I don’t always agree with Tyler Cowen on matters relating to health care and health economics. I do, however, agree with a lot of what he wrote in reaction to Rep. Ryan’s budget plan. Below, I’ve removed non-health comments (not that I don’t agree with them, I just don’t want to get into those), picked out the health care bits I do largely and unambiguously agree with, and edited (with “[…]”) for efficiency:
2. Ryan nails our dysfunctional, “who is really responsible for paying for Medicaid?” structure. That said, I’ve long preferred the federalization of Medicaid. […]
3. […] Medicaid should be one of the last parts of the health care budget to cut. […]
4. […] I would urge maximum transparency. Health care costs are increasing by about five percent a year. That means a fixed value voucher loses about half its real value, in terms of command over health care resources, within fourteen years. […] If that is the decision we are going to make, let us understand it as such. […]
5. It would be nice to have a scientific estimate of how much fixed value vouchers would lower the rate of growth of health care costs. I’m not convinced the effect here is large, but I’d like to see it studied more closely.
6. Ryan’s budget repeals ACA and thus in the semi-short run it could considerably increase Medicare costs. There is no reason why Ryan’s plan shouldn’t keep the most fiscally responsible aspects of ACA. Ryan exempts the current elderly from any Medicare cuts at all, see David Leonhardt’s remarks. […]
8. As I’ve already blogged, the vouchers idea won’t help cut health care costs. Let’s create some multiple public options within Medicare, some of which would allow people to trade health care benefits for cash. […]
10. There’s not nearly enough on reforming the dysfunctional supply-side of our health care institutions. Nor does science or basic research receive much discussion. […]
13. [… T]he plan is not intended to be enacted into law.
I would only add that not all voucher plans have the same consequences as Rep. Ryan’s. My readers, by now, must know this.
