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Posted by on Aug 23, 2012 in Health, Law, Politics | 27 comments

Romney Losing on Health Care

Short and sweet: new poll. 60/40. Key states.

After more than a week of frenzied campaigning on the issue, Medicare ranks as the third-most crucial issue to likely voters in Florida, Ohio and Wisconsin — behind the economy and health care, according to new Quinnipiac University/New York Times/CBS News polls of the three swing states. The Republican proposal to retool the program a decade from now is widely disliked. …NYT

We voters have done the math! We figured it out for ourselves!

Roughly 6 in 10 likely voters in each state want Medicare to continue providing health insurance to older Americans the way it does today; fewer than a third of those polled said Medicare should be changed in the future to a system in which the government gives the elderly fixed amounts of money to buy health insurance or Medicare insurance, as Mr. Romney has proposed. And Medicare is widely seen as a good value: about three-quarters of the likely voters in each state said the benefits of Medicare are worth the cost to taxpayers. …NYT

We’ve realized, finally!, that Ryan’s proposals are a scam.

“On Medicare, I don’t like the Paul Ryan plan,” said Beverly McLaren, 72, an independent from St. Petersburg, Fla., who said in a follow-up interview that Medicare worked well for her and that she planned to vote to re-elect Mr. Obama. “I can’t see how it will help at all, and we’ll have more out-of-pocket expenses, and I’m not really clear how it will work.” …NYT

Star-Ledger editors point out the hard truth: Romney isn’t leading his party, as he should. He’s lamely following them, That’s what his choice of Paul Ryan shows.

It is another disturbing signal that Romney is not likely to heave his party toward the middle, as Bill Clinton did with the Democrats in 1992. Romney is not challenging the Sister Souljahs of his party; he is placating them at nearly every turn.
His career shows he is not a real moderate, or a real conservative. He is an opportunist and has always moved in the direction the tide pushes him.

So don’t expect Romney to govern as he did in Massachusetts.

Republicans are marching to the right, and Romney is likely to float with the tide again. …Star-Ledger

Float with the tide! Whew! Now back to whether Hurricane Isaac will wipe out the entire Republican party, carried away by God’s punishing winds and tides, so to speak.

As the storm approached, military authorities at the U.S. base in Guantanamo Bay, Cuba, canceled several days of pretrial hearings in the case of five prisoners charged in the Sept. 11 terrorist attacks. They also planned to evacuate about 200 people, including legal teams and relatives of Sept. 11 victims. …CBS News

Cross-posted from Prairie Weather

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  • ShannonLeee

    “Roughly 6 in 10 likely voters in each state want Medicare to continue providing health insurance to older Americans the way it does today”

    well, that isn’t so great for either guy because both are arguing that the other will change medicare in the future.. Mitt has a voucher program and Obama has Obamacare, which is still unclear for many Americans.

    “fewer than a third of those polled said Medicare should be changed in the future to a system in which the government gives the elderly fixed amounts of money to buy health insurance or Medicare insurance”

    that is a little better for Obama because it obvious hits at the Ryan plan…which Mitt owns right now.

    The Ryan plan was a political disaster when it was passed by the House… it now becoming a national disaster for the Romney campaign. You just can’t defend it and comments like, “well shucks, medicare will be gone in 10 years anyway if you stick with Obama”, does not register with the average citizen.

  • adelinesdad

    “…Medicare worked well for her…”

    Good for her. It won’t work for her grandchildren without changes to make it cost significantly less.

    “Roughly 6 in 10 likely voters in each state want Medicare to continue providing health insurance to older Americans the way it does today”

    I’ve got bad news for the 6 in 10: it can’t. For the record, 6 in 10 said “Medicare should continue as it is” as opposed to “Medicare should be changed”. Some issues can’t be decided by polls. There is a right and a wrong answer to that question. The wrong answer is still wrong no matter how many people choose it.

    The same poll says that 7 in 10 people support voter ID. I’m not dismissing the poll. It has political consequences. But, in terms of what is good and bad policy, it means little.

