OK. We hate Ryan's medicare plan.

[1KansasDem]

What do we propose?
Wyden/Ryan is start?
Doesn't something HAVE to be done, or the whole thing blows up in a few years.

Yes. I am wearing my asbestos underware.

[spanone]

1. you're posting the thread, you tell me

[SunsetDreams]

22. I would like to hear the OP's Ideas also

Here is what the ACA already did. What it DID NOT do is cut Medicare in anyway that would effect beneficiaries negatively, in fact quite the contrary.

The Affordable Care Act makes many changes to strengthen Medicare and provide stronger benefits to seniors, while slowing cost growth. As a result, average Medicare beneficiary savings in traditional Medicare will be approximately $3,500 over the next ten years. Beneficiaries who have high prescription drug spending will save much more – as much as $12,300 over the next 10 years. In comparison, Medicare beneficiaries with low drug costs will save an average of $2,400 over 10 years.

This report provides estimates of savings from the Affordable Care Act to seniors and people living with disabilities enrolled in traditional Medicare. The Affordable Care Act will favorably affect beneficiary expenditures in four ways. First, premiums for Part B physician and certain other services are expected to increase at a slower rate than would have occurred without the Affordable Care Act, resulting in lower Part B premiums over time. Second, beneficiary copayments and coinsurance under Part A and B will increase more slowly because the Affordable Care Act slows the rate of growth in payments to hospitals and other providers. Third, closing the Medicare prescription drug coverage gap, often called the “donut hole,” will lower costs for beneficiaries who otherwise would have been required to spend thousands of dollars out of their own pocket for their prescription drugs. Finally, the Affordable Care Act will provide many preventive services to seniors at no additional cost.

The Affordable Care Act will save approximately $500 billion over the next ten years through reduction in extra subsidies paid to Medicare Advantage plans, reductions in the rate of growth in provider payments, and efforts to make the Medicare program more efficient and to reduce waste, fraud and abuse. These reductions will lead to corresponding savings for beneficiaries through lower copayments and premiums. A slower rate of growth in Medicare is expected to result in a slower rate of growth in beneficiary out-of-pocket payments, and a slower rate of growth in Part B premiums. In addition, the closing of the donut hole will result in large savings for beneficiaries with high levels of prescription drug spending.

Total savings per traditional Medicare beneficiary are estimated to be $86 in 2011, rising to $649 in 2020 (see Table 1). For a beneficiary with spending in the donut hole, estimated savings increase from $553 in 2011 to $2,217 in 2020.

Anyone can go there and read for themselves what was already done. If the summary doesn't satisfy, you can read the actual law, particularly sections 2 and 3. http://www.healthcare.gov/law/resources/reports/affordablecareact.html

[dsc]

2. simple

bring our health care costs in line with those of other countries. If we did that the Medicare problem would cease to exist or be a very minor fix.

[Raster]

3. Well we begin by removing the cheney*/bush* rule that prohibits Medicare from negotiating for bulk..

...prices for drugs and services. Everyone gets a bulk discount, why shouldn't Medicare?

Then we add EVERYONE IN THE COUNTRY to Medicare to gaurantee each and every citizen a shot at competent medical care.

[Freddie]

39. Ding! Ding! Ding!

We have a winner!

[SunsetDreams]

4. funny you should mention Wyden...

The Romney campaign’s lone evidence that Ryan is a bipartisan leader amounts to a vague blueprint he co-wrote with Democratic Sen. Ron Wyden (D-OR) late last year that mirrors key elements of his Medicare plan. Wyden voted against Ryan’s budget and said Romney’s characterization of their work was dishonest.

“Governor Romney is talking nonsense. Bipartisanship requires that you not make up the facts,” Wyden’s office said in a statement. “I did not ‘co-lead a piece of legislation.’ I wrote a policy paper on options for Medicare. Several months after the paper came out I spoke and voted against the Medicare provisions in the Ryan budget. Governor Romney needs to learn you don’t protect seniors by makings things up, and his comments sure won’t help promote real bipartisanship.”

http://tpmdc.talkingpointsmemo.com/2012/08/the-myth-of-paul-ryan-the-bipartisan-leader.php?ref=fpa

[1KansasDem]

5. I'm not talking about Ryan's budget plan

Only about medicare.
Ryan's answer does not appeal to me.
But I'd like to hear some alternatives.

