Comments for Representative Ryan Proposes Medicare Plan Under Which Seniors Would Pay Most of Their Income for Health Care at http://www.cepr.net , comment 1 to 38 out of 20 comments http://www.cepr.net Mon, 20 May 2013 12:35:23 +0100 FeedCreator 1.7.3 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8259 I find it interesting that the CBO analysis and the discussion is about premiums for a 65 year old person. The CEPR has calculated that a 75 year old would spend over $40,000 a year or 143% of median annual income after the Medicare contribution, based on the Ryan plan. Think about it, what private insurer would even write a policy for the average 75 or 80 year old? Check it out http://www.cepr.net/documents/publications/ryan-medicare-2011-04.pdf - Look Ahead Wed, 13 Apr 2011 05:19:31 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8087 Freddio66, There won't be any more unpaid bills with Ryan's plan because the level of support for most seniors will be roughly the same. Support for high-income seniors will be lower, and support for low-income and poor-health seniors will be higher (via federal contributions to HSA accounts for those individuals). - BV Fri, 08 Apr 2011 08:21:57 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8085 no one has considered the fact that if seniors cannot afford medical care they will still go to the emergency room, they will not simply lay down and die. How many poor seniors along with the other 42 million uninsured will it take to overwhelm the hospital system and end medical care even for the rich? The system will collapse because of unpaid bills. - freddieo66 Fri, 08 Apr 2011 07:42:20 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8082 Two examples to drive the point home: Consider a 25-year-old who has medical insurance, but needs no medical treatment over the course of the year. For that individual, administrative costs made up 100% of the insurance company's costs. Does that mean the company was inefficient? Consider the difference between a 4-year-old and a 65-year-old who has a hip replacement. We'll assume that both cost the insurance company $400/yr in administrative expenses. For the 4-year-old, one checkup will cost $100, so the insurance company is paying 80% in administrative costs. For the senior, the hip replacement will cost $10,000, so Medicare is only paying 4% in administrative costs. Is this because Medicare was more efficient? What you must consider is that the make-up of the enrollees is different between overall private insurance and Medicare. That difference makes Medicare [i]look [/i]more efficient when the numbers are stated as a percentage of medical services - but that's because Medicare recipients receive more and higher dollar medical services. In actuality, Medicare has higher per-enrollee administrative costs. Switching to private insurance will not drive costs up 50%. Even if you accept the (misleading) 5% vs 20% argument (which would indicate a 17% difference in costs - 100/85 = 1.17 ), exactly how does that magically balloon into a 50% difference (100/66 = 1.50) in 2030? - BV Fri, 08 Apr 2011 05:46:11 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8080 Jhand wrote: [quote]And anyone relying on private health insurance need read the fine print very carefully to be sure they are getting the coverage they think they are buying. [/quote] The implication of this statement is that those on Medicare don't have the same issue. That's not true. My parents are on Medicare, and have had a number of issues with Medicare not covering something they should. - BV Fri, 08 Apr 2011 05:31:38 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8079 jhand, Either you're not reading the whole thing, or you're missing the point. Stating admin costs on a "percentage of medical costs" basis is not useful. [b]No[/b] administrative costs are proportional to the dollar value of medical services. Most administrative costs (enrollment, collection of premiums, providing, plan information, general management, information technology) are proportional to the number of enrollees. Even claims processing isn't related to the dollar value of medical services - rather it is related to the number of claims. Seniors tend to have high-dollar medical services (hip replacement, heart surgery, etc.), which makes the administrative costs [i]look [/i]like a small percentage. And according to the CBO, claims processing only makes up ~8% of total administrative costs. So a per-enrollee number for administrative costs is a much better way to compare efficiency. In actuality (and I've provided the numbers in detail), if you look at costs on a per-enrollee basis, Medicare costs [b]more[/b] than private insurance. - BV Fri, 08 Apr 2011 05:28:28 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8065 I'll get it right yet. According to Krugman, it was the Heritage Foundation that posted and pulled the bogus numbers. Mea culpa, mea culpa, mea maxima . . - jhand Thu, 07 Apr 2011 17:14:34 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8064 