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Title : Romney Vs. Obama: The Romney-Ryan Medicare Excogitation Compared To The Obama Medicare Plan—Who’S Telling The Truth On Medicare?
link : Romney Vs. Obama: The Romney-Ryan Medicare Excogitation Compared To The Obama Medicare Plan—Who’S Telling The Truth On Medicare?

Romney Vs. Obama: The Romney-Ryan Medicare Excogitation Compared To The Obama Medicare Plan—Who’S Telling The Truth On Medicare?

They both are too they both aren’t.

I’ve never seen a calendar week inwards wellness aid policy similar terminal week. The media reports receive got to live inwards the thousands, all trying to brand feel of the furious debate betwixt Obama too Romney over Medicare.

As someone who has studied this number for to a greater extent than than twenty years, it has also been to a greater extent than than exasperating for me to lookout adult man each side merchandise claims too for the press to essay to brand feel of it.

This spider web log post service is quite long because the dependent area thing is complicated. If you lot desire to cutting to the chase, run across my conclusion too summary at the halt of this post.

Allow me to listing a few of the questions people are quest too give you lot my convey on it.
Will electrical flow seniors endure nether the Romney-Ryan Medicare plan?
No.

Let me start past times proverb something that volition probable surprise you. If I could live manly somebody monarch for a day, I would prohibit anyone over the historic menses of threescore from voting inwards this election. This election is genuinely almost the hereafter too the large decisions on the tabular array are almost the long-term authorities spending too entitlement issues that should live made past times younger voters who volition receive got to pay for them too volition exercise goodness or endure from them.

Those inwards their 60s too older are almost for sure going to cruise to the halt with the benefits they immediately have.

Whether its Obama’s Medicare plan, based heavily on the Medicare cost command board imbedded inwards his wellness reform neb (which doesn’t get to touching on infirmary costs until 2020), or the Romney/Ryan Medicare premium back upwardly conception (that has no outcome on anyone immediately over the historic menses of 55), today’s seniors' benefits are insulated from this issue.

Medicare is already evolving. Both Democrats too Republicans desire to run across changes inwards the means Medicare pays doctors too hospitals (more for value too less for the book of services) too that could touching on the means providers process people inwards the coming years. But inwards this sense, both sides acquaint seniors with a similar future.

If you lot are over historic menses 70, at that topographic point is virtually no adventure at that topographic point volition live whatsoever pregnant changes to Medicare benefits inwards your lifetime. Even if you lot are over 60, the chances that at that topographic point volition live whatsoever major structural changes to Medicare benefits equally long equally you lot are to a greater extent than or less are quite small. As bad off equally Medicare is, both Republicans too Democrats receive got shown no inclination to fool with existing benefits for people immediately retired or unopen to retirement—this is almost the hereafter of Medicare for people immediately inwards their 20s, 30s, 40s, too 50s.

It is ironic that it is today’s seniors, who vote inwards larger numbers than the people inwards their 20s too 30s, that seem to live driving this equally an election-year number out of fright of what volition tumble out to their benefits!

I constitute it fascinating to run across a poll of late that said younger people are to a greater extent than supportive of the Romney/Ryan conception than today’s seniors! Apparently, the younger voters don’t mean value they are going to larn anything similar their father’s Medicare conception anyway (which is correct) too are happy to take away heed that Romney too Ryan receive got a conception to save something for them.

While of course of study I can't enjoin seniors non to vote, I would inquire them to vote with only the best interests of their children too grandchildren inwards mind.

Can Medicare, equally nosotros know it live preserved for the side past times side generation?
Absolutely not.

Whether nosotros should save it for electrical flow seniors or not, it seems sure nosotros will. Again, Obama’s cost board doesn’t start doing the heavy lifting until 2020. Romney too Ryan’s Medicare conception wouldn’t get for 10 years too only for those retiring at that time.

I volition enjoin you lot that Romney too Ryan receive got taken the to a greater extent than courageous political stand—they state Medicare can’t live preserved too large fixes receive got to happen. Now, that doesn’t necessarily hateful they receive got the right policy answer only that they are willing to human face upwardly the problem.

