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March 2, 2015

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Letter to the editor:

Ryan won’t attract independent voters

The Democrats should be celebrating as much over Rep. Paul Ryan being selected as Romney’s running mate as they were when Sen. John McCain selected Sarah Palin in 2008.

This election will be decided by moderate and independent voters. Independent voters, for the most part, are not extremists in either direction. They certainly are not in the Tea Party camp, with which Ryan identifies.

Ryan’s budget will be the focal point of the campaign. Romney will have to give it his endorsement. Not only is Ryan’s budget extreme, it also is against the elderly, women and the poor and supportive of the millionaires and billionaires.

Independent voters usually push for compromise when it comes to political issues. Compromise is not in Ryan’s or the Tea Party’s vocabulary.

Romney has just given Obama’s re-election chances a big boost.

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  1. Robert Blanner, as usual, has it wrong. Independents and moderates are not monolithic, as Mr. Blanner would like to believe. Some lean left and some lean right.

    The Tea Party has been reluctant to compromise but so has the Obama administration. Ryan's budget would impact the elderly, women and the poor, along with most other Americans and the wealthy will be affected less, but that's because they are wealthy and can better deal with any changes that we do make. Many Americans are not big fans of the Ryan budget or any of the changes that must be made.... but many also realize that if we do what Obama wants to do, we will see more deficits, more debt and more borrowing and printing money.

    Romney/Ryan may lose to Obama/Biden or they may win but I suspect the election will be close. Many, on both sides are reluctant to admit it, but more and more Americans are beginning to realize that sacrifices are necessary, they are coming, they will affect the poor, women, the elderly, the wealthy... all of us... and the real question is, do we act to control these sacrifices or do we do little now and wait until the sacrifices control us.

    Obama has become like Bush in that he must certainly see the danger ahead, but because to address it will be painful and unpopular, he is unwilling to take the bold actions necessary. I gave Obama credit for going after health care with the ACA, although the execution was botched.

    I give credit to Romney/Ryan for going after the debt/deficit and entitlements, although they don't address defense/foreign aid spending properly and I do think the wealthy are going to have to pay more taxes, along with the rest of us.

    I am going to support those, like Romney/Ryan that call for bold action (which we must have) even though I disagree with part of what they call for and think they leave out important parts of what must be done. Their plan will need to be altered but it is a bold plan... that recognizes the danger ahead.


  2. This letter desribes a phoney political analysis of Paul Ryan. Ryan's Medicare plan will not touch anyone who is 55 years or older at present. They will have the same plan as everyone has right now.
    For anyone under 55, the plan would either furnish a voucher to buy health insurance in the private market or have the same coverage as exists presently. To the contrary, Obamacare when fully implemented will slash Medicare by at least 500 billion dollars. The GOP must do a good job in getting this message out there to people, so letters like this one will be ignored. Actually, Ryan is an effective and articulate spokesperson for the GOP ticket, and will attract much positive attention to the Romney ticket. People who have witnessed Paul Ryan in person have been very positively impressed by his persona and his ideas.

  3. Interesting that Ryan was a member of the Simpson-Bowles Deficit Commission but voted against its final report that, if it received enough votes, would have required an up or down vote in both houses of Congress. One can only wonder why Ryan would not accept that as a significant first step toward fiscal reform if that is his true objective. It is most likely he held out for more tax cuts for the wealthy.

  4. Iteresting too that Ryan voted against the Simpson-Bowles Commission report recommendations AND President Obama scrubbed it. What does that tell you?

    Independents voted for Obama in 2008 because of his positive message of hope and change. President did a strategic about face and has gone negative. In large part because he is a failed leader and policy maker and can't run on his record. Obama will lose the independent voters for all the above reasons.


  5. Already the left is defining the Romney-Ryan budget. Of course by saying that not only will it push your grandmother over the cliff but give her social security and medicare to the wealthy. Wrong. Anticipate that Romney-Ryan will attack the left like junk yard dogs for their contrived lies on the GOP budget. And challenge Obama/Biden to develop and present their own. Geithner was right, and spoke for all the empty Obama suits when he said, we don't have a plan but we know we don't like yours.


  6. I want to modify my above post in two respects:

    1. Under Obamacare, Obama would cut Medicare to current recipients by $716 billion to fund Obamacare.Under the Ryan plan, there would be no cut to existing seniors, and everyone 55 years and older now would receive the same benefits they now enjoy.

    2.Under Ryan's plan for Medicare, those under 55 now would be given a government Medicare subsidy
    to purchase their Medicare on a special Medicare insurance exchange.In my opinion, the details on this aspect are somewhat vague yet as to whether these subsidies over time would keep pace with healthcare insurance costs.

  7. Fact Check: "Under Obamacare, Obama would cut Medicare to current recipients by $716 billion to fund Obamacare."

    Politifact: Mostly FALSE!

    Fact Check: "Paul Ryan's budget relies on the same $700 billion in savings from Medicare that Mitt Romney and other Republicans have been attacking Democrats about. "

    Politifact: TRUE!

    Maybe HoustonJac should question the propaganda he hears from Rush Limbaugh?

  8. Paul Ryan isn't a fiscal conservative.

    "Ryan is not a "fiscal conservative." A fiscal conservative pays for the government he wants. Ryan never has. His early "Roadmap for America's Future" didn't balance the budget until the 2060s and added $60 trillion to the national debt. Ryan's revised plan, passed by the House in 2011, wouldn't reach balance until the 2030s while adding $14 trillion in debt. It adds $6 trillion in debt over the next decade alone -- yet Republicans had the chutzpah to say they wouldn't raise the debt limit!"

    The GOP remains as gullible as ever.

    The GOP mantra: Do as I say, not as I do!

    Paul Ryan personally voted to add trillions to the national debt, and yet the GOP treat him as if he's some sort of deficit hawk? What a sham!

    The reckless Bush tax cuts? Ryan financed them with debt.

    The war in Afghanistan? Ryan financed it with more debt.

    The war in Iraq. Ryan financed it with even more debt!

    The trillion-dollar Medicare Part D expansion? 100% debt!

    He voted for debt-financed bailouts, and for the debt-financed TARP, and now criticize them? What a phony!

    Now he wants to replace Medicare with CouponCare to pay for his recklessness in seven terms of Congress? The American people aren't buying it.

    Paul Ryan has ZERO credibility when it comes to the deficit and the debt. Yet his fan club fawns over the rhetoric while ignoring his record.

    Typical republicans... prop up a phony sham in place of a serious candidate. Paul Ryan is Sarah Palin without the lipstick.

    "[Paul Ryan] is not the guy you pick to win Florida. This is the guy you pick to win Fox and Friends."

  9. Why consider what the loony left says about Paul Ryan? Does you really think anyone Mitt chose would meet with favor from those who are determined to undermine the USA and our freedoms by adding to the deficit, pandering to illegals, parasites and perverts, restricting our rights and killing the unborn? They are politically insane and you don't argue with crazy people; you avoid them or lock them up. Let's just get our satisfaction come November by ridding the Oval Office of Osama Obama and his toady fellow travelers. Let's regain the USA and the stature it once represented to all the world. Vote Romney & Ryan!

