WHY RYAN'S MEDICARE PROPOSAL NEEDS HELP ...

Of the many policy objectives presented by Rep. Paul Ryan's (R-WI) budget proposal - which is supposed to help fix the budget mess - perhaps the worst is what he and the Republicans are proposing for America's publicly managed, and much beloved, Medicare program.

To be sure, protecting tax cuts for billionaires, and setting social security up so that its funds get sent to Wall Street, are unconscionable budget goals. But they don't hold a candle to Ryan's proposal to dismantle Medicare so that the the health insurance industry - whose profits quadrupled during the Bush years - get greater access to the Medicare financial pie.

Specifically, Ryan's plan does two things:

* In effort to reduce program costs it will force elderly Medicare enrollees to pay more out of pocket expenses.

* In the name of "free market" competition, Ryan's proposes to hand Medicare management over to the private health insurance industry.

The idea behind making the elderly spend more is a simple one. If the patient pays more of their medical costs the Medicare program (and the taxpayer) doesn't have to dig so deep. Pretty simple, right? The problem here is that estimates suggest a senior who collects $12,000 per year from social security will see half of that amount ($6,000) go to the health care industry, even with vouchercare (most seniors take in about $28,000 per year).

When it comes to bowing to the free market mantra, while the Ryan plan continues to allow the federal government a small role in the program (like collecting taxes and transferring them to the health care industry) Ryan's plan essentially privatizes Medicare.

It's this prospect that scares the hell out of many Americans.



To be sure, there are examples where the private sector does an effective job of managing health care. But they're mostly in Europe.

The Netherlands and Switzerland, for example, have privately managed insurance providers running their "universal coverage" health systems. But here's the catch. Government mandates and restrictions for private insurers in these countries go well beyond what is proposed or practiced in the U.S. And, besides, European-like mandates strike most Americans as "socialistic."

But the socialism tag is a red herring in America's political arena for two reasons.

First, most politicians and most Americans have no clue what socialism is, so they're prone to throwing the term around for every initiative they don't really understand. Consider it's usage as a child-like tantrum, akin to when kids are told they have to leave the store.

Unfortunately, these "socialism" tantrums do nothing for our political dialogue, except lead to silly and forced caricatures, like this one ...



Second, socialism has nothing to do with America's consumer-driven model, which has been "widely discredited" on many levels. Business and Pulitzer Prize-winning journalist Michael A. Hiltzik writes that assuming elderly consumers - who now have "skin in the game" - will become discriminating health care insurance shoppers is wishful thinking.

As Hiltzik pointed out in "A moral approach to curing Medicare," studies show that (financially) strapped patients and consumers:

* Forgo not only ineffective but effective treatment.
* Lack the expertise to judge what's necessary and what's not.
* Are vulnerable to multimillion-dollar ad campaigns by drug and device companies pushing them into uninformed decisions.

Throw in a life threatening illness that hits at the wrong time, or the on-set of Alzheimer's, and what you're looking at is a real mess when you think about the elderly in a health care market dominated by an unregulated insurance industry.

There's more on how terrible the Ryan plan really is (read Hiltzik's piece; it's excellent). But you get the point. Ryan's plan is not well thought out.

- Mark