Obama too the Democrats, past times proverb Romney-Ryan “would halt Medicare equally nosotros know it,” receive got taken the safer too to a greater extent than conventional political road past times non lilliputian with the “third rail” of American politics that are the entitlement programs.

But Obama too the Democrats are beingness misleading when they state they tin save Medicare “as nosotros know it.” Yes, Democrats could save the traditional construction of Medicare—a defined exercise goodness entitlement guarantee built to a greater extent than or less a universal puddle everyone, rich too poor, is in. But to exercise that, they demand to enjoin us only what exercise goodness cuts, structural changes, and/or revenue enhancement increases they are willing to implement. There is no means the electrical flow Medicare conception tin live sustained without huge changes.

Obama too the Democrats are beingness disingenuous past times trying to utilisation the Romney-Ryan conception to scare voters without facing this tough number inwards a direct means themselves.

The Republicans receive got been harping since the 2010 elections on the $700 billion cuts inwards Medicare that Obama too the Democrats used to assist pay for the Affordable Care Act but doesn’t Ryan receive got the same Medicare cuts inwards his budget plan?
Yes.

Obama too the Democrats did cutting $500 billion betwixt 2010 too 2019 from what Medicare would receive got paid during that fourth dimension when they passed the novel wellness police delineate inwards 2010 (those same cuts immediately add together upwardly to $700 billion betwixt 2013 too 2022). It is of import to notation that these are non absolute cuts from the programme but rather the slowing of Medicare growth. Before the cuts, Medicare was predicted to grow at an annual charge per unit of measurement of 6.8% a year—after the cuts it is projected to grow at an annual charge per unit of measurement of 5.6% during the same period.

So, acre $700 billion is a lot of money, the Medicare cuts only amount to a rattling little reduction inwards what providers larn paid over the ten-year period—it does non straight trim senior benefits or increment premiums. In fact, doctors--who human face upwardly the endangerment of large cuts carve upwardly from the novel wellness law--had no cuts. Hospitals agreed to modest cuts inwards telephone commutation for seeing to a greater extent than patients with insurance. Medicare Advantage plans volition run across reductions inwards the payments they were getting that were already inwards excess of what Medicare pays itself for the same patients.

The Obama Medicare cuts were never going to materially wound Medicare, equally nosotros know it.

Democrats also played games past times double counting those cuts when they were allowed, nether arcane federal budget rules, to both trim the cost tag for the novel wellness police delineate too extend the solvency of the Medicare program.

And, it is truthful that Ryan did assume those same cuts would move along over the life of his latest budget fix—which passed the House on a party-line vote. That is hypocritical of Republicans who blasted these same cuts inwards the 2010 elections. But Ryan supporters also debate that acre he would move along those cuts, he would only count them once. Because he would repeal the Affordable Care Act, those cuts inwards hereafter spending would live used entirely to extend the life of the Medicare trust fund.

Ryan makes a credible signal regarding how he would utilisation the money. But, if Obama is pain Medicare past times reducing Medicare’s 10-year growth charge per unit of measurement from 6.8% per twelvemonth to 5.6% per year, thence so is Ryan.

It is also of import to think that Ryan’s large premium back upwardly Medicare reforms would non get for 10 years. So these Medicare spending reductions, betwixt immediately too then, receive got naught to exercise with his “premium support” proposals.

Romney has immediately said that if he is elected he volition contrary these Medicare cuts. OK, but he is going to receive got to notice some other $700 billion inwards federal spending cuts to supersede them if he is going to striking the deficit reduction targets too Medicare trust fund goals inwards the House budget bill.

Both sides are making the same cuts too receive got genuinely been playing games with this one.

Republicans are using the success of the Medicare Prescription Drug Plan equally evidence that the marketplace position tin command wellness aid costs. Is this evidence on their side?
Not inwards whatsoever variety of clear cutting way.