[SunsetDreams]

8. Ryan's Medicare plan is in his budget

I'm sorry Wyden ACTUAL involvement didn't fit that "Wyden/Ryan" misunderstanding in your OP.

The Romney campaign’s lone evidence that Ryan is a bipartisan leader amounts to a vague blueprint he co-wrote with Democratic Sen. Ron Wyden (D-OR) late last year that mirrors key elements of his Medicare plan. Wyden voted against Ryan’s budget and said Romney’s characterization of their work was dishonest.

“Governor Romney is talking nonsense. Bipartisanship requires that you not make up the facts,” Wyden’s office said in a statement. “I did not ‘co-lead a piece of legislation.’ I wrote a policy paper on options for Medicare. Several months after the paper came out I spoke and voted against the Medicare provisions in the Ryan budget. Governor Romney needs to learn you don’t protect seniors by makings things up, and his comments sure won’t help promote real bipartisanship.”

http://tpmdc.talkingpointsmemo.com/2012/08/the-myth-of-paul-ryan-the-bipartisan-leader.php?ref=fpa

[1KansasDem]

17. Yes, there's a whole bunch of crap in Ryan's budget.

I wasn't looking at discussing all of them. Just hoping to hear some ideas on medicare.
Call me an alarmist, but the program has some serious funding problems in the near future.

[SunsetDreams]

19. You can still edit your OP

to take out Wyden/Ryan. They were not in agreement. I've provided the link that disputes that.

[nenagh]

35. *****Agree... ****

I just saw the Wyden reference..... And thank you for your response....

[JaneyVee]

6. We propose expanding it by raising the threshold for those that pay into it.

[1KansasDem]

9. What is the

medicare thresshold?

[Jack Sprat]

25. It's 65 and older presently.

It would save money to offer it to everyone. The healthcare providers are costing over 20% in overhead costs that have nothing to do with medical care. The various provider are issuing rebates for the overpayments they were charging beyond the 20% limits imposed by ACA. That's just how much more we all have to pay if we're not elegible for Medicare. So there's a 20% plus savings you get just by adopting a national single payer system.

[nanabugg]

7. Obama admin have already made great strides in ferreting out fraud and abuse by providers but

it doesn't get talked about much. The truth is that some your "untouchable" medical profession is guilty of all kinds of fraud in the system that past lax enforcement has allowed to mushroom.

[1KansasDem]

11. I don't think we can "save" medicare

by trying to eliminate waste, fraud and abuse. It sounds good (we're trying). But all politico's use the waste, fraud, and abuse meme. It just nibbles around the edge of big problems.

[JaneyVee]

12. Nibbles around the edges? Its $60 billion year.

Do you know how much healthcare you can get for $60 billion?! On top of that make people up to $500,000 pay in. 95% fixed.

[1KansasDem]

15. I don't disagree that the waste, fraud and abuse exists.

It's nearly impossible to ever make a dent in it. Remember when VP Gore really went after Pentagon spending. Got rid of a toilet seat here an ashtray there.
I'll guarantee those wasteful items have been replaced by new ones.
A certain amount of W,F& A will always be their. I don't think you can plan on spending the savings.

[Cleita]

10. Medicare is fine.

My father, my husband and now I were able to lead a quality of life because of it and when the end neared for both my dad and my husband, they were able to get the medical care they needed until the end. It doesn't need the fixing any of those clowns are proposing. I hope when my time comes it will be there for me like it was for my dad and my husband. If it's not, I will kill myself in the presence of one of them to make a statement.

[1KansasDem]

13. Medicare is not fine.

Yes, it's a great program that has served us well, until the current demographics began kicking in.
Some changes HAVE to be made. Exactly what those changes will be is the quandary.

[Ron Obvious]

16. We can start...

We can start by changing Medicare part D to allow Government to bargain for much lower drug prices because of volume. Something Medicare part D explicitly disallowed.