    Link to actual poll (I’ve learned the hard way not to trust summaries):

  • adelinesdad

    Correcting myself: “Medicare should be changed” appears to be a summary answer for “Medicare should be changed to a system in which the government would
    provide seniors with a fixed amount of money toward purchasing private health
    insurance or Medicare insurance.”

    So, I stand corrected on that point. I’d argue that the summary answers do not adequately reflect the choices. If the summary answers were actually presented to the respondents, I’d argue the question is confusing. But anyway, my points about polls and policy, and the voter ID question results, still stand.

  • petew

    Hey adelinesdad,

    whether or not Medicare can continue in the future unchanged, is a good point. But the fact that most retirees do not think Ryan’s plan will help seniors as much as the GOP claims, can’t help but be good for Obama.

    It’s not like Obama has been refusing to place the issue of entitlements on the table, it’s that no overture he makes to Republicans will ever be acceptable because (Good heavens) that might actually make Obama look good. Instead of their mantra being, “jobs…jobs…jobs etc. they are really making it about,…obstruction…obstruction…obstruction.

    It’s true that changes in benefits or how they are collected, may have to change in the future, but I think voters are responding to the President’s proposals more favorably because, they know he is not out to use a chain saw to make such tweaks. They also understand that he is more in touch than Mitt when it comes to understanding what the middle class is going through.

    Considering the fact that Obama has met incredible resistance every step of the way, it is downright miraculous that our economy is doing as well as it is! voters are also becoming aware that the huge cuts and avoidance of raising revenues for even the wealthiest among us, will not benefit them, and, in fact, amounts to throwing our Government’s safety nets under the bus. I don’t think that the middle class will go along with Mitt and Paul, and, in many ways, they have become more aware of the potential risks than other groups of voters.

  • RP

    This is a actuarial opinion on the report provided on the Medicare program. Please read the 2-3 page report and note they do not beleive the information the government provided them to be attainable and therefore will not give the program a clean report.

    The question for voters is “Do you want a government that lies so they get the results they desire or a government that tells you the truth so you are not screwed in the future?”

    Right now we at least have a discussion happening with a program that is going bust and Obama is lieing about when he talks of saving the program. He is just letting future administration worry about paying for this entitlement.

    Thats what this actuary is saying in a round about way and that is why they will not give it a clean report.

  • Rcoutme

    As far as I can tell, we as a nation are still not interested in looking at the situation from a macroeconomic point of view. That is not just short-sighted, it is engaging in a fantasy argument about a fantasy monster–with the two sides differing on just how to slay that dragon.

    What will be a reasonable amount to be spent on seniors and disabled (medically) in the future? No one starts with that question? You have GOT TO BE KIDDING!!! It matters very little how you plan to pay for something if you don’t even have a clue as to what the expenses will be given the various payment methods.

    Neither side is saying something such as, “Well, if we have seniors pay for all the costs themselves, then the life-expectancy would drop to thus and such and the total amount paid would be XYZ.” Then they need to give us the costs and benefits of their plans BASED ON WHAT WILL BE PAID–REGARDLESS OF WHO PAYS, but very much in regards to how it gets paid (as the consequences will be very, very different).

    I just went through an operation to remove a part of my kidney (cancer). I am home and recovering. I can not imagine what kind of pain I would be in if I were on the street, having been left there by some hospital because I was a homeless dude who they had had to treat! My family would likely have found some way to pay for my operation had Medicare not covered it. That would NOT BE TRUE for all people who need similar operations; thus the outcome based on who pays (and how much) greatly affects both the costs (those who simply have no way to afford it don’t get it) and benefits (death for those w/o the ability to obtain the necessary health care).

    The data ought to be chartable (don’t ask me to do it, I have CFIDS and just went through a major operation). We could all then look at various options and decide, as a nation, just where we want to fit in with all of this. If some politicians have ways to create efficiencies, those can be tweaked to determine how that will affect our results as well. When certain assumptions are questioned, present both sets of data. In other words, If Ryan’s Fantasy comes true, vs., primary assumption of 85% of the economists, vs doomsayers who hate Ryan and there assumptions. Three columns easy to read and contrast and compare.

