Ryan’s Plan: Rationing Care by Wealth, the New American Way

The CBO sent Representative Ryan a letter analyzing his proposals.

Federal payments for Medicaid under the proposal would be substantially smaller than currently projected amounts. States would have additional flexibility to design and manage their Medicaid programs, and they might achieve greater efficiencies in the delivery of care than under current law. Even with additional flexibility, however, the large projected reduction in payments would probably require states to decrease payments to Medicaid providers, reduce eligibility for Medicaid, provide less extensive coverage to beneficiaries, or pay more themselves than would be the case under current law. (Medicynical emphasis: The indigent will either get less care or  to pay for it themselves (really!)

A private health insurance plan covering the standardized benefit would, CBO estimates, be more expensive currently than traditional Medicare. Both administrative costs (including profits) and payment rates to providers are higher for private plans than for Medicare. Those higher costs would be offset partly but not fully by savings from lower utilization…..  (Medicynic: meaning people who can’t afford care won’t get it) Moreover, CBO projects that total health care spending for a typical beneficiary covered by the standardized benefit under the proposal would grow faster than such spending for the same beneficiary in traditional Medicare under either of CBO’s longterm scenarios.

Medicynical note:  Yes, this is the same CBO that Representative Ryan and his followers criticized when it projected significant budgetary savings for the Health Reform package passed by the last congress.

As noted yesterday, there is nothing in this regarding insurability, community rates for the insured, and mandating coverage of pre-existing illness.  It seems a license for insurance companies to cover the healthiest and leave the rest to no or inadequate  coverage.   It’s a cynical and somewhat sophisticated way to ration care by monetary resources and wealth.

It should be noted that almost half of baby boomers and succeeding generations of retirees have inadequate retirement savings:

Excluding their homes, 24 percent of boomers say they have no retirement savings. Those with nothing include about 4 in 10 who are non-white, are unmarried or didn’t finish college.

At the other end, about 1 in 10 say they have banked at least $500,000. Those who have saved at least something typically have squirreled away $100,000, with about half putting away more than that and half less.

Every other industrialized nation provides health care coverage for virtually it’s entire population.  Cutting access to care, providing inadequate  coverage for the aged, sick, disabled and infirm, and doing nothing about the 50 million uninsured appears to be the new American way.

More here: Representative Ryan Proposes Medicare Plan Under Which Seniors Would Pay Most of Their Income for Health Care

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