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Wyden and Ryan
Democrats are questioning the Ryan-Wyden plan to end Medicare as we know it
(Ron Wyden: Yuri Gripas/Reuters, Paul Ryan: Kevin Lamarque/Reuters)
Rep. Pete Stark (D-CA):
“Despite Wyden’s claims otherwise, the Wyden-Ryan plan ends Medicare as we know it, plain and simple. If these two get their way, senior citizens’ health coverage will depend on what big insurance offers and what seniors — most of them on modest, fixed incomes — can afford. That combination will jeopardize health and economic security for seniors.”

Rep. Jim McDermott (D-WA) adds: "I don’t know why Ron Wyden is giving cover" to Ryan. And a Democratic aide sums it up pretty well:

“For starters, this is bad policy and a complete political loser,” this aide said. “On top of the terrible politics, they even admit that it dismantles Medicare but achieves no budgetary savings while doing so — the worst of all worlds. Thanks for nothing.”

The lamest thing about the whole plan is that there's no reason to think that turning Medicare into a voucher program—even if it's a voucher program with a public option—will save money over the current system. In fact, Ryan and Wyden rely on a trigger to reduce costs, just like the debt ceiling deal.

Ryan and Wyden both contend that, when it’s finally drafted, their legislation will score as a cost saver, because it includes an enforcement mechanism: if Congress can’t find health care savings on its own, the plan automatically caps spending on the program and allows it to grow at a rate lower than medical inflation.

Triggers didn't work with the debt ceiling and they won't work with Medicare.

Also, note that while the Ryan-Wyden plan is similar to what Obamacare would have been like with a public option, the difference is Medicare already is an efficient single-payer system that provides universal coverage, while the individual insurance market is not only inefficient, it fails to cover tens of millions of Americans. So even though the plans look similar, it's important to compare them to what currently exists.

Originally posted to The Jed Report on Thu Dec 15, 2011 at 09:29 AM PST.

Also republished by Daily Kos.

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Comment Preferences

  •  what's going on here? (11+ / 0-)

    Why is Wyden doing this?

    •  Ryan found a useful idiot? (18+ / 0-)

      I don't trust Mr. Ryan at all. He makes Newt look honest.

      The GOP is the party of mammon. They mock what Jesus taught.

      by freelunch on Thu Dec 15, 2011 at 09:34:01 AM PST

      [ Parent ]

      •  Well I wouldn't call Wyden and idiot but (4+ / 0-)
        Recommended by:
        Mr MadAsHell, franklyn, Lucy2009, fabucat

        I really don't understand him going along with this idea as I currently understand it.  Some of his original ideas for the ACA which may have actually made private insurance more competitive, were rejected by the Senate.  This was the amendment which would allow anyone to take the money their employer is paying toward their health insurance benefits and purchase insurance on the private market, regardless the size of the employer.  That amendment was defeated in committee even by some supposed "liberal" democrats who got phone calls from large corporations who did not want their employees to be allowed to do this.  Maybe he's thinking he can do something like this with Medicare to make Part C more cost effective but I'm just not really sure.  As I said before, IMHO as long as corporate profit is involved in this market, it will not work to help consumers.

        Mr. Boehner, where are the jobs?

        by Tx LIberal on Thu Dec 15, 2011 at 10:40:06 AM PST

        [ Parent ]

        •  Actually, the amendment you describe (1+ / 0-)
          Recommended by:

          sounds pretty stupid....the private market is always more expensive than an employer plan, unless you get one of those "swiss cheese" policies that doesn't cover necessary care. It makes perfect sense for liberals to oppose such an amendment, which would not save money because health insurance is an area where market competition does not drive prices's not like buying a car.

          Medicare does need reform to  get costs under control, but the reform he's proposed is the opposite of what's needed.

          "All governments lie, but disaster lies in wait for countries whose officials smoke the same hashish they give out." --I.F. Stone

          by Alice in Florida on Thu Dec 15, 2011 at 05:04:41 PM PST

          [ Parent ]

          •  Their "market competition" is on Wall Street. (0+ / 0-)

            It has nothing to do with the consumer.

          •  Not for very small companies (0+ / 0-)

            Depends to the "group" you belong to but there is not that much difference for small employers who are placed into pools or groups of small employers (at least in TX).  They base your rates on the average age of employees so the younger employees end up paying higher rates than they would in the individual market.  Sometimes the plans offered are not as good as what you could get on the individual market.  That was the real point.  As long as profit is involved in health insurance, consumers are going to get the shaft!

