Repeal board before it takes affect-Where Did We Hear This? No Death Panels?

Discussions for Patients, Family, and Friends HD For Patients
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As a practicing physician, I recognize the urgent need to stem the rise in health care costs that threatens to overwhelm Medicare.

We won’t achieve a sustainable victory over costs, though, by interfering with the ability of doctors to give elderly patients the care they need. Nor will we restore Medicare back to financial health by outsourcing difficult funding decisions to an unelected panel of political appointees. Responsibility for these decisions should remain with our elected officials who are held accountable for their actions with each election.

For all these reasons I am opposed to a provision in last year’s healthcare reform bill, which creates something called the Independent Payment Advisory Board (IPAB). Thankfully, there is bipartisan legislation introduced in the House to abolish this Board before it is scheduled to take effect two years from now.

This new legislation was introduced by Rep. Phil Roe of Tennessee, one of the few medical doctors serving in Congress. He described this Board as a flawed mandate to cut spending with no responsibility for improving patient care. In calling for elimination of the Board, he cited sentiment by Republicans and Democrats that “unelected bureaucrats shouldn’t be able to make unaccountable decisions” on the health care for our seniors.

A closer look at this Board strengthens the case for repealing it.

Well-intentioned as it might have been, this Board is neither a fair nor practical way to cut Medicare spending. And despite what its title implies, the powers of this Board are more dictatorial than advisory.

The so called “recommendations” of the Board would be virtually beyond challenge. Its 15 members appointed by the President to six-year terms would in effect have the power cut Medicare spending. It would be almost impossible for even Congress to override the Board mandates. Physicians and their patients directly affected by those decisions would have zero opportunity to appeal them.

Under current regulations, a patient and their doctor can appeal to Medicare with a recommended test or treatment is denied coverage. It’s a difficult time-consuming process, but it’s worth it if my patient gets the care he or she needs. This type of appeal does not exist for the sweeping cuts this Board is empowered to enact and I am concerned that these cuts will mean that our seniors will have increasing difficulty in getting the care they need.

The new health care law requires that this Board to make recommendations each year for increasingly larger reductions in the Medicare spending rate. But hospitals are exempt from those recommendations for the first five years. That leaves payments to doctors for the care they provide seniors as a major target for mandated reductions. It also ignores the reality that this type of cut will limit the number of Medicare patients a medical practice can accept, making it harder for seniors to receive the care they need.

Due to short-sighted cost-cutting mandates in the past, Medicare is legally required to reduce payments to doctors every year. Congress has usually voted to rescind those cuts, but the Board’s cuts would not be subject to cancellation by Congress. As American Medical Association President Cecil Wilson has warned, it would leave doctors subject to two arbitrary sets of annual cuts.

This kind of blind cost-cutting is no way to reduce spending ion Medicare or the country’s other entitlement programs. We need a solution that focuses on patient needs… That solution will undoubtedly involve some difficult decisions, and those decisions need to be made by people we can hold accountable at the next election, not by bureaucrats appointed by the President.

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The White House website has a fact sheet on the Independent Payment Advisory Board. Perhaps the doctor who wrote what you posted might have been relieved if he’d actually read that fact sheet instead of making assumptions or taking talking points from Dick Morris and Fox News.

The Facts About the Independent Payment Advisory Board
Posted by Nancy-Ann DeParle on April 20, 2011 at 05:46 PM EDT

Last week, the President outlined a framework for reducing our deficits and debt that is based on the values of shared responsibility and shared prosperity. We know we can’t reduce our deficit without reducing the growth of health care spending. But we also cannot bring down health care cost growth by simply raising costs for seniors and States and ending Medicare as we know it. That’s why the President opposes any plan that would simply place the burden of deficit reduction on seniors and undermine Medicare.

The President’s framework instead builds on the improvements made by the Affordable Care Act. It tackles Medicare fraud and excessive payments for prescription drugs, proposes a stronger Federal-State partnership in Medicaid, and includes a series of health care reforms that would save $340 billion by 2021, $480 billion by 2023 and at least an additional $1 trillion in the following decade.

