To the editor: Michael Hiltzik addresses House Speaker Paul Ryan's (R-Wis.) "solution" for senior healthcare — namely, privatization with limited federal voucher subsidy. It's the same old Republican vision that lifting the reins on free-market competition will make things better for everyone. ("Paul Ryan is determined to gut Medicare. This time he might succeed," Nov. 23)
But don't forget that the big insurers can play ball with each other. The thing is, government programs are driven by collective conscience, while private programs are driven by the goal of making as much money as possible. Under privatization, I shudder to think about the terrible healthcare options that low-income seniors might wind up with in the affordable premium range — a box of Band-Aids and a pamphlet on pain management.
The only real way to help Medicare serve an aging population may be to raise Medicare tax rates on income in, for example, the top 25%.
Ken Hense, El Segundo
To the editor: If we revise and replace the Affordable Care Act, the provisions of the law that affect Medicare will need to be addressed.
Contrary to Hiltzik's assertion, Medicare is going broke. It is now estimated that the hospital fund will be insolvent in 2028, two years earlier than last year's estimate.
It is also true that one-third of all enrollees in Medicare opt for Medicare Advantage. They do so to take advantage of lower costs and better healthcare. Compared with fee-for-service, Medicare Advantage enrollees experience lower rates of hospital admission and readmission and stay in the hospital for fewer days.
Hiltzik also states that the Independent Payment Advisory Board has not been created. In fact, it was created as part of the Affordable Care Act. The fact that there has not been anybody named to the board is a problem, since the Health and Human Services secretary gets to assume too much power without a board.
If our objective is to provide access to quality, affordable healthcare, expansion of Medicare Advantage programs is more likely to get us there than any single-payer plan.
Kevin Minihan, Los Angeles