Do you realize Ryan's Medicare plan is more progressive than our overall health care system?

[Armstead]

Now before you get out the stones (or popcorn), let me make clear that I fully recognize that Paul Ryan's plan to replace Medicare with a voucher system is awful and regressive. It is a cynical attempt to wreck a system while trying to put lipstick on their pig by pretending they are not trying to gut Medicare, which they know would be unacceptable to the public.

No Way should it be allowed to replace the present Medicare system.

HOWEVER, there is one fact about it that should put the rest of our health care system -- and the recent "reforms" -- into perspective.

As awful as Ryan's plan is compared to the present Medicare system -- IT IS STILL MORE PROGRESSIVE AND HELPFUL THAN THE HEALTH CARE SYSTEM WE HAVE FOR EVERYONE UNDER THE AGE OF 65.

It offers a voucher to cover the cost of coverage. There is nothing even remotely close to that in our current healthcare system for anyone who is not on Medicare, or is poor enough to qualify for Medicaid.

The vast majority of average Americans on a moderate or middle class income are forced to swim in the unaffordable, shark-infested waters of the ;private insurabnce system. They pay too much for too little coverage. It is a budget killer for those who do not have employer-supplied coiverage, it is often a budget killer for those who do......and it is a big burden on business.

If Ryan's plan were to be applied to the working/middle class, it would be seen as a major progressive improvement to the present system of "tough luck-- you're on your own" Darwinian market-based health coverage.

Once again to emphasize -- this is not about how great Ryan's plan is. Quite the contrary. The fact that such an awful policy is better than what we have for the majority of the population shows how bad our healthcare system -- including post "reform" health care -- really is.

[MadMaddie]

1. When asked how the voucher program would work

Former RNC Chairman responded, "We don't know"! When asked what happens after the $17,000.00 Voucher is spent he also responded, "Lets' wait and see"!

If an American has a critical illness $17,000.00 won't be a drop in the bucket. The "Cost of Coverage" is a joke.

The government needs to go after the escalating cost of medical care and health insurance. They should not touch Medicair a system which is working.

[Armstead]

3. You might be missing my point

Ryan's plan is awful, especially when compared to Medicare as it exists.

But it is still better than the system for most people below 65 who are not on Medicare or do not qualify for Medicaid.

The comparison is bad to worse.

[Rosa Luxemburg]

108. We need a single payer healthcare system that provides 'real' coverage

[Armstead]

113. I totally agree with you on that

[babylonsister]

2. How much is that voucher you're touting worth? And for an older

person, who typically has more health issues?

I await your insight; I've heard it's not worth a helluva lot, and to boot, if you're about 87 and have to dick around with who will cover you at what cost, how is that more progressive?

[Armstead]

4. You also are missing the point

The point is not that I am "touting" his voucher system.

But the reality is that a comparable plan for youngewr people not on Medicare would be far more of a rescue than our current system provides.

It is not saying it is a good plan. But what we now have (for non-medicare recipients) is even worse -- NO HELP WHATSOEVER.

[karynnj]

42. Why even bring Ryan's plan into it? Why not just ask why there is

not Medicare for all - with the government paying for most of it - rather than it being limited to those over 65. You know the answer - Sanders, speaking of something less radical - a single payer system said in 2010 that no more than 10 Senators would vote for it. (He never named Senators, but I would assume that includes Dodd and possibly Feingold, though he might have been too much a budget hawk.)

The current plan does have subsidies for many who are above the Medicaid level, but below a threshold.

[Armstead]

47. I brought it into it to make a point abou0t how bad our system is

However bad, rotten, evil, whatever Ryan's plan is, when you compare to to what we have now for most people, it is more progressive. Not progressive, but more progressive. That is a criticism of the present system, not praise for Ryan's plan.

And as for the supposed help from HCR....It still locks us into an unsustainable system of "market based" healthcare coverage as the only path -- and it increases its dominance by forcing everyone to buy into it.

I am not sure what you are referring to regarding Sanders. But, while I agree that there is not now the political swill for a truly single-payer system, there would be the public support for the political will for a public option, expansion of Mewdicare or some other step in that direction that could at least move in the direction of comprehensive public insurance.

[Mimosa]

73. Armstead, you are right

Too bad some people can't admit the basic premise is correct.

[ejpoeta]

72. if they really were interested in 'saving medicare' then they would open it up

and let anyone buy into it if they wanted. they won't do that of course, and they even admitted it themselves. people would flock to it in droves. if people had the option to put their premiums into the medicare system, then voila... because most everyone hardly uses their insurance if they are healthy. maybe going to the doctor for check ups and the occasional flu or shot or something. all that money would sit there shoring up this system. we know that won't happen, but if they REALLY were interested in 'saving medicare' then that would be the most reasonable course of action short of instituting medicare for all and abolishing the for profit system.

[Armstead]

76. (Sigh) You are absolutely correct but that was not my point.

I fully realize that Ryan's plan an effort to dismantle Medicare as much as the GOP thinks the public would allow.

But that was not my point. Assume for a moment there were no existing Medicare system, and such a plan was proposed. It would be seen as a start and a step foreward from nothing.

If you take Ryans proposal and take it out of the Medicare situati0on and place it into the present healthcare system, it WOULD be more progressive than what we have.

That is not saying it is a good plan. It is a bad plan that shows just how crappy the mainstream health coverage system is for people who do not qualify for Medicare or medicaid is.

-----Frankly if the current crop of Democrats had been around when the original fight to start Medicare was going on, it never would have been proposed, much less passed. They would have found a thousand excuses why the public would never accept socialistic health care for old people.

[ejpoeta]

84. i understand what you are trying to say. the republicans hate government

involvement, but they have a plan that were it to be one for any american would be an improvement from what many of us have. if we were not on the state plan, our insurance out of pocket before the insurance company paid a dime would be $5k per person on top of the premiums. so what you are saying is that if everyone were given such a voucher towards insurance it would be an improvement.

but this is just to get their feet in the door. once they switched it so the elderly are now forced into the open market, then it would be easier to take that voucher away from them too.

and you are right... if medicare were being brought to a vote today it would not have succeeded. too much corporate involvement to have anything to help the rest of us these days.

[Armstead]

86. You've got it....with one small correction

I know that the GOP sees this as a step towards decimating Medicare and all public coverage.

