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OK - Just What Is the Ryan Medicare Plan?


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American Thinker:

Much chatter today centers on the Ryan Medicare Plan, a proposal to reform Medicare first proposed by Wisconsin congressman Paul Ryan as part of "A Roadmap for America's Future" to guide the House Budget Committee under Republican Party control. Though hype and rhetoric surround the subject, little real understanding has seeped down into the public at large. Let's try to sort it out.

To understand where Ryan is heading, one must first understand the basics of Medicare. The current Medicare program provides single-payer medical care insurance for people 65 and over as well as people under 65 with certain disabilities or special medical conditions. It is composed of four parts: Hospital Insurance (Part A) covering inpatient hospital and specified skilled care; Medical Insurance (Part B) covering doctor services, outpatient care, and certain preventive services reimbursed at Medicare-approved amounts; Advantage Plans (Part C) providing Medicare Part A and B benefits through approved private companies under contract with Medicare; and Prescription Drug Insurance (Part D) providing reimbursements for prescription drugs purchased through private companies approved by Medicare.
Under this four-part program, enrollees choose from two basic options.

(1) "Original Medicare" (also called fee-for-service Medicare) offers Parts A, B, and D benefits for those wishing to select their own doctors, hospitals, and care providers with the option to also purchase "Medigap" insurance coverage sold by private companies to augment caps in Medicare reimbursements.

(2) "Medicare Advantage" provides Parts A, B, and D benefits through privately-administered healthcare plans requiring use of specified doctors, hospitals, and other providers under plan-specific co-payments and additional premiums.

It is becoming increasingly clear that, with the ever-growing number of seniors becoming eligible for Medicare, payment of benefits at current levels will become unsustainable. To correct for this problem, the controversial Patient Protection and Affordable Care Act ("ObamaCare") establishes an Independent Payment Advisory Board (IPAB). This special 15-member panel, to be appointed by the president with Senate confirmation for 6-year terms beginning in 2013, is intended specifically to reduce the rate of future per-capita spending on Medicare.

According to analysis of the ObamaCare legislation, if the Actuary of the Centers for Medicare and Medicaid Services determines that Medicare expenditures will exceed the target rate of growth specified in the law, the IPAB must develop proposals to reduce those expenditures. While legislation states IPAB proposals cannot specifically ration medical care, IPAB can issue recommendations pertaining to Medicare payments to providers and suppliers which could not help but have the same effect. To make matters worse, Congress specifically inserted wording allowing IPAB recommendations to take effect without congressional approval -- thus exempting elected representatives from making the tough choices needed. snip
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