By Samuel Metz, M.D.
The Oregonian, May 24, 2011
Robin Hood was legendary for stealing from the rich and giving to the poor. Now Rep. Paul Ryan proposes to do the opposite: He will rob poor seniors of their health care dollars and give tax breaks to the rich.
Rep. Ryan’s gallantly titled “Path to Prosperity” proposal will convert government Medicare spending to a lump-sum voucher program. This looks like a heck of a deal if you are rich enough to pay for your family’s current health care (and rich enough to pay for your own when you are old, gray, retired and living on a fixed income). But if you already struggle to pay your health insurance premiums (presuming you are lucky enough to have coverage at all) and have no money left to pay for deductibles, co-pays, excluded conditions and medications, Sherwood Forest starts to look like your best retirement home.
Ryan’s proposal is so simple that even the Sheriff of Nottingham would envy it. By reducing federal spending on the health care needs of our seniors, well, we reduce federal spending. What’s not to love about that?
If you’re not among the privileged nobility, there’s a lot not to like. Remember that even under current Medicare rules, seniors who need health care (roughly all of them) pay 40 percent of their health care expenses with out-of-pocket dollars. Under the Sheriff of Nottingham plan — sorry, Ryan’s “Path to Prosperity” plan –seniors in the year 2030 (that’s all of us who are at least 48 years old) will pay half our total incomes on health insurance premiums. The other half will pay for deductibles, co-pays, excluded conditions and medications.
And where will we get money to pay for food, rent, heat and clothes? The way the poor burghers in old Nottingham did: We won’t.
Even the purchase of a policy won’t guarantee health care. There’s nothing in the “Path to Prosperity” that requires an insurance company to offer anything other than a one-page statement, “This is a health insurance policy.” If that’s all you can buy for your lump sum, you might as well use the policy for compost. The Center for Economic Policy and Research estimates that under this plan, our soon-to-be starving, homeless, freezing, dressed-in-rags seniors will cough up an extra $20 trillion of their own money to get health care in the next 75 years. We better start selling our chickens at yard sales right now.
The Sheriff of Nottingham would be insanely jealous of this revolutionary plan. Tax the poor and give them no services? Spare yourself and other wealthy nobles any taxes at all? Brilliant!
But when the sheriff celebrates his 65th birthday, he might find himself roasting hot dogs around the campfire with Friar Tuck, Little John and Robin if he wants to get health care.
Samuel Metz, an anesthesiologist who lives in Portland, is a member of Mad As Hell Doctors and the Portland chapter of Physicians for a National Health Program.
http://www.oregonlive.com/opinion/index.ssf/2011/05/the_sheriff_of_nottingham_ride.html