Ryan Plan Vs. ObamaCare?

[kiwiman127]

The inflation rate for health care has historically, has increased at a greater rate than the CPI.

And why do you think that is? That extraordinary inflation only happen after LBJ screwed with the health care system in this country. All the subsequent meddling in health care at the state and federal level (from Dem's and Re pubs alike) only made the situation worse. Limit real competition and prices go up.

If you look at the chart I posted with Post #10, the health care cost started rising faster than the CPI in the mid 80's, 20 years after LBJ. I'm not defending LBJ mind you, I'm just addressing your theory.

 

[eflatminor]

And of course both plans have insurance companies in the driver's seat.

You apparently have no clue about the health insurance industry. Do you realize health insurance companies have among the LOWEST profit margins among large corporations? It varies year to year but 3 to 5 percent is not uncommon. That too much for you? How about Apple, Inc.? Their iPhone has a profit margin of nearly 60%. Shall we nationalize them too? How about bottled water? 50 to 200 percent profit margins! Looks like we'll have to take them over too, eh?

 

[eflatminor]

the health care cost started rising faster than the CPI in the mid W's

Right about the time our governments really hit the accelerator on health care meddling.

 

[kiwiman127]

It doesn't screw seniors who are 55 or over....

With Obamacare....Medicare will go BROKE....very quickly....

then what....?

death panels to get rid of them...?

Ryan's plan doesn't screw over those over 55 but it screws those under 55 as the chart in a previous post clearly shows.
Ryan doesn't want to talk about it and neither do the supports of Ryan's plan, which is basically corporate welfare for the health care insurance industry. They come out like bandits with Ryan's plan, while those who need health care insurance and who live on a fixed income get thrown under the bus.

yeah they don't get the free ride anymore but those under 55 still have time to plan and save for their old age....

however with BOcare.... BOTH those under AND over 55 get screwed....Medicare will no longer exist...

Way to address the biggest problem with Ryan's plan and why pushing this plan will kill the GOP in 2012. This plan, pure and simple throws the elderly on fix incomes under the bus. Being as that classification basically includes the working middle class, we're talking about millions and millions of people. And these are the same people who have seen very little is any wage growth in the last 30 years in Real Dollars.

REAL WAGES
1964-2004
Average Weekly Earnings (in 1982 constant dollars)
For all private nonfarm workers
Year Real $ Change
1964 302.52
1965 310.46 2.62%
1966 312.83 0.76%
1967 311.30 -0.49%
1968 315.37 1.31%
1969 316.93 0.49%
1970 312.94 -1.26%
1971 318.05 1.63%
1972 331.59 4.26%
1973 331.39 -0.06%
1974 314.94 -4.96%
1975 305.16 -3.11%
1976 309.61 1.46%
1977 310.99 0.45%
1978 310.41 -0.19%
1979 298.87 -3.72%
1980 281.27 -5.89%
1981 277.35 -1.39%
1982 272.74 -1.66%
1983 277.50 1.75%
1984 279.22 0.62%
1985 276.23 -1.07%
1986 276.11 -0.04%
1987 272.88 -1.17%
1988 270.32 -0.94%
1989 267.27 -1.13%
1990 262.43 -1.81%
1991 258.34 -1.56%
1992 257.95 -0.15%
1993 258.12 0.07%
1994 259.97 0.72%
1995 258.43 -0.59%
1996 259.58 0.44%
1997 265.22 2.17%
1998 271.87 2.51%
1999 274.64 1.02%
2000 275.62 0.36%
2001 275.38 -0.09%
2002 278.91 1.28%
2003 279.94 0.37%
2004 277.57 -0.84%

Source: U.S. Bureau of Labor Statistics

So you're in favor of the continuation of the screwing over the working middle class?