Key to these savings is a proposal to strengthen the Independent Payment Advisory Board – IPAB, which was created by the Affordable Care Act. Here’s how IPAB works:

•15 experts including doctors and patient advocates would be nominated by the President and confirmed by the Senate to serve on IPAB.
•IPAB would recommend policies to Congress to help Medicare provide better care at lower costs. This could include ideas on coordinating care, getting rid of waste in the system, incentivizing best practices, and prioritizing primary care.
•IPAB is specifically prohibited by law from recommending any policies that ration care, raise taxes, increase premiums or cost-sharing, restrict benefits or modify who is eligible for Medicare.
•Congress then has the power to accept or reject these recommendations. If Congress rejects the recommendations, and Medicare spending exceeds specific targets, Congress must either enact policies that achieve equivalent savings or let the Secretary of Health and Human Services follow IPAB’s recommendations.

IPAB is a backstop – it would only take effect if Medicare costs grow too fast. We’re already implementing a series of reforms that will improve the quality of care and reduce costs. In fact, according to Congressional Budget Office projections, Medicare spending won’t hit the targets that would cause IPAB’s recommendations to take effect in the next decade. But independent experts agree that IPAB will offer constructive ideas and help keep Medicare cost growth per enrollee affordable in the long run:

•Experts including former Bush Administration Medicare Official Mark McClellan called for “[strengthening] and [clarifying] the authority and capacity of the Independent Payment Advisory Board (IPAB).”
•Former Congressional Budget Office Director Former CBO Director Robert Reischauer called IPAB a “big deal” that “could generate substantial savings.”
•Experts from the Commonwealth Fund wrote “the Affordable Care Act includes important provisions that will finally begin to control unchecked health care costs, such as…the creation of the Independent Payment Advisory Board. Building on and extending these provisions across the health system has the greatest promise of slowing the growth of government health care budget outlays, private insurance premiums, and underlying health care cost trends.”
•A coalition of economists including three Nobel laureates said “the Affordable Care Act contains essentially every cost-containment provision policy analysts have considered effective in reducing the rate of medical spending” including an Independent Payment Advisory Board.

Under the President’s framework, seniors will have their guaranteed Medicare benefits. People on Medicare won’t be saddled with thousands of dollars in additional health care costs. And Medicare beneficiaries will be able to choose the health care plan and doctor that work for them.

The same can’t be said for the Republican plan. Under their proposal, a typical 65-year-old who becomes eligible for Medicare would pay an extra $6,400 for health care, more than doubling what he or she would pay if the plan were not adopted. Guaranteed Medicare benefits would be eliminated. Big health insurance companies would decide which benefits and insurance plans are available and could limit seniors’ choice of doctor. And in some cases, seniors might not have any health care choices at all.

As with deficit reduction, there is a right way and a wrong way to strengthen Medicare. The wrong way is to simply slash benefits, leave seniors with higher premiums and hope for the best.

The right way is to identify and implement what works on an ongoing basis to lower costs and improve care, set spending goals, and have a way to ensure that they are met – which is what IPAB does. Reducing our deficit and debt is a goal we all share, and we can achieve that goal and ensure our seniors get the quality, affordable health care they need and deserve.

Nancy-Ann DeParle is White House Deputy Chief of Staff

The Ryan (Republican) plan says nothing about providing money to those who are under 65 to buy insurance in 2022 when that plan would take effect. How many people 65 or older could afford to buy insurance for the $15,000 the government would give them if they have a pre-existing condition (like kidney disease or kidney failure or kidney transplant) if these same Republicans repeal the Affordable Care Act? How many people 65 and older could pay premiums and all their healthcare costs with a $15,000 voucher. Look at your dialysis bills. Will you be 65 in 2022? If not, how will you pay for healthcare if you lose traditional Medicare because those who think privatizing Medicare is as good an idea for patients as it is for insurance companies? If you’re going to accuse the IPAB of being a “death panel” couldn’t the Republican plan be labeled as a death squad because anyone who can’t get insurance won’t have access to care. To me it is disgraceful for a country that touts itself as the best in the world to put tax deductions that create or expand individual wealth ahead of providing a basic level of universal healthcare. “What would Jesus do” or tell us to do to help those who have less among us? I don’t think he’d say to cut taxes and let them fend for themselves.

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[QUOTE=Beth Witten MSW ACSW;21050]The White House website has a fact sheet on the Independent Payment Advisory Board. Perhaps the doctor who wrote what you posted might have been relieved if he’d actually read that fact sheet instead of making assumptions or taking talking points from Dick Morris and Fox News.

