Although many things about Sen. Paul Ryan’s budget proposal trouble me, one of the things that troubles me most is Ryan’s belief about how Medicare can be transformed.
Now that Ryan has been named Mitt Romney’s running mate in the 2012 US election, this Washington Post Fact Checker article, and the material it links to regarding Paul Ryan’s budget, provide some insight into the Ryan budget.
Remember, this is the budget that Romney earlier said he would sign if he were president and it landed on his desk.
Regarding healthcare, it’s vitally important to remember that on Day One of the Romney presidence, Romney has said, he would repeal the Affordable Care Act. So all the requirements and provisions of this Act, such as those preventing insurance companies from denying coverage based on pre-existing conditions that applicants may have, would be gone.
Very clearly, the Ryan budget ends Medicare as we have known it since 1965 when it was enacted. The Ryan plan replaces the Medicare program with a voucher program. This means that senior citizens would be given a voucher for a certain amount of money, which they would then be expected to use to go onto the open market and purchase insurance.
Let’s start with the first obvious and enormous problem with implementing the Medicare reform Romney and Ryan propose: access to insurance. Unlike people in their 20s or 30s, most senior citizens would have pre-existing conditions that would make it impossible for them to get coverage from any insurance company. So, even if you had a voucher that said you could buy insurance, senior citizens unable to get insurance would not be able to do as Ryan and Romney recommend: buy insurance on the open health insurance market.
Those senior citizens who might be healthy enough and fortunate enough to be able to get coverage would likely not be able to afford it, even with the dollars provided through the voucher program. This is because someone in his 70s, even without pre-existing conditions, would be more likely to develop a serious illness, and this would mean that the premium rates charged by insurance for coverage would be so high that only very wealthy senior citizens would be able to afford to pay the premiums for such insurance.
This points out something important about the way that the Romney-Ryan plan for Medicare reform would adversely affect everyone but the very wealthy.
So, the situation the Romney-Ryan plan for Medicare would produce would be this: millions of senior citizens would be unable to either get or afford health insurance. This means that they would have to be uninsured, and would have to pay for all health care services out of pocket. Have you looked at the cost of an appendectomy, or a hip replacement, or open heart surgery lately? If you were a senior citizen, would you be able to pay the tens or hundreds of thousands of dollars you would have to pay for this insurance, because you would be uninsured? No.
This is, in fact, the situation the nation was dealing with before 1965, when Medicare was enacted. And Medicare was enacted precisely because millions of Americans could not get or could not afford health insurance.
I am sure that Ryan believes his plan for reforming Medicare would work beautifully, because, at age 42, he is too young to know what life in the United States was like before he was born, and what life was like before Medicare, which was created because there were millions of senior citizens who could not get or afford private health insurance. And apparently he is not capable of reading history to learning about what life was like before Medicare. This is sad. Very sad.