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What others say: Stop the 'Mediscare'

Published: Thursday, Dec. 29 2011 12:00 a.m. MST

In this April 13, 2011 file photo, House Budget Committee Chairman, Rep. Paul Ryan, R-Wis. gestures during a news conference on Capitol Hill in Washington.

Associated Press

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The following editorial appeared recently in the Chicago Tribune:

What was the biggest political lie of 2011? Lots of competition there.

But recently Politifact, the St. Petersburg Times' fact-checking website, declared its winner: the claim by congressional Democrats that House Budget Committee Chairman Paul Ryan's budget plan would "end Medicare."

Ryan's innovative proposal kept Medicare intact for people 55 or older, Politifact noted, "but dramatically changed the program for everyone else by privatizing it and providing government subsidies."

The big Mediscare lie worked; Ryan's plan didn't clear the Congress.

Too bad. Ryan visited the Chicago Tribune editorial board earlier this year, and we liked his fresh thinking about how to avert the oncoming fiscal train wreck for Medicare.

Recently, Ryan and Democratic Sen. Ron Wyden of Oregon introduced a new plan — think of it as Ryan's now-familiar philosophy, Version 2.0 — to tame Medicare costs while maintaining quality health care for seniors. There's much in this for lawmakers of both parties, if only they'll give it a chance.

The congressional duo is telling Americans the truth: Medicare's current fiscal trajectory is unsustainable. Too many baby boomer seniors. Too much limitless fee-for-service spending. Too little cost control.

Some Democratic pols have greeted anything from Ryan with the usual Mediscare fear-mongering: That the plan will bounce Granny out of Medicare as she knows it. That it will cut benefits and raise premiums.

Credit Wyden and Ryan for braving decades of Mediscare attacks to produce a thoughtful and dramatic overhaul of system. Here's how it would work:

The feds would create a "premium support" plan, which means the government would give seniors a certain amount of money to buy health coverage, either from traditional Medicare or from private insurers who would compete with it. Poorer seniors would get more money; richer seniors less. No one would be denied coverage.

Competition would make consumers more cost-conscious and restrain prices. There is evidence that this would work. Check out what happened with the Medicare drug benefit that started in 2006. Private drug plans compete for seniors' business, and that keeps prices — and government outlays — much lower than projected.

And what if it didn't work? The Ryan-Wyden plan would cap Medicare spending, based on inflation and the rise in the gross domestic product. If Medicare exceeded that cap, the law would target that overspending: It might trigger cuts in payments to providers, such as doctors or drug companies, or possibly boost premiums for affluent beneficiaries.

We're skeptical about how — and if — the cap would work, in part because the plan is sketchy on that point. Then there's political reality: Congress never will be eager to cut Medicare payments. Note how lawmakers have tried and failed for almost a decade to enforce a Medicare physician fee cut.

Ryan and Wyden promise more details on how their plan would work. Bring them on.

In the meantime, let's all credit these lawmakers for thinking big. They've demonstrated that bipartisan agreement is possible on a Medicare overhaul. We'd say it is essential.

The longer some politicians resort to Mediscare, the harder it will be to rescue Medicare.

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