One of my Senators announced a new reform for Medicare.
The headline and short text astounded me because he (Dem) has
partnered with Paul Ryan (Rep) to make changes in Medicare.
Wyden started his political career in Oregon working with seniors,
so he has been
trusted by them... so far.
My reaction was WTF ???
In any case, the following article describes the Wyden-Ryan proposal in some detail.
It is long... and Forbes is highly biased towards business, etc., but this is the meat.
Forbes
Avik Roy
12/15/11
Ron Wyden and Paul Ryan's Bipartisan Plan for Health Care and Medicare Reform
Quote:
This morning, Democratic Sen. Ron Wyden (Ore.) and Republican Rep. Paul Ryan (Wis.)
have shaken up Capitol Hill with an intriguing, bipartisan plan for reforming Medicare,
and also the private-sector employer-sponsored insurance system<snip>
The basic idea behind competitive bidding is that, say, on a county-by-county basis,
you let private plans and traditional Medicare offer plans with the same actuarial value compete,
to see who can offer the same package of benefits the most efficiently.
Each plan in a given county will name a price for which they are willing to offer these services,
and seniors are free to pick whichever plan they want.
However, the government will only subsidize an amount equal
to the bid proposed by the second-cheapest plan.
If you want a more expensive plan, you have to pay the difference yourself.<snip>
The plan would only go into effect for people aged 55 or younger today.
These future seniors would buy insurance on a “Medicare Exchange,” which
would require plans to guarantee coverage regardless of pre-existing conditions,
and require plans to charge similar premiums to those who are healthier or sicker.<snip>
Wyden-Ryan would expand means-testing throughout the Medicare system.
Currently, higher-income individuals pay more for Medicare under the program’s
traditional benefit for outpatient physician services (Part B),
and also for the newer prescription-drug benefit (Part D).
Under Wyden-Ryan, means-testing would also apply to the
premium support payments offered through the Medicare Exchange.<snip>
One of the most intriguing aspects of the Wyden-Ryan plan is its drive
to gradually migrate our inefficient, employer-sponsored private insurance system
to a true individual market where people buy health insurance on their own.<snip>
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Right away I see
negatives.
* health care costs do not vary by county... ZIP codes are better delineators
* reimbursement to 2nd-lowest bid leads to 2nd-lowest quality of care
* freedom to chose more expensive plan assumes one can afford it
* Two- or multi-tiered systems pit the younger against the older
* It appeals to those whose goals are to eliminate Medicare
* It entices employers to eliminate existing health plans
Right away I see
positives.
* means-test in Medicare system is logical
* prohibits exclusion for pre-existing or more serious conditions
.