  10. Ksand99,

    In truth there is no great plan out there regarding Medicare. R's should be honest and admit that under the Romney/Ryan plan, those under 55 currently will not get as good benefits as we do now and they will have to pay more for them.

    But honesty would also not be kind to President Obama. As Politifact reports, Obama's plan "makes significant reductions to Medicare Advantage, a subset of Medicare plans run by private insurers."

    As people may or may not know, traditional Medicare only covers 80 % of medical bills. My wife, who is on Medicare with a Medicare Advantage plan was in the hospital recently with what we thought might be a heart attack. She was there for about 2 hours and the bill was $ 8000. Without Medicare Advantage, her 20 % of the bill would have been $ 1600 (for 2 hrs). With it, the bill was $ 65.00.

    Those changes to Medicare Advantage will hurt seniors like my wife. Politifact also says "Hospitals, too, will be paid less if they have too many re-admissions, or if they fail to meet other new benchmarks for patient care." While more efficiency is a laudable goal, it should also be recognized that the results of this will likely include reductions in care, also potentially hurting seniors.

    I believe that President Obama and his supporters wanted to see 30 million people have access to health insurance in an expensive market that many of them could not easily afford. Subsidies would be necessary to make that happen. If he went to voters and asked them them for higher taxes to pay for this, he had no chance and he knew it. So the work around was to get the money through changes and hoped for savings in other areas. Medicare is one of those areas. I don't agree with this approach.

    I'm not a big fan of Romney/Ryan plan either but I do recognize that something must be done with Medicare. President Obama was right when he talked about 'bending the cost curve' but when he outsourced the ACA to Congress, having been in Congress himself, he should have known the lobbyists would see to it that never happened.

    If we want to fix health care, it is a single payer system or finding real ways to bring down the costs of care and insurance and that means Congress resisting the lobbyists (good luck on that). There are no other real solutions. I don't favor what they have in Canada or England but I also detest paying $ 600 a month for my crappy coverage with a $ 2500 deductible, and no dental or vision coverage.


  11. Regarding the refute above to my 716 billion slash in Medicare under Obamacare,the following comment is taken from

    "Because Medicare spending gets bigger every year, the cost-saving mechanisms in the health care law also get bigger. Also, it takes a few years for the health care law's savings mechanisms to kick in. In fact, the effects of time are the main reason the $500 billion number has turned into $700 billion."

    If you are in Medicare now, the Obama plan will cut your benefits without mercy. Believe it. Ask your doctor.Alot of independent doctors will be retiring, or going to work in hospital groups so they can still afford to continue. The future of healthcare gets beat up under Obamacare.

  12. Politifact:

    In an interview on the CBS program 60 Minutes, Mitt Romney said Obama "robbed Medicare" of $716 billion to pay for "Obamacare." We found that exaggerated what Obama had done in the health care law.

    While the health care law reduces the amount of future spending growth in Medicare, the law doesn't actually cut Medicare. Savings come from reducing money that goes to private insurers who provide Medicare Advantage programs, among other things. The money wasn't "robbed." We rated the statement Mostly False.

    Responding to the Romney attack, Obama campaign spokeswoman Stephanie Cutter said Ryan's budget relies on the same $700 billion in savings from Medicare that Mitt Romney and other Republicans have been attacking Democrats about.

    Ryan has confirmed that, and we rated it True.

    Sorry, Houstonjac. Politifact rates your claim as false. Stop repeating lies you've heard from Limbaugh and read the facts.

  13. Willard's hand-picked the tea party golden boy (Drudge says he has 7% body fat, ladies!) who thinks rape victims should be forced to carry their attacker's child to term, and who supports forcing women to undergo medically unnecessary ultrasounds! Isn't he dreamy?

    The tax returns are now the least of Romney's problems. Paul Ryan's vision of replacing Medicare with CouponCare is now front-and-center. Willard said he supported CouponCare, and offered to sign it into law. Romney-Ryan CouponCare would force seniors onto the open market, driving up costs for the rest of us, while increasing the out-of-pocket costs for those on fixed incomes.

    Forget death panels, Romney-Ryan CouponCare would bankrupt thousands of seniors nationwide.

    Tax returns? Old news. Let's talk about the choice America has in November. A return to Bush-era programs that Paul Ryan supported... like debt-funded wars, debt-funded Medicare entitlements, and debt funded stimulus and bailouts? And now GOP zombies think Paul Ryan's the answer? HE'S THE PROBLEM.

    It might help if people like Paul Ryan were booted out of Congress and shunned. Instead, he's the one the GOP turn to for "conservative" leadership. Too bad Ryan was so weak-willed and spineless during the Bush years, huh republicans?

    The GOP standard-bearer is a complete fraud.

  14. Paul Ryan's plan: hastening the demise of Medicare, according to Medicare's trustees.

    "Obama's Affordable Care Act Medicare cuts reduce how much the program pays hospitals, private insurers and other providers. The $716 billion in savings helped free up funds to pay for other health programs, like the expansion of insurance to 32 million Americans."

    "That was the primary purpose, at least. There was also a really important side effect: The health care law extended the solvency of Medicare's Trust Fund. If the program pays hospitals less, each dollar stretches a little bit further. Earlier this year, the independent Medicare Board of Trustees estimated that with these cuts the trust fund would remain solvent through 2024."

    "Without those cuts, however, the budget gets a little tighter. Medicare keeps paying providers at the same rates it does now, but each dollar buys less. And that means, according to these trustees, that the trust fund would no longer be able to cover Medicare's costs as soon as 2016."

  15. Mike, I might take your concerns about Medicare Advantage more seriously if you noted the same cuts to Medicare Advantage were a centerpiece in Paul Ryan's budget.

    If you are an insurance company providing coverage in the Medicare Advantage program, you're getting the same cut no matter who wins the election, since Romney has said he would sign Ryan's budget into law.

    If you do not keep the cuts to the wasteful program, you threaten the solvency of Medicare.

    Secondly, why in the world would someone who claims to want an efficient and inexpensive government favor Medicare Advantage? It's a huge waste of taxpayer money.

    "A Government Accountability Office (GAO) report released Wednesday by House Ways and Means Health Subcommittee Chairman Pete Stark (D-CA) found that the private insurance companies administering these plans have spent less than projected on beneficiaries, while raking in an extra $1.4 billion on top of their $35 billion in profits."

    Medicare Advantage is a failed project of Newt Gingrich's congress during the 1990s. It's less efficient than Medicare and bilks taxpayers out of billions to line the pockets of health care CEOs.

    Any actual conservative would demand it be axed immediately.


    "But are there still some out there that do not know Ryan's Medicare plan does not have one-iota affect on CURRENT seniors? It affects only those 54 YEARS OLD AND YOUNGER. And still gives them the CHOICE of regular or unleaded."

