Why does the Wyden-Ryan Plan on Medicare is so bad?

[Sec. of State Superique]

There were many political commentators during the 2012 arguing that the Medicare Options of Paul Ryan and Ron Wyden would lead inevitably to the destruction of the Medicare Traditional System but I can't see that. Rick Ungar, a Contributor of Forbes, said that the private plans would only choose those with good healthcare and, by cherry picking seniors, they would make the Government Option a huge high-risk polls, inevitably creating a too expensive governmental and killing it. But I think that he doesn't really know what was written on this Bi-Partisan Bill. Just like and even stronger than in the Affordable Care Act Exchanges, the new Medicare Exchange would create strict community rating demands as well as not allowing private plans to choose only the healthier seniors. Basically, there would not be any kind of cherry picking because the law disallow the Market of doing so.

From an strategical point view, I understand that it is very easy for the Democratic Party to attack the Ryan-Widen Plan but, in fact, if you consider how things would end up happening, the Medicare Options plan would be the testimony of how Single-Payer Healthcare is the only wise alternative for cheaper and better healthcare. On this Medicare Options system that would likely emerge, Private Plans would never be seen as the better option and I have no doubts that they wouldn't beat the traditional Public Medicare Option. Ron Wyden himself could argue that this would be one of the major reasons why every American should have the right to decide if they want private coverage or the traditional Medicare.

The Plan would be like that: Exchanges for Everyone but with a Public Option >>> Single-Payer Wins!

[Sec. of State Superique]

Please, I deserve an awser =(

[Southern Senator North Carolina Yankee]

Its called the electoral college or more specifically Florida.

I realize that is rather cynical but I highly doubt many of these political strategists no much about the issue, they certainly know how to count though. All the way up to 270.

If Obama embraced it, certainly the Republicans would have responded the same way, most likely.

[anvi]

I'm a bit puzzled as to what the change is supposed to be in the Ryan 2.0 plan.  If I understood the first plan correctly, it did allow seniors to keep their Medicare coverage until 2020-something, but offer subsidies for seniors who might want to opt out of Medicare to purchase a private plan offered on the exchanges.  But after 2020-something, the only plans that would be available to seniors would be the plans offered on the exchanges, which would be subsidized and subject to federal minimum coverage regs.  In other words, the first plan represented a slow phaseout of Medicare in exchange for subsidies for private plans.  I don't see how this plan is different.  Even if seniors continued to choose traditional Medicare until the 2020's, future seniors wouldn't have that option.  So, if Dems embraced Ryan-Wyden, it would constitute embracing an eventual phase-out of Traditional Medicare.  That's why most Dems don't embrace it.

Of course, these kinds of plans attempt to sell today's seniors by promising them they they can keep their traditional Medicare, so that keeps Pubs, at least theoretically, electorally safe in Florida and perhaps some other places, while at the same time only deferring on decimating a big entitlement program and getting the bulk of its spending of the government's back.

But the irony of it is is pretty thick.  Since the computer malfunctions that accompanied Obabacare's rollout, it's now apparently become Pub fad to ridicule the idea of state exchanges and insist they won't work (even though the idea was originally theirs).  But Ryan is continuing to insist that state exchanges are still good ways in the long run to give seniors good options to shop for private plans.  No need to get the story straight, I guess, since double-standards always work better than a straight story.    

[Sec. of State Superique]

The Wyden-Ryan plan phase out the government plan or Ryancare does that? Or both?

[anvi]

Effectively, in my view, the answer is both.  Others may disagree.  But here is why I say so.

This is a link to the policy proposal Wyden and Ryan co-authored:

http://budget.house.gov/uploadedfiles/wydenryan.pdf

And this quote is from the bottom of page 7 and the top of page 9  of the proposal.

"As put forward by this proposal, the reformed Medicare program would allow future retirees (those who first become eligible by turning 65 on or after January 1, 2022) who choose the traditional fee-for-service Medicare plan to do so. Beginning in 2022, these seniors would also be given a choice of private plans competing alongside the traditional fee-for-service option on a newly created Medicare
Exchange. Medicare would provide a coverage-support payment either to pay for or offset the premium of the plan chosen by the senior, depending on the plan’s cost. The Medicare Exchange would provide seniors with a competitive marketplace where they could choose a plan the same way Members of Congress do. All plans, including the traditional fee-for-service option, would participate in an annual competitive bidding process to determine the dollar amount of the federal contribution seniors would use to purchase the coverage that best serves their medical needs. The second-least expensive approved plan or fee-for-service Medicare, whichever is least expensive, would establish the benchmark that determines the coverage-support amount for the plan chosen by the senior. If a senior chose a costlier plan than the benchmark, he or she would be responsible for paying the difference. Conversely, if that senior chose a plan that cost less than the benchmark, he or she would be given a rebate for the difference. Payments to plans would be risk- adjusted and geographically rated. Private health plans would be required to cover at least the actuarial equivalent of the benefit package provided by fee-for-service Medicare."

The language of this policy proposal (it was never a piece of legislation) makes it appear that fee-for-service Medicare would compete with other plans in the state exchanges.  Theoretically, seniors could stay on traditional fee-for-service Medicare, but its cost-growth restrictions would not make it more attractive than other plans, because, over time, it would pay for fewer and fewer services.  Its primary function, as far as I can tell, would be to provide a "benchmark" that determined, on the basis of a cost-growth rate of the GDP+1% (far slower, mind you, then the long-established rate of health care cost inflation), how much private premium coverage support seniors now younger than 54 would be offered.  In other words, what I see Ryan-Wyden doing is converting, by 2022, traditional Medicare into a largely private-plan premium support program from an independent fee-for-service government program.  No real substantive changes from the ones Ryan proposed in his 2011 budget; I think he just inched up the private-plan premium coverage reimbursement by .5%.

Here, again, is the irony of it all in a nutshell.  Ryan-Wyden essentially wants to convert Medicare into Obamacare for seniors.  Wyden at least was consistent in his convictions by supporting this plan but voting for the ACA.  Ryan, on the other hand, rails against the ACA for the general public, but thinks that, for seniors, the highest-risk, highest-cost pool of insured, the ACA framework is a good idea.      

[Sec. of State Superique]

Ugh. So the Wyden-Ryan plan really sucks. I could support if the traditional Medicare would least forever in the exchanges but not this sh**te!

[anvi]

Well, the policy proposal by Ryan-Wyden does say traditional Medicare will continue to exist, but it will be so reigned in in terms of coverage with the cost-growth restrictions imposed on it that Unger, in the essay you linked in the OP, thinks it would be effectively "dead" by the 2020's.  He is probably not far off.  Under Ryan-Wyden, seniors in the 2020s and beyond would largely know Medicare as a premium reimbursement program.