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Ryan's Plan Is Our Best Hope for Increasing Medicare Efficiency

Medicare reform needs to address underlying causes of rampant healthcare spending to control it

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This commentator is clearly biased (check the American Enterprise Inst. for verification of perspective.) and off-point.

We need to deal with primes, not symptoms, and the prime issue is the Medical-Pharma-Insurance Complex is grossly inefficient. Irrespective of this approach or that approach, unless the basic rules of operation are changed ... any improvement will be marginal.

To understand the depth of market distortion in the Medical Monster consider, where else would you pay for:

> Whatever price "they" feel like for whatever they decide needs to be done whether there is any value added or not.

> An unitemized bill in the tens of thousands - try to get an itemized bill and look at it and ask questions about the $20 aspirin and $2,000 room rates with nominal care. The bill doesn't change.

> No negotiation allowed, you just pay whatever your insurance company doesn't - even if you are not improved.

> You pay 30-50% "overhead" for Healthacre "administration" and another 30-40% more for Health Insurance "administration". Neither add any value to the medical results.

It is absurd - and to Mr Ryan, Mitt and this commentator I say there is no competition - every "provider" feeds with no negotiation or required performance, just some more than others.

Fix the prime and we will fix the whole problem.

Apply to other politically protected industries, like Oil, Banks, etc. Do they need entitlements in the billions when they make trillions.

Any other approach other than focusing on the fraud and profiteering is kicking the can down the road.

Michael S King of CA 10:36PM August 19, 2012

Excelllent analysis by Antos....he provides a compelling argument for the Ryan approach to reform of Medicare. Those that criticize have no plan or counter proposal to offer...they favor letting Medicare continue as it is and having it go bankrupt in 10 years.

Bill Winkenwerder of VA 11:56PM August 17, 2012

Overall healthcare costs (the total amount paid for healthcare services consumed) will not decrease unless the rate and/or the quantity (or both) decrease. How many providers are stepping up to voluntarily reduce the amount they are reimbursed? So much for decreasing the rate. That leaves utilization decreases, which means less care, and ultimately unhealthier citizens. Shifting cost from insurers to the insured is not a reduction in total healthcare cost. It is simply what it says - shifting costs.

justathought of KY 5:25PM August 17, 2012

Private for profit health insurance companies have only one goal in mind....Maximizing profits.

With that in mind, any fairy tale story that they "competition" will drive down costs appears just that...a fairy tale.

The insurance industry has a powerful lobbying group in Washington just to make sure that competition doesn't interfere with their profits.

Insurance companies have no desire to watch their profits decline in the face of competition.

As medical costs go DOWN the need for insurance DECREASES because if people can afford to pay medical bills...they don't need insurance.

The reason why people don't buy insurance for their garden tools is because if one breaks they are cheap enough to replace.

Insurance companies know that high medical costs forces people to buy insurance

naksuthin of CA 4:10PM August 17, 2012

To add to the previous post, in short, leaving the task of shopping for healthcare plans to seniors basically wipes out any possibility for a competitive market place, and leaves them at the whim of insurance companies that will be free to raise prices endlessly. Perhaps they'll be able to choose Medicare, but that program will be so gutted because there are no guarantees made by the government in Ryan's plan which is very murky on how it will defund the program. By taking away a single standard of care, Medicare will become the poorman's old age health care, like a foodstamp program for elderly people who are not wealthy enough to buy into a more expensive plan. Families will be burdened with figuring out how to pay for their parents care. With Obama, we keep Medicare as a right for everyone, rich and poor, but implement efficiency standards and regulatory agencies to make sure the program is not wasteful. In the end, the government will save money, because it won't have to pick up the pieces as old people fall through the many cracks in the Ryan/Romney system, and end up needing emergency care that is not covered by any insurance.

A Lapin of CA 1:39PM August 17, 2012

No one who proposes that health insurance companies will lower their premiums for old people (despite whatever prediction models they conjure to support their claims) once there is a fair market place has ever had to pay for their own insurance. I am self employed, and my insurance is raised sometimes on a monthly basis: it has gone from $89/month for disaster coverage only to $250/month for the same (nearly non-existent care unless I reach my $5000 deductible) over the last 5 years. I am only 33, so I have been able to do a lot of research to find a slightly lower premium, but how can Ryan expect someone in their 80s, suffering from various ailments, to find the most competitive priced insurance plan? It's so complicated and I have a masters, got 1570 on my SAT, and am 33 years old!

A Lapin of CA 1:28PM August 17, 2012