    FALSE. This is not true, especially in the case of Medicare Advantage.

    The Ryan budget, which Romney has said he would sign into law, makes an identical cut to Medicare Advantage, which would affect current seniors, including Mike's wife.

    Had the Ryan budget passed the Senate and been signed into law, the "cuts" to Medicare Advantage would have been just as fast as those in the ACA, and would have affected "CURRENT seniors."

    Seems some people don't even know the details of the plans they support! Before you sign on the dotted line, you might want to read the details, rather than mindlessly bleating and repeating what you've heard from Rush Limbaugh and Sarah Palin.

    Even Mitt Romney's suddenly running away from the radioactive Ryan plan:

    "Mitt Romney on Wednesday unequivocally rejected more than $700 billion in Medicare spending cuts proposed by his running mate, Rep. Paul Ryan of Wisconsin."

    This is, of course, after Willard said he would sign those same cuts into law.

    Gullible republicans...

  17. "R's should be honest and admit that under the Romney/Ryan plan, those under 55 currently will not get as good benefits as we do now and they will have to pay more for them."

    Mr. Casler:

    Ryan has said exactly what you said when asked. I've heard him when asked on several occasions say so.


  18. Ksand99,

    I'm not an actual conservative. I'm a moderate. All the private sector insurance companies and all the health care providers are expensive and inefficient and that's mostly because there is no real competition in either industry and they have a captive audience who MUST use their services. It's kind of like the legal system. The problem is that if you turn it all over to government, you still have the captive audience and no competition and the costs are hidden and born by the taxpayers, like in England and Canada. Of course I know Medicare Advantage is expensive and inefficient and I hate that my wife has to have her SS reduced to pay for Medicare Advantage, but Medicare only pays 80 %. If anything serious comes about, I can't afford to pay the 20 %.

    My point is that the ACA is a lousy fix for what is wrong. I give Obama credit for trying when the R's didn't do anything, but I call a spade a spade and the ACA is poor legislation.

    And yes, I am willing to admit that Ryan's plan will impact Medicare, just like the ACA will. So we have two poor choices.

    I believe Medicare cannot stay as it is. Ryan admits that, and proposes changes but isn't willing to admit that under his plan, seniors in the future will have 'premium support' that will not cover costs like today's Medicare does and they will be hit with higher out of pocket costs.

    On the other side, Obama seems unwilling to admit that his proposed fix will not be nearly enough to save the program and that if a panel decides what Medicare will and will not cover and its aim is to reduce costs, the Medicare program and what it covers will be less than it is now.... exactly the same issue Ryan's plan has.

    We need some honesty and there is precious little of it on either side.

    Bottom line for me: Americans should be told frankly that if you want Medicare to stay as it is for the future, Medicare taxes are going to have to be raised 'substantially' and often in the future. If that isn't acceptable, then we are going to have to change Medicare into something less than it currently is for future participants.

    Try listening for that honesty from eith party. All you will hear is Deafening silence!


  19. Carmine,

    I have watched Ryan and I watched him with Brit Hume. He talks about premium support and vaguely says extra will be available if needed.

    The problem now is the program covers too much and costs too much. The only ways to fix that is to cover less, reduce costs or ask the consumer to pay more. Ryan's plan will ask the consumer to pay more. I don't really blame him for soft peddling that fact because the D's will repeatedly smash him over the head with it, but it is a fact none the less and it needs to be admitted... and admitted plainly.


  20. Kepi: "I would like to thank you for ALL of your excellent comments! It is refreshing to read your posts. Thank you!"

    You're welcome. There are still some people who are willfully ignorant of the budgets, legislation and positions of the politicians they support.

    Case in point: Mike and Mark.

    They're fighting against a cut to Medicare Advantage that their own candidate for Vice President championed, and that their candidate for President said he would sign into law.

    Meanwhile, independent fact checkers have supported my assertions and rated theirs as "mostly false."

    Medicare Advantage allows eligible seniors to purchase a private health insurance plan with the taxpayers footing the bill. The entire idea of Medicare Advantage was to reduce the cost of insurance for seniors. The theory was that private insurers, due to the magic of competition and the free market, would provide services at a less-expensive rate.

    Unfortunately for the GOP, that never happened. The average Medicare Advantage per-patient cost was 117 percent of regular Medicare recipients in 2010.

    Now the "conservatives" are championing a program that wastes money and that their own budget decimates.

    It's ideology above common sense, really.

  21. Mark,

    I cannot and do not disagree with you. Taxing the wealthy is simply NOT the panacea Obama claims it is. But neither is just cutting taxes, as the R's claim.

    16 trillion in debt isn't going to be paid off by a reviving economy, by raising taxes on the wealthy or by cutting taxes everywhere. That's all a bunch of hooey.

    We will need to do the following:

    Cut some taxes to make us more competitive.

    At some point everyones taxes are going to have to rise.

    We are going to have to rewrite the income tax code and remove the ways the wealthy currently escape taxes and block the new ones that will be created. We are going to have to either tax a lot more or rework the entitlement programs and defense and foreign aid programs.

    We are going to have to really attack the waste and fraud in government.

    We are going to have to invest in alternative energy 'research' and start totally developing and utilizing our fossil fuel resources.

    We are going to have insist that every American with an income pays incomes taxes.

    That's what true honesty would be. Neither party engages in that.


  22. "And yes, I am willing to admit that Ryan's plan will impact Medicare, just like the ACA will."

    Funny... you didn't mention it earlier when you went on and on and on about how the Obama cut to Medicare Advantage would be a hardship on you.

    I wonder why...

    "I'm not an actual conservative. I am a moderate."

    And the duck says, "I AM NOT A DUCK!" yet it quacks.

    Ryan-Romney CouponCare is a disgrace and dishonors our nation's current and future senior citizens.

  23. Hey, look who's talking about Mitt Romney's taxes again!

    Paul Ryan's running mate, Mitt Romney!

    Remember how Reagan used to say "Trust, but verify?"

    Mitt's version is a little more: "Hey, just trust me! And don't ask any more questions!"

  24. Mr. Casler:

    Ryan isn't silver coating the reality. Just the opposite. He's taken on the thrid rail of entitlements when no one will. Yes, Obama-Biden will slam them on it and exaggerate the reality to the extreme. As I said Obama-Biden will say R-R will take away your grandmothers' social security and give to the rich. Romney-Ryan will hit back with the truth like junk yard attack dogs. We've kicked the can down the road for too long and have reached the point of no return. If not now, then never. And the USA, with cities and counties already Europeanesque, will be beyond fixing. That message will resonate with Americans. In fact already has. Wisconsin, Ryan's home state.


  25. Ksand99 and Kepi,

    You two do a pretty good job of criticizing the Romney/Ryan plan and it deserves some criticism. Here is a statement and a question for you:

    Medicare covers 80 %. Medicare Advantage covers most of the other 20 %. Obama's plan will really change Medicare advantage. The program is on course to go broke as it is and nothing in the Ryan or Obama plans have any chance to continue to leave Medicare as it is without it going broke. Please tell me what you two see as Obama's 'plan' to save Medicare and keep it as it is?

