FIXING RYAN’S MEDICARE PLAN
May 10th, 2011 | 8 responses
Loopy Wisconsin Republican and U.S. Representative Paul Ryan proposed last month a much-maligned Medicare Voucher Plan to replace the current system for people under 55 today. It would be phased in when they eventually retire during the next decade. Perhaps the original proposal could be modified to improve the entire U.S. healthcare system. This idea might also fit in with the current House Republican demands to permanently cut trillions of dollars in Federal spending as a pre-requisite to raising the U.S. debt ceiling.
Many people including this writer criticized the Ryan plan for not addressing the overall exorbitant costs of the U.S. healthcare and health insurance systems. The huge Healthcare Reform Bill passed by a Democratically-controlled Congress and signed by President Obama in early 2010 did not come close to addressing or solving why this nation spends so much on healthcare with very limited results in comparison to most other advanced nations around the globe. Until huge cost differentials in charges levied by U.S. hospitals, physicians, medical equipment and testing providers, and pharmaceutical companies are better aligned with those found in the rest of the world, we’ll never solve our nation’s steadily growing national financial conundrum and our huge federal budget deficits.
Congressman’s Ryan’s plan would change Medicare from a centralized federal payment system for the medical and hospital needs of most seniors to one where the Federal Government would simply provide vouchers to seniors to buy private healthcare insurance – and then it would let the chips fall where they may. Within the deregulated private sector, somehow individual patients would be able to shop around and negotiate for the best insurance and healthcare deals. It would likely not contain any individual mandate on seniors to purchase anything whatsoever.
The Ryan plan would effectively permit the over-priced Medicare Advantage Plans to swallow up the entire federal Medicare insurance system. It would be an attempt to merge all the worst features of our existing healthcare system into one horrendous new program. At least it would all be voluntary – even though there would be no alternatives except going without healthcare. Rather we need a viable alternative to the current U.S. healthcare system.
Most critics of the Ryan plan state the vouchers would not come close to paying for worthwhile health insurance. Furthermore, private health insurers would not be regulated to control premiums, co-pays or deductibles. What services insurers could limit for reimbursement are not specified or regulated – but such governmental rules would be an anathema to conservative libertarians everywhere. Finally, actual healthcare costs will have already skyrocketed exponentially over the next 10 years so that the federal vouchers would be effectively worthless.
Until we address uncontrolled healthcare costs, all the cost-shifting from the Federal government to the 50 states and upon individuals citizens, might make the Federal books look better but it would not provide better healthcare to the vast majority of Americans. Furthermore most all democratic and republican healthcare plans fail to honestly address mounting medical expenses in our society. Perhaps we need to change our providers of healthcare services to finally solve anything.
It is well established that most all developed nations, such as in Western Europe and Canada, provide all their citizens with excellent health care for about half the total GDP or per capita cost of the U.S. system – and many nations do it for even less. The U.S. still has over 50 million uninsured people – and millions more discover too late that they are woefully under-insured for many healthcare services and products. More than 60% of U.S. bankruptcies have been, still are, and will be due to huge and un-payable medical bills resulting from higher co-pays, deductibles, and denials of coverage by health insurance companies. More and more U.S. employers are dropping healthcare benefits or charging their employees more in co-pays and providing fewer services for the same dollars. We desperately need to find less expensive hospitals, physicians and suppliers of medical equipment and drugs.
Many developing nations, including Mexico, Colombia, Argentina, South Africa, India and others around the globe provide excellent health care at amazingly lower prices when compared to those found in the U.S. for the same medical care and equipment. Medical tourism by U.S. citizens has been steadily growing over the past 20 years and not just for cosmetic procedures but also for many life-saving and necessary operations that are unaffordable in the U.S.