The Facts About the Independent Payment Advisory Board
Posted by Nancy-Ann DeParle on April 20, 2011 at 05:46 PM EDT

Last week, the President outlined a framework for reducing our deficits and debt that is based on the values of shared responsibility and shared prosperity. We know we can’t reduce our deficit without reducing the growth of health care spending. But we also cannot bring down health care cost growth by simply raising costs for seniors and States and ending Medicare as we know it. That’s why the President opposes any plan that would simply place the burden of deficit reduction on seniors and undermine Medicare.

The President’s framework instead builds on the improvements made by the Affordable Care Act. It tackles Medicare fraud and excessive payments for prescription drugs, proposes a stronger Federal-State partnership in Medicaid, and includes a series of health care reforms that would save $340 billion by 2021, $480 billion by 2023 and at least an additional $1 trillion in the following decade.

Key to these savings is a proposal to strengthen the Independent Payment Advisory Board – IPAB, which was created by the Affordable Care Act. Here’s how IPAB works:

•15 experts including doctors and patient advocates would be nominated by the President and confirmed by the Senate to serve on IPAB.
•IPAB would recommend policies to Congress to help Medicare provide better care at lower costs. This could include ideas on coordinating care, getting rid of waste in the system, incentivizing best practices, and prioritizing primary care.
•IPAB is specifically prohibited by law from recommending any policies that ration care, raise taxes, increase premiums or cost-sharing, restrict benefits or modify who is eligible for Medicare.
•Congress then has the power to accept or reject these recommendations. If Congress rejects the recommendations, and Medicare spending exceeds specific targets, Congress must either enact policies that achieve equivalent savings or let the Secretary of Health and Human Services follow IPAB’s recommendations.

IPAB is a backstop – it would only take effect if Medicare costs grow too fast. We’re already implementing a series of reforms that will improve the quality of care and reduce costs. In fact, according to Congressional Budget Office projections, Medicare spending won’t hit the targets that would cause IPAB’s recommendations to take effect in the next decade. But independent experts agree that IPAB will offer constructive ideas and help keep Medicare cost growth per enrollee affordable in the long run:

•Experts including former Bush Administration Medicare Official Mark McClellan called for “[strengthening] and [clarifying] the authority and capacity of the Independent Payment Advisory Board (IPAB).”
•Former Congressional Budget Office Director Former CBO Director Robert Reischauer called IPAB a “big deal” that “could generate substantial savings.”
•Experts from the Commonwealth Fund wrote “the Affordable Care Act includes important provisions that will finally begin to control unchecked health care costs, such as…the creation of the Independent Payment Advisory Board. Building on and extending these provisions across the health system has the greatest promise of slowing the growth of government health care budget outlays, private insurance premiums, and underlying health care cost trends.”
•A coalition of economists including three Nobel laureates said “the Affordable Care Act contains essentially every cost-containment provision policy analysts have considered effective in reducing the rate of medical spending” including an Independent Payment Advisory Board.

Under the President’s framework, seniors will have their guaranteed Medicare benefits. People on Medicare won’t be saddled with thousands of dollars in additional health care costs. And Medicare beneficiaries will be able to choose the health care plan and doctor that work for them.

The same can’t be said for the Republican plan. Under their proposal, a typical 65-year-old who becomes eligible for Medicare would pay an extra $6,400 for health care, more than doubling what he or she would pay if the plan were not adopted. Guaranteed Medicare benefits would be eliminated. Big health insurance companies would decide which benefits and insurance plans are available and could limit seniors’ choice of doctor. And in some cases, seniors might not have any health care choices at all.

As with deficit reduction, there is a right way and a wrong way to strengthen Medicare. The wrong way is to simply slash benefits, leave seniors with higher premiums and hope for the best.

The right way is to identify and implement what works on an ongoing basis to lower costs and improve care, set spending goals, and have a way to ensure that they are met – which is what IPAB does. Reducing our deficit and debt is a goal we all share, and we can achieve that goal and ensure our seniors get the quality, affordable health care they need and deserve.

