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Trying to make sense of Ryan’s Medicare reform


Herewith some points to help understand House Speaker Paul Ryan’s proposal to overhaul Medicare:

His plan calls changing the program so that individuals eligible for Medicare would get a fixed contribution from the Feds to put toward buying private insurance.

The idea is to boost payer competition and encourage more cost- consciousness in beneficiaries as they select plans.  The hope is that giving beneficiaries  a choice of various health plans will lead payers to offer more competitive prices, leading to lower premiums.

Many Republican senators have said that they want to focus on “repealing” the Affordable Care Act and not touch Medicare for a year.  But the tricky thing is that the ACA is interwoven with Medicare.

Meanwhile, Democrats senators strongly oppose privatizing  Medicare.

And President-elect Trump  himself may also present an obstacle for Medicare changes, which could be very, very unpopular with many voters. In the past, he has said that he would not cut Medicare, Social Security or Medicaid. Of course, he says wildly conflicting things all the time, so who knows?

His transition Web site includes a promise to “modernize Medicare, so that it will be ready for the challenges with the coming {it is actually already underway} retirement of the Baby Boom generation — and beyond.” His nomination of Tom Price, M.D., as secretary of health and human services, might signal Medicare reform; Dr. Price has said that Republicans could push Medicare reform through a “fast-track budget procedure” to  would void a Democratic filibuster.

But are they willing to take the heat from millions of elderly people if they do?


Public programs look better than insurance via ACA for kids


Medicaid got by implication a big plug with the results of a National Survey of Children’s Health report.

The study said that children in low-income households with private insurance  obtained through the Affordable Care Act (ACA) received fewer regular checkups and  had higher medical costs than children on public insurance plans — which mostly means Medicaid and the Children’s Health Insurance Program (CHIP).

The report said:

Only 83 percent of children insured through the ACA’s qualified health plans had a preventive medical visit compared to  88 percent of those on Medicaid and 95 percent on CHIP.

Parents of children with private insurance also reported the highest “prevalence of out-of-pocket costs” No surprise there.







Survey touts clinical, financial merits of Medicaid


An opinion piece on the Commonwealth Fund’s Web site concludes:

“The results from the Commonwealth Fund Biennial Health Insurance Survey, 2014, suggest that people with Medicaid coverage have better access to healthcare services, including proven preventive care, and fewer medically related financial burdens compared with those who lack insurance. Our findings also suggest that, compared to those with private coverage, Medicaid enrollees have nearly equivalent levels of access to care on many important dimensions. Medicaid coverage also appears to offer better financial protection than private insurance against the cost of illness. This last observation may reflect the steady increase in recent years in many private plans’ deductibles and copayments.”

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