My reference was simply to the concept of some financial help for non-Medicare recipients.

[karynnj]

101. All true - but that is not where we are starting - for people that age, we are starting with

Medicare.

[bornskeptic]

88. How much are you prepared to pay to buy into Medicare?

It would be something like $650 per month if they opened it up to everyone, or maybe $750 per month if they only opened it to people 55 or older, as some were suggesting.The current cost is about $850 per month, as you could easily check. The reason why it wasn't opened up is because knowledgable people understood that almost nobody would enroll, because of the price, other than people with serious and expensive medical consitions, which would mean the premium would continue to soar until almost no one would be interested.

[ejpoeta]

91. do you know how much my husband was paying for insurance??? for two of us it

was like $200 every two weeks and then the $2500 deductible for Cigna, i think back in 2005. how many people are already paying that much for a plan with a high deductible?

[Liberal_Stalwart71]

67. There's nothing wrong with our current Medicare system. I have no idea what you're talking about.

And I don't think you do, either!

The only problem that we have now is with the Medicare Plan Part D, which is a huge giveaway to the prescription companies/Big Pharma!! However, Part D has nothing to do with Medicare. It's a separate program, and a SCAM!

Other than that, most Americans are quite happy with Medicare as it exists. That's why progresives were pushing Medicare For All two years ago.

[Armstead]

82. Christ on a cracker -- are you even reading anything here?

The only thing wrong with our basic Medicare system is that it is not the basis of a universal system that would be available to everyone.

If I were king it would be Medicare for All (or at least for those who want to buy into it as an alternative to the extortion of private insurance.)

[Liberal_Stalwart71]

92. You think a voucher system would provide a "Medicare For All" system

My response to that is bullshit. It most certainly would not!

Again, call up Bernie and ask him what he thinks of that. I can assure you that he'd call bullshit, too!

[ProSense]

5. Nonsense!

Think Progress :

<...>

Indeed, the two approaches are very different. Ryan would cut Medicare by simply “reducing the amounts that the federal government would pay for enrollees on a per capita basis” — i.e. cutting the federal government’s contribution to the program and shifting those costs on the individual.

The Affordable Care Act, on the other hand, slows growth in the program by eliminating overpayments to private insurers, getting rid of waste in the program and slowly phasing in payment adjustments that encourage providers to deliver care more efficiently. As a result the law extends the life of the Medicare trust fund by 12 years and allows seniors to retain all of their guaranteed Medicare benefits.

"If Ryan's plan were to be applied to the working/middle class, it would be seen as a major progressive improvement to the present system of 'tough luck-- you're on your own' Darwinian market-based health coverage."

Vouchers?

[Armstead]

6. What is there now?

Quick....If one is not old enough for Medicare and not poor enough for Medicaid, what public program is available to help them cover the exorbitant cost of healthcare coverage?

[frazzled]

8. The Affordable Care Act, as of 2014

Too young for Medicare and not poor enough for Medicaid, with no coverage from a job? Under the affordable care act, a "silver" plan would cost a family of four:

at 100-150% of poverty level (middle range income of $30,000): average $600 per year ($50 per month). This is a premium subsidy of 96%, with an additional $3,300 cost-sharing subsidy.

at 150-200% of poverty level (middle range of income $42,000): $2400 per year ($200 per month). This is a premium subsidy of 83%, with an additional $1,800 cost-sharing subsidy..

at 200-250% of poverty level (middle range of income $54,000): $4000 per year ($333 per month). This is a premium subsidy of 72%.

at 250-300% of poverty level (middle range of income $66,000): $6100 per year ($508 per month). This is a premium subsidy of 57%.

at 300-350% of poverty level (middle range of income $78,000): $9200 per year ($766 per month). This is a premium subsidy of 44%.

at 350-400% of poverty level (middle range of income $90,000): $14,100 per year ($1175 per month). This is a premium subsidy of 35%.

Similar subsidies for singles, tied to income. Not perfect, by any means, but it beats the Ryan plan, which offers nothing to anybody (under 65).

[Armstead]

13. Far from perfect -- I read up on that

A lot of ifs and and buts regarding who might qualify for what, and it still relies primarily on the good graces of private insurance (or puts more people on Medicaid which is a dubious proposition) and tax breaks.

Since we're talking hypothetically about how Ryan's plan would compare for non-Medicare, whether Ryan's plan would be better otr not would depend on the size of the voucher. (And again, I am not promoting Ryan's plan. Rather it is a comparison between a porcupine and a skunk.)

My basic point is why not get rid of all that bullshit and offer some kind of public plan that is progressive in payments, as an alternative to private insurance?

[frazzled]

44. I don't think you read very well

No ifs and buts about who will qualify: it's all based on income. There will be no "good graces of private insurance" on the Exchange: the law requires that they offer certain benefits if they are to be included on the exchange, they must take everyone regardless of preexisting conditions, they may not charge even one cent more for someone with a preexisting condition, may not cap your annual or lifetime benefits, etc.

A voucher would leave you open to the current private insurance market, in which they can turn you down for a hangnail, and max you out if you happen to have, say, an unfortunately accident like a pistol shot to the head like Gabrielle Giffords and need a year of hospital and rehab care.

[Armstead]

48. An exchange assumes insurers will want to participate

I suspect a lot will decide it is more trouble than it's worth.

I am not saying the "subdies" are all bad. Howeever, when you dig into the weeds, it kicks a lot of people into medicaid, or has other limitations that would be real confusing as to who qualifies and who doesn't, and how much of a break they might receive, based on different factors.

It is another example of trying to solve a fairly straightforward problem with a convoluted mess intended to protect the interests of a private interest group rather than the actual public good.

[Bluenorthwest]

41. And there is the casual bigotry again.

Family, blah, blah. Singles, blah without details. But the fact that the heterosexual community means 'only families approved by the President's faith staff, McClurkin and Warren etch. Your community says my family is not even a family. Strangers to each other, the President says we 'lack a spiritual element' you see, and straights like Newt or Kobe are blessed and sacred, Sanctified in fact. Kobe's 'marriage' is Sanctified and created by the hand of Goddy God God. And the rest of us can go fuck off, that is the current 'plan'.
Discrimination, mandates, and more discrimination.

