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Will Donald Trump Privatize Medicare?

Will Donald Trump Privatize Medicare?

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Greenbeard

Greenbeard

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We know Paul Ryan is champing at the bit for this but on the campaign trail Trump pledged to protect Medicare. But, as with so many of his campaign promises, he appears to have begun to reverse himself. So what comes next?

The WSJ considers What a GOP Government Potentially Means for Medicare Beneficiaries:

Medicare beneficiaries could face big changes as the Republican Party, fresh off its election sweep, looks to revamp the federal health-care system.

While Donald Trump had said before his campaign’s launch that “I’m not going to cut Medicare or Medicaid,” the president-elect’s transition website has signaled support for longstanding Republican-backed plans to “modernize Medicare.”

In addition, if the Trump administration amends or repeals the Affordable Care Act—as Mr. Trump has vowed to do—Medicare beneficiaries could lose some basic benefits, although upper-income participants could see reductions in their premiums.
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The bigger question is whether the incoming administration and the Republican majority in Congress will push to revamp Medicare itself by scrapping the current payment system—in which the federal government covers a percentage of the cost—in favor of fixed-dollar subsidies for retirees to purchase insurance.

“Trump has adopted the language conservatives have been using for a long time when they talk about modernizing Medicare,” said Howard Gleckman, a senior fellow at the Urban Institute think tank. “He went from saying, ‘I am not going to touch Medicare’ to saying, ‘I am dropping hints that I am going to do some pretty dramatic things to Medicare.’ ”

The Trump transition team didn’t respond to requests for comment.
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One must remember that Medicare is funded by an extremely regressive tax. Changing that aspect is not a bad idea.
 
Trump, in many respects, is a mystery. If one were to take his public statements seriously, he wouldn't want to touch (or, necessarily enhance) Medicare at all. But because he is an elected official in the Republican Party with a Speaker of the House very set on significantly altering the designs of Medicare, Trump could be more than persuaded to follow at least some of Ryan's lead. Trump can also say by doing so he's "saving it" from "disaster" (I include the last word, because he uses it all too frequently).
 
Greenbeard said:
We know Paul Ryan is champing at the bit for this but on the campaign trail Trump pledged to protect Medicare. But, as with so many of his campaign promises, he appears to have begun to reverse himself. So what comes next?

The WSJ considers What a GOP Government Potentially Means for Medicare Beneficiaries:
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He might try. He has, after all, championed a lot of bad ideas. He does seem to be backing off on the worst of them, so maybe he won't try to "privatize" i.e. put a cap on Medicare.

Giving seniors a fixed dollar amount with which to purchase insurance in a market where the price keeps going up and up and no one really wants to insure the most expensive demographic is the king of bad ideas.
 
I voted "he will try but fail." I also considered "I don't know" because Donald Trump is very controversial.
 
Fiddytree said:
Trump, in many respects, is a mystery. If one were to take his public statements seriously, he wouldn't want to touch (or, necessarily enhance) Medicare at all. But because he is an elected official in the Republican Party with a Speaker of the House very set on significantly altering the designs of Medicare, Trump could be more than persuaded to follow at least some of Ryan's lead. Trump can also say by doing so he's "saving it" from "disaster" (I include the last word, because he uses it all too frequently).
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Well, if he promised not to, maybe he will.
 
Dittohead not! said:
He might try. He has, after all, championed a lot of bad ideas. He does seem to be backing off on the worst of them, so maybe he won't try to "privatize" i.e. put a cap on Medicare.

Giving seniors a fixed dollar amount with which to purchase insurance in a market where the price keeps going up and up and no one really wants to insure the most expensive demographic is the king of bad ideas.
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So is offering an ever declining payout to potential care providers. A big difference between SNAP and Medicare is that SNAP covers 100% of the retail market price while Medicare falls well short of doing that. If SNAP offered 60% (or less) of the retail price then it would be accepted by many fewer food outlets.
 
