Medicare is one of the hot topics in this year's presidential and congressional elections, with Republicans and Democrats claiming their opponents' plans will jeopardize, remake and even undo the 46-year-old program.
"The Ryan budget, which is what Bill Johnson voted for, will kill Medicare as we know it," Democrat Charlie Wilson said recently, referring to his opponent in the race for Ohio's 6th Congressional District seat.
"It's Charlie that cut $716 billion out of Medicare when he voted for the president's health care law," said Johnson, the incumbent Republican who unseated Wilson in the 2010 election.
While people pay into Medicare, it's an open-ended program, with taxpayers picking up the costs beyond the original focus, hospital coverage, according to www.factcheck.org, a nonpartisan project of the Annenberg Public Policy Center of the University of Pennsylvania. A 2012 Medicare trustees report estimates the hospital trust fund will be exhausted by 2024. Meanwhile, health care costs continue to rise and more and more baby boomers enter the system every day.
Dealing with those problems was part of the sweeping health care law derisively dubbed "Obamacare," a moniker President Barack Obama now accepts. It creates a board with the power to force payment cuts on the health care industry if Medicare costs rise above certain limits.
Republican challenger Mitt Romney meanwhile favors an approach he calls "premium support," which would allow future retirees to choose between traditional Medicare and private plans the government would help fund. Romney says competition will help lower health care costs, but critics have said that isn't possible without capping benefits, something the former Massachusetts governor opposes.
On the Web
A look at the claims made by the presidential candidates about Medicare can be found in the article "A Campaign Full of Mediscare" on www.factcheck.org
Each side has a lot to say about the other's plans, making the issue a potentially confusing one. FactCheck refers to the strategy of claiming Medicare is being gutted or about to end as "Mediscare" and says both parties engage in it.
Some campaign ads feature older individuals that might lead some viewers to believe the dire predictions being made for Medicare will affect current beneficiaries. But FactCheck says neither Ryan's nor Obama's plan "has much of a direct impact on current beneficiaries."
But it does not deny they could be affected.
The $716 billion Johnson and Romney refer to is to be trimmed from "future growth of Medicare spending over the next 10 years," FactCheck says. To Johnson, that's no different from cutting it.
"By any definition, that's going to reduce money available to Medicare," he said.
About $1.8 billion would be cut from seniors living along the Ohio River, Johnson said.
The president's health care law does call for gradually eliminating extra payments for the Medicare Advantage program, which likely would result in some changes for seniors using that plan, FactCheck says. Wilson said that program is 16 percent more expensive than regular Medicare and could be used to buy things like gym shoes and health club memberships. That money is put to better use elsewhere, he said.
"By the investment of the $716 billion, we extended the life of Medicare by eight years," Wilson said.
Johnson said he supports eliminating fraud and inappropriate expenses from Medicare, but reimbursements to providers cannot be slashed too low or they'll stop accepting Medicare patients.
The approach Johnson supports is the one touted by Romney and Ryan. He bristles at critics referring to it as a voucher program.
"It's not a voucher program," he said. "It gives people an option. They can go with traditional Medicare."
And Johnson is adamant that Medicare would stay the same for those currently receiving it.
"We protect Medicare for everybody that's 55 years of age and older," he said.
A campaign video posted online by Wilson's campaign claimed Johnson had voted to end Medicare by supporting Ryan's plan. A complaint was filed with the Ohio Elections Commission over that and a committee found probable cause to refer it to the entire commission. However, that complaint and one by Wilson's campaign against Johnson's over statements made in a press release about the probable cause vote were both dropped last week in a settlement agreement.
Wilson maintains the Ryan plan would end Medicare "as we know it," but acknowledged that wouldn't happen until the "voucher" portion is instituted. Still, current seniors would feel the effects, he argued.
"From day one, we lose 9,800 seniors that fall back into the Medicare Part D donut hole," Wilson said, adding that would cost 6th District residents an estimated $96 million over 10 years.
Wilson attributed the return of the donut hole to Johnson and other Republicans' pledge to repeal Obamacare, which included provisions to close the hole, the period when seniors have to pay 100 percent of the costs of their medications once they reach a certain threshold.
Johnson said that wouldn't happen. There are provisions of Obamacare - like prohibiting insurers from denying coverage for pre-existing conditions and allowing children to remain on their parents' insurance until age 26 - he believes are worth enacting in other legislation, after the original legislation is repealed in its entirety.
"What we will not do is put another 3,000-page bill in front of the American people and ask them to pass it before they read it," he said.
Another oft-repeated criticism of Ryan's plan is that it would increase costs for future Medicare recipients by an average of $6,400. But FactCheck says that claim is based on Ryan's original proposal, not the one he and Romney now favor. That could lead to increased out-of-pocket costs, but there hasn't been an estimate from the nonpartisan Congressional Budget Office.
Wilson said the $6,400 is the last estimate they have, and argued the new plan is not significantly different from the original.
"They may move those numbers around, but it's going to be in that ballpark," he said.
Area voters said they are concerned about Medicare, but had differing views on how best to address it.
Devola resident Doug Farr, 79, said he believes the election could impact what Medicare provides for him.
"I don't believe what the Democrats say," he said. "I trust Ryan's plan. I think he is a man of integrity."
Aurelius Township resident Mark Wharton, 58, said he thinks it will take more than one man - even if he is president - to solve the issues facing Medicare.
"I would be leaning towards Romney, but I'm not sure he can do it either," he said.
In a recent letter to the editor, Williamstown resident Chester Meeker pointed to Obama's stance on Medicare as one reason voting for him would be "moving forward and not backward." He said thanks to the provisions of the health care law addressing the donut hole, it cut the amount he had to spend on a three-month supply of one medication from more than $700 to more than $300, and noted the hole would eventually be phased out entirely.