    Anything else is trying to figure out how to slay that dragon. I suggested two +5 daggers, but my son thinks that using a +3 bastard sword of dragon slaying is better. What do you think?

    • DR. CLARISSA PINKOLA ESTÉS, Managing Editor of TMV, and Columnist

      Rcoutme, my family and i are holding you in prayer for recovery and strength and healing. That’s a promise. Hang in there. If you can comment on current affairs, you’re doing good …keep going.

      archangel/ dr.e

  • Rcoutme

    A couple of more thoughts. In a macroeconomic point of view, it looks as if Obama plans to try to get the same services but lowering how much of the GDP it will consume. Reducing the payment that current providers obtain in the future is equivalent to reducing the GDP portion of the sector.

    Ryan’s plan appears to plan on reducing services. Specifically, Ryan’s plan would make the recipients of the services pay out of pocket to keep the same coverage. Since it is unlikely that all seniors (and disabled) will be capable of doing so, Ryan’s plan, by definition, is a reduction in services.

    Either way, both plans are based in that fantasy game I was talking about.

  • adelinesdad


    I agree that the poll has political implications. My caution was against using it as a stick to say “policy X is bad.” I suppose that should go without saying but I think too often we get caught up in that.

  • adelinesdad


    It is quite remarkable that they said:

    The Trustees believe that this outcome, while plausible, will
    depend on the achievement of unprecedented improvements in health
    care provider productivity. If the health sector could not transition to more efficient models of care delivery and achieve productivity
    increases commensurate with economy-wide productivity, and if the
    provider reimbursement rates paid by commercial insurers continued
    to follow the same negotiated process used to date, then the
    availability and quality of health care received by Medicare
    beneficiaries relative to that received by those with private health
    insurance would fall over time
    , generating pressure to modify
    Medicare’s payment rates.

    (emphasis added)

    So much for the spending reductions not affecting beneficiaries, as we’ve been told Republicans keep lying about.

  • adelinesdad


    A complication to the approach you suggest is that the total amount that it will cost does partly depend on the mechanism for paying for it, and how much it depends on it depends on ideology. Liberals believe that government will coordinate efficiencies (an assumption the Trustees are skeptical about as RP’s link points out) while conservatives think the market will (which is arguably equally faith-based since private insurance markets have not shown much efficiency in the past). The only advantage the most recent Ryan premium support/voucher plan has is that if it doesn’t work to create efficiency, at least the government still pays as opposed to rationing (“the
    availability and quality of health care received by Medicare
    beneficiaries relative to that received by those with private health
    insurance would fall over time”).

    Still, I think the numbers you are looking for generally are provided by the CBO and other sources, usually by extrapolating costs out into the future based on historical growth in medical costs. For example, they did score Ryan’s initial proposal and determined how much the government would pay and how much individuals would pay (far too much), which implies that they had an estimate for how much care would cost over-all. I don’t believe they have scored Ryan’s most recent plan which would tie the value of the premium support/voucher to the cost of the plans in the marketplace, which, as I said, would put the government on the hook for any failure of the marketplace to create efficiencies.

  • adelinesdad


    I didn’t see your follow-up. I think an argument can be made that you have it backwards. Reducing payments to providers and hospitals may result in reduced services as the Trustee’s worry. Ryan’s (most recent) plan ties the value of the voucher to the cost of the second lowest competing plan (this is the technical definition of “premium support” as opposed to “voucher” which is fixed, I’m told) which all must meet a minimum standard* of coverage. That means that standard is guaranteed at no extra cost to the patient. The government is on the hook, in that case.

    *The minimum standard is that it must be actuarially equivalent to Medicare, a standard which I think is not quite high enough: The standard should be that it covers exactly what Medicare covers or more, so that would need to be fixed.

  • RP

    Why can’t politicians have the same type conversation about Medicare like the comments above and not use scare tactics to win votes?

