Allowing private Medicare-approved plans to compete directly with a traditional Medicare plan might strengthen the infrastructure of both medical care delivery systems. This goal might be achieved by creating new incentives for plans to develop better delivery models for managing patient care. Exceeding the cost containment caps would not trigger automatic cuts or higher premiums. Instead, Congress would be forced to make supplemental appropriations, as is done now.
Herein is an opportunity for Congress to levy an excess consumption tax on
junk food in order to raise revenues to cover current costs and provide reserves for future cost increments, inflation adjustments, population increases and other conditions that could forseeably raise costs. This same opportunity to implement an excess consumption tax exists for Obamacare as well.
Small businesses with 100 workers or less could offer their employees a free choice option . This free choice option gives employees the right to use the amount that their employer contributes toward health coverage to purchase health insurance now and in a transition to retirement.
This description admits essentially that employees of small businesses will be required to contribute to their health insurance costs alongside the employer. Again, implementation of an excess consumption tax on junk food could make premiums more affordable to both employers and employees.
At present, there is an open question as to how vouchers would be administered
under the Ryan/Wyden Plan. A voucher system could be subject to cost cuts in the future. Traditionally, Congress has made changes to protect the Medicare program on a continuing basis. Again, the idea of an excess consumption tax on junk food would provide badly needed funds to anticipate the growth in medical costs arising from the consumption of junk food.
In addition, the Ryan/Wyden Plan should address the open question as to where cost savings go. Are cost savings plowed back into the Medicare Plan or will they go to another part of the federal budget outside the Medicare System? There is another question as to the investment of surplus funds in the Medicare System. These surplus funds should be invested in high quality financial instruments with a low risk of loss. At bottom, derivative instrument investments should be severely limited in favor of risk averse investments.