[Mimosa]

95. BlueNorthwest, I too, am tired of everything tied to mythical families of 4.

Also the ACA of 2010 does nothing to curb the age related premiums which price out many above age 50. And over 55? Horrible rates which those tax credits don't put a dent in.

[ProSense]

11. Trying to claim that

there is anything progressive about Ryan's plan is absurd. It's a voucher system with a cap that does nothing for anyone.

[Armstead]

14. I said it in comparative terms. "More" progressive than what we have is not saying it is good

[ProSense]

17. It's not progressive at all.

It sucks.

[Liberal_Stalwart71]

68. That's what Medicaid is for. For children, we have the SCHIP program.

As a supporter of Sanders, you don't know this?????


*banging my head against the wall*

[Armstead]

75. I know what Medicaid is, and SCHIP

Medicaid is okay as a provider of last resort for those who truly need it. But having to push people into a form of government charity is a signal of failure of the overall system.

In my opinion, the real goal should be to make systemic changes that makes health coverage accessible to everyone and affordable based on their income (rather than the dictates of corporate pirates and accountants).

I'm pretty sure Bernie would agree with me on that.

[Hippo_Tron]

7. For those who get screwd by an insurance company refusing to pay...

Or can't afford premiums or a co-pay/deductible yes you're right. But there are also plenty of people whose insurance companies do pay and can afford their co-pays/deductibles, and can afford their premiums or are fortunate enough to have an employer cover most of it.

I'm not discounting the havoc that our private insurance system has wreaked on many Americans. It's downright tragic that people die from inadequate health care in the richest nation on earth. These people would certainly trade our system for a $17,000 voucher. But, there are also plenty of people who do fine in the current system. If there weren't, we'd have had single payer long ago.

[Armstead]

9. Some do okay, but they are getting fewer and fewer everyday

...as people lose jobs, or their employers shift more of the burden onto them, or they run up against the brick wall of co-pays and denial of benefits -- AND as rates continue to skyrocket upwards, the situation is becoming more untenable for more people every day. And people who are self-employed are screwed from the git go.

There is a large appetite for real reform and some form of affordable public alternative. What's missing is the willingness of politicians to support it.

And again -- I am not promoting the Ryan plan per se. Just pointing out that what we have is even worse than what he proposed for Medicare.

[Hippo_Tron]

12. The "some" is still larger than you think

Polls show pretty overwhelmingly that most people are satisfied with their current insurance. Now, that number might drop somewhat if many of those people had to try and get their insurance to pay for anything more than a routine doctor's visit or prescription. Most people don't like "the system" but many of them see that as an abstract thing that doesn't effect them.

When the "are you satisfied with your current coverage" number combined with the uninsured number gets a lot lower than it is now, is when there will be enough political pressure for single payer.

[Armstead]

15. You got the crux of it. If you have a ;pretty car with no engine....

you will be satisfied with seeing it in the garage -- until you have to drive it.

Polls also show that a majority of people want the option of public insurance available.

And while an emplkoyee may be satisfied with a plan, that doesn't mean their employer is. Some of the biggest (though qiuet) supporters of an alternative system are business executives, who know it is unsustainable for them and society as it is.

[ProSense]

19. And you see Ryan's plan as having an engine?

Really?

Why Ryan’s Medicare Proposal Is Not Like The Plan Members Of Congress Get

The RW is busy trying to make this argument to sell Ryan's plan. It's bogus.

First of all, Ryan's plan does nothing to control cost, doesn't take into consideration any issues related to pre-existing conditions and catastrophic care or set defined benefits.

There are a lot of things that make the health care law attractive, from the default federal exchange to the state waiver to the subsidies.

"And while an emplkoyee may be satisfied with a plan, that doesn't mean their employer is. Some of the biggest (though qiuet) supporters of an alternative system are business executives, who know it is unsustainable for them and society as it is."

Business and labor hate vouchers. You may want a more progressive plan, but Ryan's is not it.

[Armstead]

26. Fer Pete's sake...For the 11th time....

I am NOT saying Ryan's plan is good, or advocating for it.

Let me repeat slowly....His plan for Medicare sucks. IT should be thrown in the dumpster.

However what we currently have in place for people not yet of Medicare age, or not qualified for Medicaid is worse that what he is proposing for Medicare.

My point --for the 12th time -- is that our present health care system is worse in terms of affordability of coverage is even worse. That is not a reflection on how "good" is plan is -- It Is a sad commentary of how bad our system is.

[ProSense]

43. "I am NOT saying Ryan's plan is good, or advocating for it."

From the OP:

"If Ryan's plan were to be applied to the working/middle class, it would be seen as a major progressive improvement to the present system of 'tough luck-- you're on your own' Darwinian market-based health coverage."

That's utter nonsense.

Ryan's plan and progressive shouldn't be in the same sentence. In fact, the plan isn't even a plan in the sense of health care for people under 65.

[Armstead]

46. Once again you are being a brick wall

If you want to state how the present health care reform is good, or whatever, that's fine.

But you are missing my basic point...deliberately?

You are intelligent, and yet you continue to misconstrue the point, which I won't bother to repeat yet again. Why?

[ProSense]

50. What point:

that a plan to end Medicare as we know it is better than reforming the system?

Maybe you could get Alan Grayson to push Ryan's progressive plan instead of Medicare for all?

Hell the Republicans are already on board.

How's this for a slogan: Repeal Obamacare because Ryancare is more progressive!

It needs work.

[Armstead]

51. Take Reading Comprehension 101, re-read my OP and get back to me if you want...

[ProSense]

53. The OP is ridiculous.

You're claiming a plan is progressive, but then saying you're not advocating it because it sucks.

Take logic lessons.

[Armstead]

55. The reality is ridiculous

and "more progressive than..." does not say it actually is progressive.

Cutting someone's hands off is better than chopping off the whole arm, but that does not make it good.

[ProSense]

56. From the OP

"If Ryan's plan were to be applied to the working/middle class, it would be seen as a major progressive improvement to the present system..."

The reality is that's bullshit!

[Armstead]

58. Try a little mental exercise...

Imagine early in his presidency, President Obama makes a big speech to introduce his reform plans.