    Thanks to Ryan some are starting to pay attention to the details and not accepting the junk fed to us by the political consultants.

  • petew

    adelinesad and Rcoutme,

    I won’t pretend that both of you aren’t talking over my head and that I am able to follow your points without great difficulty. But there is one statement made by adelinesad, about liberals believing in “coordinating inefficiencies.”–Am I right to assume that a couple of examples of this are

    1. the attempt to use the individual mandate as a means to add payments made into the system when beneficiaries are young, so that they, being relatively healthy, would enable the Government to divert more funds into the care of the elderly? I believe that Ryan’s plan also has a similar provision.

    2.Doesn’t the government plan to examine all of the ways that medical care could be managed more efficiently, such as by transferring the data into a digital systems and rewarding Dr.s for outcomes rather than the number of tests they administer–sometimes only through fear of possible malpractice suits anyway.

    I know many have scoffed at the gullibility of Democrats who think slick methods of streamlining and delivering care more efficiently are only theoretical pipe dreams. But, I understand that the Government has engaged in long term studies of health care systems which have worked successfully in many parts of the country and that there is a bounty of good ideas out there–ones that can be emulated. Ironically one of these is Romney’s universal health care for those in Massachusetts which first established health care availability for all, and then worked on finding ways to deliver that health care cheaply and efficiently so that the costs could be reduced. I understand that they have been greatly successful in that quest and, that the costs of health care for individuals in Massachusetts, has fallen quite a bit.

    So getting back to the statement of “Democrats believe that government can coordinate inefficiencies,” that seems to be delivered by you with much skepticism. On the contrary! I have heard that much of it works and has resulted in solid success in different parts of the country over the years. I have also heard of large clinics which pay their Dr.s a fixed salary for their collective efforts. This challenges the common notion that Doctors are only in it for the money and care very little for patients. But just the opposite may most likely be the case. The fact seems instead, that most Doctors do not put themselves through the financial and mental crucible required to learn their professions and, they don’t endure eight years of expensive higher education, for lack of idealism. Naturally they care about their patients because the work they do, can only be done by an elite few and, is nothing like picking up a trade such as, plumbing,or bricklaying. I assume that the salaries paid by the previously mentioned clinics were quite a bit less than some Doctors earn, but I am also sure that it provided them with a very comfortable living.

    Anyway, many facilities have succeeded with many innovations that had at first, been met with skepticism. And remember the ACA is only a blueprint that can accommodate many tweaks and adjustments. Perhaps it is not as efficient as a single payer government system, but I am impressed that Obama was even able to accomplish something even this good–providing about 30 million Americans the dignity of affordable health care. this is all impressive because in the past, any serious attempt to diminish the power of the insurance and pharmaceutical industries has been met with utter and complete resistance!

    Are these points relevant so some of the issues you are discussing? Please comment and let me know. Maybe I’m barking up the wrong tree but these are also points worth discussing.

  • adelinesdad


    Thanks for your comments and questions. Firstly, I said that liberals believe that government can “coordinate efficiencies” not “inefficiencies”. Your misreading (it happens to all of us) may be making that statement sound more sarcastic and dismissive than I intended it to be.

    I don’t have any problem with trying to find efficiencies. I don’t know if or how the individual mandate plays into Medicare spending, but yes, what I had is mind is certain efforts such as moving away from pay-for-service using such things as Accountable Care Organizations. My understanding is that there is a lot in the bill that encourages efficiencies in Medicare. I don’t know the details of all of the provisions, but my intent is not to say that none of them will work. I assume very smart people more knowledgeable than I worked very hard to come up with ideas that had been in the works for a long time. I support those efforts in general.

