I doubt if anyone wants to really learn about the Ryan plan... but just in case somebody actually wants to know something..

"Last time around, it was Ryan’s Medicare proposal that got the most attention—and, over time, that caused Republicans the most political grief. Instead of preserving the traditional government insurance program, Ryan had proposed that, starting ten years from now, the government would give seniors vouchers with which they could buy private coverage. He promised to keep the old program in place, for seniors who were already on it, and he promised to regulate the private market so that all seniors could still get coverage. But, over time, the value of the voucher would likely have diminished relative to the cost of medical care—producing the huge budget savings Ryan wanted, in part to pay for tax cuts, but also leaving seniors exposed to much larger medical bills. The Congressional Budget Office determined that, by 2022, the typical senior 65-year-old be responsible for two-thirds of his or her medical costs.

Ryan has stepped away from that plan, although not by as much as you may have heard. He’s still calling for turning Medicare into a voucher program that would not make the same guarantees of benefits, for example. The difference is that traditional Medicare would remain as an option for seniors, even beyond the next decade. He also envisions the voucher growing a little more rapidly. That, combined with newly revised projects that suggest the cost of health care is growing less rapidly than anticipated, would likely give seniors more protection than the first Ryan budget did. In these respects, it's similar to the bipartisan Medicare framework Ryan put together with Senator Ron Wyden, the Democrat from Oregon.

But Ryan's new plan would still leave seniors more vulnerable than they are now—and more vulnerable they'd be even under Obama's latest, most aggressive proposal for cutting Medicare cuts. Chief among the reasons: Even the new Ryan vouchers wouldn't guarantee access to a set of benefits. If costs rise faster than the value of the vouchers, as they very well might, seniors would have to make up the difference themselves.

Still, it’s not the Medicare population that takes the biggest hit this time. It's the Medicaid population. For starters—and this was the very first thing Ryan mentioned at his press conference—Ryan would repeal the coverage expansions of the Affordable Care Act. This is old news, I know. But few people seem to appreciate the impact. Take away the Affordable Care Act and you take away insurance from the 30 million people who are supposed to have it come 2014, when the law goes into full effect. About half of them are supposed to get that coverage from Medicaid.

Now throw in Ryan’s proposal to convert Medicaid into a block grant, under which the federal government would no longer guarantee insurance coverage for everybody that meets eligibility standards. Instead, the government would simply write checks to the states, for predetermined amounts, and let them figure out how best to spend the money. To generate the savings his budget needs, he’d reduce the value of those grants over time, relative to health care costs and current projections.

"Ryan claims that, given the freedom to innovate, states will find more efficient ways to stretch their dollars. But Medicaid already costs less, apples to apples, than private health insurance. And even to the extent states could find new efficiencies—and I'm willing to believe that at least some could—those wouldn’t be enough to replace the dollars Ryan wants to take out of the Medicaid system. Ryan proposes to reduce the program’s funding by more than $800 billion over the next decade, above and beyond the reduction that comes with repealing the Affordable Care Act. According to the Center on Budget, the result would be funding 22 percent below what it is now. (See figure at left.) And the cut would grow over time. “Another way to look at it,” says Edwin Park, of the Center on Budget, is that “in 2040, measured as a percentage of the economy, Medicaid/CHIP spending will be half the levels they are today—when there is no coverage expansion and not taking into account aging of the population and rising health care costs.”

Altogether, the CBO says, spending on Medicaid, the Children’s Health Insurance Program, and subsidies for private insurance would be nearly 75 percent lower in 2050 than projected under current law. (See figure below, from the CBO report.) Let that sink in for a minute: Ryan wants to reduce the government’s investment in helping people get health insurance by three-quarters. It’s impossible to know exactly how such a cut would play out, at least right now, but when the Kaiser Family Foundation asked the Urban Institute to project the impact of last year’s block grant proposal, it determined that between 14 and 27 million people would lose insurance.

Could such a proposal ever get through Congress? Probably not. Those numbers are as fantastical as the one on discretionary spending. But Ryan's willingness to endorse such plans says something. As Ed Kilgore and Ezra Klein observe, the decision to shift the burden of cuts so that the poor feel relatively more of them is no accident. The Republican base these days is disproportionately white and old, which means it’s more willing to tolerate cut to programs that seem mostly to benefit non-white, non-old people. In fact, left-wing polemics about Ryan’s insensitivity to the poor—like the one you are reading, for example—may not bother the base that much."

