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1 Buck  Tue, Dec 20, 2011 11:11:32am
a voucher system in which the value of the vouchers would systematically lag the cost of health care, so that there was no guarantee that seniors would even be able to afford private insurance.

You see? That is what Polifact is talking about. He states that like he knows it to be a fact. It isn’t.

I don’t think this is the right place to debate the Ryan plan in detail. However there is nothing it in that would suggest that the vouchers (really a rebate/payment based on their tax return) would not cover the insurance of the future. He might want to believe it. However he is inventing it.

What is true however is that the system as it is now is unsustainable in it’s current form. That some kind of reform (changes) will have to take place. Even Obama agrees with that.

It is only what form these changes will be that is still to be discussed.

2 mr.fusion  Tue, Dec 20, 2011 11:35:34am

re: #1 Buck

I don’t think this is the right place to debate the Ryan plan in detail. However there is nothing it in that would suggest that the vouchers (really a rebate/payment based on their tax return) would not cover the insurance of the future. He might want to believe it. However he is inventing it.

Center on Budget and Policy Priorities

The CBO report also reveals that the vouchers, or “defined contribution amounts,” that Ryan would provide to seniors to buy coverage from private insurance companies in lieu of current Medicare coverage would be adjusted each year only by the general inflation rate. For more than 30 years, health care costs per beneficiary in the United States have been rising about two percentage points per year faster than GDP growth per capita. The Rivlin-Ryan plan of last fall would have provided vouchers that rise with GDP per capita plus one percentage point. But because they would be adjusted only for overall inflation, the vouchers under Ryan’s new plan would rise about two percentage points per year less than the Rivlin-Ryan vouchers and about three percentage points per year less than the rate at which health care costs have been growing. Over time, the impact on beneficiaries would be huge, as CBO documents.

Moreover, CBO estimates that the total health care costs attributable to Medicare beneficiaries would be considerably higher under the private insurance plans they would purchase under the Ryan plan than under a continuation of traditional Medicare, because private plans have higher administrative expenses and higher payment rates for providers. Since the Ryan proposal would reduce the federal government’s contribution for beneficiaries’ health care costs even as it caused total costs to increase, beneficiaries’ out-of-pocket spending would rise dramatically.

In 2022, the first year the voucher would apply, CBO estimates that total health care expenditures for a typical 65-year-old would be almost 40 percent higher with private coverage under the Ryan plan than they would be with a continuation of traditional Medicare. (See graph.) CBO also finds that this beneficiary’s annual out-of-pocket costs would more than double — from $6,150 to $12,500. In later years, as the value of the voucher eroded, the increase in out-of-pocket costs would be even greater.

CBO wrote that “Paying more for health care would be particularly challenging for elderly people with less savings and lower income.” [5] And Alice Rivlin said that she does not support Ryan’s new proposal. Rivlin observed that it would result in a massive cost-shift over time to beneficiaries and that the growth rate Ryan set for his vouchers is “much, much too low” and “I don’t think that’s defensible.”[6]

3 Buck  Tue, Dec 20, 2011 12:51:15pm

That is the interpretation of the CBO report, not the CBO report itself. It is also not the Ryan plan. The Center on Budget and Policy Priorities is not the unbiased reporter that you might make them out to be.

From the actual CBO report:

The premium support payments would also vary with the income of the beneficiary. People in the top 2 percent of the annual income distribution of the Medicare-eligible population would receive 30 percent of the premium support amount described above; people in the next 6 percent of the distribution would receive 50 percent of the amount described above; and people in the remaining 92 percent of the distribution would receive the full premium support amount. (page 8)

So as I stated, the amount the person gets “vary with the income of the beneficiary”. I said “payment based on their tax return”. Now with the top 8% of income earners getting less than the full payment (seems fair right?), the overall cost goes down. Someone trying to make trouble would say that people are not going to get enough (as much as they would under the old system), but it really is a reflection of a system that would make the top 8% earners pay more. You can’t average that into the over all calculation, it would be misleading.

4 jamesfirecat  Tue, Dec 20, 2011 12:55:09pm

re: #3 Buck

That is the interpretation of the CBO report, not the CBO report itself. It is also not the Ryan plan. The Center on Budget and Policy Priorities is not the unbiased reporter that you might make them out to be.