"We must have a complete overhaul of our healthcare system, to make care accessible and affordable for everyone, and to make the system more efficient and cost-effective. It is a huge problem, and there is much that will need to be done. As a first step, to alleviate the immediate financial pressures on individuals and families who are not eligible for Medicare or Medicaid, I am proposing that we provide a voucher to provide immediate relief towards the costs that they now pay for premiums, funded through a special small surtax. This is not the actual solution, but at the very least in this difficult economy, it will help to make health insurance more affordable in the short term, while we work to develop and pass a longer term strategy."

You don't think this would be hailed by many as a great first step...and condemned as sociualistic Big Government by the CONservatives?

Yes that is fantasyland but try thinking a little bit outside the box for a change.

Again, and I hate to repeat myself -- Ryan's plan is NOT an acceptable replacement for Medicare, and it is NOT a reasonable solution for overall healthcare access. But compared to what we have now it is more in the progressive direction that the "you have to buy private insurance by law, and we might help you a little bit if you meet certain stringent guidelines."

[ProSense]

61. Maybe

Imagine early in his presidency, President Obama makes a big speech to introduce his reform plans.

"We must have a complete overhaul of our healthcare system, to make care accessible and affordable for everyone, and to make the system more efficient and cost-effective. It is a huge problem, and there is much that will need to be done. As a first step, to alleviate the immediate financial pressures on individuals and families who are not eligible for Medicare or Medicaid, I am proposing that we provide a voucher to provide immediate relief towards the costs that they now pay for premiums, funded through a special small surtax. This is not the actual solution, but at the very least in this difficult economy, it will help to make health insurance more affordable in the short term, while we work to develop and pass a longer term strategy."

You don't think this would be hailed by many as a great first step...and condemned as sociualistic Big Government by the CONservatives?

...You should try reading Ryan's proposal, not the one you wished he had proposed.

Why is Ryan advocating the repeal of the health care law (which did overhaul the system) instead of amending it to include vouchers?

"Yes that is fantasyland but try thinking a little bit outside the box for a change."

Yes, it's definitely "fantasyland."

[Armstead]

63. My final word on this subject

I have no problem if you want to disagree with my belief that the current health care reform is not really an improvement. Or that a voucher system is awful, but would still be more progressive than what the situation is at the moment (and has been for far too long).

But at least don't misconstrue and misstate my original contention and point.

[Hippo_Tron]

20. Getting people to simply say they want a public option isn't going to do the trick though

In order to have a successful universal health care, people need to not only want a public option but also plan on using it. When most people want to keep their current insurance but want a public option, it means that they feel bad for those who don't have insurance and want the public option to be available for them. Alternatively, it's possible that they want it for themselves just in case they should ever lose their coverage, but given that people are satisfied with their insurance without really taking it for a test drive, I doubt many are thinking far ahead.

The stage we're at right now is that people want a two-tiered system. They want to keep their insurance and their altruistic nature leads them to want some kind of government plan for those who are less fortunate than them. However, building a system based on altruism isn't going to work. Social Security was so successful because FDR was smart enough to know that everybody had to receive benefits so that it wasn't given the stigma of something that's only for the indigent.

Had we gotten a public option this go-around I think the best we would've done is get one that is only used as a last resort by those too poor and or too sick to get anything better. And while that's better than nothing, it's not what we need to solve the health care problem in this country. We need a universal system that everybody is wants to actually use. And that's not where we're at as a nation yet. We are getting there slowly but surely, though.

[Armstead]

27. I disagree -- My brother is one tiny example

First of all leadership is not waiting for support to drop out of the sky. It requires leaders to take the leap and actually lead.

There are more and more people like my brother out there every day.

He was a middle management type. He and his wife had decent jobs, good coverage..all the rest.

He was satisfied. He is the type who is apolitical and who is not a wing nut, but would not have been very receptive to a change in the system.

Then the shit hit the fan. HE lost his job. His wife had a health problem that required tests and diagnostic procedures. His teen aged daughter got diabetes.

Their insurance refused to cover most of his wife's medical bills,and after much fighting with the company they gave up and are eating the debt.

They are scared shitless because their daughter is out of college and they have no clue how she is going to get or afford coverage for healthcare, which she HAS TO GAVE because of her diabetes.

He has gone from being reasonably content about health care to a rabid hater of private insurance and the present situation.

There are many horror stories like that, and many more people getting angry frustrated and scared every day.

[JVS]

24. Does Ryan's plan harm those for whom the current system is functional?

[Armstead]

28. It is far worse than Medicare

But it would less horrific for the rest of the population that is not on Medicare or Medicaid than what is currently in place.

Since the GOP is NEVER going to propose anything like that for the overall p
But iun a broad sense, a voucher would, at least provide some financial relief for average people -- which is currently non-existent.

[Liberal_Stalwart71]

69. You think middle-income/working-class people would benefit from Ryan's

plan, irrespective of the rising costs of health care?

I have the same problem with a Medicare voucher as I do with an education voucher. Why? Because who's to say that the insurance company won't choose "middle-class" families who can afford to pay the residual costs of providing health care that the voucher cannot cover completely? It is STILL discriminatory.

And it STILL sucks!!!

You should be ashamed to even put the word "progressive" anywhere near the words "Paul Ryan."

[EC]

10. There's a voucher for low income

people in the AHC.

[ClarkUSA]

16. So you have words of praise for Paul Ryan's plan yet only criticism for Obama's HCR? Gotcha.

Despite this fact, too:
http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=433&topic_id=657652&mesg_id=657697

Very interesting.

[Armstead]

32. It is not "words of praise" for Ryans plan

His plan sucks. This is a matter of comparative bads -- not supportive of his plan.

But as I noted in a reply above, it is less horrible than what we have now for everyone not on Medicaid.

As for the proposed "solutions" in HCR, it is at least as bad or worse. It is too convoluted with so many ifs, and and buts, it still keeps people in the grip of private insurance -- and it pushes more people onto Medicaid.

It is not as clean a solution as a real public option, expansion of medicaid or an actual single payer system.

[Raine1967]

18. It isn't. it's a akin to the fair tax.

That isn't progressive either.

Would you like to defend the Fair Tax and tell us it's progressive?

[Armstead]

33. No and I don;t defend Ryans plan either. But the current system is VERY regressive.

[vaberella]

21. You say this plan is not great but better---yet you find Obama's HCR just bad period.

Wow...wow.

