Most infamous of those bureaucratic denial-of-care mechanisms is the so-called Independent Payment Advisory Board (IPAB), a board of 15 bureaucrats who can set reimbursement rates and exclude particular treatments and cures from Medicare coverage altogether to bring overall Medicare spending in-line with the cap. And IPAB’s dictates cannot be overturned even by Congress unless it musters a supermajority, a constitutionally-questionable scheme to insulate IPAB from democratic accountability. Hospitals are protected from IPAB cuts until 2020, meaning the initial cuts will hit doctors and nursing homes even harder, forcing fewer and fewer to accept Medicare patients.
Ryan’s plan, on the other hand, would continue to provide benefit levels similar to what Medicare offers now, and achieve cost containment not through bureaucratic control but through individual choice and competition. Workers who are presently 55 or younger (there are no changes for current retirees or those near retirement, unlike Obama’s plan) would, when they qualify for Medicare, receive a benefit equal to the cost of traditional Medicare in the market in which they live. They would have the choice of using that benefit amount – known in this plan as “premium support” – to stay in traditional Medicare or opt instead for private plans that would be required to offer coverage that is no worse than the traditional program.
A group of Harvard researchers analyzed this plan, developed by Ryan with Democratic Senator Ron Wyden of Oregon, and found that if it had been in effect in 2009 it would have saved 9 percent with no reduction in care.
So the real question is not whether Medicare will be cut. It must be, will be, and already has been. The question is how it will be cut: bureaucratic denial-of-care or individual choice? Voters who understand what’s at stake will overwhelmingly favor the Ryan plan.
Phil Kerpen is president of American Commitment, a columnist on Fox News Opinion, chairman of the Internet Freedom Coalition, and author of the 2011 book Democracy Denied.
American Commitment is dedicated to restoring and protecting America’s core commitment to free markets, economic growth, Constitutionally-limited government, property rights, and individual freedom.
Washingtonian magazine named Mr. Kerpen to their "Guest List" in 2008 and The Hill newspaper named Mr. Kerpen a "Top Grassroots Lobbyist" in 2011.
Mr. Kerpen's op-eds have run in newspapers across the country and he is a frequent radio and television commentator on economic growth issues.
Prior to joining American Commitment, Mr. Kerpen served as vice president for policy at Americans for Prosperity. Mr. Kerpen has also previously worked as an analyst and researcher for the Free Enterprise Fund, the Club for Growth, and the Cato Institute.
A native of Brooklyn, N.Y., Mr. Kerpen currently resides in Washington, D.C. with his wife Joanna and their daughter Lilly.