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Medicare: The facts

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Tuesday, Aug. 28, 2012 9:20 PM

The Obama campaign is trying to peg Mitt Romney and Paul Ryan as the guys who will “end Medicare as we know it,” and make seniors pay thousands more for health care. The Romney campaign is trying to paint President Barack Obama as the one who is “raiding Medicare,” and cutting benefits for current seniors. The reality is that both campaigns propose cutting the growth in future Medicare spending. Each is trying to scare seniors about the other’s campaign’s plan. Medicare has major financial challenges. As the population gets older, and medical costs continue to rise at current rates, Medicare cannot pay for all the benefits currently promised without an eventual tax increase, more federal borrowing, or both. What would happen if Congress chooses not to raise payroll taxes, or take some other action, and allows the hospital insurance trust fund to run dry on schedule? There’s little doubt that seniors would suffer. If the trust fund runs dry, the trustees state, “beneficiary access to health care services would rapidly be curtailed.” The trustees estimate the payroll tax at current rates “would cover only 87 percent of estimated expenditures in 2024 and 67 percent in 2050.” The candidates disagree strongly on how to reign in Medicare costs, but both have proposed cutting — or, if you’d rather, “saving” — money from the future growth of Medicare spending.

President Obama and Romney have the same goal, but use differing strategies. The Obama administration aims to trim $716 billion in the future growth of Medicare spending over the next 10 years, largely by reducing the growth of payments to hospitals and others under that Part A umbrella. The Romney-Ryan plan offers a choice of private plans similar to the Medicare Advantage plan. The exchange and subsidies Romney proposed are similar to the exchanges and subsidies provided for younger workers in Obama’s Affordable Care Act.

Cutting Medicare spending isn’t an easy proposition for either side. “There are not any magic answers out there,” says Marilyn Moon, senior vice president at the nonpartisan American Institutes for Research. Unless the President and Congress finds a way to deliver more care at the same or better price, she says, “somebody is hurt. It’s either the beneficiaries, the taxpayer or the provider.” Each side is accusing the other of saddling seniors with higher costs and reduced coverage.

Actually, neither campaign’s plan changes Medicare for current beneficiaries very much. When Republicans talk about seniors losing benefits under the health care law, they’re normally referring to that change in Medicare Advantage. When Democrats talk about seniors losing benefits, or paying more for prescriptions, under the Romney-Ryan plan, they’re referring to the GOP-proposed repeal of the improved benefits contained in the ACA. Romney wrongly claims that “money you paid” for Medicare is being siphoned off to pay for Obama’s health care law. The new law doesn’t take a dime out of the hospital insurance trust fund, which is already being drained because current benefits exceed current payroll taxes. Romney is actually referring mainly to future reductions in the growth of payments to hospitals, not to taxes paid by workers in the past. The evidence is inconclusive that Ryan’s market-based approach will work either better or worse than Obama’s regulation-based system. The claim that the Republican approach would “end Medicare” is blatantly false. The claim that it would lead to higher costs for seniors is possible, but unproven. “It’s very interesting trying to get any credible information with all the smoke being blown,” said Wilensky, who was head of Medicare under Bush, “which is too bad because these are very serious issues.”

Source: http://factcheck.org/2012/08/a-campaign-full-of-mediscare/

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