Well we know where you stand. :puke: But I'm sure you'll have others following your example. So it's whatever---Right Wing talking points are pushed a lot on this board as long as it's a "viable" counter against Obama.

[Armstead]

49. No, you should know my positions better than that by now

The reason I brought it up is that it did strike me that if a Democrat, lets say Obama for the heck of it, proposed offering a voucher to everyone (not on Medicare or Medicaid) to help people pay their insurance costs it would be called a progressive policy, and a great start by many -- and a very liberal policy. And the right wing wuold probably call it socialism.

That's not because it is a good plan, or truly very progressive. But it is progressive compared to the present system. and a lot more straightforward that the overly complicated and question-raising Rube Goldberg machinery that passed for "reform" recently.

[vaberella]

103. I don't agree with that.

I should know your positions by now but posts like this kinds of derails it. As to what I don't agree with...I think you're assuming that there are ardent followers of EVERYTHING President Obama does here. Us, so called cheerleaders, don't love everything he's done. Even I said I'm not feeling "race to the top" and I don't like his suggestion of bringing that to the "medical sector (hospitals)" either.

As far as the medical voucher President Obama put in place--it doesn't remove the foundation of Medicaid/Medicare. Far from it. And they would be used in line---with forcing your employer to pay a certain amount on health care. This guy doesn't even want any of that.

[Liberal_Stalwart71]

70. They call it the "Obama Deranged Syndrome." We got DUers on this board

who vocally joined the Teabaggers in calling for a government shutdown. "The ends justify the means" people on this forum are displaying characteristics that are more and more Teabagger-like, just because they are angry that Obama's plans aren't "pure enough." They want everything the way they want it RIGHT NOW! Incrementalism is not desirable. For some reason, they believe that change should have come in less than two years, despite the Republican filibusters and the Blue Dogs/Corporatists in the Democratic Party in *both* houses of Congress. Miraculously, one man should have been able to push throug a "purist" agenda, even though our U.S. Constitution calls for three separate and distinct branches of government, each having its own set of powers and "checks" on the other two.

For some reason, they believe that Obama has centralized all *legislative* powers in the Executive Branch. Or something like that...

[Armstead]

78. No this is much bigger than Obama

Some of us have been committed to the goal of meaningful health care reform for many years (decades) and are angry that Obama AND the Democratic establishment blew a golden opportunity to take a major step in that direction.

Feel free to disagree but at least get your motivations correct before you fling around terms like Obama derangement syndrome.

[Liberal_Stalwart71]

93. Are you going to defend the lie that what Ryan is proposing is like what members of Congress receive

Because if you are, you must know that it is a lie.

What members of Congress and their staffs--and all federal employees like myself--enjoy is NOT what Ryan is proposing! The voucher system that he is proposing is not what they have. It is NOT what I have.

So, stop pretending that somehow what he is proposing is anything like a progressive system. It is NOT!!

[Name removed]

22. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Armstead]

34. Ryan's plan is shit -- absolute shit, and if you re-read the OP you might realize that

His plan is shit. It is far, far worse than Medicare.

But the concept of a voucher for everyone is more progressive than what we currently have for people under 65, and is more straightforward than the "you might qualify for a subsidy if you meet very specific criteria" in the new health reform law.

Once again, my point is not to praise Ryan's plan. But in terms of comparative awfuls, it is less awful than the current system -- and about as awful as what we'll get under the new HCR a few years from now maybe.

We should be able to do better than "slightly less awful."

[Liberal_Stalwart71]

71. The concept of a voucher is progressive? Really? Geez, you HAVE been hitting the bottle!

Why don't you call up Bernie Sanders and ask him if he believes that the concept of a voucher is progressive.

You have totally lost it. :(

[Armstead]

77. Well I lost it long ago but that is beside the point

If you bother to re-read my OP and my responses to you and others, it should be abundantly clear that ratrhger than saying vouchers afre progressive, I am saying that the awful is better than what we have.

You may disagree with me that the present systemn is awful. You may disagree with my belief that Obamacare was a wasted opportunity because it further entrenches the domonance of private insurance, and prevents the real solution of public insurance.

But at least understand what I did say and why.

[Liberal_Stalwart71]

90. That came out of your post. I didn't make it up. Ask Bernie Sanders if he believes that the concept

of a voucher is progressive. Again, I haven't made anything up. That sentence was taken straight from your post.

And step away from the booze this time, my friend.

[Armstead]

100. I said it is MORE PROGRESSIVE than nothing -- which is what most people get now

A shitty crappy voucher of 5 cents is an improvemenmt over the current "No healthcare help for you" system that is in place.

MAYBE there might be mild improvements in the new HCR eventually. But the basic concept forces most people by law into private insurance until they are old enoiugh for Medicare. That is not progressive either, and any "subsidies" are just another word for voucher.

I am not sure whether you are being obtuse or deliberatly ignoring my point. I really don;t care whether you agree with me or not, but at least get what I am saying right.

Let me repeat this very slowly for you -- I agree with Bernie Sanders that ultimately the only system that makes sense is single payer universal coverage with premiums based on income. If that is not possible,the least step we cpould take wiould be a public option and/or option for younger people to buy into Medicare.

I dislike the Obamacare because it is going in the opposite direction from that, by further embedding private pirate insurance as the only source of coverage.

Obamacare's subsidies are not much different that Ryan's vouchers ultimately.

[uponit7771]

23. The voucher is only 15 grand, but you think Obamas plan is worse?

[BzaDem]

25. You should really look at it through two entirely different lenses: the reform, and the amounts.

If we were to compare the affordable care act (2014 and beyond) to Ryan's plan in terms of the reform (i.e. exchanges, mandated benefits packages, community rating and guaranteed issue, medical loss ratios, other insurance regulation, etc), the affordable care act is MUCH, MUCH better than Ryan's plan. They don't even compare.

If we were to instead simply compare the subsidy amounts, of course Ryan's plan would be better (at least in the initial years). But this is hardly a surprise -- before the affordable care act, we had an 80-100% subsidy for healthcare for those over 65 (Medicare), and a 0-25% subsidy for healthcare for the non-poor under 65 (the employer healthcare tax credit).

