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A COMPARISON OF NATIONAL MEDICARE PLAN FEATURES BETWEEN THOSE CONSTRUCTED BY THE OBAMA ADMINISTRATION AND CONGRESSMAN PAUL RYAN. THE CHOICES ARE DISTINGUISHED BY CRITICAL DIFFERENCES IN PHILOSOPHY, ECONOMIC STRUCTURE AND IMPACT, AND HOW CITIZENS WILL BE AFFECTED WELL INTO THE FUTURE.
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TOPIC OUTLINE
OVERVIEW / BACKGROUND
OBAMACARE vs PAUL RYAN‟s-PTP - -
Very Different Competing HC visions
THE ECONOMIC REALITY
The National Problem is SPENDING ; ENTITLEMENTS
are a root factor.
THE MEDICAL REALITY
MEDICARE is on an UNSUSTAINABLE FISCAL PATH
PRESIDENT OBAMA‟S PLAN ELEMENTS
PAUL RYAN‟S PLAN ELEMENTS
AMERICAN HERITAGE FOR
INDIVIDUAL RESPONSIBILITY
CONCLUSIONS
A Pivotal Choice
TODAY: A TALE OF 2 PLANS FOR AMERICAN HEALTHCARE
1. PRES. OBAMA‟s PLAN
(PPACA) :
BIGGER GOV‟T IS THE ANSWER. JUST LEAVE IT TO US.
2. PAUL RYAN‟S PLAN
(PR -PTP):
BIG GOV‟T IS THE PROBLEM. WE MUST GET BACK TO OUR HERITAGE OF FREE MARKET ENERGY, CITIZEN CHOICE AND INDIVIDUAL RESPONSIBILITY.
BUT ALSO: A TOUCHY POLITICAL OVERLAY
THESIS:
Competing HC visions offer gov‟t decision-making vscitizen decision-making.
PPACA vs PR-PTP offer fundamental differences in addressing cost growth, HC access and impact on the Nation‟s debt.
HEALTHCARE - SUMMARY OVERVIEW
Paul Ryan has offered
an INTEGRATED
Budget plan including
putting HC on a solid,
long term basis by
reining in TOTAL
Gov‟t deficit.
His “PR-PTP” Budget
was passed by the
U.S. House on April
14, 2011 and tackles
the “hot potato” :
RUNAWAY
ENTITLEMENTS.
IT IS NOT WITHOUT
POLITICAL RISK.
PR-PTP Paul „s integrated approach is unique and supported by many serious HC Analysts. In contrast, President
Obama „s plan has been belittled by many economists.
PROVIDING HEALTH AND RETIREMENT SECURITY - -
PR-PTP ensures universal access to health
insurance; and it rescues and strengthens Medicare,
Medicaid, and Social Security – by making them
permanently solvent.
LIFTING THE DEBT BURDEN - -
It returns Federal spending growth to sustainable
rates, and lifts the huge debt burden from the
shoulders of future generations.
PROMOTING AMERICAN JOB CREATION AND
COMPETITIVENESS - -
It promotes solid, sustained economic growth and job
creation here in America, and puts the United States
in a position to lead – not merely survive – in the global
marketplace. The plan also modernizes job training
programs to meet the effects of globalization.
Reforms should be gauged by 2 Key Criteria:
• Create or destroy jobs?
Squeeze benefits or fundamentally address cost growth?
NOTE: Job growth is pivotal to providing resources for progress.
An historical Roadmap exists to show the way: Gingrich bipartisan effort of the 1990‟s Ref: “Roadmap for America’s Future Act of 2010” (H.R. 4529), 111th Congress,
introduced by Representative Paul Ryan (R–WI)
TOPIC OUTLINE
OVERVIEW / BACKGROUND
OBAMACARE vs PAUL RYAN‟s-PTP - -
Very Different Competing HC visions
THE ECONOMIC REALITY
The National Problem is SPENDING ; ENTITLEMENTS
are a root factor.
THE MEDICAL REALITY
MEDICARE is on an UNSUSTAINABLE FISCAL PATH
PRESIDENT OBAMA‟S PLAN ELEMENTS
PAUL RYAN‟S PLAN ELEMENTS
AMERICAN HERITAGE FOR
INDIVIDUAL RESPONSIBILITY
CONCLUSIONS
A Pivotal Choice
The National
Deficit
Problem is
SPENDING ,
NOT LACK OF
TAXES.