 

[ScreamingEagle]

Ryan's plan doesn't screw over those over 55 but it screws those under 55 as the chart in a previous post clearly shows.
Ryan doesn't want to talk about it and neither do the supports of Ryan's plan, which is basically corporate welfare for the health care insurance industry. They come out like bandits with Ryan's plan, while those who need health care insurance and who live on a fixed income get thrown under the bus.

yeah they don't get the free ride anymore but those under 55 still have time to plan and save for their old age....

however with BOcare.... BOTH those under AND over 55 get screwed....Medicare will no longer exist...

Way to address the biggest problem with Ryan's plan and why pushing this plan will kill the GOP in 2012. This plan, pure and simple throws the elderly on fix incomes under the bus. Being as that classification basically includes the working middle class, we're talking about millions and millions of people. And these are the same people who have seen very little is any wage growth in the last 30 years in Real Dollars.

REAL WAGES
1964-2004
Average Weekly Earnings (in 1982 constant dollars)
For all private nonfarm workers
Year Real $ Change
1964 302.52
1965 310.46 2.62%
1966 312.83 0.76%
1967 311.30 -0.49%
1968 315.37 1.31%
1969 316.93 0.49%
1970 312.94 -1.26%
1971 318.05 1.63%
1972 331.59 4.26%
1973 331.39 -0.06%
1974 314.94 -4.96%
1975 305.16 -3.11%
1976 309.61 1.46%
1977 310.99 0.45%
1978 310.41 -0.19%
1979 298.87 -3.72%
1980 281.27 -5.89%
1981 277.35 -1.39%
1982 272.74 -1.66%
1983 277.50 1.75%
1984 279.22 0.62%
1985 276.23 -1.07%
1986 276.11 -0.04%
1987 272.88 -1.17%
1988 270.32 -0.94%
1989 267.27 -1.13%
1990 262.43 -1.81%
1991 258.34 -1.56%
1992 257.95 -0.15%
1993 258.12 0.07%
1994 259.97 0.72%
1995 258.43 -0.59%
1996 259.58 0.44%
1997 265.22 2.17%
1998 271.87 2.51%
1999 274.64 1.02%
2000 275.62 0.36%
2001 275.38 -0.09%
2002 278.91 1.28%
2003 279.94 0.37%
2004 277.57 -0.84%

Source: U.S. Bureau of Labor Statistics

So you're in favor of the continuation of the screwing over the working middle class?

That's what you *whine* call it...

I call it a change for the better.....for people to start paying for their own health care....individual responsibility vs. nannycare.....this approach will help begin the bringing down of prices when our "free" market is actually set free...

 

[kiwiman127]

And of course both plans have insurance companies in the driver's seat.

You apparently have no clue about the health insurance industry. Do you realize health insurance companies have among the LOWEST profit margins among large corporations? It varies year to year but 3 to 5 percent is not uncommon. That too much for you? How about Apple, Inc.? Their iPhone has a profit margin of nearly 60%. Shall we nationalize them too? How about bottled water? 50 to 200 percent profit margins! Looks like we'll have to take them over too, eh?

If the health care industry held down their administrative and marketing costs, then they'd realize higher profit margins. And then there's the poor CEO's salaries.
No one can tell me that the health care industry couldn't increase their profit margins by ending needless bureaucracy.
Finally, your NOT defending those who will be forced to give up their new Ryan's Medicare because they won't be able to afford it after their rates climb at a much higher rate than their fixed income.
Why is it that the defenders of Ryancare avoid that question?

 

[kiwiman127]

yeah they don't get the free ride anymore but those under 55 still have time to plan and save for their old age....

however with BOcare.... BOTH those under AND over 55 get screwed....Medicare will no longer exist...

Way to address the biggest problem with Ryan's plan and why pushing this plan will kill the GOP in 2012. This plan, pure and simple throws the elderly on fix incomes under the bus. Being as that classification basically includes the working middle class, we're talking about millions and millions of people. And these are the same people who have seen very little is any wage growth in the last 30 years in Real Dollars.