So even a large increase in the subsidy for those under 65 (the affordable care act) is still going to be lower than a large decrease in the subsidy for those over 65 (Ryancare). But that doesn't mean the affordable care act isn't worth enacting, or that Ryancare is worth enacting -- it simply reflects the state of both healthcare systems before anything was enacted. The affordable care act is a significant improvement over the pre-status-quo.

[Armstead]

36. Thank you for a thoughtful answer. Here's my response

First of all, (again) I am NOT advocating for Ryans plan in any situation. Medicare should stay put.

I frankly used that as a comparative jumping off point for shock value -- although it is more progressive than the present system.

Among my objections to the affordable care act is that it leaves us at the mercy of the private insurers and the "marketplace", and it lacks teeth to really control how much they gouge the public. The controls in HCR still have loopholes big enough to drive a Mack Truck through -- and before it goes into effect, insurers will be able to jack up levels to new heights.

As for subsidies or whatever they call the assistance to consumers -- they are too convoluted and God-only-knows who will actually find some relief from high insurance costs. It is yet another Rube Goldberg machine that uses pretzel logic to fit a basic public need into the inherently unworkable private market for coverage.

My own belief is that the answer is to offer everyone access to affordable public coverage based on sliding scale income-baaed prices.Single payer coverage wold be the most cost effective and equitable answer....But being realistic about the ability to do that now, a much better step in that direction would have been an optional buy-in to Medicare for younger people or some other a "public option" through government supported insurance.

[vroomvroom]

29. I see where you're coming

but you forget that $17,000 actually isnt that much for a system that overcharges for anything.
Yes there will be people under 65 that prolly wont visit that often to the emerg but it is "those times" when you realize $17K is quite tiny...especially if that has to last you for your entire life..not just before 65.

I personally think the 2014 plan is just as stupid as Ryan's but between the two i'd rather hold my nose for the 2014.

America has no choice but to be dragged kicking and screaming to what the rest of the world already knows for the last 40 years....Single Payer is the onyl solution. Any other way is just pure greed for the small few looking to get as much money from the sick and dying before it all changes.

[Armstead]

37. I don't disagree with you

But we certainly should be able to do better than have the only choice be between two awful systems, when a public option would have been a better way to at least take steps in the right direction.

[RichGirl]

30. A very important fact to keep in mind.

Neither medicare or social security started out being what they are today. They started much smaller and built up slowly. That's how we need to look at Obamacare...just the beginning, leading up to universal healthcare.

Whatever the good points of the Ryan plan are, they will disappear quickly and be replaced with further screwing the general public in favor of the wealthy.

Neither side is putting out exactly what they want. So it's important to look at intention. I know both of their intentions and I'll stick with Obamacare any day! It will get better, Ryan plan worse....simple.

[Armstead]

38. True....However I do not share your optimistic view of the direction of Obamacare

I could accept the current HCR reform as a small step in the right direction if i thought that's what it is.

But I see it as a step in the wrong direction, by further entrenching the dominance of private insurance. Instead of offering some small public option or other version of public social insurance, it took those off the table and is trying to make the private insurance system slightly more palatable. Which is substituting cosmetic change, while further digging the hole the marketplace coverage has been pushing us into.

Because of that i think it is a step backward.

[Vinca]

31. But Ryan's plan is not for people under 65, so there is nothing to cheer about.

People under 65 are still left with the Republican Plan - if you get sick, die quickly.

[vaberella]

35. No it's for when you turn 65. n/t

[Armstead]

39. I am not talking about the Ryan plan as it is

My point was that if you look at it compared to what we have, it is more progressive than today's Darwinian marketplace approach.

The current healthcare system is already "get sick and die quickly." The current reforms that were enacted only say "maybe die slightly less quickly"

[karynnj]

40. I agree that it is a better deal that what non-Medicare eligible people get,

but it is NOT as good as you describe. It does not guarantee that "It offers a voucher to cover the cost of coverage." In fact, there is no way it could possibly do so. He costs out the vouchers as being considerably cheaper than Medicare. However, Medicare is less expensive than private insurance. It has about a 2% overhead vs a 20 % overhead for private insurance.

The difference is that it starts with a group of people, who are expected to get nearly free medical insurance. I agree with your implicit question - which is whether everyone should be able to get nearly free insurance - obviously paid for by taxes. If this were accepted, which unfortunately it isn't, this could be done via increasing the subsidies and having them apply to everyone or almost everyone in the health care plan, extending Ryan's plan to everyone, or expanding Medicare as we know it to everyone. If the country moved to accepting this, the cheapest most efficient and best way to do it is Medicare for all.

Comparing Ryan's vouchers to the HCR plan is unfair.

[Armstead]

45. If everyone got a $10 voucher it would be better than we have, which is nothing

My point was not to praise Ryans plan but to compare the bad to the worst. A $10 voucher to everyone would be better than what we have now for most people (not on Medicare or qualified for Medicaid).

I agree with you that the most efficient and effective way to broaden access to affordable (not free, but income based payments) would simply be to expand Medicare eligibility.

[ProSense]

52. What utter nonsense.

A voucher to buy health insurance is not a solution.

$10? Absurd.

[Armstead]

54. I agree but try addtressing what I actually said

[ProSense]

57. Simply handing people a voucher

would do nothing to address this and would make the current system less efficient.

Ryan's plan does nothing to control cost, doesn't take into consideration any issues related to pre-existing conditions and catastrophic care or set defined benefits.

There are a lot of things that make the health care law attractive, from the default federal exchange to the state waiver to the subsidies.

Just saying Ryan's proposal is more progressive based on vouchers is absurd.

[BklnDem75]

59. Utter crap

Who do you think is eligible for medicare under the age of 65? I don't even see the word 'disabled' mentioned in his 'Progressive' plan. Under Ryan's plan, it actually raises the eligibility age to 67 in 2033.

'Under the proposal, most elderly people would pay more for their health care than they would pay under the current Medicare system. For a typical 65-year-old with average health spending enrolled in a plan with benefits similar to those currently provided by Medicare, CBO estimated the beneficiary’s spending on premiums and out-of-pocket expenditures as a share of a benchmark: what total health care spending would be if a private insurer covered the beneficiary. By 2030, the beneficiary’s spending would be 68 percent of that benchmark under the proposal, 25 percent under the extended-baseline scenario, and 30 percent under the alternative fiscal scenario.'

http://www.cbo.gov/ftpdocs/121xx/doc12128/04-05-Ryan_Letter.pdf


Which part of the 'Plan to Prosperity' is Progressive? Did you even read the plan?

