Sunday, May 29, 2011

Young And Old Targeted

There it is, in black and white, in the GOP's 2012 budget proposal, approved in the House and defeated in the Senate, entitled "The Path to Prosperity: Restoring America's Promise." In a nod to the doublespeak of George Orwell's 1984, Ryan titled a subsection "Saving Medicare" and claimed the plan would

Save Medicare for current and future generations while making no changes for those in and near retirement.

Uh, no. As Igor Volsky explains at Think Progress:

In 2022, newly-eligible beneficiaries would have to enroll in a private plan, but existing beneficiaries (those who are over 55 today) would also have the option of leaving traditional Medicare. As Ryan’s budget put it, “While there would be no disruptions in the current Medicare fee-for-service program for those currently enrolled or becoming eligible in the next ten years, all seniors would have the choice to opt into the new Medicare program once it begins in 2022. No senior would be forced to stay in the old program.”

That opens up the possibilities of private plans trying to lure away the healthiest beneficiaries (as is currently the case in Medicare Advantage) and of health care providers abandoning traditional Medicare patients for the higher reimbursement rates of private insurers. For chronically ill seniors who are more likely to remain in fee-for-service Medicare this means two things: higher costs (as the healthier beneficiaries exit the risk pool) and fewer doctors.

But if current retirees remaining in traditional Medicare will beginning in 2022, as Volsky speculates, face higher costs and fewer doctors, so will current retirees be faced with higher costs or reduced services beginning in October under the Ryan/GOP budget plan because

A new Medicare benefit that guarantees senior citizens free annual physicals and no co-pays for cancer screenings or mammograms would be repealed in October under a spending blueprint the House passed last month, Health and Human Services Secretary Kathleen Sebelius said Thursday.

That's because the Republican blueprint calls for repealing last year's health care reform law, Sebelius told reporters at a news conference.

House Republicans say their Medicare overhaul plan targets people under 55, but Sebelius and several Senate Democrats said the plan also would affect current beneficiaries.

Under the health care reform law, the "doughnut hole" in Medicare prescription drug coverage will gradually close.

But at least individuals currently 55 and over would not get shafted quite as much as those now under 55. That would apply only to the short term, however, given that, as Paul Krugman notes,

if you think about the political dynamics that would emerge once Americans born a year or two too late realize how much better a deal slightly older Americans are getting, you realize that this is a promise unlikely to be fulfilled.

Apparently, that is a Republican wet dream. Think Social Security, much of which Republicans also want to privatize. Individuals who invested wisely (or were lucky)- or at the right time- will profit somewhat, notwithstanding whatever is taken off the top by stock brokers. Those who invest at the wrong time will be out of luck- and will, no doubt, say "That's the breaks of the game. At least my neighbor prospered while I'm losing my home. Thank God for the market!"

Medicare, Social Security- it's all the same. Americans may be set against Americans, but at least Wall Street and the insurance industry make out like bandits.

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