OK, so the Republicans are endlessly criticized for "not compromising". Ryan does that by partnering with a Dem to try to salvage Medicare, and the Dem is efiscerated by his own!!! Really?!? Do you want Medicare to survive? Guess not.
Would you care to identify the provisions in the bill that you consider to be a compromise? Or are we to the point that the simple act of getting a cosponsor from the other side of the aisle qualifies as compromise all on its own?
Wyden is catching hell on this because there are a lot of people who rely on medicare, and there are about to be a whole lot more as more boomers become eligible, and it seems every time Congress gets involved it gets more complicated, more expensive and covers less than ever before. These are the same jokers that came up with brilliant ideas like the donut hole and forcing you to choose a menu of drugs that they'll pay for before you know what you might need. People are skeptical of changes to medicare for good reason.
Also, talk of free market competition is often a prelude to privatization and gutting government programs. If there wasn't money to be made by the private insurers on this deal Wyden wouldn't be anywhere near this thing. Making it easier for private insurers to compete with medicare is likely just the first step. If Ryan and his ilk have their way they'll hack away at medicare until they force people into the arms of the private insurers--all in the name of "deficit reduction."
The free market would dictate that those who do not need care should not pay for it. There is no free market incentive for people who are healthy to buy health insurance. Their incentive is to wait till they get ill, buy insurance and have the insurer pay the cost. Their is no free market incentive to insure at risk people. None. The free market incentive is to let sick people die and not put resources into an outcome that is, in a sense, predetermined. There is no free market incentive to insure people who are at risk or in bad health. Krugman is right but I am not sure how useful Wyden is, really.
You're mistaken about the economics of insurance. Selling health insurance (especially with lifetime benefit caps) is a very profitable business assuming the insurer can use the law of large numbers to their advantage and negotiate covered procedures and reimbursements.
The underwriter knows that fewer "healthy people" will incur liabilities than unhealthy ones, which is why they have lifestyle management programs that incentivize weight loss or smoking cessation.
Healthy people should buy health insurance for the same reason non-smokers buy fire insurance on their home. In case disaster strikes.
Health insurance is not the same as health care coverage. Insurance is to cover the unexpected, which has varying degrees of risk, just as Mister Tee explains. Health "insurance" would be much cheaper if we did not expect/demand it to cover the "expected" (like "preventative" care).
Medicare "as we know it" is not economically sustainable.
What Wyden-Ryan are proposing would not even affect anyone already on Medicare and would offer a choice to those now under 55 when they do become eligible.
The "private" vs "public" furor is about who you think that a bureaucracy run by politicians would be better than a bureaucracy run by a profit making entity.
It would still be a bureaucracy and the rules would still be made by the government.
For my money, you can fire private sector bureaucrats if they screw up. Public sector bureaucrats never have to worry about that.
Of course, we can always wait until we get where Europe and California are.
What Wyden-Ryan are proposing would not even affect anyone already on Medicare
The hell it wouldn't! If Congress lets for-profit insurers in the door it won't be six months before they start complaining that they can't make a profit under the initial program conditions, citing "unfair" government competition. This grandstanding will be accompanied by a full-court press for ever-bigger subsidies and an ever-shrinking (i.e., less attractive) public option. Medicare as we now know it will be gone within a decade. That's the Ryan plan in 100 words or less. Don't be taken in by Republican expressions of "concern" for the "future" of Medicare. Republicans have hated Medicare with a passion since the '60s and will never stop trying to kill it.
Comments (14)
finally - something I can agree with from Krugman...at least a broken watch isn't right more often.
Posted by trash man | December 20, 2011 6:09 AM
Krugman's acting as though his daughter started dating someone without his approval.
Posted by David E Gilmore | December 20, 2011 7:07 AM
OK, so the Republicans are endlessly criticized for "not compromising". Ryan does that by partnering with a Dem to try to salvage Medicare, and the Dem is efiscerated by his own!!! Really?!? Do you want Medicare to survive? Guess not.
Posted by Waiting for 2012 | December 20, 2011 7:22 AM
I don't see what is particularly useful about Wyden....