Nancy-Ann DeParle is White House Deputy Chief of Staff

The Ryan (Republican) plan says nothing about providing money to those who are under 65 to buy insurance in 2022 when that plan would take effect. How many people 65 or older could afford to buy insurance for the $15,000 the government would give them if they have a pre-existing condition (like kidney disease or kidney failure or kidney transplant) if these same Republicans repeal the Affordable Care Act? How many people 65 and older could pay premiums and all their healthcare costs with a $15,000 voucher. Look at your dialysis bills. Will you be 65 in 2022? If not, how will you pay for healthcare if you lose traditional Medicare because those who think privatizing Medicare is as good an idea for patients as it is for insurance companies? If you’re going to accuse the IPAB of being a “death panel” couldn’t the Republican plan be labeled as a death squad because anyone who can’t get insurance won’t have access to care. To me it is disgraceful for a country that touts itself as the best in the world to put tax deductions that create or expand individual wealth ahead of providing a basic level of universal healthcare. “What would Jesus do” or tell us to do to help those who have less among us? I don’t think he’d say to cut taxes and let them fend for themselves.[/QUOTE]

The cuts from the Obama Care plan were to take effect immediately, this is why Senior Medicare Advantage plans had to be exempted from these cuts. Under the Ryan plan, this issue does not come up until 2021. Under the plan, people who are currently on Medicare will be exempted(Wall Street Journal). Cutting taxes and eliminating regulations will bring medical costs back to earth. It is government regulation that is driving costs thru the roof. Competition keeps prices down in every other sector of the economy, why not health care? I have heard these individuals who agree with Obama talk for years about refusing health care, they really believe it, I have heard it time and again. High taxes and regulation are not and will not ever be compassion.

The way to help seniors is to cut taxes and eliminate government regulations, reducing medication costs to about 15 percent of the current cost. Vouchers work in many other sectors of the economy, such as for rent costs, etc. Seniors suffer because of interference from the government. In fact, after the stock market crash of 1929, unemployment never even reached 10 percent. It was after the policies of Hoover and FDR that unemployment reached 25 percent in the 1930’s.

I have heard the Medicare and fraud song before, when a person in the government talks about fraud, this means that they have nowhere else to go. The fraud cutback song has been made for years, however, it never happens.

You:
“A coalition of economists including three Nobel laureates said “the Affordable Care Act contains essentially every cost-containment provision policy analysts have considered effective in reducing the rate of medical spending” including an Independent Payment Advisory Board.”

NDXUFan: You are making my point for me. Cost-Containment means that they are going to cut spending on Medicare, especially for dialysis patients or consumers. They are going to reduce spending on Medicare thru this board, I do not know how else to read this statement. “Reducing the rate of medical spending?” This means cutting spending, not keeping it the same or increasing it.

You are critical of insurance companies, I hate to inform you the government does the same thing, all of the time, think Medicaid. If Medicare costs grow too fast, at what point of increase does Medicare costs grow too fast, 1 percent, 5 percent, 10 percent, or 20 percent??? Again, at what point does health care become “Affordable?” $1.00, $5.00, $10.00, $20.00 or $100.00 dollars? What is affordable to you is not affordable to me or the man down the street.

How else do you think they are going to reduce the deficit or debt, but, not chopping the largest program on the block???

This post is not even close to economical reality. Nothing on this earth is free, just the price paid by the consumer or senior. By the way, the average senior has a net worth of $438,000 and a condo in Florida.

You:
If Congress rejects the recommendations, and Medicare spending exceeds specific targets, Congress must either enact policies that achieve equivalent savings or let the Secretary of Health and Human Services follow IPAB’s recommendations.

NDXUFan: This means that if Medicare spending exceeds the Medicare spending target, Congress must make cuts in Medicare to achieve the targeted savings OR the Secretary of HHS must follow the IPAB’s recommendations to chop or cut Medicare spending, i.e. refusing to pay for needed treatment or rationing.

You:
It tackles Medicare fraud and excessive payments for prescription drugs, proposes a stronger Federal-State partnership in Medicaid, and includes a series of health care reforms that would save $340 billion by 2021, $480 billion by 2023 and at least an additional $1 trillion in the following decade.

NDXUFan: This means they will stop or will not pay for certain prescription drug costs for people who need them. Stronger Federal and State partnership, means more Federal oversight and less state control, more regulations, which equals more costs. How do you think they will save this amount of money without cutting costs???

I hate to inform you that I have been in the game since the mid-70’s and I know all of the political code words and games these people play. Competition stops the games that insurance companies play, however, the government seems to favor a monopoly in Ohio. This woman working for Obama is a political huckster, her response is economic nonsense.

