And Laura D'Andrea Tyson Is Not a Niallist: She Still Believes That the Facts About Medicare Matter a Lot
When formulating public policy, evidence should be accorded more weight than ideology, and facts should matter more than shibboleths. The Romney-Ryan plan for Medicare reform depends on assertions that are ideologically consistent. But the Republicans plan is not supported by the evidence and does not survive serious scrutiny. Perhaps that’s why the Romney campaign has been deliberately misrepresenting President Obama’s Medicare record….
[ACA] reforms to slow the growth of Medicare spending… include both voluntary and mandatory changes in how providers deliver health care to promote better care coordination at lower cost, reward the quality and outcomes of services rather than their volume and reduce fraud and abuse…. [T]he creation of accountable-care organizations…. Health experts believe that these organizations will significantly improve care and lower costs… based on evidence, not ideology. Medicare beneficiaries will also benefit from reforms that penalize hospitals for preventable re-admissions….
Romney and… Ryan have promised to repeal the Affordable Care Act and with it the reforms behind the $716 billion in Medicare savings (although Mr. Ryan duplicitously counts the savings from these reforms in his deficit-reduction plan). Medicare beneficiaries would be the losers….
In contrast, the last major health legislation, the 2003 Medicare prescription drug bill, added about $400 billion to the 10-year deficit. Mr. Ryan, the self-described deficit firebrand, supported this bill, without a single dollar in savings or additional revenue to offset its costs. Now Mr. Ryan has espoused – and Governor Romney has embraced — a proposal to transform Medicare… while cutting taxes, especially for high-income earners, and slashing spending on Medicare and other government programs…. There is no evidence that such a system would control Medicare spending more effectively than the current Medicare program strengthened by Affordable Care Act reforms. Indeed, the evidence points decisively in the opposite direction….
Advocates… argue that competition would encourage more cost-sensitive behavior by beneficiaries, providers and insurers. The facts do not support this…. [P]rivate insurance premiums per enrollee for comparable coverage have increased more rapidly than Medicare spending per enrollee for more than 30 years. Medicare’s superior performance is all the more remarkable since its elderly beneficiaries include a sizable share of the sickest individuals who are the largest consumers of health care services. And Medicare’s cost advantage is likely to continue into the future….
[T]he C.B.O. has concluded that replacing traditional Medicare with competition among such plans would drive up total health-care spending per Medicare beneficiary…. A voucher system would do little to control the growth of health care costs, but it would shift their burden onto Medicare beneficiaries in the form of higher premiums and reduced care. Cost-shifting should not be confused with cost containment….
A “serious” deficit hawk committed to saving and strengthening Medicare, not one whose primary goals are repealing health-care reform and cutting taxes for the wealthy, would base his Medicare plan on the evidence. Mr. Ryan and his running mate can’t be serious.