Ryan and Medicare

To say that Paul Ryan’s proposed changes to Medicare would have no impact on existing seniors is just wrong.  Andrew Sullivan’s readers hit this on two counts:

1) Readers continue to be better spokespeople on this issue than Debbie Wasserman Schultz:

The big effect Ryan’s plan would have right way on the over-55 set is the change to Medicaid spending. Block grants to the states for Medicaid would not keep pace with health care cost growth, thus either forcing states to pay more and more (and raise taxes to fund these payments) or spend less on Medicaid. About 50% of Medicaid spending [pdf] is consumed by the elderly (though they comprise only about 20% of the recipients) and most particularly about 50% of all long-term care in this country is at least partially funded by Medicaid.

Okay, technically, that’s a Medicaid, not Medicare issue.  For many seniors, they’re reliance on Medicare and Medicaid is intricately woven, thus cutting Medicaid (as Ryan proposed to do dramatically) will have a big impact on these seniors.

2) An important point that it seems is all too often overlooked when Ryan says it only affects those younger than 55:

A reader writes:

The Ryan Medicare plan absolutely will effect people currently on Medicare.  If you establish that in 10 years the Medicare risk pool will stop growing and start shrinking, you do damage to how the program works.  First, you increase the risk in the pool and drive up cost by stopping younger healthier seniors from entering the plan.  Second, as the pool shrinks Medicare looses power to dictate reimbursement rates.  Doctors will begin not to accept Medicare patients because not only will the volume of patients no longer justify the low reimbursement rates, but those left in the pool will be older, sicker and more expensive to treat.  The program that they say will be in place will not only become much more expensive to maintain then projected, but it will collapse on itself.

Short version: Ryan/Romney can claim all they want the Ryan budget would not hurt existing seniors.  They’re just not telling the truth.

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About Steve Greene
Professor of Political Science at NC State http://faculty.chass.ncsu.edu/shgreene

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