Posted by tankfixer | December 20, 2011 7:55 AM
Waiting for 2012,
Would you care to identify the provisions in the bill that you consider to be a compromise? Or are we to the point that the simple act of getting a cosponsor from the other side of the aisle qualifies as compromise all on its own?
Wyden is catching hell on this because there are a lot of people who rely on medicare, and there are about to be a whole lot more as more boomers become eligible, and it seems every time Congress gets involved it gets more complicated, more expensive and covers less than ever before. These are the same jokers that came up with brilliant ideas like the donut hole and forcing you to choose a menu of drugs that they'll pay for before you know what you might need. People are skeptical of changes to medicare for good reason.
Also, talk of free market competition is often a prelude to privatization and gutting government programs. If there wasn't money to be made by the private insurers on this deal Wyden wouldn't be anywhere near this thing. Making it easier for private insurers to compete with medicare is likely just the first step. If Ryan and his ilk have their way they'll hack away at medicare until they force people into the arms of the private insurers--all in the name of "deficit reduction."
Posted by Pragmatic Portlander | December 20, 2011 8:13 AM
Here's another one.
http://www.huffingtonpost.com/dean-baker/the-cowardly-senator-wyde_b_1158619.html
Posted by smarana | December 20, 2011 9:00 AM
Nothing better than a New York liberal beating up another New York liberal(?).
Posted by Mike (the other one) | December 20, 2011 9:00 AM
The free market would dictate that those who do not need care should not pay for it. There is no free market incentive for people who are healthy to buy health insurance. Their incentive is to wait till they get ill, buy insurance and have the insurer pay the cost. Their is no free market incentive to insure at risk people. None. The free market incentive is to let sick people die and not put resources into an outcome that is, in a sense, predetermined. There is no free market incentive to insure people who are at risk or in bad health. Krugman is right but I am not sure how useful Wyden is, really.
Posted by George | December 20, 2011 11:22 AM
That's funny. Many people use the exact same term to describe Krugman.
Posted by MJ | December 20, 2011 3:51 PM
George.
You're mistaken about the economics of insurance. Selling health insurance (especially with lifetime benefit caps) is a very profitable business assuming the insurer can use the law of large numbers to their advantage and negotiate covered procedures and reimbursements.
The underwriter knows that fewer "healthy people" will incur liabilities than unhealthy ones, which is why they have lifestyle management programs that incentivize weight loss or smoking cessation.
Healthy people should buy health insurance for the same reason non-smokers buy fire insurance on their home. In case disaster strikes.
Posted by Mister Tee | December 20, 2011 4:22 PM
Health insurance is not the same as health care coverage. Insurance is to cover the unexpected, which has varying degrees of risk, just as Mister Tee explains. Health "insurance" would be much cheaper if we did not expect/demand it to cover the "expected" (like "preventative" care).
Posted by Mike Parr | December 20, 2011 4:38 PM
Medicare "as we know it" is not economically sustainable.
What Wyden-Ryan are proposing would not even affect anyone already on Medicare and would offer a choice to those now under 55 when they do become eligible.
The "private" vs "public" furor is about who you think that a bureaucracy run by politicians would be better than a bureaucracy run by a profit making entity.
It would still be a bureaucracy and the rules would still be made by the government.
For my money, you can fire private sector bureaucrats if they screw up. Public sector bureaucrats never have to worry about that.
Of course, we can always wait until we get where Europe and California are.
Posted by John D | December 20, 2011 6:50 PM
What Wyden-Ryan are proposing would not even affect anyone already on Medicare
The hell it wouldn't! If Congress lets for-profit insurers in the door it won't be six months before they start complaining that they can't make a profit under the initial program conditions, citing "unfair" government competition. This grandstanding will be accompanied by a full-court press for ever-bigger subsidies and an ever-shrinking (i.e., less attractive) public option. Medicare as we now know it will be gone within a decade. That's the Ryan plan in 100 words or less. Don't be taken in by Republican expressions of "concern" for the "future" of Medicare. Republicans have hated Medicare with a passion since the '60s and will never stop trying to kill it.
Posted by semi-cynic | December 20, 2011 10:02 PM
Krugman calling someone an idiot is an endorsement of that person in my book.
Posted by antiplanner | December 21, 2011 8:36 AM