The U.S. should negotiate with a dozen advanced and developing nations (including Canada, Mexico, the United Kingdom, France and others) several agreements for their healthcare systems to cover U.S. citizens for any and all medical care at flat-rate annual fees. The Federal government already outsources many defense-related programs and other public services. The U.S. private sector extensively outsources manufacturing, customer services, and even professional services. Why not outsource the U.S. healthcare system as well?
Certainly the cost of flying (or bussing U.S. citizens living close to Canada or Mexico) sick seniors (even anyone else who is sick in the U.S.) overseas plus the cost of such foreign medical care, would be far less expensive than doing it in the U.S. We already have a serious shortage of physicians because the AMA has long artificially limited the number of doctors that can graduate from U.S. medical schools. The cost of maintaining large America hospitals and medical clinics is growing very quickly each year – at rates that exceed inflation. (They are only exceeded by the cost of an American college or university education.) Today much of our medical equipment and many of our drugs are manufactured abroad to be re-sold domestically at grossly inflated prices to American consumers.
Therefore, the best way to control U.S. healthcare costs is to simply move most of the industry overseas where labor, equipment, and infrastructure costs are just a fraction of those found in the U.S. As more and more people are permanently unemployed, or stuck in low-paying jobs without any healthcare benefits, and more people will not have sufficient retirement income to pay for standard U.S. healthcare insurance (yet alone afford a mortgage, food, utilities and a typical American lifestyle from the not-so-distant past) the vast majority of Americans and U.S. Seniors will not be able to afford the healthcare system we have created domestically. We need affordable healthcare alternatives.
Our only solution to our national healthcare quagmire will be to extensively utilize much less expensive systems elsewhere around the globe. These foreign health systems have better overall healthcare results than our currently expensive and completely dysfunctional system. We might need to retain some Emergency Rooms for time-sensitive medical conditions and real emergencies. Otherwise, everything else healthcare-wise for U.S. citizens should be done overseas.
We could also outsource many of our senior living and long-term disability centers to low-cost countries in Latin America, Africa and Asia. It might be cheaper for both Medicare and Social Security to relocate many retired Americans overseas as well. (We must simply ensure the U.S. dollar does not crash in value against other global currencies or these modest suggestions would be rendered moot.)
Our foreign relocation program could be extended to the millions of unemployed people and to most liberals in the U.S. – imagine how happier everyone else would be without all these whiny misfits. We could outsource many aspects of our Federal Government in Washington DC to highly educated, skilled and motivated low-cost workers in Mumbai and Bangalore, India. Many domestically-headquartered global corporations could also save a lot of money by selecting far cheaper versions of their greedy and incompetent CEOs from many other locations around the globe.
The outsourcing possibilities are endless and we know Americans can do anything we set our minds to do. Outsourcing is as American as a meth mom, steroids in baseball, frozen apple pie, corrupt crony corporatism, greedy globalism, Charlie Sheen and Tiger Woods. We just have to pass a modified Ryan Medicare Plan immediately. We could start this massive and long-overdue outsourcing of the U.S. healthcare system by January 2012 – and we might not have to raise the U.S. debt ceiling as much as originally planned.
Submitted 5/10/11 by Marc Pascal, happily ranting from Phoenix, Arizona. This blogger (over-50, without health insurance, and taking pills to control hypertension) when he really gets sick will probably visit France or Italy to see some friends and relatives – and will simultaneously get some excellent and inexpensive healthcare. At least I know the languages from previous long visits to these countries so I will know what they are doing.
8 Responses to “FIXING RYAN’S MEDICARE PLAN”
A fine idea, Marc, we can just deport the sick. Out-of-the-box thinking like this warms my libertarian hailstone of a heart.
That’s “co-payments,” not “co-pays” [sic]. The rest of it, a big weight on us all. The voucher system would” transform” Medicare, as I have noted before, end the direct federal commitment associated with provision of health care to the elderly (smarter lefties want this expanded to include everybody), and the vouchers would be a joke — insufficient for lower-income elderly and simply a sick(ening) joke for everyone else.
