The Democrats say presumptive Republican vice presidential candidate Paul Ryan’s reform plan will “end Medicare as we know it.” That’s true as far as it goes, but the facts are that President Obama’s initiatives and his inaction will do the same thing. The question for voters is a simple one: Which outcome do you want?
Here are the overriding facts. Medicare, in its current form, has long-term unfunded liabilities of $37 trillion. In short, using any measurement scale, it is unsustainable. Even the most generous of projections say it will go bankrupt in 11-12 years. Doing nothing makes that outcome inevitable.
Obamacare simply speeds the process. According to the Congressional Budget Office, it will pull $716 billion from Medicare over the next ten years. It will also cut physician and hospital reimbursements. According to various polls, that will force doctors to reject new Medicare patients and will nudge older physicians into retirement. It will also convince brighter students to seek other lines of work.
Among its more than 160 provisions affecting Medicare, Obamacare sets up an independent advisory board that will control patient eligibility for various treatment regimen, prescription drugs and surgical procedures. The physician and patient will not decide a course of action. It will be decreed by an appointed group whose decisions are final and binding.
The Ryan approach would scuttle Obamacare. It would give seniors 55 years old and older continued, full access to Medicare without change. Instead of robbing Medicare funding, Ryan believes medical coverage costs can be controlled through competition and greater efficiency.
He would do that through an optional voucher system for those under 55. That means younger Americans would have the option – not the requirement but a choice – to obtain government financed vouchers and seek medical insurance coverage from the source of their choice. If the coverage they obtain is more expensive, they pay the difference. If it is less, they pocket the difference. If a catastrophic treatment or procedure exceeds the coverage, the patient would pay an initial, small amount and the government safety net would re-emerge to handle the balance.
The process would set up competition among insurers who would push their best package of benefits and the highest quality of care at the cheapest prices. According to The Heritage Foundation, a number of agencies have endorsed this approach including The American Enterprise Institute, the Cato Institute, the National Center for Policy Analysis and the Progressive Policy Institute.
The truth is, Medicare is facing a day of reckoning in the very near future. If no one does anything, it will crash and burn, leaving current recipients – and those who had planned to be recipients – in a morass of indecision and finger pointing.
Ryan has offered a plan that protects today’s seniors and hopefully preserves that benefit for younger Americans. To this point, Obama has offered no plan to save Medicare.
So the questions are: Who plans to “end Medicare as we know it" and what outcome do you prefer? The answers seem clear to me.