• Ryan’s rebuttal

    In Chicago this afternoon, Rep. Paul Ryan will rebut critics of his plan for Medicare, endorsed by the House GOP in April. According to NRO, his prepared remarks will include this:

    Our plan is to give seniors the power to deny business to inefficient providers. Their plan is to give government the power to deny care to seniors.

    “Our plan” here is the House Republicans’ one to convert Medicare into a premium support program. “Their plan” is anything Obama and the Democrats have offered or passed, like the Affordable Care Act.

    There are two things odd about these sentences. First, the Republican plan has nothing to say about providers, like hospitals or physicians. It’s a plan for insurance reform under Medicare, not a plan for provider organization or payment reform. Second, the ACA has nothing in it to deny care to seniors. In fact, Medicare is not permitted to do anything of the sort.

    So, this segment of the speech seems like a rebuttal, but not of the arguments that have been offered against Rep. Ryan’s plan and not in support of what that plan actually is.

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    • Objective reality has no place in the modern Republican party. What part of this is so hard to comprehend? Facts have a notorious liberal bias – like math, so asking for straight talk from any R elected is like looking for gold at the end of a rainbow.

    • Actually, his point in the op-ed was not that the current Obama plan denies care, but that it will be the certain outcome of the ultimate need to control costs, which he argues the President’s plan does not do.

      • But neither does Ryan’s plan…it does nothing about costs. So now you have private insurers with the need to control costs, *compounded with* the need to generate a profit, creating even more downward pressure on costs. So following your logic, there will be more denial of care with teh Ryan plan than with the Obama plan–starting with seniors, who are the most in need of healthcare.

    • @ Jonathan: I don’t think that’s right. Ryan makes explicit reference to the IPAB, which is already in the ACA. Yes, Obama recently said he wishes to strengthen the IPAB, but Ryan surely wants his charge of rationing to apply to the non-enhanced IPAB that is currently codified in the ACA. Or do you have evidence to the contrary? I might not have seen it.

    • Why would a senior care whether or not their insurer is efficient, anyway? Being an efficient business is certainly correlated with offering the most bang for your buck, but it’s not a perfect relationship even if seniors were somehow able to determine which company provides the best care for their voucher bucks. There are plenty of thriving businesses today that could certainly squeeze a few more bucks if they felt it was best for business… the fact is that cost control is one of many competing concerns for a health insurance company whose investors expect it to grow at a rapid pace, whereas a government solely interested in providing the best care for a given amount of money would have a much narrower focus.

      • The “inefficient providers” Ryan is talking about are the doctors, nurses, and hospitals, which are the main drivers of cost. Add a layer of profit on that for the health insurance companies–which actually provide no value in the service delivery chain whatsoever–and you have your total cost picture. The only cost efficiencies to be gained that are totally assignable to the insurance companies are their profits–which is yet one more reason for a single-payer public option for the US.

    • Ryan again ignores the fact that private insurance has not controlled costs in the past, yet he assumes it will do so if only we give them more money.

      Steve