On the Romney/Ryan side of things are these facts:
1. Because of Obamacare, Medicare benefits ARE reduced by over $700 billion over the next ten years.
The Dems can dress this up by saying that “it's just cuts in payments to providers, not a cut of benefits,” but the bottom line is that if you pay lots less money to providers, fewer providers will take Medicare, those that do will shove more patients into smaller amounts of time, there will be longer waits for Medicare patients to obtain services, meaning that Medicare recipients will receive fewer services, and the quality of care will decline.
2. Obamacare and the Obama regime offer no long-term solution for fixing Medicare beyond the next decade or so.
After 2024, the system falls off the cliff, and the Obama regime has not plans to prevent it from failing.
On the Obama regime side, there is this:
1. The actions of the Obama regime DO lengthen the life of the Medicare Trust Fund (or rather, it increases the amount of Treasury IOUs that the federal government credits to the Medicare program).
Why? That's simple. The amount of money coming into Medicare will increase (Medicare taxes are going up), while the amount of money going out will be reduced by over $700 billion over the next decade. This stretches the life of the trust fund.
2. And, because of the unified budget counting approach used by the federal government, which offsets overall deficits in the federal budget by any surpluses in specific programs such as Social Security, Medicare, the highway trust fund, etc., the reduction in Medicare spending combined with the increase in Medicare taxes DOES actually result in a lower overall deficit number for 10 years, which is then used to help pay for Obamacare.
So, the task of Romney/Ryan is to emphasize:
1. The immediate cut of benefits to current Medicare recipients, and that Romney/Ryan will restore them.
2. The long-term plan for folks currently under 55 to obtain Medicare through premium support.
The first part is easy, but a little tricky. The second part is also doable, I think, but tougher.
Folks will understand intuitively that if you take $700 billion from a program, you're going to get $700 billion less of what you're paying for. And by getting rid of Obamacare, the overall effect on the deficit is neutral.
But the tricky part is that technically, getting rid of Obamacare and restoring the Medicare cuts DOES reduce the life of the “trust fund.” What Romney/Ryan will need to do is just be honest - in the short term, before we get the Medicare fixes in place, Medicare will have need to resort to the general revenues received by the Treasury to meet the promises made to current seniors and those soon to be seniors. Fortunately, by getting rid of Obamacare, we'll have the resources to do that.
I think that's a winning argument.
On the second point, premium support for younger folks, the Dems are going to scream “vouchers, vouchers, vouchers!”
Premium support isn't the same as vouchers, but it's a more involved discussion. As envisioned by the Ryan plan, insurance companies will be permitted to offer health insurance policies to Medicare recipients. The plans must provide the same level of benefits as what I'll call "Standard Medicare," the program that the government will offer to seniors who don't want to buy a private insurance policy.
All insurance policies must provide, at a minimum, the same benefits as Standard Medicare.
The government will provide premium support to seniors so that a senior who buys the second-cheapest Medicare insurance policy will have the same costs as if he elected to take Standard Medicare, and will have the same benefits as Standard Medicare.
That means that there will be at least one insurance package that's cheaper that will be available to seniors, that will offer the same benefits as regular Medicare.
So, folks who are now under 55 will be able to choose between:
- Standard Medicare. Seniors will pay according to the then-current formulae, and they will receive the standard benefits.
- Second-cheapest private insurance plan. This will provide the same benefits as Standard Medicare, and will have costs to the recipient similar to Standard Medicare.
- Cheapest insurance plan. This will provide the same benefits as Standard Medicare (although it may have some additional explicit cost-control mechanisms, such as pre-approval of benefits), but it will provide a lower cost to the recipient. Folks will get Standard Medicare benefits, but at a lower cost (and at a lower cost to the federal government, too).
- More expensive insurance plans. These plans will have all the basics of Standard Medicare, but can have richer, better benefits. The cost to the government won't increase; the entire cost of additional benefits will be borne by the recipient. In fact, I wouldn't be surprised if the government provides a slighly-smaller premium support for these plans as sort of a "Cadillac Plan Tax." The higher costs to the recipient may be offset for many seniors by reducing or eliminating the need for "Medi-gap" policies that currently provide some of these richer benefits.
Because insurance companies will all have to provide the same Standard Medicare benefit package, a primary means of competition will be on price. Insurance companies will look to find ways of providing the standard benefits for less than the government provides them through Standard Medicare, and for less than each other.
By offering full premium support for the SECOND-cheapest plan, the hope will be that many senior will elect to SAVE SOME MONEY for themselves and choose the cheapest plan, which will also save the government a few dollars, as well.
This is how the Ryan plan “bends the cost curve.” Even bending the cost curve by a small amount accumulates rapidly over a period of 10 - 20 or more years, and it's through this mechanism that the Ryan plan hopes to put Medicare on a surer footing for the long-term.
Of course, the hidden premise is that private insurance companies will find more efficient ways to provide benefits and services than the government provides them.
That's the bet of the Ryan plan.
I think it's a bet that most Americans will take. I think that most Americans will understand it intuitively - competition makes things less expensive.
The difficulty is boiling that down to a 30-second ad, or worse, a bumper sticker. But here's my contribution to the cause:
"Medicare: Competition makes things cheaper and better."
What's wrong with just ending the gov't programs/entitlements altogether?
Yeah, some may die, others suffer (I would be at least a sufferer or maybe dead, but I honestly would accept that ... NONE OF US have been the Patriot of the Revolution or the early days of America)
If I was running for president, I'd promise a 'solution' and then just end the damned things.
It's what businesses do when faced with an impossible fix.
In a family it's called tough love.