Say what you will, but mess with Medicare too much and you will pay the price politically, some seem forget how many Baby Boomers there are.
 
ttwtt78640 said:
So is offering an ever declining payout to potential care providers. A big difference between SNAP and Medicare is that SNAP covers 100% of the retail market price while Medicare falls well short of doing that. If SNAP offered 60% (or less) of the retail price then it would be accepted by many fewer food outlets.
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The difference is that food prices haven't been increasing by double digits for the past few decades. SNAP can afford to pay retail. A privatized Medicare with no leverage to negotiate prices would be enormously expensive and would still leave seniors with inadequate coverage.

We can't reform Medicare without reforming the rest of the health care system, including addressing the issue of costs. We have created a system that we can no longer afford.
 
Casper said:
Say what you will, but mess with Medicare too much and you will pay the price politically, some seem forget how many Baby Boomers there are.
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Yes, and we vote.
Those whippersnappers who still haven't even seen their 60th. birthday don't vote in anything like the percentages that seasoned citizens do.
 
Dittohead not! said:
Yes, and we vote.
Those whippersnappers who still haven't even seen their 60th. birthday don't vote in anything like the percentages that seasoned citizens do.
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Correct. There are some programs that are not going anywhere, Medicare and SS, one can improve them, but to harm them will mean those politicians will be going somewhere, unemployment.
 
Dittohead not! said:
The difference is that food prices haven't been increasing by double digits for the past few decades. SNAP can afford to pay retail. A privatized Medicare with no leverage to negotiate prices would be enormously expensive and would still leave seniors with inadequate coverage.

We can't reform Medicare without reforming the rest of the health care system, including addressing the issue of costs. We have created a system that we can no longer afford.
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Medicare does not exactly negotiate prices - they offer $X for procedure Y and it is a take it or leave it deal. Medicare does (somewhat) negotiate drug prices.
 
Dittohead not! said:
The difference is that food prices haven't been increasing by double digits for the past few decades. SNAP can afford to pay retail. A privatized Medicare with no leverage to negotiate prices would be enormously expensive and would still leave seniors with inadequate coverage.

We can't reform Medicare without reforming the rest of the health care system, including addressing the issue of costs. We have created a system that we can no longer afford.
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SNAP can afford what congress allocates. My point remains the same - the lower the Medicare offer for payment gets then the fewer providers that will accept it.
 
ttwtt78640 said:
SNAP can afford what congress allocates. My point remains the same - the lower the Medicare offer for payment gets then the fewer providers that will accept it.
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Correct, which is why it can't get too low. On the other hand, Medicare can't afford to pay retail in the medical care business.
 
Casper said:
Correct. There are some programs that are not going anywhere, Medicare and SS, one can improve them, but to harm them will mean those politicians will be going somewhere, unemployment.
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Very true. The unemployment line.
 
Dittohead not! said:
Correct, which is why it can't get too low. On the other hand, Medicare can't afford to pay retail in the medical care business.
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Yep, and the Medicare "discount", just like the EMTLA mandate, makes the retail price rise for others.
 
Dittohead not! said:
A privatized Medicare with no leverage to negotiate prices would be enormously expensive and would still leave seniors with inadequate coverage.
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That's an important point. Medicare Advantage plans today can more or less hang with traditional Medicare because they generally reimburse providers at Medicare rates. They still get to play in the Medicare sandbox, instead of going the full-on market competition route.

If Medicare is converted fully or partially into private insurers competing in an exchange Obamacare-style, if they're not piggybacking on Medicare's price-setting (which it's hard to imagine they would be), these plans will necessarily cost more than traditional Medicare. Even if the government ends up paying less by sticking grandma with the bill.
 
Dittohead not! said:
how do you figure that?
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If a provider needs $100 to cover costs of treatment X but EMTLA pays $0 and Medicare pays $60 then they must add $100 for each EMTLA patient and $40 for each Medicare patient to the fees paid by cash and/or privately insured patients. That may well make the ($100) treatment X now cost "full fare" patients $130 (or more) to help make up for the losses on free and discount patients.
 
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