            Mr. Boehner, where are the jobs?

            by Tx LIberal on Fri Dec 16, 2011 at 06:43:56 AM PST

            [ Parent ]

      •  Wyden is "Saving privatizing Ryan" (0+ / 0-)
    •  he's a 1%er. (18+ / 0-)

      He's voted for every trade agreement that's come up in his career, including NAFTA, CAFTA, and Colombia, and he favored ending the estate tax altogether.

      I changed by not changing at all, small town predicts my fate, perhaps that's what no one wants to see. -6.38, -4.15

      by James Allen on Thu Dec 15, 2011 at 09:39:45 AM PST

      [ Parent ]

      •  Wyden ("D"-Health Industry) (10+ / 0-)

        Open Secrets has a list of his top contributors:

        Top 5 Industries, 2007-2012, Campaign Cmte
        Industry                          Total         Indivs           PACs
        Lawyers/Law Firms        $577,917  $470,608    $107,309
        Health Professionals     $455,560   $244,745    $210,815
        Securities & Investment $447,379  $405,300    $42,079
        Real Estate                    $313,980   $279,480   $34,500
        Hospitals/Nursing Homes $264,150 $138,750 $125,400

        Surprise, surprise two of the top 5 are Heath Care.

        Poor man wants to be rich. Rich man wants to king. And the king ain't satisifed until he rules everything. B.Springsteen

        by howd on Thu Dec 15, 2011 at 04:52:52 PM PST

        [ Parent ]

      •  His largest contributions are from insurance and (1+ / 0-)
        Recommended by:

        finance. He has never been very progressive on healthcare issues. Even tho he worked closely the with Grey Panthers and Oregon has a large group of supporters for a state healthcare plan. "Healthcare for All Oregon" has never counted on him for anything but trying to convince us that plans he comes up with, with guys like former (R) senator Bennett or an ass like Paul Ryan make sense.

        He was of no help during the ACA fight and his town halls were filled with really unhappy Oregon Democrats and tea baggers who were surprised they weren't mad at him.

    •  Because he's a fool (5+ / 0-)

      “If you think I can be bought for five thousand dollars, I'm offended." Rick Perry.

      by Paleo on Thu Dec 15, 2011 at 09:40:57 AM PST

      [ Parent ]

    •  Everybody has their price. (2+ / 0-)
      Recommended by:
      hester, Minerva

      What is Wyden's price?  I have no idea.  I can't buy a congressman at any price.  We are on our own.  That is what OWS is trying to show us.

      In the GOP your status is inversely proportional to your integrity.

      by anothergreenbus on Thu Dec 15, 2011 at 04:57:12 PM PST

      [ Parent ]

  •  Don't we have this already? (5+ / 0-)

    Almost anyone can enroll in Medicare Advantage if they don't want straight Medicare coverage. What am I missing?

    The GOP is the party of mammon. They mock what Jesus taught.

    by freelunch on Thu Dec 15, 2011 at 09:32:07 AM PST

    •  as i understand Wyden's proposal (5+ / 0-)
      Recommended by:
      cany, freelunch, revsue, mimi, Lucy2009

      there are circumstances in which seniors have to pay the difference between costs and medicare benefits, with various vouchers.  setting aside that it's a half-assed way to save medicare costs at seniors' expenses, my grandmother can't figure out how to work her phone at this point, let alone some kind of a voucher.  i barely understand this plan (admittedly, i've read but one article about it), and i am not a senile person with a high school education.

      "This world demands the qualities of youth: not a time of life but a state of mind[.]" -- Robert F. Kennedy

      by Loge on Thu Dec 15, 2011 at 09:39:07 AM PST

      [ Parent ]

      •  My 97 yo mom was just in the hospital for a week (6+ / 0-)
        Recommended by:
        freelunch, TofG, revsue, hooper, Ky DEM, Lucy2009

        and because of her type of illness and her age, had to have a watcher in her room 24 hours/day.

        She has supplemental medicare ins. which should pay what medicare doesn't... but given the Ryan/Wyden plan, that would be financially prohibitive, as I see it, were their plan to come to fruition.

        Seems Wyden is a Blue Dog.

