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When is a healthcare exchange a GOOD Idea?...Well, if your plan comes from a Republican of course!

Dirty Penguin

Master Of Ceremony
Medicare | U.S. Congressman Paul Ryan
Recognizing the problems facing Medicare, the House-passed Budget:

  • Strengthens health and retirement security by taking power away from government bureaucrats and empowering patients with control over their care.
  • Repeals the new health care law’s unaccountable board of bureaucrats empowered to cut Medicare in ways that would jeopardize seniors’ access to care.
  • Saves Medicare for current and future generations, with no disruptions for those in and near retirement.
  • For younger workers, when they become eligible, Medicare will provide a premium-support payment and a list of guaranteed coverage options – including a traditional fee-for-service option – from which recipients can choose a plan that best suits their needs.
  • Program growth would be determined by a competitive-bidding process – with choice and competition forcing providers to reduce costs and improve quality for seniors.
  • Premium support, competitive bidding, and more assistance for those with lower incomes or greater health care needs will ensure guaranteed affordability for all seniors.
Letting government break its promises to current seniors and to future generations is unacceptable. The reforms outlined in the budget passed by the House protect and preserve Medicare for those in and near retirement, while saving and strengthening this critical program so that future generations can count on it to be there when they retire.


Beginning in 2024, for those workers born in 1959 or later, Medicare would offer them a choice of private plans competing alongside traditional fee-for-service option on a newly created Medicare Exchange. Medicare would provide a premium-support payment either to pay for or offset the premium of the plan chosen by the senior.


The Medicare Exchange would provide all seniors with a competitive marketplace where they could chose a plan the same way members of Congress do. 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. Health care plans would compete for the right to serve Medicare beneficiaries.



The second-least expensive approved plan or fee-for-service Medicare, whichever is least expensive, would establish the benchmark that determines the premium-support amount for the plan chosen by the senior. If a senior chose a costlier plan than the benchmark plan, he or she would be responsible for paying the difference between the premium subsidy and the monthly premium. Conversely, if that senior chose a plan that cost less than the benchmark, he or she would be given a rebate for the difference. Private health plans would be required to cover at least the actuarial equivalent of the benefit package provided by fee-for-service Medicare.



Program growth would be determined by the competitive bidding process – with choice and competition forcing providers to reduce costs and improve quality for seniors. The competitive market for Medicare choices would foster innovation and quality while ensuring that the program is financially stable. As opposed to pegging the growth rate to a predetermined formula, competitive bidding offers the ideal means of harnessing the power of choice and competition to control costs, while also securing guaranteed affordability for patients.
As a backup, the per capita cost once the program has begun could not exceed not exceed nominal GDP growth plus 0.5 percent. The President has repeatedly proposed empowering IPAB to hold Medicare growth to the same rate; the difference is that this budget proposes to use competition to control costs.



All health plans that participate in the Medicare Exchange, including the traditional Medicare option, would be required to offer insurance to all seniors – regardless of age and health status – thereby preventing insurers from cherry picking only the healthiest seniors for coverage under their plan. Additionally, the federal contribution to seniors’ health plans would be increased to account for a senior’s health status and age.



These reforms also ensure affordability by fixing the currently broken subsidy system and letting market competition work as a real check on widespread waste and skyrocketing health-care costs. Putting patients in charge of how their health care dollars are spent will force providers to compete against each other on price and quality. That’s how markets work: The customer is the ultimate guarantor of value.
Reform aimed to empower individuals — with a strengthened safety net for the poor and the sick — will not only ensure the fiscal sustainability of this program, the federal budget, and the U.S. economy. It will also guarantee that Medicare can fulfill the promise of health security for America’s seniors.

(emphasis mine)

:shrug:

Discuss.....
 
Dirty Penguin, you just don't get it. Let me use an analogy. Coke represents the kind of evil socialism that Hitler endorsed. Pepsi, on the other hand, is the kind of home-grown American thirst-quencher that made this country great. Get it?
 

metis

aged ecumenical anthropologist
It's the for-profit system that we have that has us paying nearly 18% of GDP on health care and yet we don't even have universal coverage. BTW, the next highest rate is just under 13%, and that does include universal coverage.

Therefore, if we go forward with Ryan's plan to have even more of our system put into the for-profit category, what reason should we have to believe that this plan would give us better coverage at lower cost?
 

Dirty Penguin

Master Of Ceremony
It's the for-profit system that we have that has us paying nearly 18% of GDP on health care and yet we don't even have universal coverage. BTW, the next highest rate is just under 13%, and that does include universal coverage.

Therefore, if we go forward with Ryan's plan to have even more of our system put into the for-profit category, what reason should we have to believe that this plan would give us better coverage at lower cost?

Yea, I don't like the idea of Medicare put into the private market. We need to strengthen it but I don't see how doing what Ryan is talking about doing will save money. It shifts the burden to seniors and puts them at a greater risk on the open market. I find it ironic that his site has his plan for Medicare and much of it is right out of the Heritage playbook...as well as looking very, very similar to Romney-Care and Obama-Care but geared towards senior....:sad:
 
It's the for-profit system that we have that has us paying nearly 18% of GDP on health care and yet we don't even have universal coverage. BTW, the next highest rate is just under 13%, and that does include universal coverage.

