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Four Republican senators unveil plan to kill Medicare

In the lexicon of legislative politics, the word “sunset” means the end, the final curtain, the conclusion, finis.

So, when four Republican members of the U.S. Senate – (above, left to right) Lindsey Graham, Rand Paul,  Jim DeMint and Mike Lee – endorsed a plan the other day for the “sunset” of Medicare, they were talking about killing the program.

Dana Milbank of The Washington Post EXPLAINS:

For years, Republicans have insisted that they would not end Medicare as we know it and that any changes to the program would not affect those in or near retirement. In the span of 20 minutes Thursday, they jettisoned both promises.

(Snip)

DeMint and his colleagues think the time to end Medicare is now — with a cold-turkey conversion to a private program, effective in 2014. “I think if Americans actually find out the truth about what we’re doing, it will be a very big positive for Republicans in the fall,” DeMint forecast.

All the details aren’t out, but Paul says his plan would cut funding of Medicare by $1 trillion over 10 years and reduce Medicare’s liabilities by $16 trillion. It would do that by enrolling Medicare recipients in the health plan now used by federal workers. The government would pay 75 percent of the insurance premium on average but 30 percent or less for those who earned more than $100,000 a year. The eligibility age would gradually be raised to 70 from 65. If seniors can’t afford their share of the premium, they can apply for Medicaid, the health program for the poor.

 

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28 Comments

  1. Sounds like another gift to the insurance industry and a trade of a 5% overhead program for a 30% overhead program to paynthensame bills.

  2. DefendOurConstitution

    A voucher by any other name would kill Medicare just the same (apologies to Shakespeare).

    Fresh off the debacle on the War on Women – TM (OK I know Republicans prefer to call it he Blunt Amendment), they are now trying to implement vouchers for Medicare starting very soon?

    DeMint said: “But I think if Americans can actually find out the truth about what we are doing, it will be a very big positive for Republicans in the fall.”

    I really don’t understand how this can be a smart strategy in an election year. If senior citizens find out that Republicans want to put them on vouchers (instead of Medicare) in less than 2 years, Republicans will lose the White House, the House, and may even give Democrats a super-majority in the Senate.

  3. Actually it sounds a lot like the Swiss Healthcare system which is far better than ours and FAR more privatized. This article is nothing but a hit-job. The author obviously hasn’t taken the time to explore the facts.

  4. “Ending Medicare as we know it” is a fraudulent political meme that presumes that Medicare has never changed since the day it was instituted.

    Really?

    It has changed, is changing and must continue to change in the future if it is going to be sustainable.

    Means testing and raising the eligibility requirements are 2 of the most likely changes if the coverage is to be continued for most of the population.

  5. All that vouchers do is limit the cost to the government and shift the cost to individuals. It does nothing about reducing the overall cost of healthcare.

  6. Yet vouchers put the responsibility for utilization on the patient, the one individual who can control utilization. This fact is simply a part of human nature that you refuse to recognize. If something is deemed to be free or of little cost, the individual has no incentive to use less of it.

    If the patient has “skin in the game” they will moderate their utilization and be much more cost conscious.

    Ideally, everyone one would have some coverage that at least covered catastrophic conditions and then, other, lower cost utilization would be in the control of the patient.

  7. You want to limit utilization as a means of reducing the cost to government, but high utilization, particularly as applied to preventive care, has been shown to provide better health care and outcomes for the patient. Your interest is cost. My interest is health care.

  8. That might be your all time stupid statement since my profession is health care.

    1) If we don’t control costs we will not have the ability to provide care and/or function as an economy.

    2) I am not intending to limit preventative services (although the government and Obama’s plan certainly are). I am talking about limiting unnecessary utilization. If people controlled, and cared about, their own health care dollars they are much more likely to care about costs. I see this principle in action hourly, every day I work.

  9. You want to control cost by limiting care. Cost control needs to be placed on the provider not the receipents.

  10. Inappropriate care my friend. There is a big difference.

  11. One other thing, in your first comment, you state that all vouchers do is “limit the cost to the government and shift the cost to individuals.” That is exactly the problem now. Except it is government programs, like Medicare and Medicaid, that underpay for service and result in cost shifting to individuals with insurance.

    One of the biggest disasters of “Obamacare” is the many new mandates on insurance companies, and through them, each of us as individuals to provide coverage they may or may not want.

    This is making the problem (rising costs) worse and not better.

    Of course, Obama and the Democrats know this and like it.

  12. Doc, you said “Except it is government programs, like Medicare and Medicaid, that underpay for service and result in cost shifting to individuals with insurance.”

    See! You are not interested in reducing the cost of health care. In fact, you are saying that we are not paying enough. You want all of us collectively ( it is called government) to pay less and individuals to pay more. I say we need to lower the cost of health care. For example, let the government negotiate drug costs. After all, the government is the largest collective we have to negotiate on our behalf.

