Lost in the left-wing press' constant repetition of the Democratic Party's charge that Republican Congressman Ryan wants to "end Medicare as we know it" is the fact that President Obama wants to "end Medicare Part D as we know it" and has already ended "Medigap as we knew it." Of course, the president's Patient Protection and Affordable Care Act (PPACA) also "ended Part C Medicare Advantage as we knew it."
The fact that "Medigap as we knew it" has already been ended gets lost in the political rhetoric because Medigap is not really Medicare but just highly regulated private insurance that makes up for the huge deficiencies in Part A and B Medicare. (That's Original Medicare as it is known as by the Medicare bureaucracy or "Medicare as we know it" as the Democrats call it.) As private insurance, the Democrats -- particularly highly partisan Democratic academics -- dismiss Medigap as not worth researching.
According to MedPAC in June 2011 (page 70, lower right):
"The Patient Protection and Affordable Care Act of 2010... directs the National Association of Insurance Commissioners (NAIC) to revise standards for medigap (sic) policies Plan C and Plan F. These standard (Medigap plan) types are the only ones that cover all Medicare Part B cost sharing. The new law requests the NAIC to revise Plan C and Plan F standards to include requirements for nominal cost sharing to encourage the appropriate use of physicians’ services under Part B. New standards are to be based on evidence published in peer-reviewed journals or current examples used in integrated delivery systems. NAIC’s revised standards are, to the extent practicable, to be in place as of January 1, 2015."
In fact, even some of the non-partisan adult academics who are about to move on from the election rhetoric don't seem to realize that PPACA has already apparently done what they are proposing Congress do in the future. This October 31 article in the New England Journal of Medicine proposes doing what PPACA already does.
-- Dennis Byron