Monday, April 4, 2011

The Ryan in "Ryan-Rivlin"

I just thought I'd get some information out before the sky started falling with reports about Ryan's budget:

If you read anything from this article, don't just read the title. The article explains just one of the many ways Ryan's Medicare proposal is different from the Affordable Care Act (though it's ironic in how many ways it's similar):

"Unfortunately, while Ryan has emulated a number of features from the ACA, he’s forgotten to make the adjustments the law makes to actually ensure that health care is more accessible to beneficiaries rather than more profitable to health insurance companies"

"Given that most Americans 65 and older are a walking pre-existing medical condition, it is difficult to imagine how functioning insurance pools can be constructed from a universe filled with these people. It is equally hard to see how health insurers could offer such a plan without severely restricting the benefits offered or, in the alternative, charging very large premiums – unless the government is prepared to put large enough subsidy checks in the pockets of the insurers to cover the extra costs."

This is just one of the problems with calling this proposal "Ryan-Rivlin", as Ryan is trying to do for political-cover purposes. Paul Ryan and Alice Rivlin only ever put out an agreement on a top-line policy proposal, agreeing to this voucher/premium support idea (which Rivlin delights in pointing out to Ryan is similar in many respects to the dreaded OBAMACARE!!!). But they only minimally discussed the actual particulars necessary to make this kind of policy idea a reality, which is unfortunate, because this is an importance case where the devil lies in the details. (Btw, Alice Rivlin is founding CBO Director, former OMB Director, Democrat, member of both major fiscal commissions, etc.- aka she brings a lot policy know-how and politial umph to the table).

This proposal has some THEORETICAL plausibility, especially with the kind-of protections and safeguards someone like Alice Rivlin has supported and would put in place. Unfortunately, Ryan will not be including those safeguards, which turns this theoretically-plausible concept into a disastrous reality. So to call this idea Ryan-Rivlin is a stretch- it's really a disastrous Ryan-structuring of an untested Ryan-Rivlin concept.

And this doesn't even get us started on his massive cuts to Medicaid and food stamps. Sigh.

P.S. Yes, the article's ending is over-the-top (though you have to remember that Medicaid is the nation's primary provider of long-term [including nursing home] care, so block-granting Medicaid and voucherizing Medicare will be giving the most disadvantaged elderly a one-two punch.)


Ryan Karerat said...
This comment has been removed by the author.
Ryan Karerat said...

Unfortunately, Ryan will not be including those safeguards, which turns this theoretically-plausible concept into a disastrous reality.

What can I say? I like to live on the edge.

Megan said...

1. Medicare cannot be maintained in its current form.
2. Medicaid cannot be maintained in its current form.
3. Democrats say the ACA has done everything possible to cut the costs of these programs without decreasing benefits.
4. These programs will still not be soluble.
5. Benefits must be cut to maintain these programs.
6. Paul Ryan is the only one with the balls to put out any sort of budget that cuts benefits. Even if he used Rivlin's name for political cover (which I doubt he could use her name without her agreement) he is putting himself out there like no one is willing to do. People in Wisconsin love their Medicare and Social Security just as much as everyone else does, and he has given Dems an opportunity to attack him mercilessly. He is straight-forward and sincere about everything he has put forward, claiming that he wants to cut government, and that benefits must be cut to maintain these important programs. Whether you like what is in his plan or not, you have to admit that he is a brave, sincere guy.
7.Do Democrats think the tooth fairy is going to make Medicaid and Medicare soluble without cutting benefits?

Megan said...

8. I <3 Paul Ryan.

PBM said...

Megan, your ignoring the fact that his plan includes massive new tax cuts for the rich. The reason it has to cut so much from Medicare and Medicaid is because the GOP wanted their budget to look like it was cutting more than Obama's, which meant they needed to fill in the $2 trillion gap between them caused by more tax cuts by cutting Medicare and Medicaid more.