The Ryan plan for cutting Medicare costs will cut some costs but undoubtedly will also cut coverage and increase out of pocket expenses, particularly for those with serious illness. The Journal of Clinical Oncology documents this effect in this article on insurance coverage for cancer patients. The article notes:
The risk of high burdens is significantly greater for patients with cancer compared with other chronically ill and well patients. We find that 13.4% of patients with cancer had high total burdens, in contrast to 9.7% among those with other chronic conditions and 4.4% among those without chronic conditions. Among nonelderly persons with cancer, the following were associated with higher out-of-pocket burdens: private nongroup insurance, age 55 to 64 years, non-Hispanic black, never married or widowed, one child or no children, unemployed, lower income, lower education level, living in nonmetropolitan statistical areas, and having other chronic conditions.
Medicynical note: As people age the prevalence of illness dramatically increases. Many of the elderly, if not most, would be denied insurance in the current private market or be offered insurance that is priced so high that it would be unaffordable and/or inadequate. Ryan’s plan makes no accomodation for elderly patients with medical problems, throwing them into the individual market. It will formalize economic rationing of health care and penalize most severely the elderly who have limited or no health care savings.
In doing this the U.S. would (un) distinguish itself from all other industrialized nations who provide health coverage to all citizens regardless of illness and age.
So not only do we pay more for health care than any other country in the world but also provide the least comprehensive coverage for those who need it most.