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Critical Condition

NRO’s health-care blog.

There’s No Choice but Change



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The outrageous distortions about the Ryan Medicare reform plan are coming from people who are accelerating the program’s path to insolvency.

Medicare is being used as a piggy bank by Democrats, with $575 billion in payment cuts used to finance two massive new entitlement programs in Obamacare. And this April, the president proposed taking another $480 billion out of the program to lower the deficit.

Payments to providers will be cut so deeply that seniors will find it harder and harder to get care. Doctors will stop taking Medicare or go bankrupt. A whopping 87 percent of doctors say they will stop seeing or will restrict the number of Medicare patients they see, further shrinking the pool of providers and further restricting access to care.

The powerful, 15-member Independent Payment Advisory Board will use price controls to meet ever-elusive spending targets. Rationing is inevitable, especially of newer medicines and technologies.

House Energy and Commerce chairman Fred Upton explained, “Last year, Medicare expenditures reached $523 billion, but the income was only $486 billion — leaving a $37 billion deficit in just one year. And with 10,000 new individuals becoming eligible each day, it’s only going to get worse.”

Medicare is $38 trillion in the red, and it accelerated five years toward insolvency in just the last year, according to the Medicare Trustees’ latest report.

Sen. Marco Rubio captured it best in a new video, saying, “Medicare will go broke in as little as nine years … and anyone who is in favor of doing nothing to deal with this fact is in favor of bankrupting it.”

House Budget chairman Paul Ryan recognized that reality with his plan to begin modernizing the program, starting ten years from now. He wants to give baby boomers the option of private coverage in a plan that works much like the one members of Congress have today.

Access to coverage would be guaranteed, and payments would be tailored to meet a person’s age, health status, and income level.

Medicare is a government-run, politically-driven health-care program with so many gaps that people have to buy supplementary coverage. Not surprisingly, one fourth of today’s seniors have voluntarily decided to opt out of traditional Medicare by joining private plans in Medicare Advantage. These plans are competing for their business, offering better benefits often at lower costs to beneficiaries.

Rather than slashing this popular program as Obamacare does, it should be put on an equal and sound financial footing to continue to give seniors choices in the future. This model of seniors selecting from competing private plans is what Paul Ryan is proposing ten years hence, with premium-support payments to help pay for the cost of that plan.

Here are the facts of the Ryan plan: Paul Ryan’s plan does keep the payment reductions in Medicare under current law for ten years; he doesn’t use them to create two massive new entitlement programs but to preserve Medicare.

Beginning in 2022, beneficiaries are guaranteed a choice among Medicare-approved private health options. As the Congressional Budget Office notes: “Plans would have to issue insurance to all people eligible for Medicare who applied.” In other words, all Medicare beneficiaries are guaranteed that a health plan will be available for them.

This is in stark contrast to what would happen to Medicare under current law. Without a serious course adjustment, Medicare will become a third-rate, price-controlled program that rations a lower quality of care through waiting lines and other restrictions. If the antiquated, open-ended, fee-for-service model isn’t reformed, then we will continue to pour deficit-funded dollars into the program or raise taxes to levels that would topple the economy as millions of baby boomers hit retirement.

The only way to save Medicare is to change it.



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