        202-224-3121 to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

        by cany on Thu Dec 15, 2011 at 10:08:54 AM PST

        [ Parent ]

        •  he's not, generally (4+ / 0-)
          Recommended by:
          cany, freelunch, TofG, Lucy2009

          i think people put too much stock in labels.  Sometimes politicians make mistakes, sometimes they step into wtf world.  Wyden's record is otherwise generally progressive.

          "This world demands the qualities of youth: not a time of life but a state of mind[.]" -- Robert F. Kennedy

          by Loge on Thu Dec 15, 2011 at 10:16:42 AM PST

          [ Parent ]

          •  That's what I thought too, but this is the mother (7+ / 0-)

            of all mistakes.

            202-224-3121 to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

            by cany on Thu Dec 15, 2011 at 10:26:00 AM PST

            [ Parent ]

            •  hey, Wellstone voted for the patriot act, (4+ / 0-)
              Recommended by:
              cany, freelunch, pademocrat, Mr MadAsHell

              john kerry threw out all his life experience to vote for the Iraq war.  i think Wyden simply happens to think he has outstanding original ideas on medicare and he's just completely blind to the politics.  he had that Wyden-Bennett bill,remember.

              "This world demands the qualities of youth: not a time of life but a state of mind[.]" -- Robert F. Kennedy

              by Loge on Thu Dec 15, 2011 at 10:44:46 AM PST

              [ Parent ]

              •  It's not just the politics that are all (0+ / 0-)

                wrong here, it's the would make administering Medicare more expensive while providing less money to pay for it. What we need to do is make Medicare less expensive, by cutting back unnecessary treatments and tests, not add to administrative costs and overhead.

                "All governments lie, but disaster lies in wait for countries whose officials smoke the same hashish they give out." --I.F. Stone

                by Alice in Florida on Thu Dec 15, 2011 at 05:45:26 PM PST

                [ Parent ]

                •  It'll never be law (0+ / 0-)

                  so I'm not going to take it too seriously as policy.  I almost think widen is part of a false flag deal to get the house to vote to kill Medicare again, both policy and politics are so bad.

                  "This world demands the qualities of youth: not a time of life but a state of mind[.]" -- Robert F. Kennedy

                  by Loge on Thu Dec 15, 2011 at 06:33:24 PM PST

                  [ Parent ]

          •  He's not Liberal on trade and healthcare. (2+ / 0-)
            Recommended by:
            Supavash, rbird

            Or as Mother Jones has noted, "When the Republicans see Wyden heading for the conference table, they lick their lips and rub their hands together".

    •  These would be private plans unaffiliated (0+ / 0-)

      with Medicare.

      “If you think I can be bought for five thousand dollars, I'm offended." Rick Perry.

      by Paleo on Thu Dec 15, 2011 at 09:39:55 AM PST

      [ Parent ]

    •  One would have the option to get a voucher (4+ / 0-)

      to privately purchase health insurance. There would, apparently, be some controls over what is/isn't covered and one could add money to the voucher plan to get better insurance. And if you don't want better insurance, you could keep the difference, it is alleged, so the money really isn't destined for health insurance in its entirety and the receiver isn't REQUIRED, as written, apparently, to spend it all on insurance. The meaning, of course, is that the same people could end up in the hospital, under-insured,  and without resources to pay and the unpaid amount, it would appear, could become indigent cost.  AND THAT is really strange if I have that right.  

      Currently, people on regular medicare will pay a portion of their health costs (what SS doesn't pay) AND people can and do purchase medicare supplemental plans (my mom has one which zeros out virtually all costs though I have yet to receive the bill for the last very expensive hospital visit).

      Now consider for a moment a person in their 90s. Can you imagine the cost just in that age group from a private carrier?

      My mom gets 1100/month from SS. She purchases a Blue Shield supplemental medicare plan for $904/month (ironically, the state of CA has busted Blue Shield, her carrier, and she has received in the last four months over $1100.00 in reimbursements for being "overcharged" though the company continues to lie to customers telling them that this returned money was because the company voted to hold to a 2% profit scenario...). She owns a triplex which makes her a small amount of rental money on the side... enough to keep her going (though that is not true now given she is in an Alzheimer's/memory care unit now).

      Wyden is playing with fire here, both in terms of medicare recipients and future recipients, and the political soup he has jumped into.

      Another dem jumping ship... though right now I am so pissed at him I'd like to just kick his butt into the cold red waters.

