Years ago when I worked at the Nebraska Department of Insurance and we had a choice about whether to try to make a new health care law work or try to undo it and not implement it. We chose the first course.
The law was Medicare, which was created in the 1960s because millions of elderly Americans couldn't get good enough health coverage from the private market. From Day One, in spite of opposition, we tried to make Medicare work.
We've seen Medicare become the lifeline for health insurance for millions of Americans. In our state today, Medicare affords 230,000 Nebraskans longer and more vital lives.
Lately, there's been a lot of talk about Medicare that's focused not so much on care but on cost. Nebraskans I talk to understand that to cut our national debt, we have to tackle health care spending, including Medicare.
Two approaches have emerged, with the first one reforming how Medicare pays for care in the new health reform law, and the second by changing who pays for seniors' health insurance in a plan by House Budget Chairman Paul Ryan.
The Ryan plan would turn Medicare into a voucher program and end Medicare as we know it.
The Ryan plan sets up a new system where seniors pick plans offered by private insurance companies. The government would pay "premium support" payments to the insurance companies, not to seniors.
This voucher plan transfers most of seniors' health care costs from the federal government to the patient. The non-partisan Congressional Budget Office said seniors "would pay more for their health care than if they participated in traditional Medicare."
The Ryan plan also cuts services to seniors by eliminating new wellness checkups--which more than 1,700 Nebraskans have already received--and free cancer screenings. It gets rid of new prescription drug coverage which would have 28,000 Nebraska seniors paying $16 million more for medications next year alone. These provisions save lives and reduce health care costs.
I think there's a better way for Nebraska seniors. The existing law cuts government spending by getting rid of Medicare Advantage overpayments. It reduces future Medicare payment increases to hospitals because the government will pay less for the uninsured. They cost insured taxpayers $57 billion a year for the free care they receive at hospitals when they show up sick.
It saves money by changing how Medicare reimburses health care providers so it doesn't reward them for running lots of tests. Instead, it rewards quality--good care. Medicare also will save money by moving away from paper records toward electronic records, which will deliver more cost-efficient and better care.
The Senate voted down the Ryan plan but there are those who will still push hard for it. Just as I did years ago, I'm going to support ways to make Medicare better and less expensive, not undo it.