The Paul Ryan 2012 budget proposal that just passed the House will not balance the budget, as it also reduces the tax rate for the upper income earners to 25%, currently 35% and it was 39.5% under Clinton. That adds a minimum of 1 trillion dollars to the debt over 10 years. Not smart.
As for his Medicare voucher (premium support) program, it will not work. The very reason Medicare was created is that very few insurance companies would insure people over 55 years old. The few companies that did issue policies, they would terminate the policy at age 70. Remember all these policies were called major medical and only covered inpatient services, not regular visits to the doctor. Seniors had to pay for their doctor visits out of pocket. Many seniors could not afford to see a doctor, so they would wait until the illness required hospitalization. If they were lucky enough to have a major medical policy, then they still had to pay a deductible for the hospital stay. Before Medicare, there was a high rate of premature deaths due to lack of medical care because the seniors could not afford it. As we all know, as you reach 55 or older, your health care needs increase dramatically, thus the reason insurance companies will not issue policies to this age group, unless you are covered under an employer group plan.
To think that a voucher of say $12,000 would be enough to purchase a private policy is insane. Since most seniors would not be able to pay the difference between the price of the policy and the voucher amount, I doubt any insurance company will issue policies. So we will be back to the original situation of seniors not having access to health care when they need it the most, thus many of them will die at a much earlier age. Fortunately, I'm of the age that so far will be grandfathered into the current program and will receive some sort of benefit. But the younger generation will not and that will be a major problem for their generation to deal with. The biggest problem with Medicare is the escalation of medical costs. The payroll deduction and employer contribution share has not kept pace with the increase in health care advances and longevity. Thus the reason it is consuming such a large portion of the budget. Adjustments in the contribution rates would cover the operating costs and thus neutralize the budget demand. But that could be rather dramatic.
Currently an employee pays 6.5% of his wages to Medicare and his employer pays 6.5%. So when the Republicans say you are paying 13% of your wages to Medicare, that is somewhat misleading, as most employees calculate their share based on the gross wages listed on their W-2. However, when an employer calculates total compensation to an employee in their accounting ledger, it includes their Medicare matching amount, as well as their Social Security matching amount, whatever share of the employee's health insurance policy premium they may pay and any contribution to an employee's 401(k) or pension, so in that case, you could say it costs the 13% of the total calculated compensation by the employer.
Medicare was designed for a life expectancy to about age 72. But more people are living longer due to a better standard of living and advances in medical care, such as pharmaceuticals. The only true way to reduce medical costs not only for Medicare recipients, but also every American is with a single payer national health system. This system would be able to negotiate better prices for services and medications. It could work with health care providers to improve the delivery of care more efficiently.
Tort reform has to be addressed. I suggest eliminating tort and have a no fault system, since the patient's health care will be taken care of anyway by the single payer system. A no fault fund would be established that is paid into by health care providers and from that fund, the national health care system would be reimbursed for expenses directly caused by an injury. No pain and suffering or penalty awards would be available. No lottery win for the lawyers and patient. That would save billions of dollars a year in health care costs. If there a bad provider, then that should be handled by the state licensing board. If the panel that approves the no fault claim see there was gross negligence by the provider, then that provider would be turned over to the state licensing board for discipline, training or termination of license. If there is a monetary penalty for what the provider did, then that money goes into the no fault fund, not the patient and their lawyer.
He also reduces Medicaid to block grants to the states for covering the medical costs of the indigent, disabled and poor. As we can see now, even with the federal funding, these health care costs are exceeding their state budgets and combined with the federal funds they receive. To think that they can continue providing these services is again insane. What will end up happening is that Medicaid will be terminated completely. All those who need assistance, like the very elderly that should be in a nursing home and have no children to take them in will be part of the homeless population and die. Those who are quadriplegic or otherwise in need of residential care will be homeless. Poor women with children will be homeless and without medical care for themselves and their children. Young girls who find themselves pregnant, unmarried and poor will not get prenatal care and who knows how they will deliver their baby or feed it when it is delivered? Of course we could eliminate Medicaid by having a single payer health system for everyone, regardless of income or disability.
Social Security is a self funded program. The only money it receive from the general budget is the interest paid on the treasury bonds that it purchases, like other investors does, such as your 401(k) or mutual fund. But that money would be owed to any bond holder, regardless if it was the Social Security Trust Fund or your 401(k). Does it need modification? Yes. Increasing the amount paid into the system each paycheck would take care of the problem of the future shortfall in 35 years. Privatizing it would not secure the future of the program. If half of retirees social security funds had been placed in the stock market when it crashed in 2008, they would have not received enough money to live on and would be homeless and without food. What they get now is very little. Can you live on $12,000 a year? From this small amount they have to pay for food, taxes, utilities, health care premiums, yes their is a premium taken out of the social security check each month for Medicare, and transportation. Thus they are very sensitive to variants in the market, should part of their funds had been invested in the stock market, that could drop their income from $12,000 to say $8,000. You can't live on that... I would suggest that the amount paid in by employers who have 50 employees or more be increased considerably, unless they have a well funded pension plan that can't be touched by the company and the funds guaranteed to the employees.
Is this the Republican America you want? Taking away the social safety nets for the less fortunate of our society for the profit of the wealthy and corporations, who have plenty of wealth right now. And these are the same conservatives who preach Christianity and family values. Their actions do not reflect the teachings of their faith and stated values. It is all about greed by those who have nearly all the wealth of the nation. America is better than that. Shame on those who voted in these extremist conservatives. It will be you who have to answer to future generations why you forsake compassion for your fellow human for financial greed.
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