      202-224-3121 to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

      by cany on Thu Dec 15, 2011 at 10:24:16 AM PST

      [ Parent ]

      •  Funny thing though (3+ / 0-)
        Recommended by:
        cany, freelunch, revsue
        There would, apparently, be some controls over what is/isn't covered

        Isn't this what the republicans previously called "guvment control" of health care?  Funny thing that a republican, Ryan should be supporting this, isn't it?  Maybe it's because he thinks Obama will be against it (LOL).

        Mr. Boehner, where are the jobs?

        by Tx LIberal on Thu Dec 15, 2011 at 10:45:59 AM PST

        [ Parent ]

      •  Basically... (7+ / 0-)

        What is happening now, is the federal government is the underwriter for Medicare advantage plans. The insurance companies act as a gatekeeper however Medicare still is the underlying insurer.  Kind of like a Lloyds of London.  A reinsurer.

        All republican schemes currently touted, would effectively remove the federal government and gut it as a functioning entity.  Any and all money from what was once medicare, now goes directly to the insurers.

        This is why so many analysts have come to the same conclusion about these schemes;  They don't save the government any money.  No cost savings.

        Bottom line is that beneficiaries get much less and insurance companies get pure profit.

        The added bonus is that the republicans are able to destroy one of the biggest threats to the private insurance industry-Medicare.  The only standing viable possibility America has for  a single payer option.

        It's the inequality, stupid.

        by Boberto on Thu Dec 15, 2011 at 04:59:17 PM PST

        [ Parent ]

    •  Didn't mean to copy your post earlier (1+ / 0-)
      Recommended by:

      but since you already said it, I agree you are right.

      Mr. Boehner, where are the jobs?

      by Tx LIberal on Thu Dec 15, 2011 at 10:26:18 AM PST

      [ Parent ]

  •  Yes it does (4+ / 0-)

    Unfortunately we're stuck with this clown until 2016.

    “If you think I can be bought for five thousand dollars, I'm offended." Rick Perry.

    by Paleo on Thu Dec 15, 2011 at 09:37:59 AM PST

    Recommended by:
    J M F, TomP, hooper, Mr MadAsHell
    Also, note that while the Ryan-Wyden plan is similar to what Obamacare would have been like with a public option, the difference is Medicare already is an efficient single-payer system that provides universal coverage, while the individual insurance market is not only inefficient, it fails to cover tens of millions of Americans. So even though the plans look similar, it's important to compare them to what currently exists.

    Präsidentenelf-maßschach; Warning-Some Snark Above"Nous sommes un groupuscule" (-9.50; -7.03) "Sciant terra viam monstrare."

    by annieli on Thu Dec 15, 2011 at 09:48:22 AM PST

  •  I'm from CA, but am on hold at Wyden's office (8+ / 0-)

    at the moment. I am really, really disgusted with him and they are going to get a piece of this Californian's mind when my call comes up.

    202-224-3121 to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

    by cany on Thu Dec 15, 2011 at 10:06:13 AM PST

    •  Just to be clear... (0+ / 0-)

      ...most offices aren't going to pass your message along if you're not from their state.

      Basically, if Wyden's office is like any of the offices I have experience with, you're going to talk to an intern and a staff assistant who will pretend to take notes on what you're saying, say that they will "pass the message along" just to get you off the line, and then do nothing.

      I don't know if all offices are like that, but each office I have interned at does not log the opinions of non-constituents. I'm not saying I agree with Wyden here - I don't - or that he doesn't deserve to take heat - he does. But I am saying that maybe you should consider saving yourself the price of a phone call, since all you're going to get to do is complain to the lowest level of paid staffer at best, or an intern at worst.

  •  Don't we have this already (0+ / 0-)

    with Medicare Part C, where the government pays the insurance company a specified amount and your Medicare is handled by the insurance company?
    If I remember correctly, cuts to this program are what the republicans were using as a tool to criticize the ACA because part of the means of paying for it was to reduce the amount that the government paid to insurance companies.  And if Part C doesn't is not that efficient now, what makes them think that making it even further encompassing and giving private insurance more control make it more efficient? IMO it would just increase the opportunity for insurance companies to screw more consumers, retirees,  for profit.
    The only way to attempt to make anything like this affordable is to require all health insurance companies to be not-for-profit to ensure that 100% of premiums are used to pay benefits.  IMO that's the real reason this is a non-starter because the corporatist republicans (and some democrats) in Congress will never allow that to happen.

