This past week much has been said and written about President Obama’s plan for Medicare, under Obamacare, and, Paul Ryan’s (R. Wi.) plan for Medicare outlined in his proposed budget. Rather than demagogue one or the other (I suspect we’ve all had enough of that at the moment), I thought I’d describe both plans, and let you decide.
Mr. Ryan’s plan (for anyone who becomes eligible for Medicare in 2021 or later), would create insurance exchanges where private insurers would offer coverage to seniors. The plans would operate much like today’s Medicare Advantage…seniors pick the plan they like, with the doctors they like, etc., and Medicare would provide “premium support” to the company of the senior’s choosing. The plans would not be able to exclude pre-existing conditions, and they would be guaranteed renewable. The initial payment from Medicare (which would increase annually) would be $15,000, and, higher, if need be, to help lower-income seniors.
Mr. Obama’s plan to lower Medicare costs is to create a 15 member Independent Payment Advisory Board. This board will be charged with the task of controlling Medicare spending. The members will be appointed by the President, confirmed by the Senate, but, after that, the Board will not be subject to Congressional review. All Medicare decisions will be made by this Board.
If per capita costs grow by more than GDP plus 0.5%, this board would get more power, including an automatic budget sequester to enforce its rulings. So 15 sages sitting in a room with the power of the purse will evidently find ways to control Medicare spending that no one has ever thought of before…
(Ok, that last sentence may have been a bit “argumentative”, so, just ignore it when making your decision.)
Which plan do you think will provide the best care?