  13. You can’t reduce reimbursment levels below the actual costs to provide service. That is simple business math Jerry. If you do, facilities close, and access is limited. You need only look to your average inner city (or rural setting for that matter) to see the effects on patient access to care in a largely Medicare/Medicaid population.

    You can best decrease cost by decreasing utilization. Trust me when I tell you there is plenty of misutilization, driven by both patients and physicians. I am not talking about utilization that actually effects patient health, I am talking about unnecessary utilization. Third party payors, including the government are doing some things to try and control this, but not enough in my opinion.

  14. So we pay much higher drug prices here in the US because the actual cost of the same drug by the same company is so much higher for them to sell it here as opposed to in another country? Sorry! I am will to pay actual cost, but not artificially inflated costs. Why does our health care cost twice as much as any where else in the world?

  15. Because we have a more unhealthy lifestyle than most places in the world, we use more health care than anywhere in the world, and we use it inefficiently.

  16. Not only do you want to put the cost of healthcare on the individual, now you blame the individual for our high cost of health care. How much luck do you think I would have if imtrynto negotiate my drug costs with the individual drug companies? Better than the government can do?

  17. Forget your obsession with the drug companies. I know as a liberal you love to hate profit but get over it. That is NOT the biggest problem with the reform and with Medicare rates. This article from the very liberal Madison newspaper demonstrates what I am talking about.

    http://host.madison.com/ct/news/local/health_med_fit/madison-clinic-s-decision-to-stop-taking-new-medicare-patients/article_70520894-72c8-11e1-a7d0-0019bb2963f4.html

    Medicare pays only a quarter to a third of every dollar the clinic charges, Wertsch says, often half of what private insurance carriers pay. When you figure that overhead for the clinic — which includes stuff like electricity, staff salaries, and a whopping $700,000 or so for the clinic’s electronic records system — adds up to around 80 cents on the dollar, accepting Medicare is a losing proposition, he says. “I love taking care of Medicare patients,” says Wertsch, 68. “But every time we treat them we have to dig into our wallets. What kind of business model is that?”
    Wildwood is the first clinic in Madison and maybe even the entire state to bail out of accepting new Medicare patients. Dr. Tim Bartholow, a senior vice president with the Wisconsin Medical Society, fears it might not be the last. “This is the canary in the mine,” he says.
    A massive report released just last week by the federal commission in charge of Medicare suggests he could be right. While more than 90 percent of doctors still participate in the program, a close read of the 400-page report reveals a worrisome trend: 14 percent of participating primary care doctors surveyed refused to accept new Medicare patients, compared to 4 percent of physicians in other specialties. At the same time, the percentage of beneficiaries who report a “big problem” finding a doctor doubled.

  18. You want me to forget my “obsession” with the drug companies because you know what I say is true. You just believe we should pay outrageous prices so that they can keep making huge profits. The rest of the world has caught on to their scam.

  19. Even if there was no cost to buying drugs and new drugs came on the market for free (no production cost,no R and D costs and no costs to get a drug to market) via some miracle,it won’t help you if you don’t have a provider to prescribe them 0r a hospital to check into when your sick.

  20. Very true, doc. So, is that what you think will happen if the government can negotiate drug prices? The whole system will collapse? Sounds more like fear mongering to me.

  21. expdoc: Sorry to butt into your spirited dialogue with Jerry Critter, but I thought you might enjoy this piece about reports that lots of primary physicians are thinking of quitting medicine:

    http://www.washingtonmonthly.com/ten-miles-square/2012/03/why_are_primary_doctors_thinki036191.php

  22. Jerry,

    If the drug companies have to give up that extra profit, they will spend less on R and D and we will have fewer new, cutting edge drugs. You can decided if that would be good or bad. It may actually be a relatively neutral proposition. That is why I could literally care less about that segment of the health care reform equation.

    Pat,

    No need to apologize. The effect you note in that article is real and scary. Demographics are changing such that we need many more primary care physicians than we are currently producing. It is very hard to flip a switch and suddenly create more as it takes at least 3 years and more likely 7-10 years to increase the output at the end of the pipeline. Add on top of that more senior physicians calling it quits and we literally have a disaster in the making.

  23. Most of the cutting edge research is government supported. And since R&D expenses are deductible, they are not part of their profits. Let their execs and stockholders earn less. Profits just make healthcare more expensive for all,of us.

  24. No Jerry, profits keep the companies in business and keep tens of thousands of people employed. They also support your retirement plan.

    Read this to understand why profit is necessary if we want to maintain supply and innovation, this article specifically addresses vaccines.

    http://www.who.int/immunization_financing/options/en/briefcase_vacproduction.pdf

  25. I’m not against profits, per se. I am against excessive profits, particularly excessive profits gained at the expense of the health of the American people.

  26. Who are you to decide what is excessive?

  27. Who are you to decide what is not excessive? Or is any profit a good profit?

  28. Good point. I am not and neither are you. That is up to the company, it’s shareholders and its customers.

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