It is truthful that the Medicare drug conception costs are coming inwards means below what the Congressional Budget Office (CBO) said they would live inwards when the novel exercise goodness was created inwards 2003.

However, all drug costs (employer plans, Medicaid, traditional Medicare) receive got been coming inwards much lower that were expected. At the fourth dimension the Medicare drug conception passed, prescription drug costs were exploding. Since thence a number of factors, such equally far greater utilisation of generic drugs too fewer novel expensive drugs inwards the pipeline, receive got dramatically reduced drug spending too the Medicare drug conception has benefited.

Medicare Part D costs are also coming inwards lower than expected because enrollment has been less than originally expected.

So, the evidence is rattling mixed too a lot to a greater extent than complicated making it a questionable slice of evidence inwards this debate.

Romney too Ryan state their conception volition include the traditional Medicare conception equally i of the options. But critics state at that topographic point is a goodness adventure Medicare volition halt upwardly with the sickest seniors, acre rich people are able to purchase the individual plans, thereby destroying the Medicare programme everyone has enjoyed. Is this true?
Probably not.

The Romney/Ryan Medicare conception promises to move along the degree of Medicare premium back upwardly seniors receive got today for the purchase of the minute lowest cost conception inwards your market—be it individual or traditional Medicare. All plans would receive got to furnish at to the lowest degree the Medicare benefits you lot larn today too the only cost to you lot would live what nosotros know immediately equally the Part B Premium. If a senior buys the lowest cost plan, at that topographic point would genuinely live a cash refund for the difference. If a senior buys a conception costing to a greater extent than thence the minute lowest cost plan, the divergence would live paid for out of the senior’s pocket.

Under the to a greater extent than detailed Wyden-Ryan Medicare conception with its amend consumer protections, if a wellness conception gets a disproportionate number of the sick people, it gets to a greater extent than coin to offset its costs—a device know equally endangerment adjustment—that protects Medicare or whatsoever other plan. So, it is non clear to me how, if the traditional Medicare conception got sicker people, it would come inwards to a greater extent than expensive for consumers after these inter-plan adjustments.

The Romney/Ryan conception relies on the marketplace to command costs but at that topographic point is no evidence that the marketplace position does a amend chore than government-run plans?
That is right, but Romney too Ryan are calling for a dissimilar variety of wellness conception market.

Democrats are right that at that topographic point is non a lot of evidence that what nosotros receive got done inwards the marketplace position thence far volition solve our cost problems. For example, almost a 4th of seniors are immediately inwards Medicare Advantage plans but these plans receive got historically been paid to a greater extent than to screen seniors than the authorities paid to its ain traditional Medicare plan. The charge per unit of measurement at which wellness aid costs receive got escalated from twelvemonth to twelvemonth has been lower inwards recent years for Medicare than for individual wellness insurance for those nether age-65--but nosotros also know that providers oft shift costs to individual wellness plans to offset the lower Medicare reimbursement they get.

But, no thing which side you lot accept, overall Medicare costs are nevertheless unsustainable equally to a greater extent than people retire. The condition quo, for Medicare or for individual insurance, is non an option.

Most wellness policy experts believe that nosotros must fundamentally alter the wellness aid delivery arrangement from the electrical flow fee-for-service arrangement that largely pays for quantity, to i that pays for character too cost control. The Democratic wellness aid reform police delineate has lots of airplane pilot programs inwards it to essay these novel ideas. It is also probable that the novel Medicare cost board, enacted equally role of the novel wellness law, volition halt upwardly requiring providers to larn their payments through these novel payment programs inwards gild to larn costs nether control.

Republicans also screen these same ideas that rely on things similar Accountable Care Organizations (ACOs) that pay providers a fixed payment for a population’s wellness aid needs. These novel payment systems would also convey much to a greater extent than payoff of electronic patient management systems too administrative simplification. Both Republicans too Democrats by too large grip with these efforts.

All of these ideas, by too large accepted past times Democrats too Republicans, receive got yet to live proven.

