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Republicans Teeter In Stance On Medicare

From The New York Times:

Editorial Board– June 21, 2011

Leading Republicans — after proposing to gut Medicare — are still trying to pose as the program’s saviors. How cynical can they get?

At the recent Republican presidential debate in New Hampshire, Representative Michele Bachmann of Minnesota warned that health care reform will take $500 billion out of Medicare and harm “senior citizens who have the most to lose.” She failed to mention that the budget resolution approved by House Republicans, with her vote, would retain virtually all of the same cuts in payments to health care providers and to oversubsidized private Medicare Advantage plans.

While they don’t say it a lot, even the Republicans recognize that the cuts are necessary to bring Medicare spending under control.

At the debate, Rick Santorum, a former senator from Pennsylvania, raised the old — and discredited — bugaboo that the Democratic reforms would lead to “rationing of care from the top down.” His target was a new advisory board that is designed to insulate spending decisions from the lobbying that distorts Congressional decisions.

The board will propose ways to get Medicare spending back on track if it fails to meet targets, and Congress would have to accept the recommendations or pass a comparably effective alternative. Rationing of care and cutting benefits are explicitly prohibited. The board is mostly limited to cutting payments to providers and the private plans that serve Medicare beneficiaries.

So what are the Republicans offering instead? After enthusiastically embracing Representative Paul Ryan’s proposal to eventually turn Medicare into a voucher program — with the government providing a subsidy to buy private health insurance — they backed away when voters made clear that they hated the idea. At the debate, Tim Pawlenty, a former Minnesota governor, said he would modify Mr. Ryan’s approach to retain traditional Medicare as an option, and Mr. Ryan later said he was open to the idea. The Republicans have not dropped the claim that privatizing Medicare would be more efficient.

That has certainly not been the case with private Medicare Advantage plans, which cost, on average, 10 percent more than the same services would cost in traditional fee-for-service Medicare. Over sustained periods, Medicare spending per beneficiary has also risen more slowly than private health insurance premiums.

The Ryan plan would save the government money primarily by shifting costs to beneficiaries. Nobody at the debate mentioned that.

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