Here‟s a 60
year snapshot
to compare
the two.
ENTITLEMENTS
ARE A ROOT
FACTOR
PARTICULARLY
IN THE
PROJECTED
DEFICIT SIZE .
IGNORING THE
PROBLEM WILL
RESULT IN
ENTITLEMENTS
GOBBLING UP
EVERY TAX $ .
MEDICARE IS A
BIG FACTOR IN
THIS TRIO.
The National
DEBT
continues to
grow and will
significantly
escalate in the
current
decade.
ENTITLEMENTS
WILL IMPOSE
AN ADDED
AVERAGE
FAMILY
HOUSEHOLD
TAX OF MORE
THAN $12,600.
RELATIVE TO A
HOUSEHOLD
TODAY ( after
adjustment for
inflation).
BENDING THE
CURVE:
THE OBAMA
SPENDING
PLAN
ALTHOUGH
CAREFUL NOT
TO CAUSE
WAVES PRIOR
TO 2012, THEN
ACCELERATES.
IN CONTRAST,
PR-PTP
SHOWS A
ROADMAP FOR
PROGRESS.
PR-PTP IS A BROAD INTEGRATED PLAN.
TOPIC OUTLINE
OVERVIEW / BACKGROUND
OBAMACARE vs PAUL RYAN‟s-PTP - -
Very Different Competing HC visions
THE ECONOMIC REALITY
The National Problem is SPENDING ; ENTITLEMENTS
are a root factor.
THE MEDICAL REALITY
MEDICARE is on an UNSUSTAINABLE FISCAL PATH
PRESIDENT OBAMA‟S PLAN ELEMENTS
PAUL RYAN‟S PLAN ELEMENTS
AMERICAN HERITAGE FOR
INDIVIDUAL RESPONSIBILITY
CONCLUSIONS
A Pivotal Choice
President Obama and the Democrats passed and signed the Patient Protection and Affordable Care Act of 2010 (PPACA).
Conservatives and the GOP have deep misgivings about PPACA and would like to see much of it changed along the lines of Paul Ryan‟s proposals in PR-PTP.
Democrat Leaders
have demonized PR-
PTP. House Speaker
Nancy Pelosi (D–CA)
charged that the plan
“ends Medicare as
we know it.”
But there is, of course, a central intellectual
deficiency in this attack: MEDICARE IS
ALREADY: PROJECTED TO END
“AS WE KNOW IT.”
IT‟S ENDING BY SELF IMPLOSION. Resisting
rational reform will NOT change that
- - it will simply worsen the problem.
SOME MEDICARE REFORM ISSUES
FORECASTS
BASED ON
THE
CURRENT
MEDICARE
ECONOMIC
STRUCTURE
IS WHAT IS
“ENDING
MEDICARE
AS WE
KNOW IT”.
EVEN ZERO’ING DEFENSE SPENDING WON’T SAVE MEDICARE
BUT
PPACA
WILL
THROW
MORE
OIL ON
THE
FIRE.
PART 1
CUTS TO MEDICARE PROVIDERS HAVE CONSEQUENCES
BUT
PPACA
WILL
THROW
MORE
OIL ON
THE
FIRE.
PART 2
HEALTH PROVIDER “COST SHIFTING”
BUT
PPACA
WILL
THROW
MORE
OIL ON
THE
FIRE.
PART 3
NOW,
LET’S
LOOK
AT PAUL
RYAN’S
PR-PTP
PLAN
PART 1
DEFINED BENEFIT VS DEFINED CONTRIBUTION PLANS
PR-PTP
FEATURES
ARE BUILT
ON COMP-
ETITION
AND
CITIZEN
CHOICE
PART 2
GOV’T HEALTHCARE MORE EFFICIENT ?
GOV’T HEALTHCARE MORE EFFICIENT ? NO !
NOW,
LET’S
LOOK
AT PAUL
RYAN’S
PR-PTP
PLAN
PART 3
NOW,
LET’S
LOOK
AT
PAUL
RYAN’S
PR-PTP
PLAN
PART 4
“GOP HAS SET ITS OWN TRAP”,
by DICK MORRIS, TheHill.com, May 11, 2011
“Medicare has only gone up by 16 percent since Obama took office. Medicaid, food stamps, unemployment compensation, Section 8 housing, AFDC and other welfare entitlements have risen by 54 percent. Regular discretionary domestic spending has risen by 41 percent. By directing the nation's attention to Medicare -- as opposed to these other programs -- the House Republicans have totally played into Obama's hands.”
