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Medicare and the Ryan Budget

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Medicare and the Ryan Budget

Health care is on the mind of many Americans. The Supreme Court is taking up Obamacare. Costs are going up at an alarming pace. The access to quality medical care is eroding. Hospitals are under pressure and closings are rising. Doctors brace for reduced payments for services. No wonder any proposal for altering the trajectory of all these trends gathers interest. Medicare is the gorilla in the federal budget china shop. This primate is hungry for more takings. Survival of the fittest may well come down to the realignment of the entire health care system. Just what can the public expect out of this struggle for wellness?

Within this context, the Paul Ryan budget proposal bears consideration. Forbes provides the analysis Paul Ryan's New-and-Improved Plan for Medicare and Medicaid Reform.

"Ryan’s proposal for Medicaid reform involves "converting the federal share of Medicaid spending into a block grant indexed for inflation and population growth."

Another key detail: Ryan’s plausible assumption is that competitive bidding could drive Medicare spending down without hard spending caps. However, as a backstop, the proposal caps the growth of Medicare spending at GDP plus 0.5 percent, which—not coincidentally—matches the targeted Medicare growth rate in President Obama’s budget.

The PTP 2 growth rate cap of GDP + 0.5% is meaningfully higher than that of PTP 1, which grew Medicare at the rate of inflation, something that was a principal source of criticism from the left (Alice Rivlin called it "much, much too low" ).

A key question is: what will the CBO do? Will the CBO score this new plan with the GDP plus 0.5 percent Medicare growth cap? Or will CBO give Ryan any credit for the benefits of competitive bidding?"

Congressman Ryan argues his case in the You Tube, The Path to Prosperity.

Frightening prospects and dire results are unavoidable. All should acknowledge the danger, but the denial blame game seems to be the only factor that spikes higher than the national debt.

The National Review warns in
Ryan and the Middle Class.

"Ryan’s Medicare and Medicaid reforms are both slow, workable, conservative solutions to the fiscal imbalances of those programs. The American middle class may not accept Medicare reform willingly, but it is something close to a mathematical certainty that it ultimately will accept it in some form. One possible form is that the checks stop coming as the nation becomes insolvent, another is that the government pays benefits nominally to the penny but radically devalues the dollar to do so. I suspect that the Ryan plan, or something like it, will be enacted long before that happens. We’re stupid, but we’re not that stupid."

The underlying assumption that Medicare and Medicaid are intrinsic entitlements and an inherent right is an assumption that is seldom challenged. The stupidity is not in the creative social engineering of payment alternatives, but in the very concept that personal liberty and corresponding responsibility is a chronic disease. Few distortions in the nature of a free people are more confused than the mental disorder that demands government mandated health care.

It is because of this sharp departure from sanity that the nanny state demands compliance. The pharmacology complex, which is the driving force that underpins hospital therapy and officially sanctioned medicine, is managed treatment. The managed aspect, frequently based upon the funds available for further coverage, is cold-blooded. Medicine has evolved into a monitory arbitrage function for HMO to hedge their returns.

The Whole Truth is the other cliff dropping Medicare video that counters the infamous Obamacare attack on the previous Ryan initiative.

The explosion of costs to be part of this system enriches a dependent drug society. The financial return on assets for the major drug producers is stellar. However, upon an in-depth examination of quality of care standards, how many people will agree that the medical community is ready for a major retraction, much less affordability, of services?

Treatment by pill is not all that it advertises. Health through radiation is deadly. And healing through bureaucratic panels is fatal.

The transactional fraud that exists in the government medicine administration is reason enough to scrap socialized medicine. The automatic Medicare Part A availability subjugates citizens into the medical system even if they reject the principle of state distributed healthcare. Currently accepting the copayment contribution for Part B is optional, but how long do you believe that will remain in effect?

Nonetheless, the media and pundits overwhelmingly demand government public health coverage. Criticism of the Ryan reform, especially from the Progressive Left is deafening. A more balanced approach is expressed by Bloomberg in
Paul Ryan’s Medicare Voucher Plan Improves With Each Pass,

"The danger is that Ryan may be cutting costs too steeply, forcing Americans to choose from a stingier menu of options while shouldering ever-higher out-of-pocket costs. He may also be relying too heavily on seniors’ ability to make smart decisions about their insurance -- often when they are frail or seriously ill.

To avoid these pitfalls, Ryan should clarify that insurers wouldn’t be able to charge any Medicare patient excessively high premiums. One way to do that would be to require insurers to charge the same premiums for all enrollees of the same age. To keep private insurers from cherry-picking the healthiest seniors, plans must be "risk-adjusted," insurer-speak for customizing government subsidies for the average beneficiary’s health status. Finally, participating plans must be required to offer benefits at least as comprehensive as traditional Medicare."

The out of control health care spending and the skyrocketing rise in government debt to finance the cost leads to an inevitable sentiment that people are living too long. The systemic design for a eugenic policy is the most disturbing aspect in the health care debacle. Congressman Paul Ryan is attempting to set the fracture of broken bones for managed care. The politics of government medicine is lethal. Solutions seek a miracle cure but the treatments are just as toxic as the expenditures.

James Hall – March 28, 2012

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