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By the way, what competence do these individuals in government have to run the medical system in the United States? Health insurance companies only care about themselves and individuals in government only care about increasing their power over the common citizens of the United States. Health insurance protects against overwhelming financial losses from receiving medical care. Health care is not medical care. Does equality in medical care mean that Obama and his family are at the front of the line and we are in the back of the line??? If this system is going to be as equal as he and Harry Reid claim, why are they in the front of the line and we are in the back of line, if we are supposed to be equal? Equality in medical care sounds wonderful in the land of fantasy. Yet, in the real world, not everyone is equal, as Obama, Harry Reid, and Ted Kennedy will show by standing in the front of the line.

If I was going to die and I had written a will that said a named individual could have $1 million dollars, only if he or she used this money to attend professional baseball games. If that individual was a baseball fan, they would be in 7th Heaven. Yet, how much would that $1 million be worth it to you if you hated professional baseball? In this situation, most of us would opt to take my clause that says you can have $100,000.00 and spend it as you please, along with taking the money and running. My point is that government money always(Not a false theory in this case) has strings given with the handout money, always has, always will.

It is economic nonsense or foolishness to state that the government can produce a product or service for $3.00 dollars, when it costs the private sector $10.00 to produce the item in question. The government is more efficient than the private sector, with all of the rules and regulations??? If the item in question costs the government $12.00 to produce, the government must collect $9.00 from another source, as in higher taxes to pay for the total costs in question. Again, the price paid does not equal the total cost of producing the item in question.

5

I don’t know what channel you watch on TV or what kind of radio you listen to but you paint too broad a generalization of federal and state employees. I can tell you that for the last 5 years I have been working with some very dedicated government employees who work longer hours than most people in the private sector work to keep you and other dialysis patients safe. For 4 years I was an NKF employee and had an Intergovernmental Personnel Act appointment to work with the a 7-member team of experienced ESRD nurses, state surveyors and social workers CMS Survey & Certification Group. For the last year, I have been a government contractor working that same group of individuals who have been writing Interpretive Guidance for the ESRD regulations, training surveyors on how to survey dialysis clinics, and answering questions from providers, surveyors and the public about the regulations and survey & certification issues. These people are not trying to increase their power over common citizens.

Obamacare’s insuance for those wave pre-existing conditions and can’t get insurance on the commercial market used the Federal Employee Health Benefit plan as a model. This is the coverage that government employees have through various insurance company options. Medicare is a pretty good plan, especially if you have a Medigap plan that pays deductibles and coinsurance/copays. I bet your plan is better and cheaper than mine. As a small business with 2 employees, I pay >$900/mo to BCBS just for my insurance and I have a $35 copay per MD visit and $2000 annual deductible for anything that’s not covered under the copay. How much do you pay?

The last I heard, Medicare’s administrative costs in Medicare were 3%. Until health reform, insurance companies were only required to pay out 65 cents on every dollar of premiums. The rest of the money went to administrative costs and investments. Medicare Advantage plans run through private sector insurance companies cost taxpayers more than traditional Medicare and outcomes are not consistently better (or not in the MA plans that were demonstration plans for care of dialysis patients).

I still say, unless you’re going to be 65 when the Ryan plan takes effect, unless I missed something that accounted for people under 65 in that plan (and I asked others to help me find it), you won’t get that voucher to spend however you want to and how then will you pay for your dialysis or your transplant drugs if you get a transplant. Maybe having no health coverage through Medicare will force more people with kidney failure to keep their jobs or find new jobs with insurance, which could also save Social Security money on disability checks.

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[QUOTE=Beth Witten MSW ACSW;21064]I don’t know what channel you watch on TV or what kind of radio you listen to but you paint too broad a generalization of federal and state employees. I can tell you that for the last 5 years I have been working with some very dedicated government employees who work longer hours than most people in the private sector work to keep you and other dialysis patients safe. For 4 years I was an NKF employee and had an Intergovernmental Personnel Act appointment to work with the a 7-member team of experienced ESRD nurses, state surveyors and social workers CMS Survey & Certification Group. For the last year, I have been a government contractor working that same group of individuals who have been writing Interpretive Guidance for the ESRD regulations, training surveyors on how to survey dialysis clinics, and answering questions from providers, surveyors and the public about the regulations and survey & certification issues. These people are not trying to increase their power over common citizens.

