Posted on 02/10/2010 9:06:50 AM PST by SeekAndFind
The Democrats are having trouble finding enough votes to pass their health-care bill — maybe you’ve heard? The trouble stems from the bill’s many unpopular provisions: It would raise taxes, force people to buy government-approved coverage, and cut Medicare. In the aftermath of Scott Brown’s election to the Senate, the Democrats had no clear way forward. Brown didn’t just deny them a crucial 60th vote in Senate; he did it by running explicitly against the Democrats’ version of health-care reform. How can a political party enact legislation that the public simply doesn’t want?
The obvious solution is to convince the public that every conceivable alternative would be worse. But so far, that hasn’t worked. Polling on the subject indicates that the public, while not happy with the status quo, prefers it to the Obama-Pelosi-Reid monstrosity. And the piecemeal reforms around which Republicans have coalesced — equalizing the tax treatment of health benefits, reducing the role of the state regulatory agencies, enacting some sort of medical tort reform — appear by comparison to be modest and pragmatic ways to control premium inflation.
Needing a Republican bogeyman, the Democrats found one in Rep. Paul Ryan (R., Wis.), the ranking member on the House Budget Committee and one of the more entrepreneurial members of Congress. Ryan has put forward a plan called “A Roadmap for America’s Future,” which, according to the Congressional Budget Office, would repair America’s structural deficit. Because one cannot talk about the budget picture without addressing the growth of entitlement spending, Ryan’s plan includes a way to fix Medicare to which the adjective “modest” does not apply. His approach would replace traditional fee-for-service Medicare with a voucher program, and, over time, total spending on the vouchers would be much less than what the government is projected to spend on Medicare under current law.
Suddenly, the Democrats have a big and controversial target to shoot at, and they are loading up their guns gleefully. They seem almost relieved. Like fractious conservatives in the period immediately following the fall of Communism, liberals started to crack up once their common enemy lost power. After a long year of infighting over issues such as the public option and the excise tax on employer-provided health benefits, they are reunited in their opposition to a Republican bad guy, even if Paul Ryan makes a poor stand-in for George W. Bush.
This has put the Republican leadership in a bind. On the one hand, they want to keep the focus on Obamacare — it’s not dead yet — and deny the Democrats any safe haven in the form of a controversial Republican alternative. On the other hand, the nation confronts three options when it comes to entitlement spending: control it, allow taxes to soar, or both. Republicans must come forward with a credible plan at some point. Having no plan means effectively standing for fiscal collapse, severe cuts to Medicare, and much higher taxes on the middle class.
Ryan has put a credible plan on the table. It isn’t perfect, but no plan for controlling the cost growth at the heart of the entitlement problem is going to be uncontroversial. As Ryan put it to me, “If we are going to get serious about controlling costs, then either the individual is going to be in control of their health-care decisions or government is going to be in control.” Putting the individual in control sounds like the no-brainer choice, but in the past voters have expressed a preference for less risk, not more control, when it comes to their post-retirement well-being. Getting Republicans to embrace the politically perilous task of explaining to people that the status quo entails more risk, not less, will be no easy feat.
For now, the GOP leadership wants to proceed along two tracks: Stay away from big, specific reforms until the most dangerous items on the Democrats’ agenda have succumbed to the politics of the election cycle; and, meanwhile, develop a “Contract with America”–style set of positive agenda items on which to run. The plan is to pivot to this second track at some point between now and November. But details about this new contract have not been forthcoming. Will it include a specific plan for getting us out of the debt trap? Or will it eschew these for broad platitudes, so that the focus stays on the Democrats’ unpopular agenda?
The desire to remain vague is understandable as long as there is a threat that Obamacare might pass. And the political dangers of including something like the Ryan plan in the platform for 2010 are clear. But here’s the contrarian case:
The Democrats have already put forward a health-care bill that cuts Medicare, complete with the rationing board that inspired Sarah Palin’s memorable bit of resonant hyperbole. Medicare cuts are on the table, and we know how the other side would do it: price controls that force providers to leave the system and a federal apparatus that thinks it knows better than you or your doctor what treatments you need.
The Ryan alternative — reduced spending, but in voucher form, which allows patients to comparison-shop on quality and price —would likely prove to be effective at controlling costs, balancing out the spending reductions. And if we do nothing, we’ll get Medicare cuts anyway, in the context of a debt crisis that leaves us with no choice but to ration care.
Politicians do not generally consider elections to be good times for serious conversations about the nation’s problems. This year, the nation’s problems are so great that it’s possible the calculus has changed. If they want to appeal to the growing number of Americans whose heads are spinning at the size of Obama’s deficits, Republicans might need to start that conversation. Ryan’s plan provides as good a starting point as any.
Yup.
Right now, there are just three Republican cnogressmen I have much real confidence in: Senator DeMint and Reps Michelle Bachman, and Pual Ryan. Pual Ryan is a young man that is going to go places.