    Mr. Boehner, where are the jobs?

    by Tx LIberal on Thu Dec 15, 2011 at 10:22:58 AM PST

  •  Maybe There Is Some Part (1+ / 0-)
    Recommended by:

    Of this story that we don't understand and there is a good reason for a Democratic Senator to be co-sponsoring a bill with Paul Ryan to hurt Medicare.

    "I'll believe that corporations are people when I see Rick Perry execute one."

    by bink on Thu Dec 15, 2011 at 04:35:51 PM PST

    •  There is beginning to be a (4+ / 0-)
      Recommended by:
      bink, inclusiveheart, maryabein, hester

      hell of a lot we don't understand.

      We the People have to make a difference and the Change.....Just do it ! Be part of helping us build a veteran community online. United Veterans of America

      by Vetwife on Thu Dec 15, 2011 at 04:41:04 PM PST

      [ Parent ]

    •  Oh it is probably really "complex" and (0+ / 0-)

      there are a lot of "innovations" and clearly the situation is such that it requires a new approach because the world changed forever after 9/11.  Rolling eyes.

      You know, I had someone argue that the complexities of the Euro being "new" made it somehow special requiring pretty radical departures from basic economic principles.  The reality is that the Euro is money and we have had money in some form for thousands of years.  Nothing that radically new.

    •  I can assure you that... (2+ / 0-)
      Recommended by:
      maryabein, Supavash

      if a Democrat was lured by a partisan Republican to co-sponsor a bill that affects Medicare, or even if the Democrat initiated the deal, there will be attack ads in October against the Democrat and all Democrats for cutting Medicare; Election Day will be disappointing once again, and the Medicare program will not benefit.  There is no upside, political or otherwise, in doing this deal.

      Barack Obama in the Oval Office: There's a black man who knows his place.

      by Greasy Grant on Thu Dec 15, 2011 at 04:58:06 PM PST

      [ Parent ]

    •  Are you serious, or is that just very subtle (0+ / 0-)


      "All governments lie, but disaster lies in wait for countries whose officials smoke the same hashish they give out." --I.F. Stone

      by Alice in Florida on Thu Dec 15, 2011 at 05:51:01 PM PST

      [ Parent ]

  •  Oh. (0+ / 0-)

    Thanks for giving me a reason to vote 3rd party. I've been muling this over for a LONG time (I live in oregon) and i've come to the conclusion that the reason the israel lobby gets everything it wants while progressives get run over like a train is primarily because they're a swing vote and democrats can't rely on them. If progressives want to be effective we have to occasionally vote 3rd party if the democratic candidate is too toxic. Once democrats start losing seats to significant ammounts of defections they'll be terrified of us-like they aught to be.

    I know I've comitted treason, admiting this on a democratic blog, but. no. no more of this bullshit.

  •  What the fuck is Wyden thinking? (4+ / 0-)

    Why in God's name would he give cover to one of the four biggest ASSHOLES in congress?  Ryan is a scum sucking lying son of a bitch corporate toady.

    "Repeatedly he [Voltaire] dwelt on the folly and credulousness of the masses and the selfishness and unscrupulousness of the ruling few." 'nuff said.

    by caseynm on Thu Dec 15, 2011 at 04:42:01 PM PST

  •  Another big difference (1+ / 0-)
    Recommended by:

    ...between Medicare and recent reforms is that it has been shown for nearly 50 years that medical insurance for the aged is a societal good, a benefit for all concerned (including the young who would otherwise be pressed to pay for their parents' medical bills) and should not be messed with. Let the working class experiment with insurance exchanges, but leave the old folks alone.

  •  Well it seems the wingnuts hate it too. (0+ / 0-)

    That would leave me to think it might have some merit. I don't know this is the first I heard of it.

    After reading Rep. Paul Ryan and Sen. Ron Wyden’ s outline of their new Medicare-reform plan, I am left extremely underwhelmed. Leaving the politics aside, here are my main concerns/questions (for now):

    1. If Medicare, as we know it, is unsustainable, why keep it as an option in its current form?

    2. If you keep the program in place, how will this plan manage to create a level playing field between Medicare and private plans? And if it can’t, how realistic are the cost-savings expectations? Suderman makes a good point:

    As with the Ryan budget (and ObamaCare, for that matter) the hoped-for cost-savings may be unrealistic. So is the hope that the government can spur cost-saving competition while leaving a government-run Medicare option in the mix. That’s because it’s hard to create a level playing field between private and public insurance: Look at what’s happened in Florida, where a public property insurance program knocked out private competitors using artificially low rates essentially subsidized by taxpayers. The program is now woefully underfunded, and when a big insurance tab eventually comes due, the state’s taxpayers will have to foot the bill through increased taxes or spending cuts. Medicare, meanwhile, already hides its administrative costs and inefficiencies within the unmappable jungle of federal spending; what guarantee is there that it wouldn’t do the same under this plan?

