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September 27, 2011

Paul Ryan's Speech on Health Care Reform

Of ObamaCare he says "Repeal & Replace," which I understand has become some kind of dirty word among some conservatives, who insist, contrary to the evidence, that almost nothing needs to be done in the area of health care.

That's not true. Health care is currently a weird blend of socialism and waste. Costs continue going up 2 or 3 times faster than GDP. There is something screwed up on a fundamental level here.

But the law’s new open-ended entitlement programs are its biggest failure. One has been described as a classic “insurance death spiral,” and the other requires an additional trillion in new federal spending. Both are fiscally unsustainable, and estimates suggest the costs could be much higher than initially projected.

And that ultimately is where President’s health law falls short. If you look at our debt-and-deficits problem, it really is a health-care spending problem. Today, excluding interest, approximately one-fourth of federal spending goes toward government health-care programs, such as Medicare and Medicaid.

By the time my kids are my age, the non-partisan Congressional Budget Office projects that the share of federal spending going to pay just for health care programs will reach 45 percent.

And the new health law does nothing to address the pressure that escalating health care costs are putting on the federal budget. CBO Director Doug Elmendorf has stated that the new law, “does not substantially diminish that pressure.”

Instead, it doubles down on the flawed design of open-ended, subsidized government health care. The result? A health-care system characterized by overutilization and inefficiency, in which costs are rising at 2 to 3 times the growth rate of GDP.

As any family on a budget can tell you, when one-fourth of your budget is growing three times faster than your income, you are in deep trouble – all other priorities get squeezed as you fall deeper into debt.

That is exactly the situation our government faces today.

There is no serious dispute – on either side of the aisle – that health-care inflation is the primary driver of our unsustainable deficits. As President Obama put it, “If you look at the numbers, Medicare in particular will run out of money, and we will not be able to sustain that program no matter how much taxes go up.”

And Democratic officials will even admit that the primary driver of health-care inflation is the current structure of government programs. As HHS Secretary Kathleen Sebelius recently testified regarding Medicare’s flawed fee-for-service structure, “I would say that the current fee-for-service system, yes, is unsustainable.”

So the disagreement isn’t really about the problem. It’s about how best to control costs in government health care programs. And if I could sum up that disagreement in a couple of sentences, I would say this: Our plan is to empower patients. Their plan is to empower bureaucrats.

Obama's plan is very nasty for seniors. Very nasty. This is the most under-reported political story of the decade. While Obama and the Democrats run a Mediscare campaign, it's their own policies that should be scaring the living hell out of seniors.

Just last week, the President rolled out a deficit-reduction plan that doubled down on his bureaucratic approach to controlling Medicare costs, first advanced in his health-care law last year.

The law empowers a board of 15 unelected officials – the Independent Payment Advisory Board, or IPAB – to hold the growth of Medicare spending to GDP plus 1 percent by reducing reimbursements to health-care providers. Unless overturned by a supermajority in Congress, the recommended cuts dictated by this board become law.

The President’s latest proposal simply called for letting IPAB cut deeper. This board of bureaucrats will now be tasked with holding Medicare’s growth rate to GDP plus half a percent. To put that in context, Medicare is currently growing at 6.3 percent per year.

Medicare’s non-partisan chief actuary, Richard Foster, has been clear on this point: Going from 6 percent growth down to the President’s targets, using only the blunt tools that his law gives to IPAB, would simply drive Medicare providers out of business, resulting in harsh disruptions and denied care for seniors.

In fact, the deterioration in seniors’ care that is projected to occur under IPAB would be so untenable, the board is unlikely to yield any savings at all. Future Congresses would be under tremendous pressure to undo the cuts, just as past Congresses have time and again reversed scheduled cuts to physicians’ pay.

As I keep saying here, "Business as usual" is not even on the table. Neither party actually proposes to keep the current system going. So seniors who want the current system to keep on going -- you lose. No one's even talking about that.

The Republican plan is to reform the system so that costs do not continue to skyrocket.

The Democratic plan is to do no reforms to the system at all, and just cut the amount of money paid to health-service providers -- who, let me be clear, will simply stop treating Medicare patients. Oh, the sort of doctors who can't otherwise attract a clientele will treat them; but the sort of doctors willing to work for the government's cost-controlled cut-rate reimbursements are not, let us say, top shelf.

So both parties propose cutting Medicare spending. Only one party proposes reforms to the system that actually might blunt the impact of reduced spending. That is, if spending goes down, but a reformed system results in lower prices, too, then the actual net effect of that reduced spending is lessened.

The other party just wants to savagely reduce reimbursements for those who actually treat seniors, so they can continue to piss away money on Solyndra and ObamaCare For Everyone (TM).

Those are the choices on the table. "Let's just keeping doing what we've been doing" is not among them.

Thanks to Dave @ Garfield Ridge.



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posted by Ace at 01:53 PM

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