“Ryan has put a credible plan on the table. It isn’t perfect, but no plan for controlling the cost growth at the heart of the entitlement problem is going to be uncontroversial. As Ryan put it to me, “If we are going to get serious about controlling costs, then either the individual is going to be in control of their health-care decisions or government is going to be in control.” Putting the individual in control sounds like the no-brainer choice, but in the past voters have expressed a preference for less risk, not more control, when it comes to their post-retirement well-being. Getting Republicans to embrace the politically perilous task of explaining to people that the status quo entails more risk, not less, will be no easy feat.”
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A reasonable plan, something to unite behind.
Reasonable as opposed to the unreasonable plan; and the unsustainable reality of the current plans.
Let us not bicker over the details too much. get behind Nothing will be perfect. Let us get headed in the right direction.
Whenever we hear the canard that Republicans are simply the party of of NO and have never submitted a cogent, alternative plan ( as Obama keeps repeating ad nauseum), here is EXHIBIT A of a cogent plan.
I’d like to read or hear a critique of this.
Any chance of a 1994 re-dux where EVERY republican shows up for a presser on the steps of the White House to back this plan?
that’s what’s needed to get any REAL attention from State-run media.
I won’t hold my breath. The RINOs want to ‘reach across the aisle’ and ‘compromise’ away our freedom.
To get them to pass TORT REFORM in a hurdle that can not be too high. For obvious reasons. It has helped bring doctors to Texas, since there was a dollar limit passed.
It is a fight worth fighting. Law suites has changed the face and process of nearly all avenues of existence.
Ryan fought FOR the passage of the bailout...
To me, that is an unforgivable deed.
I’ve looked at Paul Ryan’s roadmap. I’m not a big fan; he seems to intentionally limit his scope and objectives under the assumption that significant reform, rather than actual elimination of federal waste and bureaucracy, is the best we can hope for.
It’s a good starting point, but I wish his objective would have been a return to truly limited government.
Actually no it isn't. Costs of malpractice lawsuits in the form of payouts and premiums totaled about $30 billion in 2007. That's out of a $2 trillion plus healthcare industry. So do away with malpractice costs altogether and you're saving maybe 1 or 2 percent.
This is a possible solution to the exponentially increasing costs of entitlements, it isn’t an alternative to Obama’s healthcare for all. But at the end of the day, it’s the growth in entitlements that is the real disaster looming on the horizon and any plan that tries to tame that is something worth getting behind.
You may be aware that many companies are now paying into high deductible Health Savings Accounts as a tool to get their employees to move off their current plans which are larded up with state mandates.
For example, here in SW Pennsylvania, winos and druggies have a powerful lobby so companies HAVE to include "substance abuse" treatment in their policies even when you have to pass a drug test to get a job there! Over in Delaware, the gay lobby is powerful, so AIDS coverage and similar behavioral diseases are mandated so the favored group can pick the pockets of the other pool of insured.
If SocSec and Medicare are going broke, adding another major government program won't get us to more limited government and less government intrusion. Congress has three options for funding these failed entitlement programs. Raise taxes, cut benefits or some combination of the two. My guess is, the Feds will choose to raise taxes significantly and raise the retirement age to 70. While limiting benefits for SocSec recipients through freezes of COLA’s, (annual cost of living adjustments). A similiar plan to what the Greenspan Commission gave Reagan in 1983. Another short term quick fix.
It may be roadmap for a plan, And if the demons want to critisize it out of hand, then they will continue to prove that they don’t want a bill formed through bipartisanship. They only want their plan approved by bipartisan vote.
Go ahead BO, my family travels on your dime pelosi and the IBS poster boy reid. Critisize it show the nation that your version of “CHANGE SUCKS”!
>>>Something missing in the plan — WHERE’s TORT REFORM ??
Most medical malpractice cases take place in state courts. Limits at the federal level would have little impact, unless you are also suggesting these limits be imposed upon the states as well.
What is the cost of defensive medicine (tests/procedures doctors perform to lessen the likelihood of a malpractice suit)? I work in the medical field and I know there are significant costs associated with defensive medicine.
Tort reform, high risk pools (for pre-x conditions) interstate marketing and portability all would lower premiums for most Americans.
Medicaid reform and a total ban on "cost shifting" by hospitals.
Whenever they talk about "risisng healthcare costs" it's largely because the RATs are expanding medicaid and not paying their bills and reimbursing at a ridiculously low rate...the hospitals recoup costs by gouging the insured and cash paying customers.
People keep saying that, but a much bigger factor is the fact that many people are isolated from the marginal costs of their health care decisions. If a $100 drug works better than a $5 drug, but the $5 works well enough that someone, given a choice, would prefer to have the $5 drug plus $50 in his pocket, there's no reason why the person should buy the $100 drug; his doing so destroys $45 of wealth. On the other hand, if the person's "insurance" will allow him to buy the $100 drug for $20, and if he'd rather have the expensive drug than have the $5 one $15 in his pocket, there's no reason for the person not to choose the more expensive one.
Reconnecting decisions and costs would require some major insurance reforms, including replacing today's so-called "insurance" with real insurance. I've not seen much talk of that, though.
How will reducing revenues fund anything?
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