Jonathan Cohn: The Stunning Immorality Of Paul Ryan

My suggestion is that if you REALLY want to know things, read and not the political slanted crap.....because you guys that come on here and make false claims make yourselves look silly !

You have to read it all and keep it in context. The sites are slanted and bias and there you will only have what your party wants you to have

AND remember NOTHING is perfect but if the lying and backroom stuff stops things can get done

Can you elaborate? :kiss:

[quote=eweissenbach;512319]You stereotype a lot lately. You don't know what tens of millions of people read, listen to, believe, think, or how they mark their ballot all alone in that little booth.

Maybe An Awful Reason
 

My decision is based on a simple set of reasons, really. President Obama has proven a terribly weak leader and a total failure at leading or manipulating or in any way achieving progress within the Congress. That's an amazing statement when he had the majority for two years of his three and one-half in office. Yes, I know the Republicans blocked much of what he wanted to do because his party didn't have a cloture-proof majority in the Senate. But other presidents accomplished far more with less political "ammunition" than Obama had for at least half his first term.

With that as background, I have reached the conclusion that the bitter hatred for Obama by the Republicans will not abate if he wins a second term, but will probably even worsen. A dysfunctional Congress will become even more bitterly divided, very likely dragging the U.S. population with them to the far right and far left sides of social and fiscal ideology. The newfound ability of moneyed interests to continue the negative/attack ad advertising campaign enabled by the Citizens United Supreme Court decision could very well continue well beyond the actual election of a president and new Congress. Maybe it's an overstatement, but our very culture potentially could be threatened.

Romney is a new face, one who has proven to have some capability to navigate in a hostile political atmosphere. While he claims to be a far right conservative, much of his personal and political history says otherwise. I would be hopeful that like many politicians before him, he is saying what he thinks is necessary to appeal to enough voters to get elected, particularly those on the far right fringe of the Republican Party. There is some evidence of that in his rather dramatic and surprising change of positions on important issues. If he is elected, I would hope he would quickly veer towards moderation, while attempting to pull both the far left and far right more towards the middle with him to govern the country.

The situation in our national government can't get much worse than it is now, although I think it might if President Obama is re-elected. The GOP can almost certainly not be successful enough to gain the key cloture-proof majority in the Senate. So in the worse case scenario, if Romney proves to be yet another weak leader the Democrats would still have to political power, even as a minority in the Senate, to block whatever ultra-conservative legislative agenda the GOP might attempt to push thru the Congress, even if they had the majority in both houses. The situation would be very similar to what happened to Newt Gingrich's "Contract with America". He was successful in pushing a huge number of bills thru the House, most of which died an inglorious death in the Senate because the majority GOP in the Senate couldn't declare cloture.

I'll admit that's a pretty awful reason for voting for a candidate for president. But I'm afraid another four years with Barack Obama in the White House may do more damage to the country than Romney and even a majority GOP in both houses could possibly accomplish. In the worse case scenario, we'll have another chance to elect someone possibly more capable and inclined to lead in 2016.

Buggy, I hope that explains why I've concluded as I have. You may not agree, but I hope it provides a better background when I begin or enter discussions of issues here.

Fatal
 

Thanks for posting this, Bucco. It presents some statistics that people who just blindly embrace the Ryan proposal almost certainly don't know.

And it matches my own personal experience with healthcare premiums. A long, long time ago the bank I worked for in Chicago announced that it would generously and finally fund the healthcare insurance for retirees with monthly additions to their retirement payments amounting to $300 per month. The bank would then stop paying the retiree healthcare premiums, avoiding the future risk of increasing preiums from the insurance companies. At the time, the monthly premiums were about $175. It sounded like a generous offer at the time. The premiums increased to more than that amount within 3-4 years. By the time I retired early, I was paying over $1,000 a month until I turned 65 and qualified for Medicare. And now I pay a multiple of that amount for a supplemental policy.

The Ryan voucher program is a terrible idea. I hope enough people read enough to realize that rather than just voting the way their partisan "soundbite-makers" or the political attack ads tell them to. But even if they don't I can't imagine that this plan will ever see the light of day in a Congress concentrated on re-election. A voucher program really would be a politically-fatal "third rail".

Now let the criticisms of the "left leaning Congressional Budget Office" begin.