From the actual CBO report:


So as I stated, the amount the person gets “vary with the income of the beneficiary”. I said “payment based on their tax return”. Now with the top 8% of income earners getting less than the full payment (seems fair right?), the overall cost goes down. Someone trying to make trouble would say that people are not going to get enough (as much as they would under the old system), but it really is a reflection of a system that would make the top 8% earners pay more. You can’t average that into the over all calculation, it would be misleading.

Couldn’t those readjustments of how much money people have to pay based on their wealth be effectively done by readjust the current system instead of switiching over to a voucher based one?

5 Buck  Tue, Dec 20, 2011 1:00:39pm

There is a lot more to the Ryan plan. However, yes there are changes, that are in the Ryan plan that could be folded into the current system

However, as per the partizan’s view, any change to Medicare means you are killing it. Changing it, and just keeping the name is counted as killing it.

UNLESS it is changes they are suggesting, then they are just changes.

For example, it was Obama who took 500 billion out of Medicare. Now he gave it back under a different name (Doc Fix), but he got to take credit for reducing the cost of Medicare. No one seem to point out that he increased the cost of Doc Fix.

6 Buck  Tue, Dec 20, 2011 1:08:09pm

“who took 500 billion out of Medicare”, should be 500 million. Seriously… it was a typo.

7 Buck  Tue, Dec 20, 2011 1:18:28pm

Damn… it is billion. I am not feeling well. I actually think I am coming down with something.


I am going home….

8 jamesfirecat  Tue, Dec 20, 2011 1:23:02pm

re: #5 Buck

There is a lot more to the Ryan plan. However, yes there are changes, that are in the Ryan plan that could be folded into the current system

However, as per the partizan’s view, any change to Medicare means you are killing it. Changing it, and just keeping the name is counted as killing it.

UNLESS it is changes they are suggesting, then they are just changes.

For example, it was Obama who took 500 billion out of Medicare. Now he gave it back under a different name (Doc Fix), but he got to take credit for reducing the cost of Medicare. No one seem to point out that he increased the cost of Doc Fix.

If the government suggested that it would no longer fire fighters and instead giivng you money to pay to people to put out the fire should your house catch flame or hire a for profit service to put it out in the event of a fire, would it be fair to say that the government has ended the firefighter service?

9 Buck  Tue, Dec 20, 2011 3:58:34pm

re: #8 jamesfirecat

It really isn’t the same thing.

This isn’t at all changing who is providing the service. In your example it is.

However, if I can use it, and say everyone gets a certain amount of firefighting ($8,000) worth per year. If they use more than that, AND they are in the top 2% of the earners in the USA, they they pay 70% of the additional costs over the initial $8,000. People in the next 6 percent of the distribution would pay 50% of costs over the initial $8,000.
Everyone else would get the same service they always did, and would get 100% of the costs over the initial amount paid for.

Would you still say the Government is providing fire fighting service?

Not exactly, but it fits better than your example.

10 Buck  Tue, Dec 20, 2011 4:02:45pm

Oh, and James, if anyone wants to buy insurance to help pay for any of it, they can.

11 jamesfirecat  Wed, Dec 21, 2011 8:24:59am

re: #9 Buck

It really isn’t the same thing.

This isn’t at all changing who is providing the service. In your example it is.

However, if I can use it, and say everyone gets a certain amount of firefighting ($8,000) worth per year. If they use more than that, AND they are in the top 2% of the earners in the USA, they they pay 70% of the additional costs over the initial $8,000. People in the next 6 percent of the distribution would pay 50% of costs over the initial $8,000.
Everyone else would get the same service they always did, and would get 100% of the costs over the initial amount paid for.

Would you still say the Government is providing fire fighting service?

Not exactly, but it fits better than your example.

Then why insist on going to a voucher system instead of just making people pay more for the system that already exists?

12 Buck  Wed, Dec 21, 2011 6:48:31pm

re: #11 jamesfirecat

There can be a misunderstanding about what “voucher” means. In this case it is just that a limit per year will be paid for. Then after the (voucher) limit is reached the overage is reached, for some (the highest earners) they would pay more, and some (the lower 92% of earners) would pay nothing extra.

Again, this is for medicare…. so we are talking about seniors.

However the idea that the rich pay (top 8% of earners) can’t be that bad?

Cost have to cut.


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