    My problem is with how they are used in the context of ACA. I have two problems with it:

    1) The efficiency efforts are paired with large cuts to provider and hospital reimbursements. If, as the Medicare trustees worry, the efficiencies don’t pay off in an “unprecedented” way, we will be left with two options, both of which are problematic: First, providers may choose to not take Medicare patients or provide them with substandard care in order to make up for the shortfall. That means seniors have less access to quality care. Or, as the trustees suggest, lawmakers may decide to wave the steep cuts and pay providers and hospitals more. But, in that case, the full savings are not realized, calling into question whether the ACA was ever really deficit neutral. I’m for finding efficiencies, but I’m not for *assuming* those efficiencies will work in order to make the accounting work out, which leads me to my second problem:

    2) Since Medicare is probably our largest fiscal concern going into the future, any savings that can be found in Medicare should be not be used to justify other spending, but should used to make Medicare more solvent. The way the bill is structured means that, effectively, the money is taken out of Medicare to pay for new spending.

    Related to the second reason is an argument I’ve only heard made by Greg Mankiw:

    Some people will immediately discredit anything Mankiw says. I think his argument, in this case, is worth considering on the merits. The argument is that “deficit neutral” does not necessarily imply “fiscally sound”. As it relates to the Medicare efficiencies, what it means is that we should try to get those efficiencies, but then not use those savings to justify spending on something else, and I’d add, particularly not if those savings have not yet been realized and might not be.

    That’s why I don’t see the Ryan Medicare plan as hypocritical as others do. Yes, he includes the efficiency programs, but he doesn’t turn around and spend them elsewhere, which for me is the key point.

  • adelinesdad

    Sorry for the incorrect italics. Hopefully I didn’t mess up the thread.

  • Anna


    Ryan’s plan may not take the money saved from efficiencies and spend it elsewhere, but instead gives it back to the wealthy in tax cuts. Obama’s may be “deficit neutral” but Ryan’s would blow up the deficit further. I find that Republicans tend to only care about the deficit when we have a Democrat in the White House. When there is a Republican in the White House, they put drunken sailors to shame, which IMHO is extremely hypocritical.

  • DORIAN DE WIND, Military Affairs Columnist


    Having gone through similar health problems (and major surgery), let me second Dr. E. and also wish you well.

    It sounds like Medicare has helped you out. I am with you, I can not imagine being in similar situations and having no Medicare, no insurance, no financial resources.

    Setting aside all the nuanced, sophisticated, “informed” debates about healthcare in America (and I know this will be seen as a rash, naive, unintellectual, emotional statement and attitude), I wish Americans — who have found ways to rebuild Europe after World War II, who have managed to land on the moon, who have rationalized spending trillions on unnecessary wars) would find it in their hearts to find a way — and the money — to adequately take care of our indigent and elderly fellow Americans.

  • SteveK

    I wish Americans — who have found ways to rebuild Europe after World War II, who have managed to land on the moon, who have rationalized spending trillions on unnecessary wars) would find it in their hearts to find a way — and the money — to adequately take care of our indigent and elderly fellow Americans.

    Well said Dorian funny we as a nation can spend $1.45 TRILLION on a fighter but we can’t take care of our citizenry.

    Exclusive: U.S. sees lifetime cost of F-35 fighter at $1.45 trillion

    The new baseline forecasts the average cost of the F-35 fighter, including research and development (R&D) and inflation, at $135 million per plane, plus an additional $26 million for the F135 engine built by Pratt & Whitney, a unit of United Technologies Corp.

    Notice how they’re separating the cost of the engine from the cost of the plane? TOTAL COST – $161 million EACH and we’re buying 2,443 of them!

  • adelinesdad

    Ana: “Ryan’s plan may not take the money saved from efficiencies and spend it elsewhere, but instead gives it back to the wealthy in tax cuts.”

    That’s a fair point. I was referring specifically to Ryan’s Medicare plan independent of his tax plan, but in retrospect maybe that isn’t a fair comparison.

    In any case, I reserve the right to agree with parts of Ryan’s plan without endorsing all of it, just as I agree with parts of Obamacare but don’t endorse all of it.

    I’ve been thinking about a compromise along these lines, and possibly even submitting a guest post detailing this proposal. Yea or Nay?

    Keep Obamacare, but scaled back such that the insurance subsidy and mandate is only for catastrophic coverage (50% actuarial value instead of 70%), thus reducing its cost.