Let me preface my remarks with the fact that some folks continue to ignore the limits of nature. It may feel good but it is beyond the government's reach to provide everything to everybody. Secondly Obama gained support of Pharma and the health care providers because he promised them a big payout in the form of 100% participation in his plan that would eventually become a single payer plan.

Certainly there is not a perfect plan but the existing health care system with some modification was very doable. Instead Obama chose to throw out the baby with the bath water as he did with some of his other pet projects. In his haste to control he ignored the nations priorities and we are all suffering for it.

There have been sound suggestions by a number of learned people in how to handle our healthcare system without radical changes.

I believe it was Ddoug who p;ointed out in an earlier post that the real impetus of this plan will roll out in 2014. Hmmm after the election...wonder why?

The CBO has already found that a number of projected estimates are already shown to be well understated.

ObamaCare will be a disaster. We need to keep the present system and modify it to be more workable. a final thought there continues to be a shortage of doctors, especially primary care doctors exacerbated by an aging population needing more care. Just what do you think will happen with a claim of providing serivces to so many? Rationing will occur and guess what old timers when they do their quality valuations whee on the totem pole do you think we will sit?

No criticism here....non partisan issue for me. Important and Ryan had the guts to profer something to publicly discuss, although it will never BE DISCUSSED.

The voucher system is not as bad as you make it...certainly no worse than the Obamacare method of paying...BUT, it needs work and discussion.

I will not jump on anyone case for getting something out there to be considered. It was done in the light of day and you and others have a chance to critique. Cannot say that about the current bill.

Not perfect...absolutely !

On this forum, it has been dismissed out of hand by those who wish gridlock. I posted it, warts and all, because getting tired of the misinformed posting things that are just not true.

Not Endorsing, But No Alternative
 

Bucco and Rubicon, I'm certainly not embracing ObamaCare, far from it. On numerous occasions here I've referred to it as a "Rube Goldberg bill". It was the product of virtually everyone getting what they wanted included in the bill. As was widely reported the day after the Affordable Healthcare Act was passed, "the champagne corks were popping on K Street".

What I am against is throwing the bill out, either by repealing it as Romney says he'll do or by Supreme Court decision tomorrow, without having a well thought out and debated comprehensive alternative. The Republicans want it repealed. Several states' attorneys general sued to have all or part of it thrown out because of expense being shifted to the states. That's the case the Supreme Court will decide tomorrow.

But even with the groundswell of people saying they don't like the program, NO ONE HAS PROPOSED A LEGITIMATE, WELL THOUGHT OUT, INTERNALLY CONSISTENT ALTERNATIVE!

There's no question that our healthcare system is inefficient, ineffective and unaffordable. That was the reason for ObamaCare in the first place. So someone tell me how throwing it out or having the Court throw out important parts if it without any kind of reasonable alternative is good for the country? Either will be great political fodder, but after whatever happens, we will still be left with the same problem, the same unsustainable situation the existed before the bill was passed a couple years ago. And a Congress who has little or no prospect of agreeing with one another enough to come up with a replacement!

Politricians are nothing more than our enablers
 

VK: Why do people continue to speak of our present system being inefficient ,ineffective and unaffordable. Compared to what? We have a health care system now that provides for the majority of Americans, a system that is innovative and can well equip doctors and hospitals all over the country. we have people from every country in the world traveling
here for specialized care.

The so called uninsured can and do find care when needed.

My daughter coordinates care via a very famous hospital in New York for children up to the age of 6. Ask her about the countless number of poor and not so poor families whose children get special care on the taxpayers dime. And I'm speaking of care in the hundreds of millions.

As I stated in a previous post here we do not need a new system of health care we just need a tune up on the present system.

When someone talks of our present system being broken they have bit on the usual political bait and the pols continue to reel them in.

Look for those magic political words that keep taxpayers/voters off guard "fair" "compassion", etc because what it all adds up to is give me more money and more power. When is it going to stop? It will not stop until taxpayeres/voters wise up and face the fact that politicians are their enablers .

A few comments....first of all, I read recently and sorry no link as I do not recall where, that the WH has been working on back up plans. Good for them if that is the case.

WHAT A WONDERFUL opportunity for our legislators to get back some respect. THIS TIME, lets do what we were told would be done...lets discuss it in public for all to hear. I know this is NOT going to happen, but nice thought anyway.