While most Democrats rightly debate that at that topographic point is no proof the marketplace position has controlled costs, it is also truthful nosotros receive got never tried a marketplace position similar the i Romney too Ryan propose.

In Medicare Advantage, the individual plans are reimbursed past times the authorities with a fixed payment that is unilaterally determined past times the authorities for each market. The final result has been a arrangement the individual Medicare plans receive got equally good oft only gamed—concentrate on the markets that receive got the best payments too brand coin off of them. More recently, wellness plans appear to receive got made amend progress toward controlling costs but the utilisation of individual wellness insurance plans is nevertheless rattling controversial.

Romney too Ryan are immediately proposing a rattling dissimilar arrangement where wellness plans receive got to bid their cost inwards each market. They debate that competitive bidding volition final result inwards existent contest inwards the marketplace position and, with consumers immediately having a greater incentive to store their express premium back upwardly payment from the government, costs tin live controlled.

They run across a senior marketplace position where wellness plans, including the traditional Medicare program, volition receive got no alternative but to move harder to create exercise costs past times using all of these novel devices too payment systems where millions of seniors volition live intently looking for affordable care.

What exercise Obama too the Democrats suggest equally an alternative to Romney too Ryan?
The Democrats receive got taken the safer political path past times letting the other guys brand controversial proposals too proverb little almost how they run across Medicare operating differently inwards 10 years.

Democrats signal to the Medicare cost command board, a role of the novel wellness law, that gives an appointed board of experts the might to alter the means providers are paid past times Medicare—but non the might to alter senior benefits or premiums. That board begins its move inwards 2015—but non until 2020 for the largest category of costs, the hospitals.

While Republicans criticize the Medicare cost board equally naught to a greater extent than than a “non-elected bunch of bureaucrats,” the fact is that the Congress—Republican or Democratic—has non shown the political courage to brand the tough decisions to reform Medicare.

I am personally optimistic that the Medicare cost board could exercise a lot of goodness toward pushing the Medicare programme to to a greater extent than sustainable payment models. But if the Board is to live successful inwards remaking Medicare into something that is sustainable, the Medicare it does drive us to volition non live the onetime Medicare programme equally nosotros receive got come upwardly to know it—and the Democrats claim they tin preserve.

I am also personally optimistic that a arrangement of competitive bidding too consumer alternative could force the Medicare arrangement towards to a greater extent than sustainability.

And, both are untried solutions too controversial alongside the experts.

Obama says that Paul Ryan’s Medicare conception volition increment a senior’s wellness aid costs past times $6,400 a year. Is this accurate?
No. That justice is based upon a Congressional Budget Office (CBO) justice of an before version of Ryan’s plan.

Again, think that Ryan's premium back upwardly conception would only touching on those retiring inwards 2013, or later.

This year, Paul Ryan updated too improved his outset Medicare premium back upwardly plan, offered inwards 2011. He increased the charge per unit of measurement at which the federal Medicare premium back upwardly payment would grow too he opened his conception upwardly past times allowing traditional Medicare to move along to live offered.

In some other alter from the before plan, he would also guarantee that every senior would receive got plenty coin coming from the authorities to live able to purchase the minute lowest cost conception inwards their market. That conception (and all plans) would receive got to offering at to the lowest degree the electrical flow Medicare benefits too the authorities would pay the same percentage of that conception that authorities pays today. If the senior bought the cheapest plan, at that topographic point would genuinely live a refund to the senior. If the senior bought a higher priced plan, the senior would receive got to come upwardly up with the additional premiums. The traditional government-run Medicare conception could live the cheapest, the minute lowest, or a to a greater extent than expensive plan—no i tin justice that.

So, acre all seniors would live assured that they could afford at to the lowest degree the 2 lowest priced plans on the same footing equally Medicare subsidizes them today--at no increased cost to them, at that topographic point is no means to enjoin which 2 plans they would be—other than to state these plans would receive got to offering at to the lowest degree the traditional Medicare benefits.

