• One last post on Ryan-Wyden before I go

    I have to run to clinic, but I have one last thing to say on Ryan-Wyden before I go. I’ve often argued that health care policy, and reform, have to be concerned about cost, quality, and access.

    I don’t see anyone arguing that this policy is going to improve the quality of health care. And, let’s face it, seniors don’t have an access problem in terms of health care coverage. So the only reason to do this is if it’s going to reduce costs. So will it?

    I’m not seeing a lot of people who think it will. Indeed, as many have pointed out, if this kind of reform would, then the ACA should lower costs dramatically. Few people seem to believe that will happen because of competition.

    If Ryan-Wyden isn’t going to reduce costs, and by that I mean bend the curve, then why are we considering it? I’m seriously asking.

    • I tend to agree with Ezra’s take that this is not policy, but political. That is why I do not understand why Sen. Wyden would do this; it just gives cover to Ron Paul and the Republicans who desperately need cover from Democrats attacking them on Medicare.

      Is it because Democrats just want to show that they can be bipartisan? Does anyone think this will pave the way to a public option for the 64 and younger crowd? (perhaps by making Medicare so similar to the ACA, one hopes they can “merge,” creating that public option for everyone else).

      Everyone knows Medicare is going to be too expensive as is for the long-term, so it needs to change. The question is “how?”, and there are really only two options: 1) simply reduce funding to Medicare, which is what Republicans seem to want, and 2) reduce healthcare costs in general, which doesn’t seem likely to happen any time soon.

      If we want to preserve anything resembling Medicare, we need to somehow find a way to get to #2, and the only realistic shot we have at it is introducing a large, public option for everyone so that finally someone has the market power to refuse ever increasing price hikes by providers without the worry of being completely shut out.

    • “If Ryan-Wyden isn’t going to reduce costs, and by that I mean bend the curve, then why are we considering it? I’m seriously asking.”

      Seriously, the most likely explanation I can come up with is that Paul Ryan is going to run for President. This gives him an issue to run on that distinguishes him from anyone else in the race and provides a new topic of discussion that he can push the subject to instead of talking about his budget and its Medicare/Medicaid proposals. He’ll be able to say that he can work with Democrats without sacrificing conservative principles as evidenced by collaboration with Wyden. The WSJ endorsement of this plan is way more enthusiastic than anything they’ve shown for any of the candidates in the race now, and establishment folks in the loop such as Rove, Will, etc are spending a whole lot of time tearing down Gingrich and no time propping up the only satisfactory candidate in the race.

    • I may have read the proposal too quickly but it seems as though the formula it is proposing is similar to the flawed SGR used for physician payments, except this time, would apply to every other healthcare sector. Am I missing something?

    • Republicans are considering it because it will give consumers more freedom and choices than the current system.

      Also, I think there’s a lot of skepticism out there as to whether the Medicare cuts (tying growth to GDP+1) will actually occur. Perhaps that explains why Democrats are considering it.

      • @Jeremy N
        any plan that says we will try to reduce cost growth and then if it doesn’t work, we will really reduce cost growth is a tough sell. They have to have such for a CBO score, b/c of uncertainty of how to score plans to “save”. I think I have become convinced that we need cost growth caps, but the failsafe should be tax based. If we don’t achieve GDP+1 then the payroll tax goes up by x. Then people can decide how much they want Medicare to “save” on the care of their parents and grandparents, and if we don’t want it, we will just have to pay more.

    • Isn’ the public option/competitive bidding aspect the area that will theoretically provide some cost control? If so, then why was Ryan so opposed to a public option in the ACA? Unless I’m misunderstanding things (always possible).

    • “If Ryan-Wyden isn’t going to reduce costs, and by that I mean bend the curve, then why are we considering it? I’m seriously asking.”

      Because several Democrats and every Republican believe ideology trumps real world experience every time.