REAL WAGES
1964-2004
Average Weekly Earnings (in 1982 constant dollars)
For all private nonfarm workers
Year Real $ Change
1964 302.52
1965 310.46 2.62%
1966 312.83 0.76%
1967 311.30 -0.49%
1968 315.37 1.31%
1969 316.93 0.49%
1970 312.94 -1.26%
1971 318.05 1.63%
1972 331.59 4.26%
1973 331.39 -0.06%
1974 314.94 -4.96%
1975 305.16 -3.11%
1976 309.61 1.46%
1977 310.99 0.45%
1978 310.41 -0.19%
1979 298.87 -3.72%
1980 281.27 -5.89%
1981 277.35 -1.39%
1982 272.74 -1.66%
1983 277.50 1.75%
1984 279.22 0.62%
1985 276.23 -1.07%
1986 276.11 -0.04%
1987 272.88 -1.17%
1988 270.32 -0.94%
1989 267.27 -1.13%
1990 262.43 -1.81%
1991 258.34 -1.56%
1992 257.95 -0.15%
1993 258.12 0.07%
1994 259.97 0.72%
1995 258.43 -0.59%
1996 259.58 0.44%
1997 265.22 2.17%
1998 271.87 2.51%
1999 274.64 1.02%
2000 275.62 0.36%
2001 275.38 -0.09%
2002 278.91 1.28%
2003 279.94 0.37%
2004 277.57 -0.84%

Source: U.S. Bureau of Labor Statistics

So you're in favor of the continuation of the screwing over the working middle class?

That's what you *whine* call it...

I call it a change for the better.....for people to start paying for their own health care....individual responsibility vs. nannycare.....this approach will help begin the bringing down of prices when our "free" market is actually set free...

Yeah, a "free market" has a factual history of bringing down the health care costs? We have had a free market approach for years and look at the cost of health care versus overall inflation. Health care insurance has gone up over 125% in the last ten years.

 

[eflatminor]

[/QUOTE] We have had a free market approach for years and look at the cost of health care versus overall inflation.[/QUOTE]

Yea, the introduction of Medicare back in the mid 60s...that was quite the free market approach. How about state departments of insurance telling carriers what they can charge, who they must cover, etc. That's been going on for many years. That also a free market approach? How about Bush's prescription drug plan? Free market or federal meddling?

You're either stupid or terribly ignorant.

 

[eflatminor]

If the health care industry held down their administrative and marketing costs, then they'd realize higher profit margins. And then there's the poor CEO's salaries.
No one can tell me that the health care industry couldn't increase their profit margins by ending needless bureaucracy.
Finally, your NOT defending those who will be forced to give up their new Ryan's Medicare because they won't be able to afford it after their rates climb at a much higher rate than their fixed income.
Why is it that the defenders of Ryancare avoid that question?

Health insurance company CEO salaries are not only in line with corporations of similar size, they then to be quite a bit lower. So, you're wrong once again.

Ending bureaucracy? Did you really say that?! Any needless bureaucracy in insurance companies is there because a state or the federal government mandates it. NO corporation engages in needless red tape if they have any competitors.

Lastly, with a free market approach and more competition, the rate of inflation in health care will fall. Why? Because competition free from government meddling always results in lower prices. Always.

You really want to tackle inflation, fine, end the Fed, but that's another topic for another day.

 

[ScreamingEagle]

And of course both plans have insurance companies in the driver's seat.

You apparently have no clue about the health insurance industry. Do you realize health insurance companies have among the LOWEST profit margins among large corporations? It varies year to year but 3 to 5 percent is not uncommon. That too much for you? How about Apple, Inc.? Their iPhone has a profit margin of nearly 60%. Shall we nationalize them too? How about bottled water? 50 to 200 percent profit margins! Looks like we'll have to take them over too, eh?

If the health care industry held down their administrative and marketing costs, then they'd realize higher profit margins. And then there's the poor CEO's salaries.
No one can tell me that the health care industry couldn't increase their profit margins by ending needless bureaucracy.

