How easy it is to say slanderous things for a 15 second sound bite on your favorite news channel. But it’s not easy to take time to tell the whole truth and nothing but the truth.
Why? Because it doesn’t fit into 15 or even 30 seconds – or even the one minute or so that you might find on NPR. It takes a lot of reading of multiple sites to find information, and even then it is hard to find most of the truth.
So let’s look in a little more depth in the following table (and see comments and resources at the end of this article).
| Obama/Biden | Romney/Ryan | |
| Length of time for the $716 billion cut | Over a 10 year period | He wants to repeal Affordable Care Act (except Medicare) right away to save $716 billion RIGHT AWAY |
| The main target? | $415 billion cut to reduce fees to doctors, and reduction of $56 billion to hospitals. Goal is to eliminate the current “fee for service” model. Another $114 billion to nursing homes, insurance companies and others. Problem is that doctors and others may stop taking Medicare patients. This is already happening with Medicaid and nursing homes. | Aimed primarily at consumers (patients). Government would contribute a fixed amount of money on behalf of each beneficiary (so-called “voucher” plan). Anything beyond the Medicare plan would be an out-of-pocket expense for the patient. This would especially affect older women since they live very long and nearly half are poor. It is expected the Hospital Insurance Trust Fund would be exhausted in 2016 rather than in 2024. |
| Cap? | GDP + 0.5% | GDP + 0.5% |
| How is it paid for? | Everyone – having young and old in a total medical system reduces the overall cost. Under 65 people choose coverage through “exchanges” | Voucher system limits budget line (GPD + 0.5%) |
| Who will get Medicare plan? | Over 65 | Only applies to those now 55 and younger if plan is passed (that is, after 2022). Eligibility for Medicare would increase by two months every year until it reached 67 in 2033. |
| Regulation? | An advisory board to recommend cost-saving measures, to regulate insurers (costs), prevent abuses, to eliminate “fee-for-service” and emphasize prevention | Little or no regulation. Let the market decide. If competition doesn’t keep Medicare spending below target, automatic cuts kick in to the Medicare plan. With elimination of the Affordable Care Act, prevention support goes too. |
| What plan? | Medicare inside an overall healthcare plan. Costs are lessened in the same manner as the Massachusetts plan. But no private plan competition for Medicare. However, in Massachusetts, it seems that competition for senior plans may be working. | Voucher can pay for private plan or for “traditional Medicare” (in a choice menu similar to the Affordable Care Act). But will this leave poor/old with minimal care since the least costly will have the least coverage? This is a special problem for women. There is also an issue for self-employed people over 60. |
| Protection for the ill? | More likely to protect those with “pre-existing” conditions since the healthcare plan enrolls people of all ages and conditions | More indigent will settle for traditional Medicare which will end up costing government more since it will likely be populated by chronically ill patients and by those with pre-existing conditions |
| Medicare Advantage (Part C) a privatized system | Reduces payments ($156 billion ) because this program costs about 20% more than Medicare. On the other hand, there is increased enrollment (10% last year), which has already led to a decrease (7%) in plan costs. | Will expand so that with more enrollment companies will compete with menus of service. But there may be a tendency to siphon off healthy patients, so it will be more costly to care for the poor. |
| Medicare Prescription Drug Plans (Part D) a privatized system | Currently subsidized by the government at a rate steady for last 3 years | Will expand so that with more enrollment, companies will compete with menus of service. By repealing the Affordable Care Act, he would again create the “donut hole” for prescriptions. |
In an article: Ryancare vs. Obamacare: The Future of Medicare is at Stake on the MoneyMorning website it says:
“…the average annual per-capita spending growth rate through 2019 is projected at 3.1% for Medicare, compared with 4.9% for private insurance plans, according to the non-partisan Kaiser Family Foundation.”
also, it says…
“The Congressional Budget Office (CBO) projects that under Ryan’s budget, Medicare spending for new enrollees in 2050 would be 35%-45% less than under the current system. The caveat, they say, is that this could cause an increase in out-of-pocket spending for seniors, less quality of care and reduced access to health care.”
Other sources for this article:
End Medicare? Hardly. The Ryan Plan Expands On a Medicare System Seniors Love
Despite Democrats’ Warnings, Private Medicare Plans Find Success
How Obamacare’s $716 Billion in Cuts Will Drive Doctors Out of Medicare
FAQ: Obama v. Ryan On Controlling Federal Medicare Spending
The Great Medicare Compromise
Medicare Cuts: What Is the Fight About?
Why the Medicare Fight Matters to Americans Over 55