I have to take issue RJ with your assertion that both parties label the other side as being extreme when it is not justified. It is one thing to label Obama as a socialist when he has never advocated any socialist policies. I think you would agree that would be unfair to label Obama as a socialist. Howeiver, what is wrong with saying that Ryan is a Ayn Rand adherent (believing in an extreme libertarianism), that he has advocated the privatization of socia security, vouchers for medicare, and tax cuts for the rich. This is Ryan's record--what is wrong with pointing that out? Ryan's medicare plan was enormously unpopular with people who classified themselves as conservatives. Ryan is an extremist because his idea are well outside of the mainstream, not because Democrats have painted him as such.

Conservatives have succeeded with obtaining tax cuts, but they have hit a brick wall with trying to "reform" social security or medicare. People do not support getting rid of guaranteed benefits with regard to social security and medicare and gambling on free marke alternatives. And Ryan and Romney will run away from Ryan's ideas in these areas. I saw a clip of Rush Limbaugh where he started to mention Ryan's ideas on social security but then said immediately that he did not want to muddy the waters or scare people--even Rush Limbaugh was afraid to bring up privatizing social security

It's 'demagoguing' to quote Wikipedia to cast doubt on your assertions?

The 2011 Ryan Plan for Medicare is most assuredly a voucher scheme. People under 55 who are already enrolled in Medicare by 2022 would be able to remain in it, but everyone else in that age cohort would end up having to be on the vouchers. That's what he was proposing last year.

If the 2012 Ryan-Wyden plan is much different, please furnish us with the evidence.

To be honest, I'd rather not wait for DF to provide evidence.

I checked the latest 'Path to Prosperity' document: http://budget.house.gov/uploadedfiles/p ... ty2013.pdf

What it seems to be is an insurance 'voucher' (as opposed to replacing Medicare with a voucher scheme). Private insurers would offer plans, and the prices of them would be compared to a 'price' for fee-for-service Medicare. The price of the second cheapest private plan, or of the Medicare plan whichever is the lowest would set the amount of funding the senior would get (the 'voucher'). So, if the plan they choose costs more, they would have to pay the extra.

There is an assumption that this 'market' (which would have various 'fixes' used) would drive down costs, but still it allows (as does Obama's policy) a growth rate based on GDP growth plus 0.5%. It relies on private insurers being able to come up with a plan with the 'actuarial equivalent' of Medicare for a competitive price. It also isn't clear whether the benefits of Medicare might have to change in order to meet the target growth, or how to address medical inflation.

It is clearly different from Ryan's previous plan. Whether or not it would actually work is a different matter.

ant

At first you try to say you aren't just viewing his plan as extreme

Where?
Because I do view it as extreme.
But I point out that one's perception is fueled by one's experiences and knowledge.
The reason The voucher system,( or whatever semantics now chosen for a system that only pays medical costs up to a certain amount,) will seem extreme for those used to Medicare is that people are used to the current system. And like it.
Proposing to change a popular program is going to met with scepticism. Well, it already was met with scepticism when first proposed by Ryan.

danivon

There is an assumption that this 'market' (which would have various 'fixes' used) would drive down costs, but still it allows (as does Obama's policy) a growth rate based on GDP growth plus 0.5%. It relies on private insurers being able to come up with a plan with the 'actuarial equivalent' of Medicare for a competitive price. It also isn't clear whether the benefits of Medicare might have to change in order to meet the target growth, or how to address medical inflation.

Its interesting that conservatives used to be the pragmatic group. And Liberals the group who tended to believe unproven theories.
It used to be Conservatives who wanted to know how a program would actually be executed and Liberals who said "It'll all work out, trust me..."

Ricky:

Its interesting that conservatives used to be the pragmatic group. And Liberals the group who tended to believe unproven theories.
It used to be Conservatives who wanted to know how a program would actually be executed and Liberals who said "It'll all work out, trust me..."

What is the pragmatic Liberal plan to control medicare and medicaid costs which are forecasted to overwhelm the federal budget? What is the pragmatic liberal plan to control health care costs which are now predicted to represent 20% of our economy by the end of the decade?

Ray Jay wrote:What is the pragmatic liberal plan to control health care costs which are now predicted to represent 20% of our economy by the end of the decade?

Wouldn't that be the ACA?

danivon wrote:To be honest, I'd rather not wait for DF to provide evidence.