    3. Why push off urgent reforms for a decade?

    According to the Trustees’ Report, Medicare will become insolvent by 2024. If you read the letter at the back of the Trustees’ report, however, it is obvious that these are extremely rosy estimates and Medicare will be insolvent way sooner than that. This plan, which doesn’t kick in until 2022, won’t help. Josh Barro explains:
    The downside of including current over-55s in reform is smaller than widely thought, but the upside is large. Indeed, “save money now” is the key lesson I draw from pension reform fights in states around the country.

    In 2009, a lot of states passed “pension reform” that only changed benefits for newly hired employees, meaning that pension checks would start being smaller for a handful of workers around 2040. These reforms met little political resistance because current workers got to keep earning the same benefits as before. Lawmakers also found, to their chagrin, that the reforms saved trivial amounts of money in the current period. A lot of these states had to come back for another round of reform that would actually create current-period savings, and more recent pension reforms have been better.

    This is a good example of dessert-now-spinach-later policy. In this case, however, older people are the only ones eating desert and younger people are left with the spinach and little prospect of any dessert at all.
    The proposal includes no credible plan to force future Congresses to implement its reforms.
    Any bipartisan plan that makes significant reforms to Medicare would be a step in the right direction. However, I am skeptical that this plan can deliver on its promises.

    For good analyses of the plan, I recommend reading Peter Suderman, Josh Barro, and Phil Klein .

    The modern conservative is engaged in one of man's oldest exercises in moral philosophy;the search for a superior moral justification for selfishness

    by CTMET on Thu Dec 15, 2011 at 04:44:51 PM PST

  •  This is why they're trying to kill Medicare. (2+ / 0-)
    Recommended by:
    bwren, Grabber by the Heel

    Insurance companies have to start playing by new rules now.

    Depending on their size, they must spend 85 to 90% of revenues on the actual delivery of healthcare.  Not commissions to salespeople, not marketing, not lobbying and not office equipment.  This change is phasing in as I write.  If they don't spend the 85-90%, they have to mail YOU (the policyholder) a check for the difference.

    This is a game changer folks.

    This is why there is a non stop effort to obstruct, obfuscate, dismantle and destroy both the ACA and Medicare.

    Because, if HMO's must live within the realm of 10-15% margins, many will simply pull up their stakes and exit the market.  And in that vacuum, Medicare defaults to a viable public option (as it should).

    Wyden has some limited credibility in advocating on behalf of older americans.  That's history now.

    Let's hope Wyden will soon be too.

    It's the inequality, stupid.

    by Boberto on Thu Dec 15, 2011 at 04:45:54 PM PST

    •  I (0+ / 0-)

      thought they got it lowered at the last minute.

      I don't remember if it is 80% or 75%.

      Still enough to make hundred millionaires  out of the CEOs.

      •  Rick Unger's Forbes op-ed says it best. (1+ / 0-)
        Recommended by:
        Crazy like a fox

        As per Forbes;

        I have long argued that the impact of the Affordable Care Act is not nearly as big of a deal as opponents would have you believe. At the end of the day, the law is – in the main – little more than a successful effort to put an end to some of the more egregious health insurer abuses while creating an environment that should bring more Americans into programs that will give them at least some of the health care coverage they need.

        There is, however, one notable exception – and it’s one that should have a long lasting and powerful impact on the future of health care in our country.

        That would be the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers’ premium dollars they collect—85% for large group insurers—on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.

        This is the true ‘bomb’ contained in Obamacare and the one item that will have more impact on the future of how medical care is paid for in this country than anything we’ve seen in quite some time.  Indeed, it is this aspect of the law that represents the true ‘death panel’ found in Obamacare—but not one that is going to lead to the death of American consumers. Rather, the medical loss ratio will, ultimately, lead to the death of large parts of the private, for-profit health insurance industry.

