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.
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?
