Paul Ryan To Obama: Do Not Continue To "Mischaracterize" Medicare Plan

[EriktheRed]

The Republicans are losing on this issue.

No one wants to end Medicare, except Paul Ryan and his supporters. Then claiming that his plan is being mischaracterized, LOL! What a liar.

End it?? Oh no. They just want to change it to something that wouldn't provide near the amount of coverage older Americans currently enjoy while still calling it "Medicare".

 

[ElephantMcDonk]

Experts, please clarify Ryan's Medicare Plan in his budget.

Here's my question:

Say I'm currently 53 years old, plan goes into effect, fast forward 15 years, now I'm 68 subject to the new plan in place. I get Lung Cancer, caught fairly early. The expected cost for the following year to treat it is $275,000. Ryan says you can't get turned down for health insurance under his plan. How much of that cost comes out of my pocket? Then, let's say the cancer goes into remission and the average cost to cover someone in their late 60s, early 70s with that track record is $30,000 per year. How much does the government pay then vs how much I pay each year?

He keeps saying everyone is demagogueing his plan, but I don't know what the answer is to this. If the majority of the cost is to the patient that presents an interesting dilemma.

 

[The T]

Paul Ryan To Obama: Do Not Continue To "Mischaracterize" Medicare Plan


"I simply explained what our plan is, how it worked. It's been misdescribed by the president and many others, and so we simply described to him precisely what it is we've been proposing so that he hears from us how our proposal works so that in the future he won't mischaracterize it," Rep. Paul Ryan (R-Wis.) said after meeting with the president this morning.

Click here for video

Good for him...

 

[The T]

And you notice OBAMA has nothing to counter except rhetoric...

 

[ElephantMcDonk]

I'm still looking for an explanation. Say I'm an Independent on the fence and the explanation will do it for me. I recognize there are other flaws like suggesting a 2.8% unemployment rate at the end of the balancing project, but forget the other flaws for now. Just explain the Medicare part.

Let's say the plan is in effect 15 years from now. I'm a middle class or maybe slightly lower middle class person who has $200,000 in savings and have to live off of that and Social Security for the rest of my life and I'm 67. I find out I've got Lung Cancer. Average cost for a year of treatment, etc. is $275,000. How much is out of my pocket? Then it's in remission, average cost for a person in their late 60s, early 70s in that situation is $30,000 per year. I understand Ryan's plan gives an average of $7000 to each person in Medicare to buy their insurance. If most of that cost is not covered by Medicare, a person in that situation would be screwed. They wouldn't be able to afford health insurance. That's not rare. The two ways most people die in this country are cancer and heart disease. This will be a very common scenario.

 

[Trajan]

Paul Ryan To Obama: Do Not Continue To "Mischaracterize" Medicare Plan


"I simply explained what our plan is, how it worked. It's been misdescribed by the president and many others, and so we simply described to him precisely what it is we've been proposing so that he hears from us how our proposal works so that in the future he won't mischaracterize it," Rep. Paul Ryan (R-Wis.) said after meeting with the president this morning.

Click here for video

Ryan's medicare "plan", more like scheme, was doa. He needs to stop whining about it and get back to the drawing board.

whats the dem plan for saving entitlements, hc etc..?

 

[Trajan]

Paul Ryan To Obama: Do Not Continue To "Mischaracterize" Medicare Plan


"I simply explained what our plan is, how it worked. It's been misdescribed by the president and many others, and so we simply described to him precisely what it is we've been proposing so that he hears from us how our proposal works so that in the future he won't mischaracterize it," Rep. Paul Ryan (R-Wis.) said after meeting with the president this morning.

Click here for video

how come this meeting wasn't televised?

answer; because Obama got taken to school the last time....

It was the other way around..

and the world is flat...

 

[NYcarbineer]

No one wants to end Medicare, except Paul Ryan and his supporters. .

Yep

This is the mischaracterization.

Thanks Dumbfvck!

It ends Medicare. They might think that still callling it Medicare means otherwise, but it doesn't.

What cracks me up are all the working/middle class wingnuts on this forum supporting this killling of Medicare when they know darn well it would take a big bite out of their asses when they hit 65.

I say fine, make Medicare voluntary. You don't want it, great. You're out. Then when you're 65 you can take all that money you saved and go buy a private policy from a for-profit insurance company.

And while we're at it, to make you really happy, we'll repeal the Obama-care measures that required insurers to cover people with pre-existing conditions, since that is what you conservatives want, and,

we'll repeal the part about insurance companies not being able to drop you after you get sick. Since that's also what you conservatives want.

