Re "A budget to reshape the nation," Aug. 14
Does anyone remember why Medicare was created? In the "good old days" before Medicare, older people could not buy health insurance after they retired. Insurance companies would not sell to them, as most people have a preexisting condition by the time they reach 65. The elderly are bad for profits. A voucher system will not change this fact.
Medicare is the most effective and efficient insurance we have. Let's not mess with success.
Catherine G. Burke
Rep. Paul D. Ryan's (R-Wis.) budget plan will not balance the budget for at least another 28 years. The heart of his plan appears to be a reworking of Medicare, but his changes wouldn't apply to anyone older than 55. Why wait?
If we are going to balance the budget, reduce the debt and get this country moving again, we should end Medicare today. Let's tell Ryan not to waste time.
Re "Ryan plan to change Medicare is flawed," Column, Aug. 14
David Lazarus repeats all of the familiar liberal refrains about Medicare in his attack on the Ryan plan: Yes, Medicare is too expensive and unsustainable, but we shouldn't fix it without higher taxes on the wealthy, which simple math proves wouldn't fix anything.
The primary strength of the Ryan plan is that it would incentivize people to do what would really make a difference: take better care of themselves. It would help restore the concept of personal responsibility, which has been gradually replaced by a destructive entitlement mentality.
Until benefits are accompanied by an expectation of responsibility, the problems of Medicare will only get worse.
I respect Stanford business professor Alain Enthoven and believe that incentives are necessary for states to contain healthcare costs. I also agree that our present health system gets a failing grade. But his assertion in Lazarus' column that "Medicaid has become a great big game by states to get more and more money from the federal government" couldn't be further from the truth here in California.
Our Medi-Cal program, with reimbursement rates among the lowest in the country and efficient use of hospital services and drugs and other cost-cutting methods, is one of the cheapest health deals around.
Simply slashing the already lean Medicaid program is shortsighted. At the end of the day, protecting the healthcare of our most vulnerable citizens must be our long-term goal. This is a mission, not a game.
Howard A. Kahn
The writer is chief executive of the L.A. Care Health Plan.
Lazarus' last sentence on "ending Medicare as we know it" says it all: "And I'm not sure that's an improvement."
Really? Would a better choice be to let Medicare go broke and have everyone lose?
Unless the Senate gets a Republican majority, Ryan's plan is just a start to creating a Medicare program that everyone can live with.
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