    I can't find one. Ryan at least partially admits that Medicare cannot stay as it is in the future and remain solvent. Obama and D's insist that it can and they will make it so, but I just see the claims and no plan. Please explain the plan to me, if you can.


  26. You really must consider the fact the Romney has a few loose screws. For almost 20 years this man ran for a politcal position challenging his opponents to show their tax records. When they did he reneged, stalled, hemmed and hawed or laughed nervously. In all of those 20 years the only forms he released was for 2010. He now acts as if his taxes should never have been an issue, which tells me he wasn't prepared. Some say his choice of Ryan was bold. Really? I think he chose Ryan because his base was about to bail, because conservatives never trusted him. Romney whines about negative ads but he spent tens of millions carpet bombing his Republican opponents to win the candidacy, and doing the same in this present campaign. Romney is a two faced wuss.

  27. "Romney whines about negative ads but he spent tens of millions carpet bombing his Republican opponents to win the candidacy, and doing the same in this present campaign. Romney is a two faced wuss."

    And Obama did what to Hilary in 2008?

    It's politics Mr. Branco. Remember what Harry S. said.


  28. Mike,

    I don't need to point to a "plan." I can point to an accomplishment. Obama's accomplishment is law. Thanks to the ACA, Medicare is more solvent today than it was in 2009. Solvency of the program was extended by years under the ACA.

    "Without the ACA, Medicare's insolvency date would be just around the corner, in 2016 -- four years from now. The 2012 Medicare Trustees' Report projects a stable solvency date of 2024, the same as last year's report."

    There are solutions to Medicare that don't involve putting our seniors' health care at risk. Lowering the cost of prescription drugs by allowing the government to negotiate prices, and/or allowing the importation of safe drugs from Canada. Speeding cheaper generic drugs to the market. Allowing younger adults to "buy-in" to Medicare at 50 or 55, supplementing the government program with younger, healthier individuals paying premiums, or even opening up the program to all as an efficient public option can put real downward pressure on escalating health care costs, and can keep Medicare solvent for decades.

  29. Ksand99

    See my post at 8:28 I continue to stand on that statement.
    ACA is not good law. It will drain our assets and dilute medical care,and availability
    Of doctors. Ask some what they think and are planning to do .signing off on this subject. Going to listen to Rush now,then Hannity. have a nice lady.

  30. What Paul Ryan doesn't want you to know about his record on women's health and equality:

    "An examination of Ryan's record reveals a congressman who, with few exceptions, has hewed to his party's far-right base on social issues. He has supported a federal ban on abortion even in the case of rape and incest, and a ban on gay adoption."

    "In January 2011, days after Republicans took over the House, Ryan co-sponsored legislation to declare that "each human life begins with fertilization," providing fetuses the same rights as a person, thereby permitting states to ban all abortion, without exceptions."

    That's right, Paul Ryan co-sponsored a federal personhood amendment.

    I should also mention Paul Ryan supports enshrining bigotry into the Constitution, and voted for a constitutional amendment banning marriage equality -- twice.

    "He also voted against repealing "don't ask, don't tell" as well as hate-crime legislation. In 1999, he voted to ban gay couples from adopting children in the District of Columbia."

    "[Paul Ryan] is not the guy you pick to win Florida. This is the guy you pick to win Fox and Friends."

  31. "See my post at 8:28 I continue to stand on that statement."

    And you will continue to be wrong. The Ryan budget, as passed, cuts Medicare Advantage, which would affect current seniors. You've provided no evidence to the contrary.

    Repeating it doesn't make it true, just makes you look misinformed and gullible.

  32. Ksand99,

    The program is still on a path to go broke and none of the things you suggested as remedies are part of the ACA, to the best of my knowledge.

    Why isn't President Obama proposing any of this? It seems like a potent campaign issue: We can save Medicare for ever by doing (insert all the things you mentioned) or you can go for the Ryan plan that changes Medicare into a premium support program.

    Can you explain what he's not saying that and running commercials to that effect?


  33. "The program is still on a path to go broke and none of the things you suggested as remedies are part of the ACA, to the best of my knowledge."

    I'll put up Medicare's continuing solvency against Romney's current talking points, which is (as of 11:30 am, Thursday August 16, 2012) to abandon the Ryan plan and forfeit the Medicare savings, which would bankrupt Medicare by the end of Romney's first term. You really can't tell what Romney actually intends to do. He's held both positions, which are contradictory.

    Medicare gone by 2024 or 2016? That's the choice.

    You've advocated for and chosen a candidate who would see it bankrupted in 2016.

    I think most/all seniors would rather it be 2024. Furthermore, small tweaks to payment formulas can be done to extend it further.

    As for detailed plans...

    A few days ago, you said that all of Mitt Romney's plans for the economy could be found at Mitt

    Kinda funny how you expect so much out of Obama, yet not of Romney, Mike. Both campaigns have been quiet on the details of their particular plans.

    Yesterday you pledged your support to Romney, yet you were unaware this morning that Romney would sign the Ryan budget into law, thus depriving you of your Medicare Advantage benefits.

    Maybe you should be asking the same of Romney.

    It's now 11:35. Did Romney change his position again?

  34. I don't know. I know quite a few women who would rather not be forced by the government to carry their rapists' babies to term, Mark.

    I certainly wouldn't wish that upon my wife, my sister or my daughters.

    Paul Ryan disagrees.

    Paul Ryan's views on women's health and equality are stuck in 1950. Female voters will have this on their minds in November.

  35. Romney-Ryan in trouble again, disrespecting the rights of musicians:

    Alternative rockers Silversun Pickups have told the Romney campaign to unhand their hit 'Panic Switch.' "We don't like people going behind our backs, using our music without asking, and we don't like the Romney campaign."

    Romney-Ryan: no respect for copyright, equal rights or women's rights.

  36. Ksand99

    Returned from paradise. You state that Medicare Advantage departs under Ryan. Are you referring from day one. If so what is your source for that. My understanding is that anyone 55 and greater now will be unaffected by the Ryan Plan. Are you saying that is not so.

  37. Kevin, you are just trying to whip life into a dead horse.

    It is Silly Season in America -- and fact is thrown over in favor of supposition and fantasy firmly believed to be truth. Most people are now just using whatever to justify their positions. Science would call this Experimental Bias -- the interpretation of "data" as confirming one's preconceived notions together with the complete disregard of anything that might cause re-examination of those preconceptions.

    The problem reasonable people have is that Mr. Romney has no visible business plan for America. Mr. Romney is supposed to have been a venture capitalist -- and v.c.s are notorious for requiring business plans. Yet he has no plan himself. Mr. Romney also made money in the private equity business -- another business in which business plans are a fundamental requirement. Yet he has no business plan for the country.