Obamacare’s insuance for those wave pre-existing conditions and can’t get insurance on the commercial market used the Federal Employee Health Benefit plan as a model. This is the coverage that government employees have through various insurance company options. Medicare is a pretty good plan, especially if you have a Medigap plan that pays deductibles and coinsurance/copays. I bet your plan is better and cheaper than mine. As a small business with 2 employees, I pay >$900/mo to BCBS just for my insurance and I have a $35 copay per MD visit and $2000 annual deductible for anything that’s not covered under the copay. How much do you pay?

The last I heard, Medicare’s administrative costs in Medicare were 3%. Until health reform, insurance companies were only required to pay out 65 cents on every dollar of premiums. The rest of the money went to administrative costs and investments. Medicare Advantage plans run through private sector insurance companies cost taxpayers more than traditional Medicare and outcomes are not consistently better (or not in the MA plans that were demonstration plans for care of dialysis patients).

I still say, unless you’re going to be 65 when the Ryan plan takes effect, unless I missed something that accounted for people under 65 in that plan (and I asked others to help me find it), you won’t get that voucher to spend however you want to and how then will you pay for your dialysis or your transplant drugs if you get a transplant. Maybe having no health coverage through Medicare will force more people with kidney failure to keep their jobs or find new jobs with insurance, which could also save Social Security money on disability checks.[/QUOTE]

Not trying to increase control over individuals on Home Dialysis??? Hmmmm, in the last year, I have heard constantly, the state says we must do this, we must do that, etc, etc, etc.

From Forbes:

Features of the Swiss health sysetm

Swiss citizens buy insurance for themselves; there are no employer-sponsored or government-run insurance programs. Hence, insurance prices are transparent to the beneficiary. The government defines the minimum benefit package that qualifies for the mandate. Critically, all packages require beneficiaries to pick up a portion of the costs of their care (deductibles and coinsurance) in order to incentivize their frugality.

The government subsidizes health care for the poor on a graduated basis, with the goal of preventing individuals from spending more than 10 percent of their income on insurance. But because people are still on the hook for a significant component of the costs, they often opt for cheaper packages; in 2003, 42% of Swiss citizens chose high-deductible plans (i.e., plans with significant cost-sharing features). Those who wish to acquire supplemental coverage are free to do so on their own.

99.5% of Swiss citizens have health insurance. Because they can choose between plans from nearly 100 different private insurance companies, insurers must compete on price and service, helping to curb health care inflation. Most beneficiaries have complete freedom to choose their doctor, and appointment waiting times are almost as low as those in the U.S., the world leader.

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Broad general thinking??? I used to work for the government, ma’dam. Having worked for the government, I know that many government employees are very controlling towards the general public. When Hillary Care came out in 1993, over 1,400 pages of regulations, they were not trying to control the public? Do you really believe that these small amount of government employees have more knowledge of Home Dialysis than all of the private individuals on Home Dialysis, I think not. If we eliminated government control(Read MONOPOLY) of the health insurance market, you would not be paying anywhere near $900.00 per month to BCBS, due to over 2,000 governmental mandates. In fact, most Americans do not pay anywhere near $1,000.00 per year for health care(Wall Street Journal). If we chopped income tax rates to a 1 percent flat tax and eliminated government regulation in medicine, medical insurance rates would be dirt cheap, even diabetics and individuals on dialysis could be able to purchase medical insurance. Medicare’s costs are out of this universe, when we include the excessive tax rates paid to bolster Medicare from bankruptcy.

If we wanted dialysis consumers to have real power over these individuals, we would have more freedom and less government control, including the power to fire dialysis providers out the door. So, how did Obama Care have the expertise and the vision to determine what percentage insurance companies should pay out from premiums? Do they have special business skills that guide their vision that is more competent than over 300 million consumers? I think not. How does Obama know how much CEO’s should make? Was he a CEO or a high level business individual in the past or did he just make nice sounding speeches? Only 8 percent of Obama’s Cabinet has any business experience at any level.

“The truth is that the Obama health law reduces future funding for Medicare by $575 billion over the next 10 years and spends the money on other programs, including a vast expansion of Medicaid. In 2019, Medicare spending under the Obama health law is projected to be $14,731 per senior, instead of $16,162 if the law had not passed, according to Medicare actuaries (Health Affairs, October 2010). (Wall Street Journal)”

They are protecting us??? Hmmm, if they are doing such a great job, where is Nocturnal dialysis???