A correction: I said "American Heritage." I meant to say "American Enterprise Institute." I was distracted because I had to go buy materials for my classroom, materials that the school can no longer afford. My apologies for the error. - jhand Thu, 07 Apr 2011 16:29:21 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8063 To BV: I worked all day and just read your response to mine and other's posts. Believe me, I did read your post as well as the CBO's report. Please, it is not an "assertion" that Medicare is more efficient that private health insurance, it is a fact. Medicare's administrative costs run at rate of 5%, compared to private insurance rates in the 20% range. Look, I am not one to disparage private health insurance in general. However, private insurers do exclude people, raise rates when they believe they need to, and don't necessarily cover all the procedures that the insured believe are covered. I don't know why it's necessary to defend private insurance against Medicare; many Medicare users take out special policies to cover deficiencies in Medicare (nursing home care being one case). The history of private health insurance is such that we have to assume that, no matter how big Ryan's vouchers get, they will never adequately cover private premium costs. And anyone relying on private health insurance need read the fine print very carefully to be sure they are getting the coverage they think they are buying. Let's not forget that this "plan" is part of a plan that predicted driving down unemployment to a number so embarrassingly wrong that American Heritage had to pull the numbers off of its website. - jhand Thu, 07 Apr 2011 15:27:43 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8052 Note in Part 1 that I used the low end of the estimates for Medicare admin costs. Note too that Medicare is exempt from state premium taxes (as much as 5% in some states) and from state regulatory compliance. Even with these advantages, and even with using the [b]LOW END[/b] of the estimate for Medicare admin costs are nearly 20% on a per-enrollee basis than private insurance. - BV Thu, 07 Apr 2011 07:10:49 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8051 If you look at the CBO analysis of Ryan's plan, the supposed extra cost to seniors is entirely due to their (absurd) assumption that private health plans will cost 50% more than Medicare. [b]This assumption is not supported by the facts.[/b] Once you eliminate that assumption, the Ryan plan pays out only 3 percentage points less than current Medicare, and that savings comes from reducing benefits to high income individuals - note too that some of the reduction in high income benefits goes to low income and poor health seniors in the form of HSA contributions. - BV Thu, 07 Apr 2011 07:08:31 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8050 According to CBO.gov, insurance industry spends $90B on admin (including executive salaries and profits). According to Census Burear, 194.5M are on private insurance. This gives ~$460 per enrollee in admin costs. Thus, private insurance has lower per-enrollee costs than Medicare. - BV Thu, 07 Apr 2011 07:05:42 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8049 2009 Medicare spending: $508B Various studies estimate 5-15% for admin costs when everything is included. That gives $25.4B for admin for ~46M enrollees: cost per enrollee is ~$550. - BV Thu, 07 Apr 2011 07:03:44 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8048 I've tried twice now to post numbers justifying that Medicare is [b]more [/b]costly than private plans, but both times was informed that "the administrator" would need to approve the posts. I guess "the administrator" isn't interested in factual analysis... I'll try in smaller chunks... - BV Thu, 07 Apr 2011 07:01:37 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8047 sure medicare pays 20% of what medical expenses it covers. it does not cover drugs. Every hospital stay costs $1100. I receive $1200 a month in Social Security. My prescriptions cost $200. I have to go to the hospital. Now what? Another scenario, i don't go to the hospital but I have to see the Dr. once a week for 4 weeks. 20% of $400 = $80, so this month I can eat. I live with my son, so I have a roof. What if i need dialysis or in home oxygen. these are monthly expenses. 