    Mr. Romney's advisers have put out is a mushy, vague "White Paper" which makes Obama look like the Business Planner In Chief by comparison.

    Mr. Ryan was supposed to be the Man With the Plan. Except now that he has joined Mr. Romney, the Ryan Plan now has a second variant. Which Mr. Romney may, or may not, endorse as his own. So, if we elect Mr. Romney President, do we get Ryan Plan A, Ryan Plan B, Ryan Plan X, or some Romney plan yet to be devised?

    And if we don't know what the final plan will be, how do we analyze whether it is good or bad? We know from the Congressional Budget Office analysis of Ryan Plan A, that Ryan Plan A will substantially INCREASE the deficit. Ryan Plan B has not had such a CBO analysis. It is hard to see how Ryan B would not end up being the worst of both worlds: increasing the deficit while decreasing the economy and thus diminishing the ability to service the increased debt -- but we have yet to hear from Mr. Romney as to what he would really do as President.

    If Mr. Romney is vague and ambiguous how can his followers be SO CERTAIN ????? Yet they are.

  38. Ksand99,

    You are more knowledgeable on the issues than most that write letters here, and I respect you for that. I find out things every day about both Obama/Biden and Romney/Ryan and I think that is good.

    You're right, both parties have been reluctant to issues details because they are both trying to win. In my opinion, most on the left, including you are far too trusting of your leaders and what they don't say. I admit to the same on the R side.

    I have great concern no matter who wins in November. I won't repeat it because you can read my letter on it, but I have said what I think needs to be done. Most of that is not addressed by either Obama/Biden or Romney/Ryan or they disagree with it.

    I don't believe the crap about Obama not being an American or the crap about R's wanting us to have dirty water or bad food. That's all nonesense in my opinion and should be ignored.

    I do however, believe that President Obama thinks we live in a very unfair and unequal society, which is true to a certain extent, and that he plans to fundamentally change that equation, using government as his tool.

    While I recognize some inequities have gotten out of whack, I also believe that in a captialist nation, some people are going to have alot, some not so much and some very little. I'm ok with that (within reason) but I don't think Barack Obama and Michele Obama are ok with that.

    They and the people that support them have every right to pursue what they think America should be like as they were freely elected. As for me, I want some of the inequities remedied and I have my doubts as to how or if the R's running will address those, but if I have to choose (and I do) between fundamental changes in our country and our society, with which I don't agree, and the other side that says we will ratchet back some of the inequities but we believe in an America with some who do very well, some who do well, some who do mediocre, and some who do poorly, I'm going to choose door number 2.

    The only successful nations that provide the kind of cradle to grave government support that I think the President envisions here are nations that are 1/100 the size of the US and have next to no immgration. Larger nations going down this path have struggled with finances, very high taxes, and low productivity. I don't think that model will be successful here and to be frank, I want the opportunity to work very hard and be very wealthy. I believe in a safety net, but not for those that don't try. I think both President Obama and his wife believe that government should help 'everyone', whether they try or not. That's not the country I grew up in and it's not the one I want to live in.

    Thanks for debating....


  39. Author, your left leanings blind you.

    The failed Obama presidency will stop at four years.

  40. Micheal,

    "As people may or may not know, traditional Medicare only covers 80 % of medical bills."

    That is 80% of the usual, customary and reasonable (UCR) fee, which is a multifaceted formula. It is usually behind the actual charges.

    This is a very positive action.

    It is also gamed by the medical community who increases their fees so they can get paid higher amounts in the future, based on the experience they create by charging more. This has been going on since the 60's. Imagine what the cost of medical care might be today if the gaming had not occurred.

    This is what caused the government to institute more controls over the decades.

    Hospital care cost control is part of the Prospective Payment System which, in a simplified manner, is a way of containing costs and increases for Medicare services.

    Readmissions are related to hospitals and insurance carriers trying to maximize profits. They discharge patient way earlier than in past decades, and contrary to safe standards. They are establishing new substandard care as standard.

    Hospital acquired infections have increased. Bacteria are more resistant to treatment once an infection is acquired, and can be life threatening more than anytime in the past.

    When I began working in patient care in a hospital, hand washing techniques were a part of nursing education and reeducation every 6 months. Everyone had to demonstrate the process to show they were doing it correctly. This resulted in much fewer infections in the patients.

    Today? No such in-service training. It is assumed everyone was trained during their education and knows the procedure. Ha!

    Doctors are the worst. Many go from patient to patient on rounds, don't properly clean their stethoscopes, don't wash hands after touching a patient. That includes some specialists in infectious disease.

    Another standard of prior care was that patients had to demonstrate they had a return of bowel function after general anesthesia. Not now. They are discharged and if they have a problem, they are readmitted.

    Another factor today is adverse effects of medications. Far more than in the past.

    So, Medicare is trying to reverse the readmissions for a variety of reasons by focusing requiring a decrease in readmission rates, by increasing better standards of care.

    Ultimately, we really need a single payer universal plan for everyone. It is the only way to get consistent cost savings and quality care, without depriving anyone of care.

  41. Bradley,

    I could agree with your proposal but you'd get little support for it from the Progressive side since it revolves around 'personal responsibility', which is something we have lost in this country. This kind of approach will not be pushed by progressives for the reasons I stated before. Conservatives won't propose it because they'd be skewered by the left.

    Ksand99 argues that the fixes of the ACA will make Medicare solvent for many years, so nothing like what you propose is necessary. I doubt that but I actually hope he is right.


  42. High risk is not so easy to prove as resulting only from lifestyle. It is a broad assumption that is used by insurance companies to deny care or make bigger profits.

    Forcing people to make changes based on cost savings for private or government entities can lead to life threatening issues for people with complex health issues, which often effect different systems.

    These are the very people who need the availability of healthcare the most.

    It may seem a good idea to people who don't understand the details of the human body's biology and physiology, diagnosing, medical tests, and treatment, plus all the complication. There are just too many issue that surround a person's health issues.

    An example: We can encourage seniors to stop smoking to reduce risk of cancer, and then find some admitted to the hospital with a heart attack soon after quitting, for reasons that result from quitting.

    We can talk about people having type 2 diabetes because of wrong diets and being overweight, but ignore the effects of changes in the way the body functions related to problems with hormones and changes in the other endocrine system, or disabilities, as well as how their is and interaction between the systems.

    We can talk about patients taking medications to treat one condition, only to have them effect another condition, like chronic kidney disease.

    Different foods can impact the body based on the medical problems that people have, sometime those that are considered healthy foods.

    These problems occur as people age and systems are effected by many factors.

    So labeling things as "high risk lifestyle" issues is an huge oversimplification.

    Now, there is also a difference from what was once a limited view to a much more aware view, and the effects are apparent resulting from a time when "lifestyles" were very different and acceptable by the general public.

    Maybe, someday in the future, all those who have been well aware of the lifestyle impact from an early age will bring about a different set of issues as they age.