[Armstead]

60. Utter lack of reading comprehension

Please re-read my post. I clerarlky stated up front that Ryan's plan is crap, and there is no way it should be considered as a replacement for Medicare.

But, for people in the middle who are not eligible for Medicare or Medicaid a shitty voucher system is at least more than we've got when compared to the total lack of financial relief that is available now. And it is a lot more straightforward than forcing people to buy private insurance, and having an overly complicated and questionable set of conditions to possibly maybe receive some sort of subsidy.

My point was that Ryans plan is awful But that comparison just points out how FUBARED the current system is, even with the new "reforms." We are avoiding a more straightforward and effective solution by not even considering a start towards real reform such as an expansion of Medicare to other age groups and/or a public option.

[BklnDem75]

62. I read what you wrote. That's why I said utter crap

Someone has to be on drugs to think Ryan's plan is better than our current system. The fact that you'd still attempt this argument, despite the information I gave, makes me less willing to take you seriously. You don't have to like the current plan, but this is a stupid argument.

[Armstead]

64. Maybe the HCR will be better.....But the CURRENT SYSTEM is total Darwinian Exploitation

Perhaps in several years the current HCR might actually make some improvements. If I turn out to be wrong, I will be glad that I was wrong.

However, I think it was the wrong approach for many reasons.

Again, my reference to Ryan's plan was not an endorsement of it -- merely a comparison to show how bad our present system really is.

Feel free to disagree, but at least get my intent correct.

[BklnDem75]

66. When you do crap comparisons,

it's hard to trash something without endorsing the other. To claim our current system is 'total darwinian exploitation' tells me you haven't seen Ryan's plan at all. As I said, you don't have to like the current plan, but you chose the crappiest way to state your case.

[Armstead]

74. That's fair

It may be a crap comparison. If anyone construed it as saying the Ryan plan is any good, then I missed the mark.

The reason I posted it was it struck me that taken on its own terms in isolation apart from Medicare, it is (in my opinion) more progressive than anything else that's been seriously bandied about in DC.

That's more a sad commentary on how shitty the system is and is likely to be under the new "reforms" which are just glossing over the real core problem and further entrenching the role of the market-driven ripoff insurance system.

That is my opinion. Your mileage may vary.

[dionysus]

65. 4/20 was yesterday dude.

[TheKentuckian]

79. Yeah but most seem too high to read what was written.

Let us break this down a little further then. The current system is the current system, not the Wealthcare and Profit Protection Act. The system in 2014 is not what we have now and for most people they are pretty similar in providing an offset for private insurance.

A voucher for a penny would be an "improvement" over "you are on your own 100%".

The OP gave a hypothetical for comparisons sake and as mental exercises. It points the horrific status of what we live under now and the weakness of what is coming for the vast majority of people.

I'm not sure if people's reading comprehension is as poor as this thread indicates or that the talking points and partisanship are so infinitely rigid that such a discussion can't happen and pretending something was posted that wasn't by any stretch. The OP was crystal clear and the writer further clarified and still misunderstanding is feigned.

Totally intellectual dishonesty.

[Armstead]

81. Thank you. You hit the nail on the proverbial head.

[ProSense]

87. This is nonsense

A voucher for a penny would be an "improvement" over "you are on your own 100%".

The OP gave a hypothetical for comparisons sake and as mental exercises. It points the horrific status of what we live under now and the weakness of what is coming for the vast majority of people.

From the OP:

<...>

As awful as Ryan's plan is compared to the present Medicare system -- IT IS STILL MORE PROGRESSIVE AND HELPFUL THAN THE HEALTH CARE SYSTEM WE HAVE FOR EVERYONE UNDER THE AGE OF 65.

It offers a voucher to cover the cost of coverage. There is nothing even remotely close to that in our current healthcare system for anyone who is not on Medicare, or is poor enough to qualify for Medicaid.

The vast majority of average Americans on a moderate or middle class income are forced to swim in the unaffordable, shark-infested waters of the ;private insurabnce system. They pay too much for too little coverage. It is a budget killer for those who do not have employer-supplied coiverage, it is often a budget killer for those who do......and it is a big burden on business.

<...>

Those point are complete nonsense, and also assumes that Ryan's vouchers cover the cost of care. Outside of Medicare and Medicaid, the vast majority of Americans are not on their own.

As for the "unaffordable, shark-infested waters of the ;private insurabnce system," Ryan's proposal is to give people inadequate vouchers to purchase insurance in the very same "shark-infested waters."

This is a mental exercise in nonsense.

It's no different from claiming that the status quo is better than the health care law.

[TheKentuckian]

89. You are willfully making the discussion about something other than what it is.

Are serious that the the status quo is better than some help?

You are TRYING to conflate the present system with one that is not in effect and I suspect the reason is vouchers or tax credits for the shark infested waters are eerily similar. One may be more help than the other or come with important features but the essential idea is the same, more of the same with a subsidy.

You continue to scream nonsense but fail to ever explain why and that is because there is no "there" there.

Plus, your post is incoherent in context. If the VAST MAJORITY are not on their own then who the fuck is helping and protecting them? The system is inarguably predatory and clearly a cartel.

[ProSense]

94. What the hell are you talking about?

"Are serious that the the status quo is better than some help?"

Where did I say that?

You are TRYING to conflate the present system with one that is not in effect and I suspect the reason is vouchers or tax credits for the shark infested waters are eerily similar. One may be more help than the other or come with important features but the essential idea is the same, more of the same with a subsidy.

You continue to scream nonsense but fail to ever explain why and that is because there is no "there" there.

Plus, your post is incoherent in context. If the VAST MAJORITY are not on their own then who the fuck is helping and protecting them? The system is inarguably predatory and clearly a cartel.

Fail to explain?

Explanations...

Here

Think Progress :

<...>

Indeed, the two approaches are very different. Ryan would cut Medicare by simply “reducing the amounts that the federal government would pay for enrollees on a per capita basis” — i.e. cutting the federal government’s contribution to the program and shifting those costs on the individual.