There. Happy? Have fun staying healthy out there in the 'free market'.

 

[ElephantMcDonk]

Does anyone have an answer to how insurance/Medicare works under Paul Ryan's Plan if you have an expensive condition? Who foots the bill? The average payment to the insurance companies from Medicare would be $7000, but what about the folks that have something expected to costs $100s of 1000s to treat, how would that work under Ryan's Plan. I'm still trying to understand this. I've heard Ryan explain his plan more than 10 times and I've read about it plenty. I still don't know the answer to this key question. For expensive projected treatments who pays? He says you can't get turned down, but an insurance company is a business. They're not going to take on a person at a loss, unless they socialize the cost. The socialized cost would either have to be the government taking it on or the insurance company. The other alternative would be most of the cost is up to the individual. That would be a big complication for anyone with expensive healthcare when they're older.

 

[Trajan]

Yep

This is the mischaracterization.

Thanks Dumbfvck!

It ends Medicare. They might think that still callling it Medicare means otherwise, but it doesn't.

What cracks me up are all the working/middle class wingnuts on this forum supporting this killling of Medicare when they know darn well it would take a big bite out of their asses when they hit 65.

I say fine, make Medicare voluntary. You don't want it, great. You're out. Then when you're 65 you can take all that money you saved and go buy a private policy from a for-profit insurance company.

And while we're at it, to make you really happy, we'll repeal the Obama-care measures that required insurers to cover people with pre-existing conditions, since that is what you conservatives want, and,

we'll repeal the part about insurance companies not being able to drop you after you get sick. Since that's also what you conservatives want.

There. Happy? Have fun staying healthy out there in the 'free market'.

I'll take that deal, in a heart beat.

 

[C_Clayton_Jones]

Thus far, the Democrats haven't offered much, other than to cap it in the health care reform bill.

Actually, no. The Reform Bill will in essence transform Medicare into a health insurance/ HMO hybrid. It also addresses prescription drugs, a significant component of Medicare costs:

Medicare will begin paying for annual wellness visits and increase reimbursements for primary care physicians. Currently Medicare only pays for a general checkup when someone first enters the program and many health analysts believe regular check ups would help improve the overall health of elderly people and provide for better coordination of care.

Also the bill provides for an improvement in the Medicare prescription drug program. The current program includes a significant coverage gap that the legislation will eventually close. Currently people fall into this so-called doughnut hole falls after a total $2,700 is spent on drugs. Coverage begins again after $6,154 is spent.

In 2010, people who fall into the doughnut hole will get a $250 rebate. In 2011, they will get a 50 percent discount on brand-name drugs. By 2020, the doughnut hole will have been closed and 75 percent of drug costs will be covered.

HOW DOES MEDICARE ACHIEVE OTHER SAVINGS?

The legislation aims to capture productivity savings in the health system to save Medicare money.

Studies have shown huge cost variations in different parts of the country with little difference in health outcomes. The legislation provides for Medicare to test payment systems that are thought to promote better coordination and efficiency of care while maintaining or improving the quality of care.

Lawmakers hope the program will save billions of dollars by avoiding duplication of services and by providing better coordination of care for people with chronic conditions. The main aim of these delivery system reforms is to reward a quality of care rather than a quantity of services.

The bill also establishes an independent payment advisory board that will make recommendations on how to save money in Medicare and extend the financial solvency of the program.

The bill also provides more money to fight Medicare fraud.

WHAT HAPPENS ON THE MEDICARE PAYROLL TAX?

Most taxpayers will not pay the higher Medicare payroll tax. The bill calls for raising the tax to 2.35 percent from the current 1.45 percent for individuals earning $200,000 or more and for couples earning $250,000 or more. The legislation would also apply the tax to some investment income for those high-income groups.

Q+A: How does healthcare overhaul affect Medicare? | Reuters

More:

http://www.commonwealthfund.org/~/m...an_how_hlt_reform_will_affect_Medicare_ib.pdf

 

[American Horse]

If they replace it with a voucher system, you're only going to be able to get a voucher for 8,000. If you have serious health issues, you're kinda screwed.

By the way, a hospital stay costs around 1 to 2 thousand dollars per night. You may be able to stay for a week.

And if you're 52 and fall and break a hip? Get out the gun and have someone shoot you, because the new voucher program won't even begin to cover the costs.

