Wyden (D-OR), Ryan (R-WI) offer another plan to weaken Medicare.

[Mass]

http://thinkprogress.org/health/2011/12/15/389711/wyden-ryan-medicare/

Paul Ryan Convinces Ron Wyden To Support Greater Privatization Of Medicare

Rep. Paul Ryan (R-WI) and Sen. Ron Wyden (D-OR) will unveil a new Medicare premium support plan during an event at the Bipartisan Policy Center this morning that is a stark departure from the Budet Committee Chairman’s proposal to end the traditional Medicare program that most Republicans voted for.
Under the new bipartisan plan, beginning in 2022, seniors will receive a pre-determined premium support voucher to purchase benefits through an exchange of private plans or the existing fee-for-service program. The government subsidy would be determined by the “second-least expensive approved plan or fee-for-service Medicare, whichever is least expensive” and “rise or fall along with the actual cost of the policies — creating more protection for seniors and saving potentially far less in the budget.” Ryan’s budget grows the government’s contribution substantially slower than actual health care costs, shifting health care costs to beneficiaries. The plan maintains the Affordable Care Act’s cap on spending at Gross Domestic Product growth plus 1 percent and would also “add catastrophic coverage with a cap on out-of-pocket costs.”

...
But the larger problem is that competition between traditional Medicare and private plans — which, the plan says “would foster innovation and quality, while ensuring that the program is financially stable” — could also allow private plans to cherry-pick the healthiest beneficiaries and leave sicker applicants to traditional Medicare. Although the Wyden/Ryan incorporates “risk- adjustment tools” and would require CMS to “conduct an annual risk review audit of all insurance plans,” these mechanisms are still “less than fully effective in adjusting payments downward based on how much healthier these enrollees are” and private plans participating in Medicare Advantage continue to, on average, enroll healthier beneficiaries.

So here, in a nutshell, is the problem: In an interview with the Washington Post, “Ryan and Wyden acknowledged that their plan might not bring in more savings than under the current law.” Yet they’re willing to set the nation on an untested path of private competition that breaks up the large market clout of Medicare (which is now experimenting with more efficient ways to pay providers) and pushes seniors into less efficient private plans. It moves the health care system closer to the Ryan ideal in which future Congresses would be able to reduce federal costs by eating away at the premium credit seniors receive. Over time, Medicare will start bleeding beneficiaries, becoming an ever smaller program.

Now. I understand what is in it for Ryan, who can now say: see, some Democrats agree with me, but for what reason did Wyden go with this?

[ProSense]

1. Why

is this topic being avoided?

[ProSense]

2. Wonkbook: Paul Ryan and Ron Wyden want to bring Obamacare to Medicare

Wonkbook: Paul Ryan and Ron Wyden want to bring Obamacare to Medicare

Posted by Ezra Klein

Back in February 2010, I sat down with Rep. Paul Ryan to talk about health-care reform. Ryan had his own bill back then: the Roadmap, which was, in many ways, a precursor to the budget he crafted for the Republicans earlier this year. But he was open to some other ideas, too. At one point, I asked him about Sen. Ron Wyden's Healthy Americans Act. "If I were a Democrat, it’s the bill I’d be on," Ryan replied. "He’s got more mandates than I’d like. But if Ron Wyden and I were in a room, we could hammer out a deal by tomorrow."

Well, Wyden and Ryan eventually did enter that room and hammer out a deal. But not for health-care reform. For Medicare reform. Their proposal, released Monday afternoon, envisions a kinder, gentler version of premium support than what Ryan proposed in his budget. In Ryan-Wyden -- Ryden? -- traditional fee-for-service Medicare is kept as one of the options, the private plans have to be at least as comprehensive as Medicare, and if the system can't control its costs, Congress takes a bite out of providers rather than passing higher premiums onto Medicare beneficiaries.

The Ryden plan is part of an ongoing attempt by the Republican Party to carve out a more politically sustainable position on Medicare reform. Conservative activists might like Ryan's original plan, but voters don't. Wonks might admire its boldness, but they admit that its numbers don't add up. And so you've seen efforts to sand the edges off the idea: Yuval Levin's "confident market" proposal and Mitt Romney's Medicare framework, are both efforts to rework Ryan's plan in a way that preserves traditional Medicare as an option and makes market reforms more palatable to voters. With the Ryden plan, Paul Ryan has joined them in that effort to leave the Ryan plan behind and replace it with something voters -- and some Democrats -- find less threatening.

