Kumbaya 2: Fixing Medicare

So here is the analysis of the new bipartisan plan as it applies to Medicare. Remember, here at Wonks Anonymous we read it so that you don't have to.

First the good news: The Plan will save a butt load of money: that would be $650 billion by Krugman's estimate. Far more than the paltry $500 billion in cuts proposed by the late Democrat Health Reform proposal. And the money would not be used to pay for health insurance or other fripperies. Lower deficits and lower taxes for overworked lawyers and stockbrokers everywhere.

More good news: Wonks Anonymous and people born before 1955 will get regular Medicare. The younger readers cannot imagine how refreshing it is to be transformed from an evil grasping Boomer who is about to ruin the nation and should be voted off the island to a sweet cuddly senior who needs to make a hard patriotic decision and vote all those other evil grasping Boomers off the island.

There would be minor increases in income related premiums charged to the likes of Wonks Anonymous and there might be cuts but the Congressional Budget Office and Ryan are coy about this. With friends like the CBO the Democrats do not need enemies.

The real savings come from younger folks. Sorry about that Kimberly, Monica, Catherine and Sean. Age for Medicare eligibility will gradually increase to 69 years and six months - It's not really 70 folks just like $9.95 is not really $10 - and after 2021 everybody gets vouchers which they can use to buy private insurance on the individual market.

Vouchers would start at $5,900 in 2010 dollars for 65 year olds - that would be about $491 per month which is just a bit shy of the premiums charged by the insurance industry for individual plans for folks in their late fifties and sixties. Vouchers would be risk and age adjusted. Allowing for this adjustment the average voucher would be worth $11,000 per year.

That would be less than the current per person medicare spending.

Vouchers would rise in value at a rate somewhere between the increase in medical costs and the consumer price index. The CBO estimates that the dollar value of vouchers will rise by about one to two percent per year.

Everybody would get the same voucher, regardless of income. Millionaires like Paris Hilton and Brittany Spears could use their vouchers to pay for plans that offer cosmetic surgery. The rest of us you could ask your kids for financial help to finance a decent health plan. Which is very progressive because. Um . . .

But savings should not be all that painful because the plans will be administered by private sector health insurers. Sure these fine companies will need to spend a lot of money on each individual to evaluate their likely health costs and the government will need to spend more money to make sure that it gets the risk adjustments for the vouchers right. Meanwhile states will all need to increase their regulatory staff to monitor all the new private insurance contracts.

But this will all be fine because we can expect that all of the new Medicare voucher policies will be the ultra modern, super efficient high deductible policies which Jason Furman assures us will save lots of money without reducing anyone's health.

When they did a limited study they found that everyone was just as healthy in five years as they were when the study started. Except for people who had limited financial resources and serious chronic health conditions. These pesky folks tended to try to save money on meds and visits to the doctor and get sicker. But seniors nowadays are all rich as trolls and healthy as horses.

Besides, we are also going to give poor seniors Medical Savings Accounts. Provided that they are poor enough to qualify for Medicaid.

 

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