Wednesday, April 20, 2011

Obama v. Ryan on Rationing Health Care

Robert Pear reports on a controversy surrounding the President’s proposal to increase the power of the Independent Payment Advisory Board:

Mr. Obama wants to expand the power of the 15-member panel, which was created by the new health care law, to rein in Medicare costs ... Under the law, spending cuts recommended by the presidentially appointed panel would take effect automatically unless Congress voted to block or change them. In general, federal courts could not review actions to carry out the board’s recommendations. The impact of the board’s decisions could be magnified because private insurers often use Medicare rates as a guide or a benchmark in paying doctors, hospitals and other providers. Last week, in his speech on deficit reduction, Mr. Obama said he wanted to beef up the board’s cost-cutting powers in unspecified ways should the growth of Medicare spending exceed certain goals. Supporters say the board will be able to make tough decisions because it will be largely insulated from legislative politics. Lawmakers do not agree. Representative Paul D. Ryan, Republican of Wisconsin and chairman of the House Budget Committee, called it “a rationing board” and said Congress should not “delegate Medicare decision-making to 15 people appointed by the president.” He said Mr. Obama’s proposal would allow the board to “impose more price controls and more limitations on providers, which will end up cutting services to seniors.”

Paul Krugman notes:

Arguably the most important thing we can do to limit the growth in health care costs is learning to say no; we cannot afford a system in which Medicare in particular will pay for anything, especially when that’s combined with an industry structure that gives providers a strong financial incentive to engage in excessive care ... Mainly the attack is coming from Republicans, who want to dismantle Medicare, not save it — their proposal is that instead of having Medicare make choices based on expert advice, we should give seniors inadequate vouchers and let insurance company executives make those choices instead.

In other words, Congressman Ryan has an alternative rationing system – the free market. If you have little income and virtually no assistance from the Federal government, the price rationing system would basically tell you that you are not entitled to any health care services. Something tells me this is exactly the kind of society Congressman Ryan seeks. But would the rest of us agree with him if he were just honest enough to say so?


trucker said...

People who are dead set against privatization and who want more taxation to cover the Medicare problem are almost as bad as the wackadooldle Republicans. Medicare Buy In is the best way to resolve the problem. By eliminating the succubus private insurance companies via CHOICE in a free market (Medicare insurance will be 17% less expensive than the private crap), the nation saves big time and does, in fact have a rational mechanism to control runaway cost.

Anonymous said...

>>>But would the rest of us agree with him if he were just honest enough to say so?


spencer said...

Essentially the Ryan plan means that at some point the typical middle class family would soon be faced with the choice of keeping grandma alive for a few more months or sending junior to college.

So which choice would you make?

trucker said...

The rationing of public funds for health care does not prevent the individual from buying all the health care the individual can afford. And in that sense there is no difference between public and private insurance. What the rightarded find objectionable is the progressive nature of the tax system; the fact that the most affluent are tapped to subsidize the basic care of the middle. The rich will still outlive all of us, but that simply isn't good enough for the rightarded. Medicare Buy In replaces some of the tax funding with a surcharge on premiums for those who are younger and healthier. The surcharge is not progressive in the "tax the rich" sense. It does recognize that the earnings of ages 30 to 55 are higher than others and it "saves" up premiums so that the costs above 55 are less.

Anonymous said...

If it is fair to call one plan Obama Care, it is as fair to call the main alternative plan Ryan No-Care. This gets the debate down to two short soundbites, which seems about all we can or choose to handle

MCAndre said...

The Paul Krugman link is "x", not a URL.

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