The "voucher" is not for direct expenses for healthcare. The purpose of the "voucher" is for payment in part or in full for health insurance premiums for insurance which will be required to meet the requirements for Medicare coverage in the same way as Part-D drug plans are designed to meet the needs of those on Medicare. There are a variety of different "Medigap" (supplement) and Drug (Part-d) plans accorded oversight by Medicare. The Medicare Ryan replacement plans will operate in the same way.

It is important to understand that presently Medicare is not a full coverage Health coverage plan. Elderly people who qualify because of age qualify for Medicare Part-A, which has been paid for by them by FICA deductions during their working years, and that only covers inpatient hospital services; they must pay for Part-B (doctors services, outpatient care, some preventative services), and to complete their coverage they need to purchase a supplemental insurance policy to pick up the 20% that A and B don't fully cover. After all that their coverage is not complete: they will need Part-D if they anticipate needing prescription drug coverage in the future.

An elderly person (excluded from the conventional insurance market at age 65 by law), according to their ability to pay already need to insure themselves with commercial insurance coverage over and above Part-A.

The Ryan plan will remove the part A & B from direct government pay and provide what has been called "premium assistance" to seniors to buy competitively offered insurance plans with a variety of standardized options.

The standardized Ryan plans will give elderly folks a choice of insurance company and various options in their menus of choices. The insurance companies will compete to provide the coverage based actuarially. No one will be able to be refused or canceled except for non payment of premiums. Those who fall through the cracks will be supported in their need for medical care by Medicaid.

 

[Greenbeard]

I'm still looking for an explanation. Say I'm an Independent on the fence and the explanation will do it for me. I recognize there are other flaws like suggesting a 2.8% unemployment rate at the end of the balancing project, but forget the other flaws for now. Just explain the Medicare part.

Let's say the plan is in effect 15 years from now. I'm a middle class or maybe slightly lower middle class person who has $200,000 in savings and have to live off of that and Social Security for the rest of my life and I'm 67. I find out I've got Lung Cancer. Average cost for a year of treatment, etc. is $275,000. How much is out of my pocket? Then it's in remission, average cost for a person in their late 60s, early 70s in that situation is $30,000 per year. I understand Ryan's plan gives an average of $7000 to each person in Medicare to buy their insurance. If most of that cost is not covered by Medicare, a person in that situation would be screwed. They wouldn't be able to afford health insurance. That's not rare. The two ways most people die in this country are cancer and heart disease. This will be a very common scenario.

If you're looking for a defense of the proposal from a supporter, you're unlikely to get anything other than platitudes and attacks on Democrats (they're taking their cues directly from Ryan himself on this one).

That said, the documents that have been publicly released about the Republican "plan" are vague and vacuous enough that it's impossible to answer your question with any certainty because it hinges on how insurers in the proposed Medicare exchange are allowed to behave. We know, as you pointed out, that a guaranteed issue rule is in effect so you can't be denied an insurance plan on the basis of having a pre-existing conditions.

According to the CBO analysis of what Ryan gave them, the proposal also sets up age rating bands so that insurers must charge everyone of a given age the same premium (though supposedly the value of the voucher "would vary with the health status of the beneficiary," which doesn't quite make sense if beneficiaries' premiums aren't determined by the risk associated with them but rather by the average risk of the rating band they fall into, but presumably that's just sloppy language; again, a detailed account of the proposal doesn't seem to be available).

So in your example, if you're 67 you'll get some set voucher amount--the voucher amount for a 65-year-old is apparently initially set at $8,000 (on average), and seems to tick up in some not-quite-defined way as you move up through the age rating bands. So maybe as a 67-year-old you can get $9,000. You then take that money into the Medicare exchange and look for an insurance plan. It's taken as a given that this won't cover even a majority of your premium (CBO pegs the average voucher as covering 39% of an insurance plan comparable to the current Medicare benefit in 2022) and that the value of the voucher won't grow as fast as your premiums.

The first question is what plan offerings look like and how exactly the rating rules work--are they relatively standardized to allow meaningful choice between competing options and must an insurer charge everyone of a certain age in its pool the same premium, or merely everyone of a given age choosing a given plan? That is, how much power do insurers have to segment risk, shuffling off the least healthy beneficiaries into a given insurance plan (i.e. the one with the treatment they need) and jacking up premiums to discourage enrollment--or perhaps just to bleed the beneficiary dry.

Once you've nailed down how premiums and plan/benefit offerings work, you need to figure out what restrictions the GOP plan puts on cost-sharing , annual/lifetime limits, etc. That is, how much of their costs can they put onto the shoulders of beneficiaries. I suspect there would be few or no restrictions on that--or most insurer practices, for that matter.

