Over the next few months you will hear a great deal about cutting Medicare, protecting Medicare, etc. Clearly there must be some changes in Medicare. Under its current structure it simply is not affordable and even if cost was not an issue, it is very inefficient. In essence, the program simply pays whatever claims are submitted with virtually no oversight or care management.
Changing the current system means more oversight into the way care is provided and paid for. Changing the system for the future is open to debate. The basic choice currently presented is continue a government-run system or move Medicare to at least a partially privatized program but with a great deal of federal involvement.
Not currently on the table by anyone is a fundamental structure change for those currently covered by Medicare.
But make no mistake, any serious attempt to manage Medicare costs by either Democrats or Republicans means changes in the way beneficiaries receive health care, greater oversight over when, where and how services are provided, greater use of some form of managed care, some form of rationing (regardless of what it may be called) and changes in the fee-for-service payment structure.
Let’s just keep the discussion honest. Following is the text of the Ryan plan as it relates to current Medicare beneficiaries.
Medicare Payment. For future Medicare beneficiaries who are now under 55 or younger (those who first become eligible on or after 1 January 2021), the proposal creates a standard Medicare payment to be used for the purchase of private health coverage. Currently enrolled Medicare beneficiaries and those becoming eligible in the next 10 years (i.e. turning 65 by 1 January 2021) will see no changes in the current structure of their Medicare benefits. The payment will be made directly to the health plan designated by the beneficiary (similar to the administration of the refundable health care tax credit), with the beneficiary receiving any leftover amount as a payment from the health plan, or assuming financial responsibility for any difference in the payment and the total cost of the premium. This allows the Medicare beneficiary to invest the leftover amount in a Medical Savings Account [MSA] to pay for other medical expenses, or to purchase long-term care insurance.
Related Articles
- My Medicare Deficit Solution (baselinescenario.com)
- Tough Questions Ahead on Reshaping Medicare (nytimes.com)
- Obama’s health care challenge (politico.com)
- Budget Speech: Why Obama’s Inviting a Fight on Medicare (swampland.blogs.time.com)
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