Finally, your NOT defending those who will be forced to give up their new Ryan's Medicare because they won't be able to afford it after their rates climb at a much higher rate than their fixed income.
Why is it that the defenders of Ryancare avoid that question?

as i pointed out before..."administrative costs" are not the big deal in costs.....state-mandated "emergency care" is....which sucks up the bucks big time...
besides if we got rid of most government meddling the health care industry could get rid of LOTS of "needless bureaucracy"...and your aforementioned "administrative costs"...

no... they would not be forced to "give up" Ryan's Medicare....what do you think the vouchers are for anyway? $11,000 inflation-adjusted dollars to spend on cars and vacations? they will get Medicare and sick or poor people would get bigger vouchers than healthy or rich people....

 

[kiwiman127]

You apparently have no clue about the health insurance industry. Do you realize health insurance companies have among the LOWEST profit margins among large corporations? It varies year to year but 3 to 5 percent is not uncommon. That too much for you? How about Apple, Inc.? Their iPhone has a profit margin of nearly 60%. Shall we nationalize them too? How about bottled water? 50 to 200 percent profit margins! Looks like we'll have to take them over too, eh?

If the health care industry held down their administrative and marketing costs, then they'd realize higher profit margins. And then there's the poor CEO's salaries.
No one can tell me that the health care industry couldn't increase their profit margins by ending needless bureaucracy.

Finally, your NOT defending those who will be forced to give up their new Ryan's Medicare because they won't be able to afford it after their rates climb at a much higher rate than their fixed income.
Why is it that the defenders of Ryancare avoid that question?

as i pointed out before..."administrative costs" are not the big deal in costs.....state-mandated "emergency care" is....which sucks up the bucks big time...
besides if we got rid of most government meddling the health care industry could get rid of LOTS of "needless bureaucracy"...and your aforementioned "administrative costs"...

no... they would not be forced to "give up" Ryan's Medicare....what do you think the vouchers are for anyway? $11,000 inflation-adjusted dollars to spend on cars and vacations? they will get Medicare and sick or poor people would get bigger vouchers than healthy or rich people....

The average administrative cost for private insurance companies is around 17%. If they lowered that by 5% that would mean an extra 5% profit margin.
Secondly (and I have posted this way too many times), the annual increases in the vouchers is based on the Consumer Price Index (CPI) which uses the annual total inflation rate. BUT, the inflation rate for health care has increased at a much higher rate than the CPI. So every year the Medicare recipient gets a (for the purpose of an example) 2% increase, while (again as an example) their health care insurance premium goes up 5%. After ten years, that a 50% increase out of the Medicare's recipient's pocket. Most are on fixed incomes that increase closer to the CPi.
Here's the graph I posted earlier to make my point.

 

[eflatminor]

If the health care industry held down their administrative and marketing costs, then they'd realize higher profit margins. And then there's the poor CEO's salaries.
No one can tell me that the health care industry couldn't increase their profit margins by ending needless bureaucracy.

Finally, your NOT defending those who will be forced to give up their new Ryan's Medicare because they won't be able to afford it after their rates climb at a much higher rate than their fixed income.
Why is it that the defenders of Ryancare avoid that question?

as i pointed out before..."administrative costs" are not the big deal in costs.....state-mandated "emergency care" is....which sucks up the bucks big time...
besides if we got rid of most government meddling the health care industry could get rid of LOTS of "needless bureaucracy"...and your aforementioned "administrative costs"...

no... they would not be forced to "give up" Ryan's Medicare....what do you think the vouchers are for anyway? $11,000 inflation-adjusted dollars to spend on cars and vacations? they will get Medicare and sick or poor people would get bigger vouchers than healthy or rich people....

The average administrative cost for private insurance companies is around 17%. If they lowered that by 5% that would mean an extra 5% profit margin.
Secondly (and I have posted this way too many times), the annual increases in the vouchers is based on the Consumer Price Index (CPI) which uses the annual total inflation rate. BUT, the inflation rate for health care has increased at a much higher rate than the CPI. So every year the Medicare recipient gets a (for the purpose of an example) 2% increase, while (again as an example) their health care insurance premium goes up 5%. After ten years, that a 50% increase out of the Medicare's recipient's pocket. Most are on fixed incomes that increase closer to the CPi.
Here's the graph I posted earlier to make my point.

