I'm not saying I agree with the Romney fix as I surely do not. But do you know what the Romney fix is? Because I sure don't. Ryan has some voucher plan, except we can't say vouchers anymore, because it doesn't poll well. Ryan's plan isn't supposed to kick in for 10 years, anyway. But then freelyhovering posted this David Brooks column in Message 28349499 that postulated this:
Moreover, when you look at the Medicare reform package Romney and Ryan have proposed, you find yourself a little surprised. You think of them of as free-market purists, but this proposal features heavy government activism, flexibility and rampant pragmatism.
The federal government would define a package of mandatory health benefits. Private insurers and an agency akin to the current public Medicare system would submit bids to provide coverage for those benefits. The government would give senior citizens a payment equal to the second lowest bid in each region to buy insurance.
This system would provide a basic health safety net. It would also unleash a process of discovery. If the current Medicare structure proves most efficient, then it would dominate the market. If private insurers proved more efficient, they would dominate. Either way, we would find the best way to control Medicare costs. Either way, the burden for paying for basic health care would fall on the government, not on older Americans. (Much of the Democratic criticism on this point is based on an earlier, obsolete version of the proposal.) Now, as Brooks states it, that could be a reasonable plan- it's how a lot of government employee plans work, more or less. How it's supposed to cut costs and not cut benefits is sort of a conundrum, given that private insurance usually has 20% overhead, which is a lot steeper than what Medicare has. And there is this Ryan budget I versus Ryan budget II thing that I've never quite gotten straight. I'm still not sure if what Brooks is talking about is actually a proposed Ryan plan, or Brooks' interpretation, or something Brooks made up that maybe would somehow come out of something Ryan said somewhere. But checking with my friend google last night, all I got out of Romney on this is his illustrative whiteboard “No change” and “Solvent.” presentation of last Thursday.
As for the "screwed up solution", the more I read about ACA, the better I like it. Well, that's an exaggeration, the less I dislike it might be closer to the truth. The whole thing may be held together with baling wire, and with all Republicans dogmatic about doing everything they can to kill it, by hook or by crook, it could easily fall apart. But it does a lot of good things, and it's already started and will be doing more in coming years, and is a more comprehensive approach to the general health care issue than "reinventing" or patching up Medicare in some way 10 years from now. Romney's going to have to do a lot better on the whiteboard next time before I give Brooks (and Romney) any credence on this issue.
Brooks' column, originally at nytimes.com , has many other issues. First off, he makes this somewhat heretical claim:
Entitlement spending is crowding out spending on investments in our children and on infrastructure. This spending is threatening national bankruptcy. It’s increasing so quickly that there is no tax increase imaginable that could conceivably cover it. And, these days, the real entitlement problem is Medicare. Heretical because, of course, there's no way a Republican-controlled government is ever going to invest savings from fixing entitlements in our children and on infrastructure. Well, I suppose you could make the argument that if they give more money to rich people it will somehow get to children and infrastructure, but from everything Romney and Ryan have said about taxes, that's the only path available for money to be redirected.
You’re still deeply uncomfortable with many other Romney-Ryan proposals. But first things first. The priority in this election is to get a leader who can get Medicare costs under control. Then we can argue about everything else. Right now, Romney’s more likely to do this.
I don't know anybody besides Brooks who thinks that's the priority in this election. And again, to the best of my knowledge, Romney hasn't said anything deeper than “No change” and “Solvent.” , and Ryan's stuff is years out. I'd be happy if Romney chose to make that a priority, and actually proposed something. Since Romney has, to the best of my knowledge, refused to say much about what he will do with the consensus priority of this election, the economy and unemployment, except vaguely endorsing Ryan budgeting, but not really, because the Romney budget is different, but he won't say how, I find the idea that he will say anything sensible about Medicare far-fetched.
Sorry to dump this on you. For some reason, that Brooks column really got to me. By now, I know what to expect from the candidates, which is not much, and I have no problem ignoring the normal realm of bloviation from op-ed types. Brooks sounds so calm and reasonable, though, but it sure seems that he's just making crap up. |
