by Maggie Mahar and Naomi Freudlin

original posted at Healthbeat blog

“Humanity is a well with two buckets,” said Wylie, “one going down to be filled, the other coming up to be emptied.” Murphy Samuel Beckett

Maggie Mahar and Naomi Freudlin at Healthbeat Blog weigh in on Congressman Ryan’s proposal for Medicare, Medicaid, and the budget proposal.

In “Ryan’s Proposal for Medicare -- Shifting Risk to Seniors;” http://www.healthbeatblog.com/2011/04/ryans-proposal-for-medicare-shifting-risk-to-seniors-.html Maggie Mahar compares Ryan’s plan to a 401k and its difference with a pension or turning Medicare from a defined benefit plan into a defined contribution plan with the seniors bearing more of the risk and cost.

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Guest Post From Robert Bowman, M.D.

No Assumptions for a Change

Assumptions are often incorrect and the assumptions are incredibly inaccurate in primary care and in basic health access. When one starts with the assumption of more pay, then it is easy to rationalize more training or more complexity of care - even when there is little evidence other than assumption.

Primary care is often more difficult than specialty care.

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