That is a BRILLIANT plan! Just lower administrative cost by 5%, problem solved! I'm sure the industry will have NO problem keeping and attracting new workers with that plan. They probably pay them way more than they need to anyway...big corporations are known for overpaying their workers, right?

Now, one last time...of course " the inflation rate for health care has increased at a much higher rate than the CPI". Everybody knows this. The reason for that is state and federal government interference that restricts competition and increases dramatically the cost of doing business. In other words, it is the very existence of programs like Medicare (and hundreds of others) that drives costs ahead of inflation.

Of course before 1965 when LBJ launched the unconstitutional Medicare program, health care inflation was no big deal. But oh the horror...all those people dying in the streets. Oh wait, that never happened. Hmmmm....

 

[peach174]

If the health care industry held down their administrative and marketing costs, then they'd realize higher profit margins. And then there's the poor CEO's salaries.
No one can tell me that the health care industry couldn't increase their profit margins by ending needless bureaucracy.

Finally, your NOT defending those who will be forced to give up their new Ryan's Medicare because they won't be able to afford it after their rates climb at a much higher rate than their fixed income.
Why is it that the defenders of Ryancare avoid that question?

as i pointed out before..."administrative costs" are not the big deal in costs.....state-mandated "emergency care" is....which sucks up the bucks big time...
besides if we got rid of most government meddling the health care industry could get rid of LOTS of "needless bureaucracy"...and your aforementioned "administrative costs"...

no... they would not be forced to "give up" Ryan's Medicare....what do you think the vouchers are for anyway? $11,000 inflation-adjusted dollars to spend on cars and vacations? they will get Medicare and sick or poor people would get bigger vouchers than healthy or rich people....

The average administrative cost for private insurance companies is around 17%. If they lowered that by 5% that would mean an extra 5% profit margin.
Secondly (and I have posted this way too many times), the annual increases in the vouchers is based on the Consumer Price Index (CPI) which uses the annual total inflation rate. BUT, the inflation rate for health care has increased at a much higher rate than the CPI. So every year the Medicare recipient gets a (for the purpose of an example) 2% increase, while (again as an example) their health care insurance premium goes up 5%. After ten years, that a 50% increase out of the Medicare's recipient's pocket. Most are on fixed incomes that increase closer to the CPi.
Here's the graph I posted earlier to make my point.

And how many times do we keep telling you that Ryan's plan gives additional assistance for the lower incomes.
And that competition lowers the costs.
There is no competition now in the medicare plans, they are fixed by the government.

 

[eflatminor]

as i pointed out before..."administrative costs" are not the big deal in costs.....state-mandated "emergency care" is....which sucks up the bucks big time...
besides if we got rid of most government meddling the health care industry could get rid of LOTS of "needless bureaucracy"...and your aforementioned "administrative costs"...

no... they would not be forced to "give up" Ryan's Medicare....what do you think the vouchers are for anyway? $11,000 inflation-adjusted dollars to spend on cars and vacations? they will get Medicare and sick or poor people would get bigger vouchers than healthy or rich people....

The average administrative cost for private insurance companies is around 17%. If they lowered that by 5% that would mean an extra 5% profit margin.
Secondly (and I have posted this way too many times), the annual increases in the vouchers is based on the Consumer Price Index (CPI) which uses the annual total inflation rate. BUT, the inflation rate for health care has increased at a much higher rate than the CPI. So every year the Medicare recipient gets a (for the purpose of an example) 2% increase, while (again as an example) their health care insurance premium goes up 5%. After ten years, that a 50% increase out of the Medicare's recipient's pocket. Most are on fixed incomes that increase closer to the CPi.
Here's the graph I posted earlier to make my point.

