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Monday, April 18, 2011

Fixing Medicare: Obama Vs. Ryan (Who is he?) 4/18/11

Clicking on the title will take you an earlier blog posting about Rep. Paul Ryan!

Pulled Up From Below:

So let me add a caveat about projections like this ... they are practically worthless!  An interesting exercise but the numbers in 2032 will not be even be close under either of Ryan or Obama plans!

Ryan's plan appeals to the "market place" to do the allocation ... if you can afford it you can have it!  The market place approach will have huge transactional costs to be borne by the consumer - these costs can be money or personal time trying to make a choice.  This is what Walker wants in Wisconsin.


This piece is worth evaluating carefully -
Fixing Medicare: Obama Vs. Ryan - Planet Money 4/13/2011

It starts with a graphic.  The dashed line on the graphic shows the expected revenues (government) out to what looks like 2032.  Stacked on top of one another from top to bottom is first Social Security, then combined Health (Medicare, Medicaid, CHIP and Exchange Studies), then comes Other Noninterest Spending (which I assume includes Military).  Then on a solid line above the dashed  Revenue line is the label Total Primary Spending.

The Revenue line being below the Total Primary Spending line implies deficits.  The first thing to notice is the combined colored area (Health) keeps getting wider as time goes by and the other areas between their respective boundaries remain the same width.  Can you put your finger on the problem?

From the article ...
In the long run, growth in the federal deficit is all about health care — particularly Medicare, which accounts for the biggest chunk of government health spending.
President Obama and Rep. Paul Ryan, the Republican chair of the House budget committee, both recognize this.  Both want to slow the rise in Medicare costs. But they want to do it in very different ways.

The whole thrust of this article is to illustrate the difference of approaches of Paul Ryan and the Obama Administration.  The way I interpret Ryan's plan is he makes the lines stop diverging, i.e., no growth in expenditures will be allowed.  Obama has to find a way to do this too!
Under the Ryan plan, according to the CBO's estimates, the government would pay less for Medicare, and individual seniors would pay more.
Under Obama's plan, the government, rather than individual seniors, would still be on the hook if health costs keep rising so quickly.
So let me add a caveat about projections like this ... they are practically worthless!  An interesting exercise but the numbers in 2032 will not be even be close under either of Ryan or Obama plans!

Ryan's plan appeals to the "market place" to do the allocation ... if you can afford it you can have it!  The market place will have huge transactional costs to be borne by the consumer - these costs can be money or personal time trying to make a choice.

The Obama approach -
But the Obama plan aims to make it easier for the federal government to slow the rise in Medicare costs.
If costs kept skyrocketing, a special panel would come up with ways to "reduce the rate of growth ... while not harming beneficiaries' access to needed services." Congress would then have to accept the panel's recommendation or make other changes that achieve comparable savings.
What seems to be lacking in any of these discussions is what or how might the tax system be modified to moderate the assumed growth of health costs, or other more direct intervention to make the market place perform in a way we might like.  We use the marketplace to regulate things like airline routes, telephone service, radio and television - at least in ways different from today.  After all we have been deregulating for the last 40 years and where are we now.   Regulation no doubt has some rigor mortis problems but my right to live or die ... how should that be decided ... my genetics and my bank account, or the lottery.  The lottery  ... the more you spend on tickets the more likely you get health care - but you still have to win!
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More links for thought ...
Ezra Klein - WashPost 2010 - America spends way, way, way more on health care

Compares health care expenditures among nations.  The NatGeo graphic source is in the next link and is much more readable - it needs to be seen full size.

Graphic - The Cost of Care Posted Dec 18,2009 - National Geographic

Graphically depicts health care expenditures vs life expectancy among nations.  You need to see it large.

More thoughts - do any of the countries depicted have a Paul Ryan Health Care System?  Except for Mexico and the United States they all seem to have Universal Health Care.  We spend roughly $2900/yr more to die two (2) years younger than the Swiss.  As I recall the Swiss use private insurance but manage (regulate it) very uniquely?

That thought led to this link -
Healthcare in Switzerland - Wikipedia

WI 1848 Forward:Fixing #Medicare: #Obama Vs. #Ryan (Who is he?) 4/18/11: 47% 99% #AARP #ows #dems #Baldwin vs #elites

WI 1848 Forward: Fixing #Healthcare #Medicare: #Obama vs (Shift Burden to You) #Walker #Ryan  4/18/11: 47% #AARP

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