After losing a House seat in Tuesday’s special election, Republicans may be tempted to distance themselves from the Medicare reform plan proposed by House Budget Chairman Paul Ryan, R-Wis. That would be a mistake.
The plan is not a voucher plan, nor would it deny treatment to low-income seniors.
Page 46 of Ryan’s budget resolution reads, “Starting in 2022, new Medicare beneficiaries will be enrolled in the same kind of health care program that members of Congress enjoy. Future Medicare recipients will be able to choose from a list of guaranteed coverage options, and they will be given the ability to choose a plan that works best for them.”
Members of Congress and federal workers appear happy with the Federal Employees Health Benefits Program, after which Ryan’s Medicare plan is modeled. Many workers join the federal government for the plan, and work for at least five years so they can enroll in it after they retire.
Ryan’s approach would let seniors who retire in 2021 and after choose from a variety of government-approved, competing and comprehensive health insurance plans, at different prices with different levels of service.
Medicare would pay a certain portion of the insurance company premium, with the amount to depend on the income, age and health of the beneficiary. The rest of the premium would be paid by the beneficiary.
The amount of premium support depends on the income and health of the beneficiary. So if Grandma doesn’t have the money to pay the premium, her subsidy will be greater. She will not be wheeled off a cliff, contrary to Democratic ads.
As with federal workers, beneficiaries will not be able to take the government share of the plan and use it elsewhere, so it is not a voucher.
The means-tested Medicare premiums that Ryan proposes would leave well-off seniors paying more for their health care than poor seniors. After all, everyone agrees that Medicare is unsustainable now. Surely the way to solvency is to have the well-off pay higher premiums.
Another advantage of the federal employees’ insurance is the variety of plans it will offer at different prices.
More choice means lower costs. Medicare Part D, the prescription drug benefit, has cost less than was forecast because seniors have a choice of plans that compete for their business. Outside of Medicare, prices for LASIK eye surgery and cosmetic surgery have declined steadily because these services are usually not covered by insurance, so patients shop around.
The inescapable problem is that America has a deficit of $1.6 trillion. This cannot continue. Public debt is projected to nearly double, even with the most optimistic economic assumptions, over the next decade. Something has to be done.
President Barack Obama has proposed cutting costs by using the Independent Payment Advisory Board, a group of 15 bureaucrats, to decide which treatments Grandma should have. That’s rationing, and it’s very different from the current Medicare plan.
America must rein in Medicare spending — the only question is how. We should start with some more options, and a more civilized and realistic discussion.
Examiner columnist Diana Furchtgott-Roth, former chief economist at the U.S. Department of Labor, is a senior fellow at the Hudson Institute.