Is RyanCare a version of Obamacare?

by on December 18, 2010 at 7:26 am in Economics, Medicine | Permalink

More or less, Ezra says:

The Ryan-Rivlin plan basically turns Medicare into Obamacare. And in that context, Republicans love the idea behind ObamaCare and think it'll save lots of money.

Under the Ryan-Rivlin plan, the current Medicare program is completely dissolved and replaced by a new Medicare program that "would provide a payment – based on what the average annual per-capita expenditure is in 2021 – to purchase health insurance." You'd get the health insurance from a "Medicare Exchange", and "health plans which choose to participate in the Medicare Exchange must agree to offer insurance to all Medicare beneficiaries, thereby preventing cherry picking and ensuring that Medicare’s sickest and highest cost beneficiaries receive coverage."

File under "True, True, True."  My view is that when it comes to health care economics, just about everyone should have egg on their faces.

Bill December 18, 2010 at 5:24 am

The dollar cap for federal contributions would mean that 1) Q would vary, ie, benefits would not be fixed, so there would be policies that did not cover high cost illnesses; or, 2) if Q were not fixed (ie, benefits and coverage would be uncapped), then if the premium price went higher, those who could afford the premium in excess of the federal contribution would pay it, and those who couldn't would either die or be picked up in local medicaid or assistance.

I would sell short the bonds of Arizona and Florida.

Tom December 18, 2010 at 8:24 am

Agreed with SJohnson,

Making Medicare less socialist is not the same as making our regular healthcare system more socialist.

a December 18, 2010 at 11:42 am

"most liberals would strongly oppose redefining Medicare as Obamacare, but most liberals also supported Obamacare."

This is true. Liberals only supported the Affordable Care Act because it was the best feasible option; a single payer system would have been better policy.

Is the reverse true? Do you see the Ryan-Rivlin plan as just a first step in the right direction? If so, what is the policy ideal? That's the plan I would love to read.

mulp December 18, 2010 at 2:30 pm

Making Medicare less socialist is not the same as making our regular healthcare system more socialist.

But our current system is one that has "government mandated private takings."

Health care is a right at the point life is at stake, so if you agreed to take reduced Medicare payments because you can't afford to ignore more than half the health care business, they you are required to provide uncompensated high cost right to life care. When hospitals make "worth" decisions on patients and put them on the street, no conservatives defend them saying "look, those people are a burden to society so hospitals should street them in the freezing cold so they die for bing worthless.

Reagan signed EMTALA in 1987.

Not a single State's attorney or conservative legal group sued Reagan for an unconstitutional mandate and taking of property. The argument in the Florida suit different from the last case is the mandated expansion of Medicaid – the Obama response to that claim is the same as the defense for EMTALA – don't take Federal funds and you have no mandates.

EMTALA and Medicaid are needed for conservatives to win even conservative support for opposition to universal coverage of some sort. Without Medicaid, people would clearly die for lack of money. With EMTALA, the working poor who are excluded from Medicaid are prevented from dramatically dying for lack of money.

So, we have socialized health care based on a right to life, but have then sought to avoid the cost of the agent of society, government, paying for defending that right.

Conservatives have called for spending lots of money to defend people's right to life. Reagan boosted military spending greatly based on a right to life free of being overrun and killed by commies, or something. It wasn't enough that the US could totally destroy any enemy who attacked with nukes, Reagan wanted protection from an attack, not merely a deterrent. And lots of money was spent on prisons to lock up people for life to protect the right to life free of crime.

We don't hear (many) arguments like "France and England shouldn't have been too attractive a target for Hitler" and that "he shouldn't have been so rich and become a mugging target – he brought it on himself." In the way you define "socialism", every time society joins together and uses government to protect rights no matter the wealth or status or history of individuals or groups, that is socialism in action. To use the anti-government types rhetoric, "government steals from the rich to protect the rights of the poor."

The point you start down the path of demanding rights that you do not defend personally with only the means you yourself possess, you are on the road to socialism.

Floccina December 18, 2010 at 6:19 pm

Mulp,
hi, I am curios would you support may plan? Outlined here: http://un-thought.blogspot.com/2009/09/healthcare

JonF December 20, 2010 at 4:39 pm

The free market plan is just this: let the poor and the unlucky die, and thereby weed the unfit out of the species while keeping costs down for everyone else.

No, that's not deserving of egg on the face. It merits something far more severe, and not just in this life.

rejuv by caci December 21, 2010 at 7:41 pm

Reid is also one of the strongest supporters of "comprehensive immigration reform". Could be there is a correlation between the two.

The Repubs also have their version of a bill. They are allowing the 3 days of disclosures. Reid maybe trying to beat them to a vote so that the dem version is passed first.

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