On April 24th I wrote about Rep. Paul Ryan's (R-Wis) “Roadmap For America's Future,” and its planned changes to our income tax structure. Today I will look at the Roadmap's proposals for the health care system. Although there is a connection between the health care system and Medicare, I will defer discussion of Medicare/Medicaid/Social Security until a later date.
Under the traditional system, people buy medical treatment either by paying cash for services or by buying insurance. Those who cannot afford either method may be eligible for Medicaid, and those over 65 years of age get partial coverage under Medicare. Medigap insurance is also available to cover the difference between Medicare coverage and actual medical expenses.
The Patient Protection and Affordable Care Act (PPACA) is a federal statute that was signed into law by President Barack Obama on March 23, 2010. This Act and the Health Care and Education Reconciliation Act of 2010 (signed into law on March 30, 2010) collectively make up the Health Care Act of 2010. The Act becomes fully operational in 2014.
The primary purpose of the 2010 Act is to provide coverage for some 32M Americans who were not previously covered by health insurance. Illegal aliens will not be covered.
A second major purpose of this Act is to reduce the federal deficit. The nonpartisan Congressional Budget Office estimated that the legislation will reduce the deficit by $143B over the first decade and by $1.2 trillion in the second decade.
The GOP's congressional economic experts decided that the professional economists in their own budget office were blowing smoke, hence the following “improvements” are proposed by Ryan's Roadmap.
First and most important, despite the fact that a large majority of Americans support most of its provisions, the 2010 Act must be repealed in its entirety. Never mind that 32M Americans citizens will not get the health care coverage they have been promised.
Instead, they will get a tax credit of $2,300 (single) or $5,700 (family) for the purchase of health care insurance. The government will remit the credit directly to the insurance company. Keep in mind that many of these people have not been insured in the past because they could not afford to purchase insurance. Most of them have too little income to pay taxes, hence a tax credit is as helpful to them as hip boots in the Sahara.
Of course, actual health care costs keep spiraling upward much faster than the inflation rate. Even if the tax credit is indexed for inflation, how long will it be before the credit is swamped by rising medical costs?
The Roadmap also provides for state-based health care insurance exchanges - the states would be allowed to create their own criteria for health insurance requirements.
States would also be provided with tools to help them set up high-risk pools so that people who would be turned down for regular insurance because of pre-existing conditions could find “affordable” insurance. (Under the 2010 Act, insurers are not allowed to reject an applicant because of pre-existing conditions.) With state budgets already in dire straits, one can bet the family farm that such plans will quickly fall short of covering rapidly inflating medical costs.
Ryan's plan for controlling health care costs is to encourage competition by requiring that information regarding price and quality of various plans is “transparent” so that “this critical information [is] readily available before someone needs health services.” Unfettered competition between health care providers and insurers got us to where we were before passage of the 2010 Act. How did that work out?
Oh yes, the feds would assist states in establishing solutions to malpractice litigation. Perhaps a better idea would be to find a way to pay providers on the basis of the quality of their care rather than on the of the number of patients treated and tests performed.
The insurance companies love the Roadmap - it's a great way to speed up the flow of assets into the pockets of their investors. It's also a giant leap toward balancing the Federal Budget on the backs of those least able to afford it. And it's the same old Scroogican Screwgican(?) BS.
******For over 13 billion years the Spirit has been transcending and transforming point/events to adjust to their immediate surroundings. The primeval constructs were the most stable: quarks, electrons, etc.; constructs with such complete internal adjustments that they are impossible to tear apart. These were the "clay" from which atoms, the basic building blocks of the physical universe, were constructed.
Matter Matters – The Spirit Runs Through It.
“The Spirit Runs Through It” and “There Are Only Seven Jokes” are available in paperback, or at the Kindle Store.