By Victor Morawski – We showed last week how the proposed Ryan budget plan intends to save the Federal Government money on its Medicare costs and lower the deficit by changing the program from a single-payer to a premium-support plan and allowing open interstate competition among health insurers — something now forbidden — to keep premium costs down.
But not everyone agrees. Editors of The Nation, for instance, say of Ryan, “the savings he projects would come less from competition than from simple cutbacks to care and benefits.” A similar sentiment is echoed by writers at msnbc.com when they observe that Ryan plan supporters must view voters under 55 as being, “more alarmed about the national debt than they are about cuts in future benefits.”
Charges like the above will no doubt alarm younger readers who will figure that if it is enacted then they would not fare as well in their golden years as current Medicare recipients.
That this cause for alarm at the Ryan plan is baseless can be seen clearly if we simply ask ourselves, “What would it mean to say that the Ryan plan cuts care or future benefits to seniors?” His proposal changes the Medicare program from one that pays health care providers directly for their services to one which effectively pays premiums for seniors to purchase health insurance in the private marketplace (with some means testing involved).
Under it those private insurers would be paying for the care that seniors receive under Medicare, not Medicare itself. But the charge that it would cut future care and benefits to seniors would only make sense if under his proposal Medicare remained a single-payer system — which it would not. As Philosopher Thomas Kuhn famously observed about scientific theories: when one reigning theory replaces another, when the paradigm changes, old ways of speaking about things no longer apply. His point holds in other areas, too.
If under the Ryan plan Medicare is no longer providing seniors with benefits by paying healthcare providers directly for their care then charges that it would be cutting care or limiting benefits no longer seem to have any clear meaning.
One thing that they might mean perhaps is that profit-motivated private insurers simply will not offer seniors the range of services and health benefits now provided them directly under the current Medicare system by the kind, tender-hearted and compassionate Federal Government.
Here I cannot help but recall a comment whose source I’ve forgotten, that under ObamaCare we would have a resulting system with all of the efficiency of the Post Office and all of the compassion of the Motor Vehicle Administration.
In short, other than reflecting a typical liberal prejudice against private business and anyone working from a profit motive, has this suspicion any real support whatsoever? Have we any reason to think that Medicare recipients’ care and benefits would be less under Ryan’s Plan? Isn’t there just as much reason to think that competition will in fact give seniors more for less in this area, as it does in so many other areas of the economy, and not lessen benefits at all?
But there is a plan already out there, enacted into law, which does intend to produce significant cost savings in Medicare over the next ten years by lessening care and benefits to seniors: the Patient Protection and Affordable Care Act (ObamaCare). It does not mean to cut $500 billion from it simply by eliminating fraud and abuse. Keeping Medicare as a single-payer system, it would do so by making significant cuts to seniors’ care and benefits — especially as it applies to end-of-life care — using health care rationing.
On the other hand, the Ryan Plan sees the empowerment of patients as consumers as the, “critical element in restraining the growth of health costs without government rationing.”
Victor Morawski, professor at Coppin State University, is a Liberty Features Syndicated writer for Americans for Limited Government.