The fact is that Mr. Obama’s law raids Medicare. Mr. Ryan’s plan, on the other hand, stops the Medicare heist and puts the funds “saved” in this decade toward health care for another generation of retirees.

(Wall Street Journal):
“Beginning in 2022, the Ryan plan offers each new Medicare enrollee a choice of private health plans and a premium paid to the plan they choose. The key is that the premium will be equivalent to what Medicare is projected to spend under the Obama health law: $15,000 a year on average, more for the oldest enrollees, less for the youngest, all inflation adjusted.”

The CBO authors admit their analysis is “stylized.” Deceptive is more like it. (Wall Street Journal)

More from the Wall Street Journal:

After 2022, competing private plans are likely to control costs better than government-run Medicare, so the inflation-adjusted premium paid by government should be adequate. In the Medicare Part D drug benefit, competition between competing private drug plans has kept costs below what was predicted—nearly a first for a government program. A 2008 study from the National Bureau of Economic Research also demonstrated that regions with competing Medicare Advantage Plans have lower health-care costs because of the impact of competition.

The Ryan proposal also includes a $7,800 annual medical savings account to help low-income seniors with out-of-pocket costs. Amazingly, the CBO analysts exclude this $7,800 benefit from their calculations. Their warning about low-income seniors suffering is baseless.

So what can retiring Americans count on in 2022 and after? The Obama health law leaves that up to an unelected board of presidential appointees called the Independent Payment Advisory Board, a cost-cutting panel.

The board is a radical departure from Medicare as we’ve known it. Congress cedes nearly all control of Medicare spending to the board on the rationale that budgeting decisions should be shielded from outraged seniors and political pressures. On April 13, the president reiterated that the board would decide what care is “unnecessary” for seniors. Even the CBO cautioned that as the nation’s debt crisis worsens, benefits will be put on the board’s chopping block.

You mean competition has kept costs down, you do not say!!!

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Forbes:

"The 2010 Financial Statement of the United States Government, published by the Treasury Department last December, discloses repeatedly in several tables of data that the total of future cuts in payments to doctors and hospitals under Medicare as provided in current law due to Obamacare and President Obama’s Medicare reimbursement policies is $15 trillion!

Indeed, the Treasury report effectively touts the draconian Medicare cuts due to Obamacare, stating, “The 2010 projection is lower than the 2009 projection in every year of the projection period almost entirely as a result of the Affordable Care Act (ACA), which is projected to significantly lower Medicare spending and raise receipts.” These Medicare cuts were the foundation for CBO finding that Obamacare would actually reduce the deficit, despite adopting or expanding three entitlement programs.

Medicare’s Chief Actuary reports that even before these cuts already two-thirds of hospitals were losing money on Medicare patients. With $15 trillion in future cuts, health providers will either have to withdraw from serving Medicare patients, or eventually go into bankruptcy.

For future, new retirees starting in 2022, under Ryan’s reforms seniors will enjoy the freedom to choose private health insurance coverage from among a menu of guaranteed, government approved and regulated plans. Each senior would enjoy control over $15,000 from Medicare for the year to start, to devote to the private health insurance of their choice.

That amount would also grow each year under an index of price growth. Yes, more well off seniors may pay more over time for their coverage than under the current system. That is where the cost savings come from. But it is not a matter over which reasonable people can differ that taxpayers cannot afford the current Medicare system, with its unfunded liabilities rapidly growing towards $100 trillion.

In addition, the Ryan plan would provide more funding each year for lower income seniors to protect them from rising costs. More would be paid as well for those who were sicker so that plans could finance their more expensive care. So President Obama is quite wrong when he says that Ryan would balance the budget on the backs of the poor, and is abusing the debate rather than participating in it.

Consequently, under Ryan’s reforms, for future retirees after 2022, all of Medicare would be like the popular Medicare Advantage program, under which one fourth of seniors have already chosen a private insurer for superior Medicare coverage. It would be the same as well as the health insurance system that federal employees enjoy, where workers each choose among a menu of private health insurance alternatives. For Schultz to call this “little more than a discount card” is also unreasoned and abusive."