And how many times do we keep telling you that Ryan's plan gives additional assistance for the lower incomes.
And that competition lowers the costs.
There is no competition now in the medicare plans, they are fixed by the government.

Sorry, your argument will carry no weight here as it is based in logic and reason. Stop that!

 

[kiwiman127]

as i pointed out before..."administrative costs" are not the big deal in costs.....state-mandated "emergency care" is....which sucks up the bucks big time...
besides if we got rid of most government meddling the health care industry could get rid of LOTS of "needless bureaucracy"...and your aforementioned "administrative costs"...

no... they would not be forced to "give up" Ryan's Medicare....what do you think the vouchers are for anyway? $11,000 inflation-adjusted dollars to spend on cars and vacations? they will get Medicare and sick or poor people would get bigger vouchers than healthy or rich people....

The average administrative cost for private insurance companies is around 17%. If they lowered that by 5% that would mean an extra 5% profit margin.
Secondly (and I have posted this way too many times), the annual increases in the vouchers is based on the Consumer Price Index (CPI) which uses the annual total inflation rate. BUT, the inflation rate for health care has increased at a much higher rate than the CPI. So every year the Medicare recipient gets a (for the purpose of an example) 2% increase, while (again as an example) their health care insurance premium goes up 5%. After ten years, that a 50% increase out of the Medicare's recipient's pocket. Most are on fixed incomes that increase closer to the CPi.
Here's the graph I posted earlier to make my point.

And how many times do we keep telling you that Ryan's plan gives additional assistance for the lower incomes.
And that competition lowers the costs.
There is no competition now in the medicare plans, they are fixed by the government.

OK, exactly how much support?
Here is a chart basd on a CBO study. So Ryan's plan is going to help the low income recipients. But how much? The CBO's study takes health care insurance's historical increases and figures that into 2022, when Ryancare would start and below is the graph.
If Ryancare gives the Medicare recipient the same percentage of increase Medicare would give them, we'd go further in debt as a country. My guess is it wouldn't, but if it did the recipient would have to cough up more than $6,000 and that's on a fixed budget.

 

[kiwiman127]

The average administrative cost for private insurance companies is around 17%. If they lowered that by 5% that would mean an extra 5% profit margin.
Secondly (and I have posted this way too many times), the annual increases in the vouchers is based on the Consumer Price Index (CPI) which uses the annual total inflation rate. BUT, the inflation rate for health care has increased at a much higher rate than the CPI. So every year the Medicare recipient gets a (for the purpose of an example) 2% increase, while (again as an example) their health care insurance premium goes up 5%. After ten years, that a 50% increase out of the Medicare's recipient's pocket. Most are on fixed incomes that increase closer to the CPi.
Here's the graph I posted earlier to make my point.

And how many times do we keep telling you that Ryan's plan gives additional assistance for the lower incomes.
And that competition lowers the costs.
There is no competition now in the medicare plans, they are fixed by the government.

Sorry, your argument will carry no weight here as it is based in logic and reason. Stop that!

Anybody who has run a successful business has cut unnecessary expenditures and redundant procedures to enhance their bottom-line. It's called Business Management 101.
The company I work for did exactly that and the financial bottom-line improved greatly to the point of bonuses for everyone.

 

[eflatminor]

The average administrative cost for private insurance companies is around 17%. If they lowered that by 5% that would mean an extra 5% profit margin.
Secondly (and I have posted this way too many times), the annual increases in the vouchers is based on the Consumer Price Index (CPI) which uses the annual total inflation rate. BUT, the inflation rate for health care has increased at a much higher rate than the CPI. So every year the Medicare recipient gets a (for the purpose of an example) 2% increase, while (again as an example) their health care insurance premium goes up 5%. After ten years, that a 50% increase out of the Medicare's recipient's pocket. Most are on fixed incomes that increase closer to the CPi.
Here's the graph I posted earlier to make my point.

