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House Republicans adopted, almost unanimously, the Ryan plan to end Medicare. Of course they know that Medicare is popular and among seniors is far more popular than private insurance is for other people. So they wouldn't dare take it away from those currently receiving Medicare.

Their solution is to only take it away from people not currently eligible, those below fifty-five years old. From a political standpoint they think they will keep seniors on their side, assuring all those seniors who vote that their Medicare is safe. This cynical plan could work but only if those seniors hate their children and grandchildren. If not hate, Republican hope that seniors at least dislike their offspring enough that they want them to be denied the same medical security they enjoy, an assurance from the government that their medical future is safe.

It is possible that some of the parents and grandparents of these Republican Representatives feel that way about their issue, but I don't think that most grandparents feel that way. Having experienced first hand the effects of aging and the anxiety of paying for their medical care before becoming eligible for Medicare, it is reasonable to assume that most of these seniors will not wish upon their children and grandchildren a fate that is worse than what they experienced  

First, the plan. The Republican plan ends the guaranteed Medicare benefit, substituting a plan to give seniors a voucher/coupon to pay part of the cost of buying private insurance, assuming a plan is available. In addition, the plan tells people that whenMedicare ends, they can't get these vouchers when they are sixty-five, but have to wait till they are sixty-seven.

The voucher plan is unacceptable for four main reasons. First, in all likelihood it will be unworkable. Finding insurance companies to guarantee the elderly will be difficult if not impossible. Second, if any insurers participate the premiums they will charge will be far higher than the value of the vouchers. Third, the plan enriches insurance companies at the expense of seniors. Lastly and most importantly, as each year passes the burden of paying for care is increasingly shifted onto seniors.

The Ryan plan doesn't save dollars, it doesn't reduce the cost of medical care, it merely shifts those from  the government to seniors. This shift is dramatic. In a study by Center For Economic And Policy Research, using Congressional Budget Office Data, under the Ryan plan seniors will pay 35% of their income for medical care in 2022 and that percentage will increase to 68% by 2050.

This happens because the value of the vouchers only increase with the inflation rate. Health care costs have been rising far above that rate and there is nothing in Ryan's plan to control costs. This is where Ryan saves the government billions, by transferring to seniors the ever increasing difference between the value of the voucher and the ballooning insurance premiums.

And these are just median figures, They ignore the reality of the millions of seniors who will fall above those median levels. Many of those people who will have been left to the mercy of the private insurance market will be financially ruined. And when they have no money, they will be forced onto Medicaid. But Ryan proposes to gut that program too, by shifting costs to already cash strapped states.

All of that is bad enough. But the Republicans weren't satisfied. Ryan decided to save even more money to fund Billionaire tax cuts by telling people who are currently fifty-five that they are not only ineligible for Medicare, they can't even get vouchers when they reach sixty-five. No. They have to wait longer and if they were born in 1966 they'll have to wait a full two years longer.

Ryan may have thought that delaying access to his faux Medicare vouchers till sixty-seven would sail through issue since the Social Security retirement age also increases to sixty-seven for younger Americans. But that is the problem with simplistic thinking. He doesn't appear to understand that while it may be hard to find a job and sometimes even to work after sixty-five, it is near impossible to find health insurance at that age and totally impossible to find affordable insurance. That is, of course, unless you are part of the that upper 3% of the income scale.

Even Reagan understood that point and the Medicare eligibility rate was not raised as part of the 1983 Social Security deal. Also, while the 1983 Social Security law gradually raised the retirement age to sixty-seven, it still allows people to draw reduced benefits earlier, even at sixty-two. Such is not the case with the Ryan/Republican plan. Under their plan a person between the ages of sixty-five and sixty-seven gets nothing. No reduced Medicare, no reduced voucher, nothing.

But money is only part of the issue. The other is the anxiety, the lost peace of mind that comes with Medicare today. Medicare was enacted in 1965 because seniors were suffering, not just medically and financially, but also emotionally. They were needing medical care as they aged much more than when they were young and they could not find people to treat them unless they were well off. Insurance was not available. Medicare was a Godsend. For the first time they were guaranteed coverage, access to medical services and it was reasonably affordable. For some of very limited means, even paying the current premiums and co-pays in Medicare is hard, but it's nothing like the crushing burden faced before 1965.

Ryan wants to end all this. No longer will seniors know they have coverage, can get treatment and, that their costs are limited. They will be thrown back to the bad old days. Sure, there may be a policy out there. They can't know if it will be there and  can't know what it will cover. But even if it is there, they know today that the policy will be expensive and as time passes they will have to pay more and more out of their pocket to pay for it.

Seniors on Medicare today know these things. They may feel a little better that the Republican plan, as it stands today, will not affect them. Some may wonder whether, once passed, it could easily be changed to start taking back benefits they currently have. But even if not, they will know it will affect their children and grandchildren. The very loved ones who they struggled all their lives for, showering them with love and affection. The very ones they now see struggling to pay their bills, find jobs, and keep their homes. The grandchildren who they love dearly, never passing up an opportunity to brag about and spoil.

Knowing what she knows, is Granny really going to throw her children and grandchildren to wolves? The Republicans are counting on it. I think they will be surprised.

Also posted at September 17, 1787

Originally posted to September 17, 1787 on Sun Apr 17, 2011 at 03:24 PM PDT.

Also republished by The Yes We Can Pragmatists.

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