Therefore, if we go forward with Ryan's plan to have even more of our system put into the for-profit category, what reason should we have to believe that this plan would give us better coverage at lower cost?
Here's what I would say: yes I agree with you the for-profit system is not ideal. I wanted single-payer or at least a public option. But if we are going to have a for-profit health insurance system, we may as well do it right.

I don't know enough to comment on Ryan's plan, specifically. But in general terms, if insurance is going to be ultimately supplied by private, for-profit companies then we may as well set up a mechanism so they bid against each other, and consumers can easily make rational, informed choices. Conservatives are correct on this general point about maximizing the efficiency of markets. It's just that when Obama jumps on their bandwagon, they jump off.
 

esmith

Veteran Member
Dirty Penguin, you just don't get it. Let me use an analogy. Coke represents the kind of evil socialism that Hitler endorsed. Pepsi, on the other hand, is the kind of home-grown American thirst-quencher that made this country great. Get it?

A little off topic here Mr. Sprinkles, but are you suggesting that Socialism is the same as Fascism(Nazi Germany), or is your post a little tongue-in-cheek humor?
 

metis

aged ecumenical anthropologist
BTW, there's a way of having our cake and eating it too. The Germans (and starting this year, also the Danes) have a system whereas they use private insurance companies (25 in Germany at last count) that are heavily regulated so the playing field is level, also operating as non-profit companies. Yes, there is competition because we are by nature a competitive species (plus job security helps to motivate even the less competitive), and where lots of money is saved is because advertising is very limited (more pamphlets and less t.v., the latter of which is very expensive).

I don't know the percentage of overhead costs for these companies, but the American private insurers operate at an average of 29% overhead, and so much of that is due to heavy advertising plus paying investors off. OTOH, Medicare operates at roughly 3% overhead.
 

Kilgore Trout

Misanthropic Humanist
Just to remind everyone - none of this, in any way shape or form, has, or ever has had, absolutely anything to do with Obama being black. And, frankly, I'd say it's racist itself to even bring up the issue of his race.
 
A little off topic here Mr. Sprinkles, but are you suggesting that Socialism is the same as Fascism(Nazi Germany), or is your post a little tongue-in-cheek humor?
The word "Nazi" stands for National "Socialism". And Coke markets itself as a "social" drink. You do the math. I'll stick with Pepsi, the drink that made America great in the America I grew up in, job creation, freedom, something, something.
 

esmith

Veteran Member
BTW, there's a way of having our cake and eating it too. The Germans (and starting this year, also the Danes) have a system whereas they use private insurance companies (25 in Germany at last count) that are heavily regulated so the playing field is level, also operating as non-profit companies. Yes, there is competition because we are by nature a competitive species (plus job security helps to motivate even the less competitive), and where lots of money is saved is because advertising is very limited (more pamphlets and less t.v., the latter of which is very expensive).

I don't know the percentage of overhead costs for these companies, but the American private insurers operate at an average of 29% overhead, and so much of that is due to heavy advertising plus paying investors off. OTOH, Medicare operates at roughly 3% overhead.

Suggest the following article for your perusal.

Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance

5903B1F101A0D05E9BC1D8289AF88DC7.gif
 

Kilgore Trout

Misanthropic Humanist
The word "Nazi" stands for National "Socialism". And Coke markets itself as a "social" drink. You do the math. I'll stick with Pepsi, the drink that made America great in the America I grew up in, job creation, freedom, something, something.

New Coke is the one and only truly thirst-quenching cola beverage. It is the perfect, genetically bred soft-drink which will remain the ultimate choice for refreshment for a thousand years!
 
Suggest the following article for your perusal.
The analysis may be correct, but I'm skeptical for three reasons:

(1) It doesn't address Germany's system, which was the point of metis' post;

(2) It could be comparing apples to oranges; Medicare could have higher administrative costs per customer because it costs more to administer a plan full of old sick people (Medicare) than young healthy people (private insurance, relative to Medicare). If my customers are sicker and I have to process 2 medical claims per customer rather than 1 claim per customer, my administrative costs go up even if I am just as (or more) efficient in processing those claims. A more fair comparison, therefore, would be what PERCENTAGE of operating costs, or revenues are administrative? You may be interested in the following ("Trustees" represents people on Medicare, NHEA represents total health spending including private care):
blog_medicare_admin_cost.jpg

JAMA Forum: Are Health Insurers
Setting the record straight on Medicare
Medicare Is More Efficient Than Private Insurance – Health Affairs Blog
Oops! Looks like the Heritage Foundation is lying again.

(3) It's the Heritage Foundation.
 
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Dirty Penguin

Master Of Ceremony
So....Do or should conservatives have a problem with Paul Ryan wanting to do to Medicare with what's happening in Mass. with Mass. Care (RomneyCare) or the US with the ACA or are they ok with it?
 
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