This was a large alter from Ryan’s 2011 conception too President Obama should live doing whatsoever comparisons to the novel version. The CBO has non yet done whatsoever similar estimates on the novel plan.

Whose Medicare conception volition work?
My feel is that either could work. It all depends upon how they are implemented.

I volition suggest that if you lot position a conservative too a liberal, both of goodness will, inwards a room, gave both of them all the facts almost Medicare too wellness aid spending, what has too hasn’t worked inwards authorities too the market, too thence asked them to come upwardly to a conclusion, the liberal would similar the Democratic approach that relies on authorities too the conservative would come upwardly out on the side of consumer alternative too markets.

We are, inwards a political sense, a left brain/right encephalon country. Conservatives receive got far to a greater extent than organized religious belief inwards marketplace position liberty too consumer alternative too liberals receive got far to a greater extent than organized religious belief inwards the authorities too regulation. They volition both facial expression at the same laid of facts too come upwardly out inwards a fairly predictable way.

Who should nosotros believe? Who should I vote for?
In the end, trust your instincts.

When its all over, after you lot receive got read all of the confusing articles too been frustrated past times all of the counter claims too political spin, I volition suggest it volition come upwardly downwardly to your instincts. I don't run across a reliable fact-based means to predict with anything unopen to certainty which philosophy would exercise the amend job--we can't run both systems inwards tandem to notice out!

Do you lot trust authorities more, or your ain sentence too the market?

Whichever means nosotros go, at that topographic point volition live no pure marketplace position or authorities approach. The marketplace position approach, fifty-fifty the i touted past times Paul Ryan, volition receive got lots of authorities oversight too consumer protections. Even inwards a unmarried payer system, where authorities controls the insurance system, at that topographic point volition live alternative when it comes to which provider you lot utilisation too possibly which insurance fellowship you lot purchase your supplemental insurance from.

It is also notable that both Paul Ryan too President Obama receive got called for eventually capping annual Medicare spending at the country’s charge per unit of measurement of economical growth, plus half percent. They would both pass the same amount of money—less than the historic average charge per unit of measurement of growth for the program—but create exercise that to a greater extent than finite amount of coin rattling differently.

Government volition ever live involved inwards senior wellness care—very few seniors could afford to pay the actual per capita cost of Medicare past times themselves. Medicare, at some level, volition ever live a social benefit—largely supported past times the federal revenue enhancement arrangement with the sick too the salubrious inwards some of shape of mutual pool.

Anyone who says Republicans desire to throw you lot to the marketplace position dogs is only trying to scare you. Anyone who says Democrats desire to convey your freedoms away too dump everyone into a Medicare programme that volition eventually facial expression to a greater extent than similar Medicaid is no better.

But both offering rattling dissimilar paths based upon their ideologies.

Generally, exercise you lot believe inwards yourself too the marketplace position to amend create exercise wellness care, or inwards the demand for authorities to protect your interests?

Should seniors receive got to a greater extent than personal responsibleness for the cost too character of their wellness aid too live able to brand rattling dissimilar choices inwards the hit of wellness plans they buy, or should Medicare stay largely a government-managed programme built to a greater extent than or less i variety of universal insurance both the rich too the pitiful receive got to share?

Just answer these questions too I mean value you lot volition know for whom you lot volition vote inwards November.

Since I mean value either approach could work, I conception to vote for the candidates that are, first, doing the best chore telling the truth almost what they volition ultimately live forced to exercise and, second, who appear to me to receive got the best adventure of genuinely implementing their conception inwards an effective way.

Elections matter. And, thence should the truth almost what needs to live done, an might to larn those reforms passed, too to brand them work.

More exceptional on the Wyden-Ryan Medicare reform proposal:
The Wyden-Ryan Plan Will Be the Foundation for Serious Medicare Reform—and Maybe More

A Detailed Analysis of the Obama Health Care Reform Plan--The Affordable Care Act

Romney's Health Care Reform Plan: H5N1 Detailed Analysis of Mitt Romney’s Health Care Reform Plan

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