And how many times do we keep telling you that Ryan's plan gives additional assistance for the lower incomes.
And that competition lowers the costs.
There is no competition now in the medicare plans, they are fixed by the government.

OK, exactly how much support?
Here is a chart basd on a CBO study. So Ryan's plan is going to help the low income recipients. But how much? The CBO's study takes health care insurance's historical increases and figures that into 2022, when Ryancare would start and below is the graph.
If Ryancare gives the Medicare recipient the same percentage of increase Medicare would give them, we'd go further in debt as a country. My guess is it wouldn't, but if it did the recipient would have to cough up more than $6,000 and that's on a fixed budget.

A recipient contribute to his own welfare? Noooooooooooooooooooooooooooo!!!!!

 

[eflatminor]

And how many times do we keep telling you that Ryan's plan gives additional assistance for the lower incomes.
And that competition lowers the costs.
There is no competition now in the medicare plans, they are fixed by the government.

Sorry, your argument will carry no weight here as it is based in logic and reason. Stop that!

Anybody who has run a successful business has cut unnecessary expenditures and redundant procedures to enhance their bottom-line. It's called Business Management 101.
The company I work for did exactly that and the financial bottom-line improved greatly to the point of bonuses for everyone.

And you have some evidence that health insurance companies spend unnecessarily and redundantly?

 

[Rozman]

Obamacare is not a tax.That's how the administration defended it.when States challenged it as unconstitutional the administration said it was a tax and the government was well within it's rights to impose it as such.

I can't see how anyone can defend the administration forcing it's citizens to purchase anything.
Also if this thing were any good why are so many getting waivers excusing them from having to purchase Obamacare.

 

[Greenbeard]

One of the most important topics in the country is healthcare. To be honest, I am not informed about both plans, and would love to have somebody inform me about the difference between the two.

What are you asking for? Dry policy detail or the philosophical difference between the Republican and Democratic approaches to Medicare? The philosophical differences are fairly straightforward.

The GOP, in its budget, expresses a very clear desire to just get out. They no longer want to concern themselves with paying the medical bills of seniors, they don't want to have to deal with utilization volatility or provider costs, they don't want to have to worry about the quality of care seniors are receiving or their level of access. All the features that make Medicare what it is and guarantee seniors a health benefit are on the chopping block. Instead they want a privatized, voucher-based system designed primarily to limit federal financial obligations, not to guarantee access to high quality care for seniors.

The alternative vision for Medicare is one of a healthier budget picture through a healthier Medicare program: that is, improve Medicare instead of ending it. That's a big task with a number of components. It's improving the tools available to clinicians who treat Medicare patients to enable more effective and efficient delivery of health care (e.g. by offering Medicare-participating doctors and hospitals financial assistance to start using electronic health records with built-in clinical decision support tools and the ability to support quality measurement).

That means changing the way Medicare pays for care to promote value, and ultimately changing the way care is delivered to facilitate more coordinated, patient-centered care. That means tackling the alarming prevalence of medical errors by using Medicare to spearhead a national patient safety initiative.

It means tackling the drivers of Medicare cost growth--notably, chronic conditions--by encouraging community-based prevention, supporting states as they pioneer new approaches to providing care to the costliest beneficiaries (including giving those states new tools for embracing advanced models of primary care aimed at improving care for those high-utilization, high-cost beneficiaries), and transitioning enrollees from institution-based long-term care to community-based care where possible.

Perhaps more importantly than any single one of those moves is the effort to institutionalize a culture of reform within Medicare by creating an internal body with the authority and the mandate to test other new models of payment and delivery to improve care and slow cost growth.

The GOP proposal doesn't do anything like that; there's no effort to improve Medicare, the delivery of care to beneficiaries, treatment of the costliest conditions, quality, patient-centeredness. None of that is of interest to the GOP because they're not interested in fixing Medicare's deficiencies, they're interested in scrapping the program and leaving behind an inadequate privatized derivative whose function has nothing to do with improving care for the nation's elderly.