BUT POLITICAL RISK IS ALSO AN ISSUE !
TOPIC OUTLINE
OVERVIEW / BACKGROUND
OBAMACARE vs PAUL RYAN‟s-PTP - -
Very Different Competing HC visions
THE ECONOMIC REALITY
The National Problem is SPENDING ; ENTITLEMENTS
are a root factor.
THE MEDICAL REALITY
MEDICARE is on an UNSUSTAINABLE FISCAL PATH
PRESIDENT OBAMA‟S PLAN ELEMENTS
PAUL RYAN‟S PLAN ELEMENTS
AMERICAN HERITAGE FOR
INDIVIDUAL RESPONSIBILITY
CONCLUSIONS
A Pivotal Choice
BUT HISTORY IS
IMPORTANT !
The central issue in the American health care debate is whether spending should be controlled :
• By moving toward a free
market, relying on competition
to secure value for money and
economic efficiencies.
VS
• By the imposition of various
restrictions on the supply of
medical goods and services
through a centralized gov‟tand its machinery.
HEALTHCARE - PRESERVING OUR HERITAGE: LOW TAXES
As James Capretta, a former OMB Associate Director, explains:
“Efforts to control costs from the top down have always devolved into price setting and across-the-board payment-rate reductions, which is detrimental to the quality of American medicine.
Price controls drive out willing suppliers of services, after which the only way to balance supply and demand is with waiting lists”.
HEALTHCARE - PRESERVING OUR HERITAGE: LIMITED GOV’T
TOPIC OUTLINE
OVERVIEW / BACKGROUND
OBAMACARE vs PAUL RYAN‟s-PTP - -
Very Different Competing HC visions
THE ECONOMIC REALITY
The National Problem is SPENDING ; ENTITLEMENTS
are a root factor.
THE MEDICAL REALITY
MEDICARE is on an UNSUSTAINABLE FISCAL PATH
PRESIDENT OBAMA‟S PLAN ELEMENTS
PAUL RYAN‟S PLAN ELEMENTS
AMERICAN HERITAGE FOR
INDIVIDUAL RESPONSIBILITY
CONCLUSIONS
A Pivotal Choice
HEALTHCARE - CONCLUSIONS
CRITICS OF REP. PAUL RYAN‟S FISCAL ROADMAP HAVE FAILED TO
OFFER A COMPARABLE ALTERNATIVE. THE FACTS ARE THESE:
A. PR-PTP IS THE ONLY PLAN TO REFORM AMERICA‟S
ENTITLEMENT PROGRAMS, TRANSFORM THE FINANCING AND
DELIVERY OF AMERICANS‟ HEALTH CARE, REDUCE THE DEFICIT,
ESTABLISH EQUITY AND EFFICIENCY IN THE TAX TREATMENT OF
HEALTH INSURANCE, IMPROVE THE PROVISION OF HEALTH CARE
FOR MIDDLE-CLASS AND LOW-INCOME FAMILIES - - AND PRESERVE
AMERICA‟S HERITAGE OF COST CONTROL BY CONSUMER CHOICE.
B. PR-PTP IS THE ONLY COMPREHENSIVE, INTEGRATED, PRO-
GROWTH SOLUTION IN THE NATIONAL ARENA TO RESTORE FISCAL
RESPONSIBILITY AT THE FEDERAL GOVERNMENT , CREATE JOBS ,
AND IMPROVE THE FINANCIAL FUTURE OF OUR CHILDREN AND
GRANDCHILDREN.
BUT POLITICAL RISK (per Dick Morris) IS ALSO A FACTOR.
THE END
ACTUALLY, IT‟S NOT THE END - - YOUR VOICE IS IMPORTANT TO OUR NATION. CITIZEN INTEREST, DIALOG AND DATA ARE CRITICAL TO GOOD CIVIC OUTCOMES. AND THAT INCLUDES OUTCOMES WHICH SIMPLY ASSURE PROPER CONDITIONS FOR THE FREE MARKET TO WORK.