    Pass Ryan’s Medicare plan, the revised one that keeps the voucher in line with actual costs (phased in gradually)

    Restore Clinton-Era tax rates for *all* income levels (phased in gradually)

  • Rcoutme

    Still a little groggy and blurry-eyed, I am going to try to see if I can clarify. I realize that the CBO uses the figures that I suggested we all needed to debate. I know that who pays and for what matters a great deal and affects how much.

    What I was specifically trying to point out is that, from a macroeconomic point of view, we need to determine what rationing we need. If Medicare will be too expensive for the Federal Government (and states) [hereafter referred to as the government], then it will, by definition, be too expensive to treat old people with the same medical care regardless of who pays. Goods and services, for the most part, can not be stored up in order to take care of the people who will need them in the future. Dr. E. has no more capacity AT THIS TIME to currently counsel the victim of a mass shooting that will take place in 2024 than a doctor has to treat someone right now who will have a broken hip that year. Thus, the real dilemma is not how something will be paid for. If we believe that Medicare is going to be insufficient to cover the needed costs, then we are really saying that society can not cover those costs.

    As I said in a previous article, if in 30 years four people were going to be required to provide all the goods and services of 330 million people in the US, then the problem will be one of efficiency. We certainly would not have a problem as to how to cut the paychecks! The same is going to be true of Medicare in thirty years. If the expenses are going to spiral out of control to the point where the government can not afford them–well then neither will the private citizens be able to do so! Otherwise, we would only need to tax the private citizens (the ones paying out of pocket) the same amount as we would otherwise have them pay privately.

    Thus: Ryan’s plan is one of rationing. The only caveat is that Ryan is building into the model the means of rationing that care–i.e. private wealth. Obama seems to believe that the accumulation of private wealth should not determine whether or not one gets the same quality of care. Thus, he seeks to ration the care by making those providing it come up with efficiencies in order to remain in business, I guess.

    Either way, how much care are we going to be capable of providing? Are we, as a nation, going to allow the so-called Social Darwinism of private wealth determine the quality, quantity, and (ultimately) effectiveness of health care services to rule the day? If we plan to use a combination of 1) ability to pay and 2) need; to determine who gets what care, then we need to realize that that is what we are debating.

    So, to summarize: if the government can not (ever) afford something (like future Medicare) then the country, and by extension society can not afford it.

    Reason: The government can always pay the bill, the only question is how much inflation we get for having the government pay that bill. That is the nature of fiat currency.

  • adelinesdad


    I think we might be talking past each other. I think I understand your point. Let me put it this way. There are two questions:

    1) How much will it cost for an acceptable level of care for elderly people, and how can we make that sustainable? (OK, that’s two questions there)
    2) Who will pay for it?

    Your point, I think, is that changing the answer to the second question isn’t going to somehow make the costs more sustainable. I get that. But…

    The difference between Obama’s and Ryan’s plan for Medicare is not of who pays, as it seems you think it is. In both plans, the government pays. The voucher you receive is tied to the cost of the competing plans, including existing Medicare, all of which must be comparable to Medicare. That means you are guaranteed to be able to purchase a plan comparable to Medicare using the voucher. This doesn’t appear to be understood, and in some cases I think willfully ignored by some of its critics.

    If we can get passed that, then we can get back to the first question, which you correctly argue is the more central question. To that point, I said:

    Liberals believe that government will coordinate efficiencies… while conservatives think the market will…

    That is the central debate and the principle difference between liberal and conservative approach to Medicare and health care in general. Would you agree? If so, I say, let’s do both. Leave the Medicare policies that ACA enacted in place to use carrots and sticks to make providers more efficient. At the same time, allow private insurers to offer comparable alternatives to seniors. If they can do if for cheaper, great. If not, the voucher will cover traditional Medicare and there is no harm done.

    By keeping the ACA efficiency policies regarding Medicare in place, and adding the voucher (aka premium support) on top of it, the Ryan plan essentially is that compromise.