[1KansasDem]

18. Yea, I think big pharma did a little horse trading there.

[eridani]

21. That is utter tripe

Medicare is NOT bankrupt!
Understanding the Medicare Trust Fund

In their recently released report, the Medicare trustees have projected that the Part A trust fund, also known as the Medicare Hospital Insurance (HI) trust fund, will remain solvent through 2024. This is the same conclusion that the trustees made last year. Reforms included in the Affordable Care Act (ACA) have strengthened Medicare’s financial outlook and extended solvency through 2024.

The Part A trust fund and its solvency are frequently misunderstood. The trust fund is a financing mechanism for Medicare Part A, which covers inpatient services such as hospital stays and skilled nursing facility care. The trust fund is financed through a combination of payroll taxes and other revenues. Although, as noted above, the trustees have recently reported that the trust fund is solvent through 2024; that does not mean that the trust fund or Medicare will cease to exist in 2025. The trustees found that the Part A trust fund will be able to cover 100 percent of the costs of Medicare’s Part A benefits through 2024. After 2024, the trust fund will still be able to provide coverage, though at a lesser rate. According to the Center on Budget and Policy Priorities (CBPP), starting in 2025, Medicare will still be able to cover 87 percent of all inpatient costs, and over the next 75 years, the trust fund, on average, will be able to cover 74 percent of Medicare’s inpatient costs. A number of factors can affect the Medicare Part A trust fund. For example, since the trust fund is partially paid for through payroll taxes, an economic downturn could result in less people paying into the system. As the economy recovers, so will the trust fund.

Medicare Part B, which covers outpatient services such as visits to doctors’ offices, and Medicare Part D, which covers prescription drugs, are financed through beneficiary premiums and general revenues, not through the trust fund.

While action will need to be taken to make up for the future financing shortfalls of Medicare Part A after 2024, it is important to recall that congress has been taking this kind of action since 1970 to extend the life of the trust fund to ensure that people with Medicare are able to access affordable, comprehensive and quality coverage. Unfortunately, supporters of drastic changes to Medicare, such as premium support, point to the potential insolvency of the trust fund to justify proposals that would shift substantially higher out of pocket costs onto beneficiaries and their families as well as undermine the consumer protections and guaranteed benefits that the Medicare program currently provides. Strengthening the Medicare trust fund can be done without gutting Medicare’s guarantees.

Read Medicare Rights President Joe Baker’s statement on the release of the 2012 Medicare and Social Security Trustees Report. http://www.medicarerights.org/newsroom/pressreleases/2012_16.html

Read the Center on Budget and Policy Priorities report, “Medicare is not Bankrupt.” http://www.cbpp.org/cms/index.cfm?fa=view&id=3532

Read the Center for Medicare and Medicare Services press release and Trustees Report http://www.medicarerights.org/newsroom/pressreleases/2012_16.html

[1KansasDem]

30. Why are we hearing that the current rate of the growth in medicare spending is unsustainable.

Just askin'
I'm 57 and I damn sure want to make sure it's there for me and that my doctor will accept medicare's reimbursement rate.

[eridani]

34. In the long term, it isn't. It's fine until 2024

--plenty of time for action. Hoping that at least some states will have single payer by then. That would get our health care costs in line with those of civilized countries.

With the ageing of the population, doctors are over a barrel.

[cali]

38. sadly, you don't know shit about what you're talking about.

You're listening to right wing dog shit. The current rate of growth of medicare spending is far less than that of health care costs in the private sector. And Medicare will absolutely be there in 7 years. No one claims that it won't- even your adored fuckwad Ryan.

Oh, and we can do what my state of Vermont is doing:

http://hcr.vermont.gov/

Don't pretend to be a dem. it's pathetically transparent, dearie.

[Raster]

41. cali, you are a jewel. I know when you haul out "dearie"...

...someone is going to get a shellacking. Carry on.

[Jack Sprat]

23. Care to say why? Why does it need changed?

Why not make it single payer if it has to be changed? One single payer government healthcare system that cuts out all the various middleman providers which are so costly. If we can't raise taxes on the top rates, then we can't afford to fix anything. In fact, if we don't raise those rates substantially for more revenue, I don't see how we can have an overseas military presence at all. Yet, we still will and everybody on God's green earth knows it.