So, given the little information we have, it's not possible to say exactly what share of that figure you quote you would have to pay, other than "substantially more than you would under actual Medicare." The answer to your question of "who foots the bill" is simple: you do. Shifting costs to beneficiaries is in fact the only way the GOP proposal "saves" money (i.e. saves the federal government money--there is no serious attempt to address the actual cost of care). However, regarding some of the language you used, note that under the GOP proposal, no health care cost is covered by Medicare because Medicare no longer pays for the physician and hospital services of the elderly. Medicare as an insurer--a payer for seniors' health care consumption--would no longer exist.

 

[C_Clayton_Jones]

Does anyone have an answer to how insurance/Medicare works under Paul Ryan's Plan if you have an expensive condition?

You’ve already answered you own questions, just remove the question marks from your posts:

Ryan wants to give Medicare beneficiaries a voucher they can use to get coverage from a private insurance company. Initially, the vouchers would enable beneficiaries to get coverage comparable to what they have today. But the value of the vouchers would diminish over time. The Congressional Budget Office predicts that 65-year-olds would be paying 68 percent of their Medicare coverage costs by 2030, compared with 25 percent today.

What this means is that almost all Medicare beneficiaries would eventually be woefully underinsured, just as an estimated 25 million younger Americans already are and just as most of the nation’s elderly—the ones who could afford coverage at all—were before Medicare was enacted in 1965. (Most senior citizens had no health coverage before Medicare because insurance companies refused to sell it to them. That’s why it was so urgently needed.)

Are Seniors Paying Attention to Paul Ryan’s Plan for Medicare?

 

[Trajan]

I'm still looking for an explanation. Say I'm an Independent on the fence and the explanation will do it for me. I recognize there are other flaws like suggesting a 2.8% unemployment rate at the end of the balancing project, but forget the other flaws for now. Just explain the Medicare part.

Let's say the plan is in effect 15 years from now. I'm a middle class or maybe slightly lower middle class person who has $200,000 in savings and have to live off of that and Social Security for the rest of my life and I'm 67. I find out I've got Lung Cancer. Average cost for a year of treatment, etc. is $275,000. How much is out of my pocket? Then it's in remission, average cost for a person in their late 60s, early 70s in that situation is $30,000 per year. I understand Ryan's plan gives an average of $7000 to each person in Medicare to buy their insurance. If most of that cost is not covered by Medicare, a person in that situation would be screwed. They wouldn't be able to afford health insurance. That's not rare. The two ways most people die in this country are cancer and heart disease. This will be a very common scenario.

If you're looking for a defense of the proposal from a supporter, you're unlikely to get anything other than platitudes and attacks on Democrats (they're taking their cues directly from Ryan himself on this one).

That said, the documents that have been publicly released about the Republican "plan" are vague and vacuous enough that it's impossible to answer your question with any certainty because it hinges on how insurers in the proposed Medicare exchange are allowed to behave. We know, as you pointed out, that a guaranteed issue rule is in effect so you can't be denied an insurance plan on the basis of having a pre-existing conditions.

According to the CBO analysis of what Ryan gave them, the proposal also sets up age rating bands so that insurers must charge everyone of a given age the same premium (though supposedly the value of the voucher "would vary with the health status of the beneficiary," which doesn't quite make sense if beneficiaries' premiums aren't determined by the risk associated with them but rather by the average risk of the rating band they fall into, but presumably that's just sloppy language; again, a detailed account of the proposal doesn't seem to be available).

So in your example, if you're 67 you'll get some set voucher amount--the voucher amount for a 65-year-old is apparently initially set at $8,000 (on average), and seems to tick up in some not-quite-defined way as you move up through the age rating bands. So maybe as a 67-year-old you can get $9,000. You then take that money into the Medicare exchange and look for an insurance plan. It's taken as a given that this won't cover even a majority of your premium (CBO pegs the average voucher as covering 39% of an insurance plan comparable to the current Medicare benefit in 2022) and that the value of the voucher won't grow as fast as your premiums.

The first question is what plan offerings look like and how exactly the rating rules work--are they relatively standardized to allow meaningful choice between competing options and must an insurer charge everyone of a certain age in its pool the same premium, or merely everyone of a given age choosing a given plan? That is, how much power do insurers have to segment risk, shuffling off the least healthy beneficiaries into a given insurance plan (i.e. the one with the treatment they need) and jacking up premiums to discourage enrollment--or perhaps just to bleed the beneficiary dry.

