Ryan on Ryan
Three principles of entitlement spending:
- No amount of taxes can keep pace with the amount of money government is projected to spend on health care in the coming years. Medicare and Medicaid are growing twice as fast as the economy — and taxes cannot rise that fast without a devastating impact on jobs and growth.
- If you believe that spending on these programs can be controlled by restricting what doctors and hospitals are paid, know this: Medicare is on track to pay doctors less than Medicaid pays, and Medicaid already pays so little that many doctors refuse to see Medicaid patients. These arbitrary cuts not only fail to control costs, they also leave our most vulnerable citizens with fewer health-care choices and reduced access to care.
- And if you believe that we must eliminate waste, fraud and abuse in these programs, know this: Eliminating inefficient spending is critical, but the only way to do so is to reward providers who deliver high-quality, low-cost health care, while punishing those who don’t. Time and again, the federal government has proved incapable of doing that.
Full editorial at The Washington Post.
Good points. Ryan is always good.
I’ve always thought Ryan is one of the smartest policy wonks in Washington!
Go get ’em Paul Show no mercy.
Agree. Good analysis.
I was just reading what Obama said about Ryan in the off the cuff remarks at a fundraiser last night. Also, thinking about the way Obama invited Ryan to hear his speech and then made insulting characterizations of Ryan’s positions makes me think there is something serious amiss with Obama. This is not normal behavior.
Punishing people for not delivering high quality care? Guess that’s about what one expects from inside the beltway thinking. The rest of use would just take our money elsewhere, assuming DC would let us keep it.
I agree with Neil. I think the president is playing games. He has no real intention of reforming entitlement programs.
Both positions are smoke and mirrors, but neither is put into understandable language. Obama wants socialized medicine in a country where it already exists as hospital ER’s give universal and very expensive care, paid for by taxpayers and insurers. Ryan wants it to return to where it once was, an individual person’s responsibility.
No matter who pays, Ryan’s points win as it is the only logical one in a country with the demographics of ours.
But neither side addresses the major problem in a sensible manner, since 33% of our healthcare costs which are known to be $700 billion a year or so are known to be waste, fraud and abuse, mainly done by Medicare and Medicaid providers. We’re all being shortchanged by providers, by hundreds of billions every year! That adds up to $7 trillion over 10 years, twice as much as Ryan wants and even more than Obama admits to. And both sides know its scope and identity, but “allow” providers “leeway” to defraud. The only ones who are harmed, mainly financially, are patients, who like alter boys place all their trust in their “ethical role model” providers who bill through systems that pay through codes entered into government computer systems. This includes providers who bill for services never given to patients most of whom don’t exist, which CMS, the Justice Department and the FBI can’t even detect, let alone prosecute.
A few Senators and the WSJ want to open Medicare data so they can detect how much and who the providers are who do one task and bill for a higher paying one, to “make up” for payments that are “below their cost”. Heaven forbid they might simply not take unprofitable patients. But if “unprofitable” patients make up all your business and don’t provide enough profit, the choices are slim and the U.S. Government doesn’t care if you “game the system a little” – or a lot! So which providers defrauds the system? They all do. So Ryan wants direct billings to patients or insurers who won’t pay bogus bills. Makes sense to me.
Art, a third of health care spending may be wasted, but no one knows which third. Getting rid of waste is not easy and can probably only be done by turning health care into a competitive market.
I agree with Stephen. No one knows what to cut out. Put differently, no one has a reliable algorithm to tell us what not to do.