{"id":294688,"date":"2010-02-08T11:43:16","date_gmt":"2010-02-08T16:43:16","guid":{"rendered":"tag:business.theatlantic.com,2010:\/\/3.35534"},"modified":"2010-02-08T13:33:16","modified_gmt":"2010-02-08T18:33:16","slug":"the-reality-of-health-care-plans","status":"publish","type":"post","link":"https:\/\/mereja.media\/index\/294688","title":{"rendered":"The Reality of Health Care Plans"},"content":{"rendered":"

A number of you have asked me what I think of Paul Ryan’s health care plan.  I think it’s a serious plan–but it’s serious in the way that serious government plans are, which is to say that it has virtually no hope of being enacted as written.<\/p>\n

Consider Matt Yglesias’<\/a> relatively uncharitable, but accurate, summation:<\/p>\n

Right now, the rapidly rising cost of health care
\nimplies rapidly
\nincreasing Medicare costs. Ryan doesn’t have a plan to control those
\nexploding costs. Instead, his plan is to refuse to pay the bill. This
\nsaves a ton of money. If instead of paying for old people’s health care
\nyou just . . . don’t pay for their health care, then you reduce
\nexpenditures a great moment. But the reason nobody’s come up with this
\ngenius proposal before is that we’ve had a decades-long commitment to
\nfinding a way to ensure a dignified retirement, including adequate
\nmedical care.<\/p><\/blockquote>\n

Of course, this is true of the
\nDemocratic plans too; it’s just that their “not paying” consists of
\nequally arbitrary caps on provider payments which will cause some
\nproviders to exit Medicare, plus giving some board the power to decide
\nwhat treatments we can’t cover.  Whether you prefer the Democratic plan
\nor the Republican plan boils down to whether you want the decisions
\nabout which stuff not to buy to be made by possibly ignorant consumers,
\nor possibly arrogant
\n technocrats<\/a>.  I had a pretty good experience, when I was uninsured,
\n with getting providers to think seriously about which costs it was
\nworth imposing on me.  And I think that the ability of a centralized
\nboard to decide on “the right treatment” for 300 million patients is
\nhighly oversold.  But I was a pretty educated patient, so your mileage
\nmay vary.<\/p>\n

The problem with both sets of plans is that the voucher
\n cap would never withstand the assault from angry and frightened
\nseniors, while the provider caps and treatment disallowals would never
\nwithstand the pressure of various other interest groups.  That’s why I
\nwant to turn the Federal government into an income-based catastrophic
\ninsurer, for expenses that exceed 15-20% of AGI.  I don’t think there’s
\nmuch hope of controlling cancer treatments or heart surgery.  But I
\nthink we could eliminate a hell of a lot of unnecessary day to day
\nexpenses–the ER visits of convenience and CYA tests for diseases
\nthere’s no indication the patient has.  But the only way we’ll do that
\nis by making the consumer responsible for those costs.  Short of that,
\nwe’re just rearranging the deck chairs on the Titanic. <\/p>\n



\n

\n Email this Article<\/a>
\n Add to digg<\/a>
\n Add to Reddit<\/a>
\n Add to Twitter<\/a>
\n Add to del.icio.us<\/a>
\n Add to StumbleUpon<\/a>
\n Add to Facebook<\/a>
\n

\n\"\"<\/a>
\n\"\"<\/p>\n","protected":false},"excerpt":{"rendered":"

A number of you have asked me what I think of Paul Ryan’s health care plan.  I think it’s a serious plan–but it’s serious in the way that serious government plans are, which is to say that it has virtually no hope of being enacted as written. Consider Matt Yglesias’ relatively uncharitable, but accurate, summation: […]<\/p>\n","protected":false},"author":80,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-294688","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/294688","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/users\/80"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/comments?post=294688"}],"version-history":[{"count":0,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/294688\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/media?parent=294688"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/categories?post=294688"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/tags?post=294688"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}