    Right now, it is a different population in Medicare, who grew up in a different time, with different influences. Cutting them out of the availability of healthcare when they need it the most is immoral. Forcing some to chose between food and healthcare is not moral.

    The issues are complex, and no easy fix applies, no oversimplification can result in a good outcome.

    At best we can hope that those who received good information, based on research that wasn't available in the past, will benefit from what they have learned and practiced.

    Finally, you can do all you want about "lifestyles" and still not prevent the conditions that occur because of genetics, which are increasing, including Alzheimer's Disease and other dementia's, which will become a bigger crisis than the current issues in the future.

    Legalize voluntary euthanasia and build centers for people to die in with dignity.

  43. I just finished reading the chapter in Glenn Becks book on Ggeorge Soros . The book is Coward . If Beck is only slightly correct Soros has been a major influence since the Clinton admin in fashioning the health care system fundamentals both then and for Obamacare which could just as well be called Soros Care. To a large degree Soros has been Obama's puppet master in a number of areas. Interesting read.Soros is not characterized as having much human love and could not care less about the aches and pains of the aging population. If Soros were a truck driver running over people would be speed bumps on his way to a delivery.if there is an influence in Obama's position,Soros is your guy. You take Obamacare from there. I'll leave it there. No thanks.

  44. kepi, I will say that my career was in healthcare, from patient care to doing medical review for insurance and government programs, and alot in between, including the financial cost issues and quality care.

    I have a broad experience over decades which has allowed me to see many changes in populations, cultural changes, generational changes, and healthcare advancements and new understandings through research.

    It is interesting to see how one great new advancement can also carry other downsides, often relating to costs. They can also extend life long enough for people to develop problems that didn't come to the fore when lifetimes were shorter.

    So, the issues surrounding healthcare are not simple at all. Nor are costs, programs, savings, and taxes related to healthcare.

    I am totally convinced that the best opportunity to control costs and to make quality healthcare available to all is to have a single payer universal healthcare system.

    My point of is not based on politics, rather a lifelong integrated career in healthcare.

  45. "You state that Medicare Advantage departs under Ryan. Are you referring from day one. If so what is your source for that. My understanding is that anyone 55 and greater now will be unaffected by the Ryan Plan. Are you saying that is not so."

    The source for that is the Ryan budget which passed the House. The source for that is Paul Ryan, who admitted it today when he said it was part of his baseline assumptions.

    To wit:

    "On Thursday, Ryan tried to square the circle with reporters, explaining that he tried to reverse the cuts by voting to repeal the Affordable Care Act, but restored them in his own budgets anyway."

    As for when they would take effect, Ryan's budget was to take effect fiscal 2012. on "Ryan's Budget Spin:"
    "A GOP document defending Ryan's plan wrongly claims that the budget "does not cut Medicaid" and that it "spends more on Medicaid each year than it does the previous year." That's false. Ryan's own projections call for slashing Medicaid below this year's spending level for years to come."

    You're confusing Ryan's CouponCare plan, which would supposedly only affect those under 55 with his budget plan to cut Medicare Advantage, which had no such limitation.

    Pro-tip: You may want to know your candidate's position before attacking Obama, ESPECIALLY when the positions are identical. Makes it look like you're punching yourself in the face, repeatedly.

  46. Bob Jack, sounds like the equivalent to the John Birch Societies efforts with the book "None Dare Call It Treason", in the 60's.

    I don't recommend this kind of garbage to anyone, no matter what side one is on.

    It is just ultra right wing fanatic propaganda. I know having been a John Bircher at the time.

  47. "Kevin, you are just trying to whip life into a dead horse."

    Tell me about it. I'm trying to have a fact-based argument here, but I'm left refuting poorly-produced Youtube clips and tumblr blogs, the weapons of choice of the geniuses on the right.

    I thought tumblr was strictly a domain for teenaged girls. What do I know?

    The mind of the modern conservative...

    Fact check: Medicare cuts rhetoric

    It's just that the famously "wonky" budget pro Paul Ryan doesn't know what a "cut" is.

  48. Bradley,

    I will agree that some D's would support that but in my opinion, most would not. There are simply too many people on the Progressive side that for whatever reason don't believe people who make bad choices should be made to suffer the consequences of those bad choices, which is exactly what you and Dennis are proposing.

    I would support what you propose and so would many on the Conservative side, although not all.


  49. Remember when Willard "forgot" to disclose his Swiss bank account?

    "Among the assets omitted is a Swiss bank account in Ann Romney's blind trust that campaign officials said held $3 million of the couple's money until it was closed in 2010."

    AND just like the top of the ticket...

    "While being vetted by Mitt Romney's campaign, GOP vice presidential hopeful Rep. Paul Ryan amended two years of his financial disclosure statements to add an income-producing trust worth between $1 million and $5 million that he had previously neglected to report."

    Now we have an idea why Romney-Ryan's keeping the details of their bundlers secret!

    "In campaign finance reports filed Friday with the Federal Election Commission, the Romney campaign left blank the space where it was supposed to list the employers of two of its newest lobbyist bundlers, writing instead "information requested per best efforts.""

    Nothing to see here, folks. Ignore my tax returns too! Just... trust me!

  50. Peacelily,

    In some ways, a singlr payer system would be superior to what we have, especially for self employed people like me who must buy their insurnace as indivduals on the open market and pay full freight for it. That said, in some ways, our system is superior to the systems in Canada and Great Britain and this opionion isn't just idle talk by me. I personally know people from Canada and Great Britain who were in those systems but now live here and they can and do certainly tell me what was not good in those systems and what they much prefer about our health care system.

    I would prefer to fix our system but with the lobbyists buying our Congress, I don't see that happening, so we may get single payer in the end.


  51. Peacelilly

    I am not a Glenn beck enthusiast. I make an exception for his books which are well researched and well written. This chapter on Soros from Becks book Coward is worth the read.

  52. kepi: "I don't know who you think you are mocking or making angry; so I will go back and check."

    Ditto. That kind of trolling behavior is easily spotted and easily ignored.

    Everybody has a boogeyman. George Soros is the boogeyman for Glenn Beck, while the Koch brothers are the boogeymen for Ed Schultz. Anyone who believes the wild conspiracies of either needs a good long break out here in the real world.

    I used to laugh when Beck would go off on one of his long, elaborate exposes using puppets. Yes, Glenn Beck would play with puppets on his TV show.

    A grown man who plays with dolls. Hero to so many on the right...

    Is it a pop-up book?

  53. "I make an exception for his books which are well researched and well written. This chapter on Soros from Becks book Coward is worth the read."

    Do you also read Jerome Corsi, Andy Martin and Ann Coulter?

    May I suggest John Perkins "Hoodwinked", "The Secret History of the American Empire" and John Dean's "Conservatives Without Conscience"

  54. "I have read the swill and flat-out craziness the libs have thrown at this and if they are that worked up then R & R have my vote."

    Not: "I have carefully considered the issues, researched the candidates positions and weighed them against my own," but, "I'm voting out of my hatred of liberals!"

