reduced if Democrats go along with Republicans, as Democrats can still filibuster in the Senate. Unless McConnell changes the rules for the filibuster.

Trump realizes cutting Social Security or Medicare would be highly unpopular, and he wants to be popular. But the Affordable Care Act overall is unpopular, so it will get the ax.
Rememember, tax cuts along with infrastructure spending will break the bank unless social programs are cut
 
Old 11-30-2016, 10:59 PM
 
Location: Wisconsin
21,543 posts, read 44,068,928 times
Reputation: 15160
Quote:
Originally Posted by TuborgP View Post
The interesting thing is that by pulling Price out of congress and placing him in the cabinet, Trump has removed him from the legislative process. He may well now be in a weaker position to influence house action as he is no longer a player and doesn't need a platform to articulate his own plan. He might even now have a smaller platform. He can get press but in terms of lining up the difficult votes? hmmmmmm

Think about it! He now works for and reports to the man who said he didn't want to touch Medicare. By putting him in his cabinet has Trump weakened the hand of those in the House who want to dismantle Medicare, ACA and Medicaid?
Ha - I doubt Trump even considered this little wrinkle. He is generally clueless - which in this case - if Price ends up with less influence - will be a good thing.

Quote:
Originally Posted by TuborgP View Post
Rememember, tax cuts along with infrastructure spending will break the bank unless social programs are cut
Oh, indeed. Deniers all over the place - but the reality is tax cuts and repatriation result in stock buybacks and dividends to shareholders, not new jobs. Only demand creates that. Defense and infrastructure will run up the debt like crazy - some of that money coming back in increased tax revenues - but it's still a net deficit according to every reliable study done. Like $3-4Trillion at least, last I read. There's no way to spin tax cuts as a job creator. Never was, never will be. Prepare for inflation and another bust. It's coming.
 
Old 11-30-2016, 11:09 PM
 
Location: Chesapeake Bay
6,048 posts, read 3,876,928 times
Reputation: 3502
Quote:
Originally Posted by TuborgP View Post
Rememember, tax cuts along with infrastructure spending will break the bank unless social programs are cut
I have always felt that the US would reach the tipping point beyond which it could no longer afford its healthcare industry. I was thinking that point would be when healthcare was at 20% of GDP.

Perhaps we are at that point now. Maybe a national dialogue as to where and what the US wants and can afford should take place.

No doubt there are issues with Medicare but Paul Ryan has specifically targeted the group least able to absorb his proposed changes. In short, his plan would financially destroy 40-50 million people, putting them at deaths door and/or starve them to death. They are the target but they simply can not solve his perceived problem. It is mathetically impossible.

I really do think that he realizes that some version of Medicare for all is likely the only viable solution. But unwilling to go that route his objective is to destroy Medicare. Before it destroys him.
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