20% seems like a low number until you start multiplying it times what medical costs in this country. Remember 8th grade math: .2 x 1000 = 200 and .2 times 5000 = 1000. Social Security, pensions and 401k's for us "middle class" folks only stretch so far. Maybe congress should consider funding Kevorkian clinics that we could go to for a one time 20% co-pay. - Nancy Thu, 07 Apr 2011 05:56:42 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8037 jhand & curlydan: If you'd actually read my post, you'll see that I noted the CBO's (bogus) assertion that Medicare is more efficient than private insurance. That is the ONLY basis for the (supposed) extra expense to seniors under Ryan's plan. - BV Thu, 07 Apr 2011 02:03:45 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8033 Forty mules could not drag anything into the Bakerite System that is not there already, but it strikes me as remarkable that with so many peanut-gallery peanuts, presumably broader of mind than Himself, nobody thinks it worth mentioning that Ronpaulryancare won't even *begin* to save (or deathpanel) any geezers for ten or eleven years. Nobody with that little laddie's smirk could have a sense of humor too, but in principle it would be a fine send-up of the PPACA legislation: "Four years before anything much happens? See you, and raise you eight!" Naturally that leaves the poor (and seriously prose-challenged) C. B. O. mostly talking malarkey about parallel universes that we shall know nothing of. Like that 32%/35% fuss, from which I suspect the only thing of any practical value that can be deduced is that they expect medicine in America to be nearly three times as outrageously expensive in 2030 as it is now. Though that, too, *could* be spoof at the expense of the Janesville Genius, who will have saved his three percent but overlooked sixty-five. Meanwhile, I would not be happy with the J. G., were I a TopPercenter an’ generous funder of the Party of Grant & Hoover. Dr. Smirk is behavin' like the worst kind of ivy-tower bicycle parker, totally neglectin' that key principle "Life is short: eat dessert first!" "Where is my dessert, Congressman? How can I get richer tomorrow by developin' innovative health-care financial gimmicks that nobody will need for years an’ years? Which side are you on, boy?" Happy days. - JHM Wed, 06 Apr 2011 23:04:29 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8032 I agree with many of you. Cut defense, at least to some extent. People need to realize that the hawkishness is only creating more paranoia. It is a self-perpetuating nightmare that continually creates justification for its existence. Many government agencies, in fact most, inflate their essential value in order to justify their growth and continued existence. My husband said it best, in my opinion: it's like a tick that grows a dog. Our national consciousness is willing to fund, via deficit capitalism (corporate welfare) BIG pharma, BIG industry and the BIG military industrial complex, and this is CAPITALISM?? Market forces at work?? Our capitalist government has created a totally unequal playing field, where big corporations make profits, and feed off the population, absorbing huge profits, while tax paying population gets to absorb all the losses. How is it that people come up with the notion that funding education, universal healthcare and income security for the elderly and disabled is socialism? Is it this askewed idea that we all somehow may one day be able to touch the hem of a millionaire's garment? I agree with our friend Mr. Pharo, let's have some vouchers for defense! and Hugh, I agree with you. After looking at other systems, (particularly health care, but other government programs as well) America propoganda loses its luster. SF, it's not SOMALIA that looks better, nor Haiti, or Mexico for pitties sake! It's places like Tawain, Germany, Japan, Denmark, Switzwerland. Check out this video for more of a review on how other capitalistic nations with socialized medical systems. For-profit health insurance is the problem. http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/ - cbb Wed, 06 Apr 2011 20:12:59 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8031 A little off topic, but I'd also like to point out that those who think they'll be exempt from this new regime because Ryan has "promised" that those now retired, or who will retire within the next ten years, will be allowed to keep their traditional Medicare, had better think again. The only reason these folks are being told they will be able to keep their socialized Medicare is that they currently make up a large and potent voting bloc. But this is a bloc that will decline every year as people in the oldest cohort die off, to be replaced by younger folks who will not, under Ryan's new regime, enjoy the benefits of traditional Medicare; who, indeed, may be actually hostile towards their seniors, who have things so much better. (This is typical of GOP divide-and-conquer schemes.) At a certain point, those still in traditional Medicare will no longer make up a large enough voting bloc to matter, and the GOP will then take away their traditional Medicare as well. To quote Paul Krugman, any current or near-future Medicare beneficiary who votes GOP in future can be described with one word: SUCKER! - Nancy Irving Wed, 06 Apr 2011 19:47:17 +0100 http://www.cepr.net/index.php/blogs/beat-the-press/representative-ryan-proposes-medicare-plan-under-which-seniors-would-pay-most-of-their-income-for-health-care#comment-8030 To Hugh S. Get real Hugh. "Political economists tell us that the United States is better than most other nations. How?" Do you live in a spider hole. Have you seen Somalia or other failed government states. - SF Wed, 06 Apr 2011 16:49:32 +0100