Friday, November 25, 2016

The Republican Plan to Kill Medicare


It was not only angry unemployed rural/under employed, low information whites who voted against their own economic interest when they cast their vote for Donald Trump and other Republicans. Many of the elderly did the same and will likely now face the consequences as Congressional Republicans now feel empowered to move forward on a long held dream: gutting Medicare and turning it into a limited voucher program.  The pipe dream of Republicans is that "increased competition will drive down premium costs" - something that has NOT happened in the regular heath insurance arena.  Faced with suddenly vastly increased medical care costs, many of the elderly will find their so-called golden years turning into nightmare years.  Indeed, Paul Ryan may get his wish at long last of forcing many seniors to live off inadequate resources once they must choose between eating, having heat in the winter or medical care. Meanwhile, Ryan will bloviate about his Catholic values even as he utter betrays the Church's social gospel message and cuts healthcare support in order to fund tax cuts for the very wealthy.  The man, as are his GOP allies, is evil.  As for those who voted Republican, they once again allowed Republican appeals to their racism, religious extremism and/or general bigotry to cut their own throats.  The New York Times looks at the coming GOP effort to end Medicare.  Here are excerpts:
[W]ith Election Day behind them, emboldened House Republicans say they will move forward on a years-old effort to shift Medicare away from its open-ended commitment to pay for medical services and toward a fixed government contribution for each beneficiary.
The idea rarely came up during Mr. Trump’s march toward the White House, but a battle over the future of Medicare could roil Washington during his first year in office, whether he wants it or not.
“Let me say unequivocally to you now: I have fought to protect Medicare for this generation and for future generations,” Senator Joe Donnelly of Indiana, a Democrat running for re-election in 2018, said this week in a video message to constituents. “I have opposed efforts to privatize Medicare in the past, and I will oppose any effort to privatize Medicare or turn it into a voucher program in the future.”
For nearly six years, Speaker Paul D. Ryan has championed the new approach, denounced by Democrats as “voucherizing” Medicare. Representative Tom Price of Georgia, the House Budget Committee chairman and a leading candidate to be Mr. Trump’s secretary of health and human services, has also embraced the idea, known as premium support.
And Democrats are relishing the fight and preparing to defend the program, which was created in 1965 as part of Lyndon B. Johnson’s Great Society. They believe that if Mr. Trump chooses to do battle over Medicare, he would squander political capital, as President George W. Bush did with an effort to add private investment accounts to Social Security after his re-election in 2004.
Democrats will “stand firmly and unified” against Mr. Ryan if he tries to “shatter the sacred guarantee that has protected generations of seniors,” said Representative Nancy Pelosi of California, the Democratic leader.
Republicans have pressed for premium support since Mr. Ryan first included it in a budget blueprint in 2011. As he envisions it, Medicare beneficiaries would buy health insurance from one of a number of competing plans. The traditional fee-for-service Medicare program would compete directly with plans offered by private insurers like Humana, UnitedHealth Group and Blue Cross Blue Shield.
Democrats say that premium support would privatize Medicare, replacing the current government guarantee with skimpy vouchers — “coupon care for seniors.” The fear is that the healthiest seniors would choose private insurance, lured by offers of free health club memberships and other wellness programs, leaving traditional Medicare with sicker, more expensive patients and higher premiums.
“Beneficiaries would have to pay much more to stay in traditional fee-for-service Medicare,” said John K. Gorman, a former Medicare official who is now a consultant to many insurers. “Regular Medicare would become the province of affluent beneficiaries who can buy their way out of” private plans.
“I am terrified of vouchers,” said Kim Ebb, 92, who lives in a retirement community in Bethesda, Md., and has diabetes, atrial fibrillation and irritable bowel syndrome. “You get a fixed amount of money to draw on for your expenses. Then you are on your own.”
Charles R. Drapeau, 64, of East Waterboro, Me., said he was rattled by the Republican plans.
“I’m scared to death,” said Mr. Drapeau, who has multiple myeloma, a type of blood cancer, and takes a drug that costs more than $10,000 a month. “We don’t know exactly how it will work, but just the fact that they are talking about messing with Medicare, it’s frightening to me.”
Mr. Gorman said that premium support would be “a seismic change” in Medicare and could increase costs for many people in the traditional fee-for-service program, fueling a big increase in enrollment in private Medicare Advantage plans.
The Congressional Budget Office analyzed two of the leading options and found that “most beneficiaries who wished to remain in the fee-for-service program would pay much higher premiums, on average, under either alternative.” At the same time, the budget office said the proposal could slow the growth of Medicare spending if more beneficiaries enrolled in lower-cost private plans.
Consumer advocates express several concerns about premium support. Private plans, under pressure to rein in costs, could respond by creating smaller networks of doctors and hospitals. Such plans would then be less attractive to sicker patients who need more health care services.
“What happens if the voucher doesn’t grow with the cost of health care?” asked Leslie B. Fried, a health lawyer at the National Council on Aging, a service and advocacy group. “Will people have more and more out-of-pocket costs?”
The winners?  The wealthy who receive tax cuts and the insurance companies. The losers?  The average American.  Welcome to the Trump/GOP America. 

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