A Few Words About the Ryan Budget and Medicare
By Howard Peck – Medicare Supplement and Long Term Care Specialist
I like Paul Ryan and I think he’s very bright and astute when it comes to complex things like trillion dollar budgets. But what I have over Paul Ryan is the wisdom and experience that comes from sitting almost every day of the week at the kitchen tables of folks who I help navigate through the maze of Medicare.
I know Congressman Ryan meant well and he attempted to ‘think out of the box” in proposing a new structure to Medicare that would provide savings. But from my perch, his “voucher” or “premium support” that would have folks “go shopping” for medical needs would add another layer of complexity and decision making – resulting in even more stress and aggravation. Plus, his measure offered no substantial proof that it would actually work! With a voucher good for a certain value, the amount of money available to a Medicare enrollee would decrease, thereby decrease the amount of money used to fund Medicare. Ryan called it “saving money through competitive shopping”.
I suppose that for a percentage of the Medicare population (that segment who uses fewer benefits) this might be a workable scenario. But, for the chronically ill who use 50% of Medicare’s services and ultimately over 50% of its costs, this won’t work. There is no magic bullet in saying, “Well, here’s the amount you get, now work it out with your doctors and hospitals–they’ll be more than happy to deliver medicine in a competitive market.” Who’s to say that doctors and hospitals are excited about getting into a “competitive” medicine market?
Medicare has big problems and big solutions are needed. But solutions that decrease the easy utilization and easy availability of Medicare are not smart solutions!
Perhaps Congress should consult with those of us who sit at the kitchen tables. There’s a lot of wisdom “outside the beltway” that they are missing out on!