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Ryan to announce plan to keep federally funded Medicare

Harry Guerrilla said:
Yep, this is the stuff of when reality meets fantasy.
Should we keep 85 yo granny, who has cancer all over her body, on life support?
The rational answer is no, the emotional answer is yes.
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This is the reason I don't want the government making this decision.
 
Blue_State said:
This is the reason I don't want the government making this decision.
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But government is never going to tell grandma that she can't pay for it herself if she wants to. All they would be doing is saying that, from a budget perspective, we cannot afford to ignore cost/benefit analysis. By all means, purchase supplemental insurance if you think you might want to blow through a million dollars to spend an extra two weeks in a fog of pain and morphine.
 
AdamT said:
But government is never going to tell grandma that she can't pay for it herself if she wants to. All they would be doing is saying that, from a budget perspective, we cannot afford to ignore cost/benefit analysis. By all means, purchase supplemental insurance if you think you might want to blow through a million dollars to spend an extra two weeks in a fog of pain and morphine.
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I don't disagree with anything that you said.

I think this is where you and I would not agree: The government should not make the people buy into its insurance program.
 
Blue_State said:
I don't disagree with anything that you said.

I think this is where you and I would not agree: The government should not make the people buy into its insurance program.
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Yep, that's where we will party company. ;)

I think that the government, through economies of scale (and because it's nonprofit) can do it more efficiently. And I think that many people would opt out, only to find themselves without coverage in old age. This is not the 1950s or 60s, when employers routinely provided pensions and medical benefits to retirees.

OTOH, what I would accept is an option allowing people to use the actuarial value of their Medicare benefits to instead purchase private insurance. I think that what you'd find is that almost no one would opt out. Health insurance is hugely expensive for a healthy person in his or her 30s. What do you think it would cost for someone in his or her 70s or 80s?
 
this looks alot like Romney's adaptation of the Ryan Plan.

It would leave current seniors and people who are now over 55 untouched, but for all younger Americans would transform the Medicare system into a premium-support system, in which Medicare would offer a fixed amount per recipient each year and individuals could use that amount to choose from a menu of private insurance options as well as one public fee-for-service option.

The latter would be a fee-for-service plan as an option within the capped premium-support system and so competing with the private insurers, not today’s open-ended fee-for-service Medicare as an alternative to a premium-support system...

The government would define the minimum insurance benefit it would seek to provide to all covered seniors, based on the level of coverage Medicare now provides, and then there would be a process each year in which the competing insurers would offer bids proposing to provide that (or a greater) benefit at the lowest cost they could. The level of the premium-support payment would be set at the level of the second-lowest of the bids. Seniors would then be able to apply that amount toward the purchase of any of the plans on offer. Thus, there would be at least one option that would cost less than the premium-support benefit, and seniors choosing that option would get the difference back; there would be at least one plan that cost the same as the benefit, so that seniors could obtain it with only the same out-of-pocket costs they have today; and there would be other plans that cost more (perhaps because they offered more, or because they failed to find ways to drive greater efficiency in their networks of doctors and hospitals) and for which seniors would pay an additional premium if they chose. Poorer and sicker seniors would get additional help, while the wealthiest seniors would get less...
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AdamT said:
Yep, that's where we will party company. ;)

I think that the government, through economies of scale (and because it's nonprofit) can do it more efficiently. And I think that many people would opt out, only to find themselves without coverage in old age. This is not the 1950s or 60s, when employers routinely provided pensions and medical benefits to retirees.

OTOH, what I would accept is an option allowing people to use the actuarial value of their Medicare benefits to instead purchase private insurance. I think that what you'd find is that almost no one would opt out. Health insurance is hugely expensive for a healthy person in his or her 30s. What do you think it would cost for someone in his or her 70s or 80s?
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I find myself agreeing with you again...partially. Make a program that you can opt out of, and that would be great. I would caveat that with, if you opt out, you have to show that at least a equal value is going to private health insurance.

The place I disagree with you is that I don't believe the government could run it efficiently. It is not in their nature.

Our conversation is excluding the poor, but I am sure we will agree that our society has a responsibility to their care.

EDIT: If at all possible, I would prefer to see these programs at the state level, but I know that would be asking a lot.
 
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Blue_State said:
I find myself agreeing with you again...partially. Make a program that you can opt out of, and that would be great. I would caveat that with, if you opt out, you have to show that at least a equal value is going to private health insurance.

The place I disagree with you is that I don't believe the government could run it efficiently. It is not in their nature.

Our conversation is excluding the poor, but I am sure we will agree that our society has a responsibility to their care.

EDIT: If at all possible, I would prefer to see these programs at the state level, but I know that would be asking a lot.
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Every state has the ability to opt out of the current health insurance mandate. So far, Vermont has been the only state to opt out.
 
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