Myth #5: The House budget balances the budget on the backs of seniors.
Fact: Current and near-retirees are exempt from reforms.
Much of the attention given to the House budget has focused on the effects on retirees. However, virtually none of the $5.8 trillion in spending reductions in the first decade would affect Social Security and Medicare. In fact, seniors would benefit from averting the large tax increases planned in current law and from tax reforms that lower their rates while closing unneeded loopholes. Those currently older than age 55 would be exempt from any future changes to their Social Security and Medicare benefits.
Myth #6: The House budget would privatize Medicare and hand seniors vouchers.
Fact: Seniors would receive government support to purchase health insurance coverage on a tightly regulated government exchange system.
A “voucher” is usually a certificate of specified cash value that is redeemable for the purchase of goods or services. Under Ryan’s House budget plan, seniors would instead choose health plans and the government would make direct and adequate contributions to the premium cost of the plans of their choice. This “premium support” would go to Medicare-certified and -regulated plans that would compete in a Medicare “exchange,” which Ryan himself has described as “tightly regulated.”
In effect, this premium support system is broadly similar to the kind of system that Members of Congress and federal employees and retirees enjoy today in the widely popular and successful Federal Employees Health Benefits Program (FEHBP). As for “privatization,” virtually all participating Medicare doctors and hospitals (except public hospitals) are private, a quarter of all seniors are enrolled in private plans in Medicare Advantage, and 60 percent of seniors already purchase drug benefits through private plans in Medicare Part D. So, in effect, the House budget proposal extends the successful Part D financing model to the coverage of benefits under Parts A and B.[3]
Myth #7: Medicare is more efficient than private health insurance.
Fact: MedicareÂ’s administrative burdens are hidden and they outweigh private-sector costs.
On paper, Medicare’s administrative costs compared to the private sector appear comparatively small: 2–3 percent of benefit expenditures. Even accounting for radically different patient profiles and functions of Medicare and private insurance, administrative costs per person under Medicare compared to private insurance plans shows that Medicare’s administrative costs exceed those of private health insurance.[4]
Furthermore, MedicareÂ’s administrative costs do not include the enormous costs of provider compliance with massive Medicare red tape and paperwork. A 2001 PricewaterhouseCoopers study showed that for every hour spent treating a typical Medicare patient, hospital officials spent 30 minutes complying with Medicare paperwork.[5]
One administrative cost that is often overlooked is the tens of billions of dollars annually of Medicare waste, fraud, and abuse. In sheer volume, there is no comparable cost in the private sector or in the FEHBP. Private insurers have strong incentives to detect fraudulent claims, as undetected fraud hurts their bottom lines.
Myth #8: The House budget plan would end Medicare as we know it.
Fact: Obamacare ended Medicare as we know it.
Obamacare imposes record-breaking payment cuts for Medicare providers—plus an unprecedented hard cap on Medicare spending to be enforced by the newly created Independent Payments Advisory Board, an unelected board of bureaucrats empowered to lower provider payments to preordained levels indexed to inflation and economic growth. This will ensure rationing of care through provider payment cuts.[6]
Furthermore, under Section 3021 Congress tasks the new Center for Medicare and Medicaid Innovation with transitioning from the current fee-for-service reimbursement system toward capitated or salary-based reimbursements. This would literally be the end of traditional Medicare fee for service “as we know it.”
Both the House and Obama proposals impose external spending caps on Medicare. But the House proposal aims to control costs primarily through intense market competition—not just deeper payment cuts for Medicare providers—while preserving and enhancing the right of seniors to choose health care options.
Myth #9: The House budget plan would shift Medicaid costs to the states and hurt the poor.
Fact: Medicaid block grants would help states lower Medicaid costs and provide them with the flexibility to better serve the poor.
The House budget plan would remove the perverse incentives resulting from the open-ended federal reimbursement of state Medicaid spending. The block grant proposal would provide greater budget certainty at the federal and state levels. In addition, states would have greater flexibility and greater incentives to reduce costs. The proposal would also encourage states to spend their Medicaid dollars wisely and to consider innovative ways to deliver better care at lower costs.[7]
Myth #10: Most Medicare costs would continue to rise, and retirees would bear those costs with insufficient assistance.
Fact: Intense market competition would reduce costs and enable Medicare patients to secure value for their dollars.
Projecting far into the future, CBO predicts that under the House budget proposal the government’s share of retirees’ health care costs would decrease from currently about 70 percent to just 32 percent by 2030.[8] But that static analysis assumes that—despite a major change in economic incentives and intense market competition—health care costs will not be reduced. Behavioral responses to such powerful new economic incentives should not be ignored; experience with such changes proves otherwise.
10 Myths of Ryan's House Budget Plan | The Heritage Foundation