Beware outsourcing. Rather, become aware and then beware of what can be called insourcing: bringing immigrants (especially illegal, so much more exploitable, immigrants) to fill what jobs can’t be sent offshore, at much lower wages, no benefits. etc. After all, that’s the solution for jobs that can’t be relocated (and might even still be susceptible to unionization or other kinds of interventionist measures).
Cheers.
Well, let’s give this some thought, Marc. As enterprising types we would need to form a medical transportation system of buses, rail cars and planes. I suggest an LLC that could go public in an IPO three to five years out. The governemnt could provide vouchers and our ticket prices would be exactly double the voucher amount. It’s the American way. Planes, buses and rail cars could be equipped with hanging cots, three high (maybe four); more people could be crammed in than with standard seating. We’ll need tort reform to prevent loses to negligence. Think of it. Plane loads to France, RSA.
Now, Hospice. Haiti strikes me as a nice, inexpensive Caribbean isle with lots of unemployed folks willing to do the grunt work.
But, really we need to consider the bifurcation of the American continent. For the wealthy, of which we will become a part due to our medical transportation conglomerate, the continent could be separated into interior and exterior. In the interior, all remaining persons not outsourced to foreign countries and who have a net worth of less than $100m would be relocated [sorry, I meant insourced]. That would free the coastal areas to be exclusively the playgrounds of the rich. Special exceptions would, of course, need to be made, perhaps in the form of temporary worker passes, for maids, landscapers, cooks and boat crews.
Your idea is brilliant. Almost too much to take in at one sitting.
Medicare already has copayments. A voucher system won’t fix the high costs of US medical care. Even the Swiss plan has higher costs than the rest of the EU.
I think the main point is that we are getting gouged ruthlessly by the health care field. I just recently found out about the AMA and how it controls the number of new licenses issued in any given field. It really took my breath away. That and comparing the costs for routine services from standard pain medication to x-rays and MRI’s here to say, well, anywhere they have decent healthcare. Medical costs are rising much faster than inflation and the companies that make the tools and run the hospitals are making a killing. All too often the last dollars that many americans spend before they die with empty bank accounts go to pay medical bills. We are getting boned and if you think the oil companies and GE are getting away with murder, well the Healthcare industry is doing it in a more direct way by buying their way into making sure the money keeps flowing. Makes me wanna dust off my guillotine.
They also oppress better and cheaper health care tools in order to protect their products. If they have to, they’ll just buy the patent and shelf the thing.
They’ll also actively fight against research that proves their products are dangerous.
Slamfu:”I just recently found out about the AMA and how it controls the number of new licenses issued in any given field. It really took my breath away.”
That’s just the tip of the iceberg. Look up RBRVS (Relative Based Reimbursement Value Scale). It’s the medicare/medicaid scale used to pay doctors. The AMA’s own website says that it sets 95% of those rates, not based on competition, or sustainability, or even cost of education, but on what it thinks a doctor should be making for those procedures. Legislators sometimes influence the board to set other rates.
It’s really a big scam, but few people have even heard of it.
I think there are flaws in Ryan’s plan. However, I also think this article focuses, like a laser beam, on things that miss the fundamental problems.
The article takes it granted that over priced plans would take over. That may be true, but why is that? It is because we have regulated much of the competition out of health care. Otherwise, someone could make money be providing less overpriced health care and such a take over wouldn’t occur. Yet the article immediately jumps to greater government involvement. It adds the twist that suggests foreign governments, but in the end it will move more toward a government system.
One irony is that Ryan’s plan might well allow people to do exactly what the author suggests. If the vouchers are not restricted to US providers, then the holders could go to these same plans he advocates and get the care he feels will be superior.
The problem with Ryan’s plan is that providing choice to the recipients with vouchers still have problems if the market restricts competition. More government involvement doesn’t address that. It just gives up on letting people decide for themselves.