The Affordable Care Act, on the other hand, slows growth in the program by eliminating overpayments to private insurers, getting rid of waste in the program and slowly phasing in payment adjustments that encourage providers to deliver care more efficiently. As a result the law extends the life of the Medicare trust fund by 12 years and allows seniors to retain all of their guaranteed Medicare benefits.

"If Ryan's plan were to be applied to the working/middle class, it would be seen as a major progressive improvement to the present system of 'tough luck-- you're on your own' Darwinian market-based health coverage."

Vouchers?

Here

Why Ryan’s Medicare Proposal Is Not Like The Plan Members Of Congress Get

The RW is busy trying to make this argument to sell Ryan's plan. It's bogus.

First of all, Ryan's plan does nothing to control cost, doesn't take into consideration any issues related to pre-existing conditions and catastrophic care or set defined benefits.

There are a lot of things that make the health care law attractive, from the default federal exchange to the state waiver to the subsidies.

"And while an emplkoyee may be satisfied with a plan, that doesn't mean their employer is. Some of the biggest (though qiuet) supporters of an alternative system are business executives, who know it is unsustainable for them and society as it is."

Business and labor hate vouchers. You may want a more progressive plan, but Ryan's is not it.

Here

What point:

that a plan to end Medicare as we know it is better than reforming the system?

Maybe you could get Alan Grayson to push Ryan's progressive plan instead of Medicare for all?

Hell the Republicans are already on board.

How's this for a slogan: Repeal Obamacare because Ryancare is more progressive!

It needs work.

Here

...You should try reading Ryan's proposal, not the one you wished he had proposed.

Why is Ryan advocating the repeal of the health care law (which did overhaul the system) instead of amending it to include vouchers?

"Yes that is fantasyland but try thinking a little bit outside the box for a change."

Yes, it's definitely "fantasyland."

Here

Simply handing people a voucher

would do nothing to address this and would make the current system less efficient.

Ryan's plan does nothing to control cost, doesn't take into consideration any issues related to pre-existing conditions and catastrophic care or set defined benefits.

There are a lot of things that make the health care law attractive, from the default federal exchange to the state waiver to the subsidies.

Just saying Ryan's proposal is more progressive based on vouchers is absurd.

Now, maybe you should pay attention to your own reading comprehension.

As for "TRYING to conflate the present system with one that is not in effect," that's a perfect description of the OP.

[Armstead]

112. You know all you got is that "It could be worse under the GOP"

I don't sense a lot of positive enthusiasm in your responses for the versions of reforms that have been enacted, except it is better than the GOP's alternative.

Well, to put it bluntly, I agree that the Democrats version of HCR IS BETTER than the GOP's plan. But that is like saying our junk is better than their worse junk.

People will continue to be saddled with unaffordable insurance costs, with comparatively little control over the price. Not much better than Ryan's vouchers for those who are not yet on Medicare.

[Mimosa]

96. Some people can't stand the truth.

It's a LOOONG time before January 2014 for many sick people who can't afford insurance. :(

Kentuckian, the cartel got helped, they have been institutionalised as our 'providers' for the foreseeable future.

[Armstead]

80. Irony Alert for those who are taking this literaly

Let me amend my original headline on the OP. Irony was intended, but it was apparently lost on many people.

"Ryan's Medicare Plan is absolutely awful. But our current healthcare system is even worse for those who do not qualify for Medicare or Medicaid."

Agree or disagree. But at least know the intent, which was to compare something bad to something worse.

[ProSense]

83. Irony:

"Ryan's Medicare Plan is absolutely awful. But our current healthcare system is even worse for those who do not qualify for Medicare or Medicaid."

That's the same BS point in the OP.

[Armstead]

85. If you think my actual point is BS...That's fine. As long as you acknowledge my actual point...

...not your reflexive reaction to anything critical of Obama and the Democrats.

I have nothing against disagreement. But I at least prefer disagreement on an intellectually honest basis based on what is actually said and intended.

[Mimosa]

97. Right! Because we have NO HELP.

Not dead broke poor enough to become dependent upon the state? That's embarrassing and demeaning in itself. The ACA 2010 does nothing to help us until 2014 and even then we don't know whether there will be real help. Especially for people over 50, since age -related premiums will still be in place.

[ProSense]

106. "The ACA 2010 does nothing to help us until 2014 and

...even then we don't know whether there will be real help."

Here's an idea: Stop implementing ACA and replace it with the more "progressive" plan.

That way everyone is screwed!

[CakeGrrl]

98. A new way to slam Obama: "Even Paul Ryan's SHITTY plan is better"!

You can't cherry pick the Ryan plan and call it better than what was passed. That's a dishonest way to bash. You take it ALL or NOTHING and see if it passes Progressive muster.

[Armstead]

99. since i was not referring to his real plan, I can cherry ;pick whatever I want

On its own terms as it is, I agree with you -- it is a shitty plan.

But forget Ryan and his shitty plan to re
If three ort four years ago, someone proposed offering a modest voucher to help people with the cost of health insurance for the general population that is unrelated to Medicare, it would have been seen as radical liberal and most (not all) Democrats would have run away from it in fear as being "too far left."

This is not praise for the plan. It is noting that our health care system is already so right wing that even the proposal of a wingnut like Ryan is more in the direction of progreessive than what the Democrats have done.

As for the new HCR -- some good things, but it is SIMILAR to the Ryan plan by enshrining private insurance as the only source of coverage for most people who are under 65 or not poor enough for Medicaid...That's not very progressive either.

[mochajava666]

102. Well said

[Vattel]

104. I admire your patience.

That many posters somehow missing your point (which was very clearly stated) and yet you avoid expletives. Good job.

[craigmatic]

105. We really do need a program for all the people who don't qualify for the VA, Medicare, and Medicaid.

[and-justice-for-all]

107. I think its REGRESSIVE and not PROGRESSIVE...

any hint of privatizing Medicare/Medicaide is not my idea of being progrssive.

[Armstead]

110. You are correct....Now please re-read my post. Thank you.

[rury]

109. AWFUL OP!!

[Armstead]

111. Obviously you are not alone in your opinion

My example may have sucked, but I will stand my ground on the fact that we currently have one of the most regressive health care systems on the planet -- or at least among the so-called advanced nations.

And the current version of "reform" will take us in the wrong direction as a trade off for a few little tweaks to a bad system.