[bhikkhu]

26. The projections are BS

based on a smooth continuation of the unsustainable rates of growth in health care costs. Not going to happen.

One aspect of the ACA is how it is similar to the Swiss health care system. They were the last European country to adopt universal health care, and they did it in a very bankerly and deliberate fashion; the result runs well at very low costs. We have a long way to go before we get there, but there are massive amounts of low-hanging waste in our system that have been eating away at Medicare, all of our budgets, even sucking down the Pentagon's reserves. The ACA is designed to bring costs under control, which is nowhere accounted for in the "Medicare is Doomed" projections.

[Skittles]

29. stop listening to repuke propaganda

ask yourself why they never question how to pay for senseless wars

[Cleita]

36. For one thing Obamacare is targeting any fraud that might have been

perpetrated in the past. But whatever that has been, it's teensy, tiny and miniscule to the wholesale looting of taxpayer's money by military contractors in the war years started by Bush. It's estimated that not just billions but maybe trillions have been funneled into the pockets of those corporations by our Republican elected legislators and the Pentagon, yet not a one of the "fiscally conservative", balanced budget Republicans have even mentioned it, nor the fact that a lot of the money that has disappeared can even be accounted for. They would rather go after the safety nets of the poor and senior citizens instead. I'm sorry, it's just a red herring and a vicious one that endanger our security for our old age.

[Lint Head]

14. Get rid of health care for profit and institute Medicare for all.

We spend 8 times more money than all other military countries combined on our war machine. How about just spending 4 times as much.
That would save a lot of things including soldiers lives and the lives of sick people.

[Jack Sprat]

31. Guess the OP didn't like the proposals

of a medicare-for-all system, reigning in alternate spending, or finding new revenue sources. I have yet to hear of a cheaper way to administer healthcare than a single payer government provider to cut out over 20% of administative costs that the current multi-providers take from the system.

[eridani]

20. Wyden/Ryan is a proposal for mass murder, only slower

What HAS to be done is government control of costs through the unified funding of Single Payer.

[The Straight Story]

24. The difference between the cuts:

http://tpmdc.talkingpointsmemo.com/2012/08/difference-between-paul-ryan-barack-obama-medicare.php

[karynnj]

27. Ryan's plan is awful - as is Wyden's version of the same

The way to fix Medicare is to:

1) Raise the income level cap on which FICA is paid
2) Lower the rate of increase, then the costs themselves of health insurance - which will be done by the ACA when the exchanges start to work.

By the way, explain hoe Ryan's plan saves ANY Medicare cost in the first 10 years. He says NOTHING changes for those over 55. You don't get Medicare until you are 65 (ignoring disability).So nothing happens for 10 years to bend the cost curve.

Then for those under 55, he will give them a voucher for LESS than what Medicare costs - or he saves no money switching. They need to then buy private insurance where the administrative overhead is about 15% versus the 2 or 3% of Medicare. Mathematically there is NO way seniors are not hurt.

[gkhouston]

28. Medicare for all. Unlike Ryan's plan, it actually *is* bold and likely to work. n/t

[HiPointDem]

33. The rising cost of Medicare is almost entirely due to the rising cost of for-profit healthcare.

The aging population is a very small part of this picture.

Universal healthcare would remove the profit factor.

[CreekDog]

37. We propose? Most of us support single payer

our Medicare system is single payer.

Canada's Medicare system is single payer and much like our own, except less expensive (and includes everyone not just the aged).

The cost of Medicare isn't the problem, it's the the cost of insurance for younger people is so expensive under the private aspect of our system that there is not enough money left over to subsidize the elderly.

Other countries have shown that all must be included in a public system or heavily regulated system --that saves money which is spent on those who are older or chronically ill.

Obamacare gets us closer to that than we are today.

[cali]

40. "What do we propose"?

There's no "we" here. You're obvious.

[rgbecker]

42. I'm not sure why I'm bothering to respond to you, but maybe you should watch this.

The ACA is tackling many issues with Medicare, but RomRyan is ready to scrap it. What link can you provide that indicates that it "Blows up in a few years."?

&feature=player_embedded