But the secret of these types of premium-support platforms is that they are, in essence, a vindication of the Affordable Care Act. The cost containment is supposed to come through competition between plans, and works like this: "All plans, including the traditional fee-for-service option, would participate in an annual competitive bidding process to determine the dollar amount of the federal contribution seniors would use to purchase the coverage that best serves their medical needs. The second-least expensive approved plan or fee-for-service Medicare, whichever is least expensive, would establish the benchmark that determines the coverage-support amount for the plan chosen by the senior. If a senior chose a costlier plan than the benchmark, he or she would be responsible for paying the difference. Conversely, if that senior chose a plan that cost less than the benchmark, he or she would be given a rebate for the difference."

http://www.washingtonpost.com/blogs/ezra-klein/post/wonkbook-paul-ryan-and-ron-wyden-want-to-bring-obamacare-to-medicare/2011/12/15/gIQAj0CnvO_blog.html

It seems the gaol behind this plan is to prove Medicare is more efficient and cost effective. Do we need more evidence based on schemes?

Anyone want to talk about a program that's even more efficient: VA health care.

Aren't we supposed to be moving toward single payer?

Ron Wyden teams up with Paul Ryan to end Medicare as we know it

http://www.dailykos.com/story/2011/12/15/1045607/-Ron-Wyden-teams-up-with-Paul-Ryan-to-end-Medicare-as-we-know-it

[midnight]

3. Anyone from Oregon want to chime in about your Senator?

[Quantess]

8. I have been unpleasantly surprised by Wyden the last few years.

He had been a progressive for as long as i can remember. I don't know what happened to the old Wyden.

[midnight]

11. Maybe he has been enticed with those vacation junkets ALEC puts together to

win the votes from our elected officials...

[opihimoimoi]

4. Ryan??? Never TRUST them GOPers...Ryan and his GOPer friends are fucking withus...they wanna `86 SS

medicare, etc....

they snookered Wyden to suck for their shit....

[Mass]

5. Gingrich Praises Wyden/Ryan Premium Support Plan

http://thinkprogress.org/health/2011/12/15/389940/newt-medicare-should-wither-on-the-vine-gingrich-praises-wydenryan-premium-support-plan/

OK, this is all you need to know about this plan.

[ProSense]

7. Seriously

The Ron Wyden, Paul Ryan Pile On Begins

We’ll have much more later today on the big news that Sen. Ron Wyden (D-OR) and Rep. Paul Ryan (R-WI) have teamed up on a plan to partially privatize Medicare.

But to give you a sense for just how poisonous Wyden’s colleagues on the Hill find this alliance — both on policy merits and on political grounds, here’s a quote from a very senior Dem congressional aide.

“For starters, this is bad policy and a complete political loser,” this aide said. “On top of the terrible politics, they even admit that it dismantles Medicare but achieves no budgetary savings while doing so — the worst of all worlds. Thanks for nothing.”

Ryan and Wyden both contend that, when it’s finally drafted, their legislation will score as a cost saver, because it includes an enforcement mechanism: if Congress can’t find health care savings on its own, the plan automatically caps spending on the program and allows it to grow at a rate lower than medical inflation.

http://tpmdc.talkingpointsmemo.com/2011/12/the-ron-wyden-paul-ryan-pile-on-begins.php?ref=fpb

...what the hell was he thinking?

[Mass]

9. Wyden has been promoting things like that for a very long time.

He has had for years a bill cosponsored with a Republican which would have gotten rid of company based health-insurance, given the money to employees so that they go and buy their health insurance on an exchange-based market. Another one who believes markets solve all problems.

[kenny blankenship]

6. 'Cause so many Dems have been accepting Reaganite Economic Apartheid lately that he got confused?

[Bluenorthwest]

10. He'll lose my support at once for this

Unacceptable and this will not be popular in Oregon at all. Wyden will be hearing from me. And many other Oregonians I'm sure.

[JDPriestly]

12. This could result in still fewer doctors and more expensive healthcare. A lot of seniors

would have to spend down all their resources, lose their homes and then end up on Medicaid. The idea of increasing the cost of medical care to seniors is a no-go. It won't lead to anything because it won't really save any money in the long run.