  • Rcoutme

    A’s Dad: the amount that Medicare spends per patient goes up, not down, when that patient has a premium plan that he/she pays for. This suggests that the government is far better at keeping costs down than the private sector (although the correlations and actual figures may actually show an entirely different dynamic). Meanwhile, Ryan’s plan does not “leave current Medicare in place”. If it did that, the claim that he was switching it to vouchers would, in fact, be a bold-faced lie. However, for those getting Medicare for the first time after 2024(?), they do not have the option of getting what Medicare currently offers instead of taking a private plan. They will be forced into the private sector–with the corresponding reduction in payments to insurance providers garnering the ‘savings’ that Ryan claims.

  • adelinesdad


    Clearly with have a different view of the facts and as long as we do it’s hard to get beyond that to talk about what policies would or wouldn’t work.

    “the amount that Medicare spends per patient goes up, not down, when that patient has a premium plan that he/she pays for.”

    I’ve seen studies both ways on that. I don’t know if competition from the private market would make Medicare cost less, just as I don’t know if the efforts that ACA makes to the same end will work. My proposal is that we try both. But if you can make a convincing argument that private plans are likely to increase costs, that would be interesting information. However, even if they did, then the traditional Medicare option would be the cheapest and the voucher would cover it since it’s tied to the cost of the second cheapest option.

    “Meanwhile, Ryan’s plan does not “leave current Medicare in place”.

    I didn’t say that. I said it “keep[s] the ACA efficiency policies regarding Medicare in place” which is true and it’s a point Democrats have been bringing up in defense of those policies:

    “[T]hey do not have the option of getting what Medicare currently offers instead of taking a private plan.”

    Yes, they do: “Moreover, traditional Medicare will be one of the choices.”

  • ShannonLeee

    Great discussion everyone. I’ll just add this…. Germany allows wealthy people to pay for better health care by including private insurers into the system. Everyone in the country has “medicare”, but the rich can get “instacare” which is instant service by the best doctors.
    Everyone gets medical care…. Everyone.

  • petew


    Your idea about using Medicare only to pay for catastrophic illnesses is interesting , but for me it raises two important concerns. First of all, there are many people who cannot afford a simply checkup, let alone a more expensive procedure. Without adequate primary care many people will develop serious, or at least, more serious conditions, because they are undetected and unable to be treated.

    A second point is that when the populace develops more illnesses that they cannot afford to take care of, there will inevitably, be many more visits to the emergency room. This will drive up health care costs for everybody else, in order to make up for their unpaid care. These costs will cause the health care industry to race out of control costs once again.

    Efficient health care has been provided in many countries through the use of single payer government systems but we are too paranoid about threatening the insurance and pharmaceutical industries to make any real reforms. The President’s program may have many flaws and, in facts, may not be as successful as many single-payer system, but those of us who live in the land of plenty have been waiting for years to have the government attempt meaningful reforms of any kind. Let’s cut the government some slack and give this one a chance.

    It’s funny how Obama is hated among so many people who value every penny of their money, more than they value treating chronic illnesses in children, mothers and any other persons in need. “Ask not for whom the bell tolls, it tolls for you.”

  • adelinesdad


    “the main gist of my argument involves my inclination to trust liberal government rather than a government run by conservatives ”

    Fair enough. I don’t trust either of them and likely won’t be voting for either major candidate this time around. But I do see some merits in Ryan’s plan and can see some form of it in a workable compromise of sorts. Both sides, instead of demagoguing each other plans, should study and draw from them the parts that can work.

    “Your idea about using Medicare only to pay for catastrophic illnesses is interesting…”

    To clarify, my plan is to reduce ACA’s provisions (which apply to the non-elderly) to apply only to catrastrophic coverage, thus reducing its cost. I’m not proposing to change the level of coverage for Medicare. And of course helping to cover catastrophic illness would help the non-elderly afford supplemental plans which cover the rest, but I won’t pretend my plan is as generous as existing ACA, since the point is to reduce the cost of the program.

    On some other points we’ll have to agree to disagree. I just wanted to clarify what I’m proposing.

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