Let's talk Medicare. With Paul Ryan on the ticket, it's going to be a major topic. That's fine with me.
Medicare is Broke. It's not going broke, IT'S ALREADY THERE!!! Medicare, as it's been understood for 50 years, isn't an option. Left unchanged, Medicare will eventually consume our economy. The relevant question is not whether Medicare will change, but how it will change.
In 2010, Barack Obama signed massive changes to Medicare into law as part of his health care law. That legislation contained $700 billion in cuts to Medicare THAT ARE NOW WRITTEN INTO LAW. To oversee these cuts, Obama's Health Care Law creates a new entity, called the Independent Payment Advisory Board (IPAB). According to the New England Journal of Medicine:
Provisions of the Patient Protection and Affordable Care Act (now being referred to as the Affordable Care Act, or ACA) create an Independent Payment Advisory Board (IPAB) to meet the need to oversee health care system costs. The legislation establishes specific target growth rates for Medicare and charges the IPAB with ensuring that Medicare expenditures stay within these limits. The IPAB must also make recommendations to Congress as to how to control health care costs more generally.Translated into English, this means 15 unelected bureaucrats will ration health care from Washington D.C. without accountability to Congress or the American People. For the record, IPAB was what Sarah Palin was talking about when she referred to 'death panels.' That's Obama's vision.
Patient centered Medicare reform, by contrast, puts individual Americans in charge of their own Health Care. Instead of an unaccountable Medicare Politburo making decisions for the entire country, Washington D.C. would send the money directly to individuals. This would leave individuals free to purchase Health Care services in whatever manner they see fit. Over time, as traditional price signals return to the Health Care services market, costs will come down. Paul Ryan's budget proposal is one example of patient centered Medicare reform.
Medicare, as it was understood for 50 years, went away with Obama's health care law. It's not coming back, because WE CAN'T AFFORD IT. The relevant question now is what will replace it. We can either follow Obama's vision of unaccountable bureaucrats rationing care or we can pursue patient centered reforms along the lines of Paul Ryan's proposal. On way or the other, however, we must choose, because we can't afford the old status quo.