Greetings everyone, it's been a while since I've last posted. But these recent budget talks regarding Medicare finally got me off my duff. As a disabled person who had dealt with private insurance until I could get Medicare, I know what the costs can be. Indeed, it is my experiences with Medicare, which I've written about before, that has pushed me to advocate for expanding it to all. But then it dawned on me, given how crazy politics in Washington have become, what if some version of what I'm calling Ryancare passes? Well gang, we need to hijack this sucker and fix it.
Now I'm assuming here that we just won't have the votes and/or political capital to completely eliminate Ryancare. That we will be stuck with the damn thing in one form or another until we can get a majority to finally implement what's really needed. Well, if that's the case I say we do the following:
1) Push for a Public Option for our choices on where our vouchers should go. This can either be a federal PO or a state-based single-payer system (if available...ahem..Vermont??).
2) Replace the index of indicators that Ryancare uses that obviously will not meet the total costs of coverage with an index to actual healthcare costs. That base amount that Ryancare puts forth, as many have noted, will force seniors and the disabled more out-of-pocket costs in the thousands. The New England Journal of Medicine had an excellent take on this:
Although the Ryan–Rivlin and House Budget Committee plans are called “premium support,” they actually jettison all or most of the consumer protections that distinguish premium support from bare vouchers. Both would shift costs to Medicare enrollees. The CBO estimates that by 2030 the House Budget Committee plan would increase the out-of-pocket share of health care spending for a typical Medicare beneficiary from the current 25-to-30% range to 68%
~ from "How Not to Reform Medicare" by Dr. Henry J. Aaron, New England Journal of Medicine
The index needs to match the growth rates. Many seniors and disabled, particularly those of low and/or fixed income simply won't have the funds. And whatever matching funds that is mentioned in Ryancare, from what I've read of the plan, won't keep up. Of course, we also should look into why healthcare is rising, I could tell you stories of outrageous prices for some medical equipment. But that's for a different entry.
So we have a public option, instead of just handing our money to more for-profit murder-by-spreadsheet insurance companies. We insure that the vouchers are properly gaged to the real growth rates. Now let me throw you one more that may blow you away.
3) Expand Ryancare to everyone. Let's use this as federal vehicle for universal insurance coverage. If we can give vouchers to seniors to purchase (hopefully) the Public Option, we can do this for the poor. Since folks going into Ryancare will be paying their Medicare premiums, why not give that option to fox under 67? Especially the poor, who could use this. We could eliminate the grant blocks to states that were to replace the Feds' part of Medicaid with subsidies for premiums. Since the voucher program really is a transferance of your premiums, the rest of Americans who wanted to opt into this new progressive Ryancare could pay into it and have their "vouchers" go into a choice of plans (to placate the Cons out there who simply have to give United Healthcare their money) include a Public Option.
OK, I grant you, my scheme is a bit crazy and I know I haven't thought out all the angles. But if this monstrocity passes in some form, shouldn't we wrangle this beast under proper control? Just speaking for myself, if I have to get a voucher, I would prefer it go to a Public Option instead of Stephen J. Hemsley of UnitedHealth.