Once you've nailed down how premiums and plan/benefit offerings work, you need to figure out what restrictions the GOP plan puts on cost-sharing , annual/lifetime limits, etc. That is, how much of their costs can they put onto the shoulders of beneficiaries. I suspect there would be few or no restrictions on that--or most insurer practices, for that matter.

So, given the little information we have, it's not possible to say exactly what share of that figure you quote you would have to pay, other than "substantially more than you would under actual Medicare." The answer to your question of "who foots the bill" is simple: you do. Shifting costs to beneficiaries is in fact the only way the GOP proposal "saves" money (i.e. saves the federal government money--there is no serious attempt to address the actual cost of care). However, regarding some of the language you used, note that under the GOP proposal, no health care cost is covered by Medicare because Medicare no longer pays for the physician and hospital services of the elderly. Medicare as an insurer--a payer for seniors' health care consumption--would no longer exist.

yes, because taxes don't count.

The 'you foot the bill' is vacuous nonsense and just more semantical dishonesty, the money to pay for his cancer sure or out-patient treatments whatever, has got to come from somewhere, its a philosophical matter of how that occurs from the git go..... but do carry on.


Oh and I agree though with this, I want to know as well;

Once you've nailed down how premiums and plan/benefit offerings work, you need to figure out what restrictions the GOP plan puts on cost-sharing , annual/lifetime limits, etc. That is, how much of their costs can they put onto the shoulders of beneficiaries. I suspect there would be few or no restrictions on that--or most insurer practices, for that matter.

and of course we need to see same from IPAB, agreed?

 

[jillian]

Paul Ryan To Obama: Do Not Continue To "Mischaracterize" Medicare Plan


"I simply explained what our plan is, how it worked. It's been misdescribed by the president and many others, and so we simply described to him precisely what it is we've been proposing so that he hears from us how our proposal works so that in the future he won't mischaracterize it," Rep. Paul Ryan (R-Wis.) said after meeting with the president this morning.

Click here for video

maybe ryan should stop lying and saying it isn't a voucher program or pretending it wouldn't kill medicare.

rightwingnuts always say you're lying when you tell the truth about them.

 

[Trajan]

Paul Ryan To Obama: Do Not Continue To "Mischaracterize" Medicare Plan


"I simply explained what our plan is, how it worked. It's been misdescribed by the president and many others, and so we simply described to him precisely what it is we've been proposing so that he hears from us how our proposal works so that in the future he won't mischaracterize it," Rep. Paul Ryan (R-Wis.) said after meeting with the president this morning.

Click here for video

maybe ryan should stop lying and saying it isn't a voucher program or pretending it wouldn't kill medicare.

rightwingnuts always say you're lying when you tell the truth about them.

yes of course becasue the leftwing nut loonies whatever are...... honest as they have a lock on the truth!!a 2 fer!

 

[Dr.Traveler]

A Republican complaining his plan is being mischaracterized? Man kharma is a ^}}€#£€€}

The only part Ryan got right is that we should devolve Medicare to the state level via block grant. There's a reason folks have started to turn on the GOP when this plan came along. Most of it is nonsense.

 

[American Cowboy]

And how do you think we are going to continue to pay for Medicare? And Social Security for that matter?

According to a recent analysis by the Congressional Budget Office, tax rates would have to increase by 90% to pay for projected spending in Medicare and Social Security through 2050.

As the population ages, the study says, the lowest tax rate on individual income will need to jump from 10% to 19%, the tax rate on incomes in the current 25% bracket will have to soar to 47%, and the highest rate could jump from 35% to 66%. To meet the accelerating cost of entitlements, the top corporate income tax rate also will likely need to increase from 35% to 66%.

Can you say job killer!!!

 

[auditor0007]

The Republicans are losing on this issue.

No one wants to end Medicare, except Paul Ryan and his supporters. Then claiming that his plan is being mischaracterized, LOL! What a liar.

Very few want to end Medicare for a voucher system. Doesn't matter if you're Democrat, Republican, or Independent. People understand how much of a cost will be put on each individual, and they also understand that a great many will never be able to afford it.

Now for the funny part. People who see this think that it means that those who can't afford it will be left without healthcare. But that is not what will happen. What will happen is that the government will be forced to step in and help those who cannot afford it, and we'll be right back where we are. This is why we just need to work on fixing the existing program. It works well, but it pays out for too many years. As I keep repeating, the simple answer is to raise the retirement age and make people cover themselves a few more years while they actually have the ability, and then give full benefits for the latter years.