    A+ logic on that one, Heretic. Clearly your IQ is much higher than everyone else's! Great use of that gargantuan brain!

    Voters vote based on issues like the Romney-Ryan plan to replace Medicare with CouponCare, or Paul Ryan's sponsorship of the federal personhood amendment, or his opposition to birth control.

    Voters vote based on the tax plans of the candidates, whether those plans support the middle class, like Obama's plan, or would reduce Romney's personal tax burden to nil, as Ryan's tax plan would.

    Even though you think I "can't pass the IQ test of rational thought and understanding," I do understand the fundamentals. Seems you may not, though.

    But by all means, vote based out of spite. That definitely proves your intellectual superiority!

  55. "I doubt your voting record has any R's in it."

    You would be wrong, again, but I won't stop you. Obviously, with your advanced IQ, you can glean my entire voting history by reading a few website comments. Quite a handy skill!

    Meanwhile, Paul Ryan loves to whine about the stimulus program THAT HE VOTED FOR, so it should come as a shock to his supporters that behind the scenes, he was BEGGING for stimulus cash!

    "On Tuesday, the Boston Globe and Associated Press reported on documents showing that GOP Vice Presidential candidate Paul Ryan had secured more than $20 million in stimulus funds for a local energy efficiency organization."

    Oh? Paul Ryan's personal Solyndra?

    "According to the reports, the documents showed that Ryan also brought in $5.4 million for local bus services. His requests came at the same time he was publicly calling the stimulus a "wasteful spending spree."

    "However, in an interview with a local Ohio television news station, Ryan claimed he never secured funding through the program, saying "I never asked for stimulus.""

    Read PDF after PDF of Paul Ryan begging for stimulus windfalls:

    Yup, he's the LEADER of the GOP... telling the public one thing while desperate for the cash behind closed doors.

  56. Those attempting to get someone that writes letters to the Sun to change their party loyalty is nearly impossible if not impossible. I just try to point out the flaws in both sides and all candidates.

    Take me as an example, I favor R's because what they say on the economy is closer to what I believe than what the D's say. R's often don't do what they say and that irritates me. What D's say and do irritates me .

    Unless it can be proven that Romney 'cheated on his taxes', I don't care about that issue.

    It's clear to me that we either raise taxes alot on everybody so we can really afford to pay for what government spends or we cut government in places alot of us are not going to like, be that in defense or entitlements.

    We cannot afford to keep piling up debt, yet all the budgets offered so far do exactly that, just to different degrees and in different areas.


  57. "In an interview on the CBS program 60 Minutes, Mitt Romney said Obama "robbed Medicare" of $716 billion to pay for "Obamacare." We found that exaggerated what Obama had done in the health care law."

    Obama's ACA [aka Obamacare] is based on a reduction in Medicare growth over 10 years which will result in savings {$716B] that is funneled into Obamacare to pay for it. In Washington parlance a reduction in growth is called a cut. That cut comes from lower costs, reduced services, fewer recipients and/or a combination of all the above. CBO and Medicare trustees forecast that these cuts will gut the Medicare program and cause doctors and providers to turn away Medicare recipients. Let's have the debate. Bring it on. 83 days until the election and alot of ground and details to cover.


  58. Michael,

    I know people in Canada and the UK and in other countries who have the opposite experience of those you know, so it is subjective. Sometimes considerably.

    That said, the US is a leader in cancer care, and only cancer care.

    However, based on what I known in my career, most cases were better than here as far as the welfare of the patient was concerned.

    Based on my knowledge and experience, I still believe that a single payer universal healthcare plan is necessary.


    One of my points is that you are relating an ideal that is hitting at a difficult time, since common knowledge of lifestyle risks were not the same 50 and 60 years ago, as they are now.

    The populations are different. Habits are different. The current understanding will be beneficial to those who did have the knowledge and chose to follow it, versus those who chose not to follow it.

    For those already in the over 65 group, it is tough going retrospective, without causing hardship that wasn't foreseen before some of the damage was already done.

    It must be recognized how much our generational cultures have changed, as well as the social differences that have had mixed messages along the way.

    Each of us has to look beyond our own beliefs to try to understand others and a variety of influences.

    Who is going to be the "lifestyle police"? How will you base the determination of the underlying cause now and who is guilty of what?

    It takes much deeper thinking to understand the many issues that surround the presumed simple question.

    I think we need to stand back from the political views, and see ourselves as in a marriage that is a life commitment, for better or worse. That may not be popular in a time when marriage can be more like changing shoes, but it is still a good way to see things.

    We are a nation as a whole, when it comes to looking as services and policies, while difficult, we need to look at the whole, not the politics and partisanship. You can't vote on party in and forget about the other part of the nation.

    That is why we need to look more holistically at many things, and try to find ways to build union based on facts and human values.

    You cannot write off one generation because a younger one has a different view and doesn't want to pay for the other...just an example.

    It just isn't that simple if we are going to be a nation.

    If we cannot be one nation, then we need to create different countries and allow people to choose where they will live.

    The solution to all our problems doesn't lie in Social Security, Medicare, Medicaid alone. It doesn't lie in raising taxes on the wealthy alone. Another complex problem.

  59. Today's RJ had a super front page article about the "recovery" by Paul Wiseman of the AP.

    I couldn't locate a link on the RJ website, so found the article online in another newspaper. I post it here because I think it is worth reading.

    To me it shows how the partisan politics does such a disservice to the American voter. We need to understand all the things that are interrelated to create the problem, and why there is no just and simple formula for a solution.

    It will take a good deal of serious non-partisan experts to arrive at some reasonable solutions that will necessarily need compromises for the common good of the nation.

  60. There are a good many doctors in other countries who can make up the difference for American doctors not wanting to accept a change in their profit margins.

    Requirements for licensing ensure their qualifications and also can include additional training here.

    Even without such high incomes as current physicians, it is still attractive for them to come here.

    There are also a good number of American physicians who will not abandon patients in need. They are the ones who went into medicine to serve people rather than profit from them.

    New forms of practice may evolve that help to reduce costs, but much has already been done in preventing doctors from running their own in office labs, pharmacies and more over the years.

    Conflict of interest have been a focus for a long time in controlling healthcare costs. Doctors objected and still do with the arguments that they couldn't afford to practice medicine, but they are still do. Same with malpractice insurance, and any number of reductions that dealt with abuse by medical practitioners.

    Fraud has been an increasing focus, and with success in getting money back to the Medicare fund and penalizing the perpetrators.

    The biggest problem related to doctors leaving in the past and now is that they have nowhere else to go, since the feared "socialized" medicine spread like a wildfire...except in the US.

    So, let the doctors quit practice and find another profession, or retire. There will be others to take up the stethoscope, or to replace them, and happily.

    It is time for the golden goose to become Sunday dinner.

  61. I must say that there are many wonderful committed physicians in our country, and they are the ones who should be honored, and rightfully so.

    Many patients know the difference between them, and healthcare personnel certainly do.