        Why? Because there is absolutely no way for-profit health insurers are going to be able to learn how to get by and still make a profit while being forced to spend at least 80 percent of their receipts providing their customers with the coverage for which they paid. If they could, we likely would never have seen the extraordinary efforts made by these companies to avoid paying benefits to their customers at the very moment they need it the most.

        Today, that bomb goes off.

        Today, the Department of Health & Human Services issues the rules of what insurer expenditures will—and will not—qualify as a medical expense for purposes of meeting the requirement.

        As it turns out, HHS isn’t screwing around. They actually mean to see to it that the insurance companies spend what they should taking care of their customers.

        Here’s an example: For months, health insurance brokers and salespeople have been lobbying to have the commissions they earn for selling an insurer’s program to consumers be included as a ‘medical expense’ for purposes of the rules. HHS has, today, given them the official thumbs down, as well they should have. Selling me a health insurance policy is simply not the same as providing me with the medical care I am entitled to under the policy. Sales is clearly an overhead cost in any business and had HHS included this as a medical cost, it would have signaled that they are not at all serious about enforcing the concept of the medical loss ratio.

        So, can private health insurance companies manage to make a profit when they actually have to spend premium receipts taking care of their customers’ health needs as promised?  Not a chance-and they know it. Indeed, we are already seeing the parent companies who own these insurance operations fleeing into other types of investments. They know what we should all know – we are now on an inescapable path to a single-payer system for most Americans and thank goodness for it.

        Whether you are a believer in the benefits of single-payer health coverage or an opponent, mark this day down on your calendar because this is the day seismic shifts in our health care system finally get under way.

        If you thought that the Obama Administration chickened out on pushing the nation in the direction of universal health care for everyone, today is the day you begin to understand that the reality is quite the contrary.

        If you believe that the end of private, for-profit health insurance is some type of nefarious step towards a socialist society, then you might want to attend church this Sunday to mourn the loss of health insurers being able to worm out of covering the bills of a cancer patient because she forgot to write down on her application that she had skin acne for three months when she was a teenager.

        Of course, those of you who fear the inevitable arrival of universal health care really shouldn’t be too fretful. There will always be a for-profit health insurance industry for those who want to pay for it. The only difference will be that those who cannot afford private coverage will also have an opportunity to get their families the medical care that they need

        Everyone wins-except the for-profit health insurers.

        I can live with that.

        It's the inequality, stupid.

        by Boberto on Thu Dec 15, 2011 at 06:37:36 PM PST

        [ Parent ]

  •  This taps into my one major problem with Wyden. (5+ / 0-)
    Recommended by:
    Palafox, Ky DEM, franklyn, KateCrashes, Minerva

    As an Oregonian, I like Wyden's progressive stance on a lot of issues including civil liberties and promoting equal opportunity.  But he buys into this "cut-mania" and Republican belief that tax cuts for rich people are awesome.  So yeah, Ryan found his cover--but this isn't a hoodwinking of Wyden.  It's right in line with things that Wyden actually professes to believe, and for some reason he doesn't actually see how it will undermine the other things he believes in.

    Someone here in Eugene needs to call Pete and Jeff to talk some sense into Ron.

  •  Et tu, Wyden? (2+ / 0-)
    Recommended by:
    Supavash, profundo


    Religion is regarded by the common people as true, by the wise as false, and by rulers as useful.

    by stvkos on Thu Dec 15, 2011 at 04:50:02 PM PST

  •  Moving from "Do Nothing" Congress (1+ / 0-)
    Recommended by:

    to "Do Harm" Congress with Democratic help.

    Our only hope is that government does shut down Saturday.

    Readers & Book Lovers Pull up a chair! You're never too old to be a Meta Groupie

    by Limelite on Thu Dec 15, 2011 at 04:52:42 PM PST

  •  Can This Idiot Be Primaried? (0+ / 0-)

    Worse than useless, he is damaging.

  •  Thanks for nothing, indeed. (1+ / 0-)
    Recommended by:

    There was really no need to bring this issue back from the dead.  Wyden deserves the beating he's getting from Democrats and the White House.  This is really stupid politics.

    Though, I feel uncomfortable saying that the Ryan-Wyden plan is even remotely similar to "Obamacare."  The ACA extends the lifespan of the current Medicare, it does NOT hand out vouchers so that the elderly can buy private insurance.

