The 2012 Political Debate: MediCare vs. ObamaCare vs. RyanCare
Martha asked me recently what I thought about the 2012 political debate over Medicare given my previous posts about Medicare on this site and my “work” as a Centers for Medicare/Medicaid Services (CMS) volunteer at my local senior center. (Oh, and like Sy Sperling and the Hair Club, I’m also a member of Medicare.) My answer to her is that there is not enough information available for anyone to form an intellectually honest, just-the-facts-ma’am pro and con analysis about the various proposals for Medicare reform. Neither side wants to clear the air because — I assume — there is more political advantage to both candidates in keeping the debate murky.
So all I can tell you is what I would read if I were you and I felt the need to try to find out more information about Medicare — and proposals to reform it. My basic advice: Go to the source. Do not depend on the media. Do not depend on so-called non-partisan think tanks.
The best source is a 200-page booklet available on medicare.gov called Medicare and You.
I think it is especially important for those under 55 to find out how little in healthcare services and costs that “traditional Medicare” covers compared to what you have today as healthcare insurance. Traditional Medicare was designed in the late 1950s and early 1960s when basically everyone who had healthcare insurance had something called Blue Cross/Slue Shield Major Medical. Traditional Medicare insurance is Major Medical. In an era of smartphones and Mars Rovers, traditional Medicare is a throwback to Dwight Eisenhower’s Interstate Highway System and Sputnik.
Also note in the Medicare and You booklet how strongly the government urges seniors to find private insurance to supplement Traditional Medicare. The good news is that almost 85% of Medicare beneficiaries take the government’s advice and get private insurance on top of Traditional Medicare. Another 15% get Medicaid or some other kind of public assistance to supplement Traditional Medicare.
(These two groups actually overlap such that about 95% of Medicare beneficiaries get the much needed supplement. The 5% that don’t either depend on private insurance from a spouse who has not yet retired, are apparently so rich they self insure, or –unfortunately — have fallen through the cracks despite the best efforts of those of us volunteering at the senior centers.)
How do I know that 95% statistic? Other good sources — except that now you are getting down into the wonk weeds — are annual reports and statistical documents from the Medicare Trustees, their actuaries, and an independent government organization called MedPAC (which is to Medicare what the Congressional Budget Office is to the rest of the government). You can find the 95% statistic and confirm or put the lie to many other political debate claims with these sources.
There are only two other source documents that matter but if you go this route, you fully qualify as a wonk. One is a couple of thousand pages long and the other is about 16. The first is the Patient Protection and Affordable Care Act of 2010 as amended and the second is the Wyden/Ryan proposal for Medicare Reform dated December 2011. But don’t read one without reading the other.