“The hot Washington Medicare debate centers on whether congressional Republicans will, in the language of the left, “End Medicare As We Know It.” But the dirty little secret on Capitol Hill is that Obamacare already ended the program as we know it. They don’t tell you that in those clever “Mediscare” ads.
•Replaced Medicare’s traditional financing. Obamacare replaces Medicare’s fee-for-service structure—the very heart of traditional Medicare financing—with capitated payments and salaried physicians. Whether this is a good or bad idea, it’s not your grandpa’s Medicare.
•Capped future Medicare spending. While slashing roughly a half-trillion dollars in Medicare provider payments over the next 10 years, congressional liberals imposed a hard cap on future Medicare spending. Once again, good or bad idea, it’s the law right now: No open-ended Medicare entitlement.
•Put an unelected board in charge. Then congressional liberals went even further: They created the Independent Payment Advisory Board (IPAB), a group of 15 unelected bureaucrats, to cut payments to Medicare providers. In fact, unless Congress enacts an alternative plan to cut Medicare spending by the pre-ordained amount, the Secretary of Health and Human Services is authorized to enforce the board’s recommended cuts without congressional approval.”