I would think the SCOTUS is smart enough to know what is happening and the import of this to many people, thus I see no big panic scene being created no matter how they decide, but if our government gets a second chance at this and blows it again...WOW. COSTS, TORT REFORM, HOW WE PAY FOR IT....

From rubicons post: ..."We need to keep the present system and modify it to be more workable."

During the Obama care ram it through and we will read it later days....this was suggested several times without ever being addressed. Now why would that be?

The system, with it's flaws has been doing the job long before the Clintons. Remember it was Hillary's top priority. Anybody remember why it never flew?

The much more practical approach to fixing the broken parts of an already working system that everybody was familiar with would at least leave us all with what we know. The Obama care, git er done bill is still being defined. The costs are still unknown, but even Obama's budget gang used to say it would cost way more than projected. Funny how that cry from within has mysteriously gone silent.

The old adage of the devil you know is much better than the one you don't. And for all those who continue to rail about how much better off we are already....why? Because some kids can stay on the policy? Because pre existing conditions are not a problem? Because they filled in a little piece of the donut hole?

These can all be estimated as to their cost. The cost of these pied piper bread crumbs will be lost in the rounding of the costs of the pieces of the bill (of goods sold!) that go into effect in 2014.

Just another political charade that the majority by the way were against.....and most recent polls still show a majority against.
Never mind that noise...it is just we the people expressing what we did not want......and see what impact that had on Obama's crowning achievement!

btk

Comparisons
 

Compared to what? Compared to virtually every other developed country in the world. There are numerous studies done each year by international, non-partisan, unimpeachable sources.

Inefficient? Now understand that I'm talking about our entire healthcare system, not just Medicare/Medicaid. U.S. healthcare cost are now about 17% of GDP and growing both consistently and dramatically. Some estimate that our healthcare costs will consume 25% of GDP by 2050. Healthcare costs are rising far faster than the incomes of U.S. citizens. That's the very definition of inefficiency.

Ineffective? There are certain things that U.S. healthcare does very well. We are at the cutting edge of cancer treatment and certain specialized surgeries. But the overall health of Americans lags that of many developed countries. We are more obese. Our life expectancy is among the worst of the developed countries. U.S. infant mortality rates are also in the lower third of developed countries. Much of those results may be due to the fact that around 30% of our population has no healthcare insurance. We are the only developed country that does not have healthcare insurance programs covering all of their citizens. ObamaCare did mandate coverage for the vast majority of Americans, but as you know that may be reversed as the result of either legal decision or political action.

Unaffordable? We spend more than double on healthcare than the next most expensive developed country, almost $7,600 per year for every single American. And I noted above, we don 't get results that are as good. Healthcare costs have been rising at about 10% a year in recent years, while personal incomes have been flat to down. Again, if that continues, it's the definition of unaffordable.

As further background, I'd recommend reading the following paper authored by two very knowledgeable and non-partisan researchers under the sponsorship of The Urban Institute.

http://www.urban.org/uploadedpdf/411...re_quality.pdf

The researchers referenced in the above post in connection with a study they did, indeed are writing for The Urban Institute.

I see no reference to either one of them claiming to be nonpartisan politically (I'm assuming that's your "nonpartisan" reference).

I'm just wondering how you came to the conclusion they they were.

Not a big bone of contention, but just curiosity.

You can go off on a righteous fit if you want, but this is an honest question.

Two Reasons
 

A combination of two things. From its beginnings about fifty years ago, the Urban Institute has prided itself on being non-partisan. I'm not aware that the quality of their research has ever been criticized for serving one position, ideology or another.

In the mid-1960s, President Johnson saw the need for independent nonpartisan analysis of the problems facing America's cities and their residents. The President created a blue-ribbon commission of civic leaders who recommended chartering a center to do that work. In 1968, the Urban Institute became that center. Since then, their research subjects have broadened considerably, taking on a far broader and more international flavor.

When I was working, I actually had the opportunity to participate on a nationwide study of urban renewal. The participants reflected a broad group of elected officials, public officials as well as architects, developers, investors and bankers serving the real estate industry. (I was invited to participate as a banker.) So I know first hand of both the quality and independence of their research.

The other reason for my conclusion regarding their independence was simply reading the article. There is no suggestion of a partisan position in either the author's choice of research sources or the conclusions they reached.

And he didn't even need the SEALS. What a man!