GOP Docs Have Unique Stake in Ryan as Veep

By  //  August 30, 2012

Healthcare Policy

(VIDEO from HouseBudgetCommittee) Note: House Budget Committee Chairman, Representative Paul Ryan questions Medicare’s Chief Actuary, Thomas Foster on the effectiveness of premium support.

EDITOR’S NOTE: The Republican National Convention wraps up tonight.  So far it has been two full days of very compelling oratory by some of the brightest stars in the GOP speaking to the American people with a passion, determination and urgency never before seen, and certainly presenting a stark contrast to the reserved, relatively mundane GOP message of 2008.

GOP 2012 Pres/VP ticket, Mitt Romney (0n right) and Paul Ryan. (Image by

 In his acceptance speech tonight, Mitt Romney is expected to urge the American people to abandon the path they set the country on four years ago, accentuating the disconcerting present “state of the union” and President Obama’s failed economic and foreign policy record, and embrace his vision for the future, which, in response to concern about increases in the federal debt and deficit, includes reducing federal spending on entitlement programs, including Medicare.

One of the most frequently discussed proposals to address Medicare’s fiscal future and sustainability would transform Medicare from its existing defined benefit program, in which  beneficiaries are guaranteed coverage for a fixed set of benefits, to a defined contribution or “premium support” program, in which beneficiaries are guaranteed a fixed federal payment to help cover their health care expenses. 

In the MedPageToday article excerpted below, two physician congressmen and the president of the American Academy of Family Physicians (AAFP) weigh in on GOP Vice Presidential nominee Paul Ryan’s proposal to address the escalating cost of and threatened sustainability of Medicare with a premium support program.

Both GOP physician congressmen are supportive of policy directed restraint of increases in Medicare costs through programs like premium support. The president of AAFP claims to be politically neutral and does not take a position regarding any one specific plan or proposal, but believes that committed physicians and new models of care based on better quality and collaboration can produce cost savings that would make premium support programs unnecessary.

Based on 27 years of clinical practice and 10 years as a physician executive in an integrated healthcare delivery system, it is my humble opinion that Medicare sustainability will require analytically sound programs like premium support combined with transformational new models of care laser focused on delivering better healthcare value through higher clinical effectiveness, increasingly prudent operational efficiencies in both hospital and outpatient settings, and investment in optimal management of the entire continuum of health and wellness, including palliative and end-of-life care.

No matter what happens in November or subsequently with the Patient Protection and Affordable Care Act, it is imperative that physicians become increasingly more constructively engaged in policy discussion and decisions at high levels, and capitalize on opportunities to be involved in the design, development and execution of the new transformational models of care that are inevitably evolving to better meet America’s health and wellness needs and control costs.

TAMPA, FLORIDA–Vice-presidential nominee Rep. Paul Ryan (R-Wis.), who’ll speak at the Republican National Convention on Wednesday evening, has the attention of all doctors when it comes to his proposal to turn Medicare into a “premium support” program.

Some doctors here at the convention like the proposal, but it’s not without its skeptics.

Under Ryan’s proposal, which would be applicable to those who turn 65 after 2022, Medicare would provide an average of $8,000 to help offset the cost of buying private health insurance. Those eligible would still have a choice to enroll in the traditional fee-for-service Medicare program — but would receive premium support for that option just as those using private plans would.

CLICK HERE to read the entire story on