    •  ACA buys more time for Pharma & Insurance (0+ / 0-)

      The delays in implementation are a feature, not a bug.
      The contrast with Canada single payer is striking.  Right now, an individual making over $30k pays $60/mo for health care.  A married couple pay $109/mo, and a family of three or more pay $121/mo.  Those making under $30k pay less on a sliding scale.  No income and it's free.  Drugs cost 1/4 to 1/3 of prices here.  Remove parasites from the HC delivery system and better care is delivered for less.  Infant mortality and longevity both surpass our pos system with or without the ACA.
      The assault on Medicare will probably be extended to military tri-care since both systems are the closest we have to something that delivers at a reasonable cost.  Single payer is inevitable here too.  The intent of the ACA was just to stall for more profits for the 1%.

  •  Re Wyden: They musta gotten to him. (1+ / 0-)
    Recommended by:

    Maybe they're holding his children hostage.
    "an offer he couldn't refuse"...
    Dead girl or live boy?....

    •  They musta gotten to him part II. (0+ / 0-)

      Oh, "Campaign contributions"?
      Millions of dollars? In "campaign contributions".
      So, he "needs" millions of dollars in "campaign contributions".
      I see.
      ...Never mind....

    •  He was an early and ardent supporter of Bush's (1+ / 0-)
      Recommended by:

      prescription drug plan for Medicare.

      And the finance and health care industries can assure themselves that Wyden, once bought stays bought. His trade and healthcare votes and related bills directly endanger many of his Liberal positions. So I conclude his rarely successful civil liberty and other Liberal efforts are cover for his effective votes for corporate trade and the healthcare industrial complex.

      And he looks to be providing political cover for Ryan, another darling of finance and big healthcare.

      Saving "Privatizing Ryan" is no favor to Oregonians, Democrats or other Americans.    

  •  What the fuck is wrong with Ron Widen? (0+ / 0-)
  •  They (0+ / 0-)

    are just getting more brazen at letting the 99% see that they really are the same. They only serve the rich.

  •  Wyden has losted his friggin' mind. Asshole! (2+ / 0-)
    Recommended by:
    Supavash, All In
  •  Yeah (1+ / 0-)
    Recommended by:

    This is the stuff that makes me think we don't have much of a political party anymore.

  •  Bad policy, bad politics, ignorance and .... (3+ / 0-)
    Recommended by:
    Supavash, bgold, wsexson

    buffoonery, are the salient characteristics of this nightmarish hybrid Ryan/Wyden. Wyden takes away a political issue for the Democratic Party, gives cover to Paul Ryan, gains nothing, because this plan will never be seriously considered by anyone but a handful of Republicans in the Senate and the soon to be diminished T-Party caucus in the House and diminshes his own stature as a Senator.

    The stupidity of this political posturing compels us to ask; "What is a Democrat?" If Wyden is an example of what a Democrat is, then there is no reasonable criteria which could be used to determine policy outcomes in voting for a Democrat. Not to mention the Democratic Senators that just voted to remove Habeaus Corpus from the list of rights Americans once had.

    Why have I been supporting this party  for over 40 years? When Clinton gutted welfare, gave carte blanche to banks and telecom companies, signed NAFTA into law and pumped up the Dot-Com bubble as a new model for American business, I was sickened and disquieted, but told myself the Republicans had the upper hand and he did the best he could. Bush was a disaster. I looked forward to a Democratic President with the upper hand, a huge majority in the House, 59 votes in the Senate and the largest electoral mandate since 1964, rolling back the policies of Bush and Clinton would obviously be his goal. Wrong again... The people and their government are diverging, this is beginning to look more like 1859 than 1931, the Democratic Party will not survive this era if it continues to betray the people who support it. I for one will not continue to be a Democrat if this Party continues in this vein.  

    "Intelligence is quickness in seeing things as they are..." George Santayana

    by KJG52 on Thu Dec 15, 2011 at 06:10:40 PM PST

  •  Here's the thing about Medicare, (0+ / 0-)

    While I FULLY SUPPORT Medicare, where I live in the suburbs of Denver, there are NO doctors who accept Medicare.  You have to go downtown for that.  Clearly there are some real issues with Medicare that have to be dealt with.

  •  What is Wyden Thinking? (0+ / 0-)

    I've met the man. He seemed to be sane.

    "Drop kick me Jesus through the goal post of life" - Paul Craft

    by All In on Thu Dec 15, 2011 at 11:01:14 PM PST

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