I checked the latest 'Path to Prosperity' document: http://budget.house.gov/uploadedfiles/p ... ty2013.pdf

What it seems to be is an insurance 'voucher' (as opposed to replacing Medicare with a voucher scheme). Private insurers would offer plans, and the prices of them would be compared to a 'price' for fee-for-service Medicare. The price of the second cheapest private plan, or of the Medicare plan whichever is the lowest would set the amount of funding the senior would get (the 'voucher'). So, if the plan they choose costs more, they would have to pay the extra.

There is an assumption that this 'market' (which would have various 'fixes' used) would drive down costs, but still it allows (as does Obama's policy) a growth rate based on GDP growth plus 0.5%. It relies on private insurers being able to come up with a plan with the 'actuarial equivalent' of Medicare for a competitive price. It also isn't clear whether the benefits of Medicare might have to change in order to meet the target growth, or how to address medical inflation.

It is clearly different from Ryan's previous plan. Whether or not it would actually work is a different matter.

Even with the Ryan plan, Medicare costs will go up 70% over the next 10 years.

Here's what we know "Medicare as we know it" is not sustainable. Something has to be done. Democrats want to do nothing but make commercials picturing Republicans killing granny. Republicans are at least willing to put up ideas--and ideas that affect NO ONE 55 or over.

DF, why do you keep repeating the point that the proposals affect people under 55? Are you labouring under the delusion that I have argued that it does affect current seniors? Or are you arguing with someone else?

Purple wrote:

Ray Jay wrote:What is the pragmatic liberal plan to control health care costs which are now predicted to represent 20% of our economy by the end of the decade?

Wouldn't that be the ACA?

My understanding is that the ACA brought it up from 18% to 20%.

I don't think the ACA is responsible for the aging of the baby boomers, which surely must have a huge impact on national medical costs. But I don't want to get into the position of defending the ACA. I merely ask whether it doesn't in fact have some cost-containment features, and thus represent the Dem plan to contain costs. Aren't the 'death panels" in fact a part of one cost-containment feature?

Purple wrote:I don't think the ACA is responsible for the aging of the baby boomers, which surely must have a huge impact on national medical costs. But I don't want to get into the position of defending the ACA. I merely ask whether it doesn't in fact have some cost-containment features, and thus represent the Dem plan to contain costs. Aren't the 'death panels" in fact a part of one cost-containment feature?

Yes, the aging of the baby boomers has a huge impact. Yes, the ACA had some cost containment features, but not material enough or practical given the extent of the problem. I don't think the "death panel" provisions passed, although substantively I think they were a good idea. The Democrats didn't have the courage of their convictions in the face of Palin / Gingrich demagoguing.

My point is that now that we have passed the ACA, the projections are that medicare and medicaid will increase substantially and create extreme fiscal problems for the US. Health care spending will continue to be challenging for the private sector. The Democrats do not have a plan to deal with this given that the ACA does not bend the cost curve down sufficiently, if at all.

So, we have an extreme problem and one political party is not offering a solution. ACA was the only arrow in their bow and they don't claim to have another arrow as far as I can tell.

danivon wrote:DF, why do you keep repeating the point that the proposals affect people under 55? Are you labouring under the delusion that I have argued that it does affect current seniors? Or are you arguing with someone else?

Not you, just every liar associated with the Obama campaign.

Yeah, that is redundant.

So... Why address the comments to me? Do you think Obama campaign staffers are here to debate with you?

RayJay, RickyP, Purple...

There are two issues emmeshed here. One is the overall cost of healthcare to the US economy, the other is what proportions of that cost are borne by government (or taxpayers), by employers, by consumers/patients/employees, by chairty etc, and in the case of government funding, where the revenue comes from.

Apart from the emotive descriptor applied to the ACA 'death panels', they are not much different to what insurers already do - decide what they will cover with cost and effectiveness as a measure. If anything, insurance companies can be more arbitrary than the mooted policy would be, as they are clearly seen trying to avoid paying out on individual cases. But applied at a broader level, using cost v quality of life and effectiveness, such bodies can hold down inflationary costs.

Eventually we are going to go to a single-payer system, RJ, like other westernized countries. Free market solutions do not work with health care and the ACA does not go far enough with cost containment. At some point, given that we have not been able to find a solution different from other countries that have a successful single-payer system, we will simply copy them. The ACA will either hold costs in check or it won't; if it doesn't then we will have to go to single-payer. The Ryan plan is dead--the electorate is pretty much untied against having the elderly have their health care not be guaranteed.

freeman2 wrote:Free market solutions do not work with health care and the ACA does not go far enough with cost containment.

Sigh.

You discovered this, how? By virtue of the "free market" we've had in healthcare in which companies could not sell across State lines?

Is that a "free market?"