Romney picks Paul Ryan as his running mate **official thread**

[Marston]

Ryan ties the wonkish numbers bit with a passion about how while the medicine does not taste good, it is essential for your health, and that he really cares about your health, in a way Mittens is simply not capable of projecting.  In a word, Mittens is uptight - and Ryan isn't.

When you get tied at the hip to someone else's policy, and the guy who formulated the policy is a good salesman, you hire the salesman.  KISS.  

What about when the product is a piece of crap?

Ryan's plan is just a massive cost-shifting scheme. I mean, it's obvious, isn't it?

[Marston]

Ryan ties the wonkish numbers bit with a passion about how while the medicine does not taste good, it is essential for your health, and that he really cares about your health, in a way Mittens is simply not capable of projecting.  In a word, Mittens is uptight - and Ryan isn't.

When you get tied at the hip to someone else's policy, and the guy who formulated the policy is a good salesman, you hire the salesman.  KISS.  

What about when the product is a piece of crap?

Ryan's plan is just a massive cost-shifting scheme. I mean, it's obvious, isn't it?

No, it is more complicated than that.  In the end, one ends up at the same place regarding how to deal with medical subsidies we cannot afford going forward, and/or go outside of/bust the budget. One approach is that you just by regulation set forth the basket of care the government will subsidize, and when, and trim the basket if you run out of money, or appropriate more money. In the Ryan plan, you set up a budget in advance of how much you get, which is the current cost of care increased by 3% a year or something. If the amount of the sums handed out turn out not to buy enough of a basket of services down the road, just like with the regulatory regime, either you hand out more government dough, or the basket shrinks.  Just what is the real economic difference, putting aside issues of efficiency, and price policing, and more choices, etc? The answer is - none, nada, nothing.

You see what I am saying Marston?

I don't think it is that complicated. Indexing the premium-support system to no more than half-a-percent above the growth rate of the economy when inflation for healthcare is rising so much faster than that... Well, I think it's pretty obvious what the end-result will be. Medicare coupon-thingy beneficiaries will be priced out of the system and the "basket of services" - as you call it - will shrink lest seniors pay more out-of-pocket. That's the whole cost-shifting thing I was talking about.

That kind of system give the feds a lot more leeway in saying to seniors that the problem lies with the private insurers who set the premiums and then the whole usual political game of hot potato takes place with the private insurers saying that the feds should appropriate more money to the premium-support vouchers and the feds saying that the insurers should lower/not increase premiums. And, as usual, in the end nothing gets done and people will suffer.
 

[Marston]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

[Marston]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

Under the current status quo, the guarrantee itself as presently constituted no longer exists as a going concern in the future. That is why Wyden and Rivlin and other Democrats have embraced some form of premium support system.

I don't think anybody is advocating the status quo. The simple fact of the matter is that Medicare reform cannot be done without comprehensive systematic reform. Something must be done to address the over-utilization of health services in this country. Yes, some form of rationing will have to exist, regardless of the system in place - as it should. Also, the abhorrently high administrative costs associated with health insurance (which ironically range from 5-20% in the private health plans Ryan advocates throwing everyone in.) needs to be addressed. Medicare's administrative costs are only roughly about 2%, btw. The lack of focus on preventive medicine/care, the large uninsured population that waits to obtain care until their condition becomes acute and the fact that the U.S. Congress is PHrMa's whipping boy require a cure, as well. The list goes on and on, sadly.

Ryan is just attempting to reduce federal liability, not solve the actual problem. I thought it was obvious but perhaps not.   

[Marston]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

Just one more time - the Medicare "guarantee" is effectively dead - as it should be. And yes, of course, everybody should get some basket render in a logical and cost effective way, everybody, regardless of ability to pay. The pre Obamacare system was itself an epic fail, which deserved to die.

No, no I don't think it is. There are a plethora of mechanisms that could be implemented that could effectively extend Medicare solvency. There just isn't the political will (on either side of the aisle) to do so.

Meh, I just suppose we'll have to agree to disagree on the rest and let the chips fall where they may.

[Marston]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

Under the current status quo, the guarrantee itself as presently constituted no longer exists as a going concern in the future. That is why Wyden and Rivlin and other Democrats have embraced some form of premium support system.

I don't think anybody is advocating the status quo. The simple fact of the matter is that Medicare reform cannot be done without comprehensive systematic reform. Something must be done to address the over-utilization of health services in this country. Yes, some form of rationing will have to exist, regardless of the system in place - as it should. Also, the abhorrently high administrative costs associated with health insurance (which ironically range from 5-20% in the private health plans Ryan advocates throwing everyone in.) needs to be addressed. Medicare's administrative costs are only roughly about 2%, btw. The lack of focus on preventive medicine/care, the large uninsured population that waits to obtain care until their condition becomes acute and the fact that the U.S. Congress is PHrMa's whipping boy require a cure, as well. The list goes on and on, sadly.

Ryan is just attempting to reduce federal liability, not solve the actual problem. I thought it was obvious but perhaps not.   

That is because Ryan's plan is designed as a budget and not an all encompassing overhaul of healthcare. He doesn't chair the health, education and welfare committee.

Just like you don't think anyone is arguring for the status quo, well neither do I think that any one is seriously desiring to not address an overhaul of the Healthcare system, primarily focused on addressing those very rising costs you mention. In terms of real details this one is even more difficult to propose in an election year then a budget plan. The good thing is that with two "numbers guys" the chances are likely that both realize what the numbers are telling them have to be done and both Romney and Ryan have experience on the healthcare issue (one from expanding coverage, the other on the federal liability) to be able to tackle that problem. Romney does realize the problem to be sure, in his book he lemented that Romneycare didn't address the overal cost issue (expanding coverage is only a very small piece of solution pie here) and that most of which had to be addressed at the federal level.

Fair enough. I just doubt, given the Romney track-record of running away from anything healthcare related, except for promising to "...kill Obamacare dead on day one", that he'll seriously risk his political capital on healthcare reform given the disastrous effects it had on Obama, Pelosi, Reid and Co. during the 2010 midterms.