  62. I'm independent, to a fault I've been told. AND I'm for Romney and Ryan. Lived in Wisconsin for a time and saw what the Socialists did to Milwaukee. The Republicans want to shore up Medicare and SS. Medicaid might take a hit and it should. Do the math: a trillion a year in welfare programs is $10,000 per taxpayer. Unsustainable. (335 mill or so Americans, 225 mill or so adults, less 110 million taking social welfare, less 100 million retired and/or paying next to nothing = 100 million taxpayers.

  63. OK so the 110 mil on social welfare and the 100 million retired and/or paying little are often the same people.

  64. "I question your posting and you say "a few". Is 5,275 posts "a few"?? This clearly explains the Liberal mindset."

    Well I didn't know I had a fan club who read every post I've ever written in the 5 years I've been a member of this community! Like Paul Ryan, I'll tell you one thing, but behind closed doors I might be consulting a lawyer for a restraining order. But... yay! You have a huge IQ... AND you can count? Yet you're basing your vote on spite, rather than the issues...

    I love the "But I'm an independent" schtick they always pull. Sure, that's what they say... but when they step in the voting booth, they pull the lever for Sharron Angle.

    They claim Paul Ryan is a fiscal conservative when his record reveals he's a total fraud. Bailouts, stimulus, wars and massive entitlement expansions... all debt-funded and approved by Paul Ryan.

    They accuse Obama of wanting to cut Medicare Advantage, yet Paul Ryan's own budget called for the same cuts to the program... and Mitt Romney swore to sign the budget, with those same cuts, into law.

    Now: it turns out while Paul Ryan was telling Fox News viewers and conservatives that the stimulus was a waste of money, he was secretly begging for stimulus cash for his district.

    At what point will these people realize Paul Ryan is a complete and total fraud?

  65. I am happy I have some real insight to offer, kepi.

  66. For any interested, Medicare Advantage (Part C), and Medicare's prescription drug program (Part D) are optional, just as Part B (physician and outpatient services) is. Patient's have a choice as to participation, and within those parts, what kind of participation.

    Medicare(Part A), the inpatient hospital coverage of Medicare, is mandatory. So when a politician says that Medicare will be the same, they could mean a variety of things, but only one thing is certain, Medicare Part A.

    Most people don't understand the differences and are able to be fooled into believing no changes will occur, when in fact, that is not necessarily true.

    I would like to add some information about the payment of outpatient services under Part B. The 80% that Medicare pays is as I said based on the UCR rate. A physician who participates in Medicare and agrees to accept the UCR rate must accept that rate for "covered services", and cannot bill the patient for the charges in excess of the UCR rate.

    However, if the physician provides a service that is not covered, the patient pays full price.

    Also, if the physician doesn't agree to the contract with Medicare as a participating provider who accepts the UCR rate, they are allowed to collect any amount above the UCR rate that they charge, including the 20% copay.

    A physician who doesn't accept Medicare patients cannot treat Medicare patients. This doesn't give an incentive for doctors to not accept Medicare patients.

    If a patient is covered on a Medicare Advantage Part C plan, they can go to a Medicare participating physician, who isn't a member of the plan and pay more. However, they cannot go to one who doesn't participate in Medicare at all, even if they are willing to pay full fee in any of the Medicare plans.

    If a physician doesn't accept Medicare patients and makes an exception, the physician would be breaking the law in treating them. It is a Catch-22 of the Medicare program to ensure that doctor populations are not reduced for people on Medicare.

    That can be a disadvantage depending on the patient's needs. But many people on Medicare cannot afford otherwise under Part B and C and more so for those in Part C.

    Medicare Part C, or Medicare Advantage, has many different plans with many different premiums and benefits. They can be different in different states. Patients have to decide what they can afford between what is offered in their area. Not all are equal in many respects.

    For those who meet the poverty level requirements, Medicaid can assist in paying the premium. This is cheaper for the state than having to put the patients on Medicaid because they can't afford to pay the premiums.

    I wonder how many people who can easily afford to pay their own costs for physicians, outpatient services, and drugs, or pay for private insurance, also participate in Medicare Parts B or C, and D so they can save money. That could also contribute to the rising costs of Medicare.

  67. "prior post was a "oops"


    The joke writes itself, folks.

  68. TEA,

    There is no United Nations International Health Organization. That right off the bat shows these figures are suspect.

    Also, I could not find the article you referred to in the conservative Investors Business Daily.

    If you can provide the direct source link to both the IBD article with these statistics & references, and the UN International Health Organization data analysis, it would be helpful in validating the authenticity of these figures.

    I have serious doubts as to the accuracy and sources of these statistics. I have experience in statistical data collection and analysis in healthcare. I have seen reliable source documents comparing multiple countries, that would contradict what you presented.

    I can also tell you that there can be very logical reasons for differences that are based on appropriate care and services. I know things about each of those categories that explain the differences, and do not reflect negatively on Canada or the UK.

    Also, the statistics are very general and that would not give an accurate understanding of the issues. The do not look very professional as reported.

    It appears to be another right wing attempt to make people think what you want them to think, rather than real life reliable statistical data analysis.

    There is alot of information needed to understand how these statistic were arrived at, and by who. What was the population from which the data was collected? What methodology did they use? What was the real source of the data and analysis? When was it collected? What other statistics were included? How many data sources were needed to get this information? What formulas were used to determine the percentages? And many more questions.

    I can't help asking all this since you began by quoting a non-existent source.

  69. Bradley,

    ""PeaceLily", you believe that people are too old, or too set in their ways to make positive changes in their own healthcare."

    Wrong, I do believe in making positive changes, but not everyone fits into the same shoe size, has the same resources, or opportunities, or finances to do all that is necessary. There are realistic reasons why we cannot put everyone into one basket. If we could there would be much more equality than exists in our country.

    You are to be commended on your efforts to reform your ways, but I think you are also rigid and intolerant in your approach toward others.

    However, I can't condemn you, I can only see you as one individual with a point of view. I have another based on my experience and knowledge.

    I have no partisan influence in my views on healthcare. They are strictly based on my experience and knowledge. Although, I do have a view of people being very different and with various different influences in their lives that explain, rather than excuse, why they are as they are.

    We can work to help people change through education and support, by understanding them as individuals, rather than authoritarian form of condemnation and dictates. Everyone can do that in many facets of life. It is something that can bring people closer together.

    Flexibility in life can be very beneficial in encouraging others to work for change.

    Black and white stands are often shortsighted because we live in a world of colors, hues, tones, textures, and more in life and issues pertaining to our world. If not, it would be a world I wouldn't want to live in.

    Everything isn't about partisanship, Bradley. My concerns are about people above all else. People are more important than money or politics. If there is a problem, we need to really think about people first in seeking the best solutions possible. That requires many considerations, facts, realities to understand the breadth and depth of a problem.

    A sock it to them or guillotine approach is one that I find lacking in respect for people.

    This is just my view, Bradley, and I still respect you for yours, even if I disagree with them.