Well, maybe a little evidence

Ezra Klein:

Democrats believe the best way to reform Medicare is to leave the program intact but vastly strengthen its ability to pay for quality. Republicans believe the best way to reform Medicare is to fracture the system between private plans and traditional Medicare and let competition do its work.

It’s worth saying there’s no particularly good evidence for either option.

It's worth adding, however, that the profit motive which underlies private plans means that the pools of potential customers would be arranged concentrically, from less healthy and usually older consumers on the outside rings, paying more, to healthier and probably younger consumers on the inside, paying less. The real bodily basket cases are then dispatched to traditional Medicare, which can deny no one, yet Medicare (which would be ratcheting down its payments to providers) would in no way meet actual healthcare costs, thus those consumers would get stuck with the difference--and good luck finding an affordable supplemental plan, as you suffer from heart disease, emphysemia and cancer.

And for all this there is pretty good evidence; that being the entire history of private healthcare.

postscript: I should also add that Klein does go on to note that "Competition hasn’t worked very well in the health-care system." I didn't mean to be unfair to Klein, who's one of the best analysts around, but perhaps I was. My point was simply that the profit motive has no ethical place in a social field as vital as healthcare.

Comments

[Ted Frier]

I wish I could find it, but there was a Wall Street Journal editorial that came out during the health care debate that basically conceded the only way to make the conservative's preferred reform work -- letting the private health care industry sell across state lines -- was having the government create a "high risk pool" to take care of all the expensive cases it's not profitable for companies to cover. Cherry-picking, in other words, is built into the conservative business model, with the taxpayers getting stuck with the dregs.

[Robert Lipscomb]

Democrats want to reduce overall expenditures by reducing operating costs while maintaining benefits.

Republicans want to reduce overall expenditures by reducing benefits while maintaining operating costs.

[Turgidson]

The Democrats' evidence is that Medicare is a wildly popular and successful program that has greatly improved quality of life among our seniors. So preserving this system has plenty of empirical evidence.

The ACA began to "bend the cost curve," so to speak, vis a vis Medicare and health care generally - modestly, anyway. There is undoubtedly more that can be done along those lines (though maybe not the political will, since the GOP will, without irony, lie about "Medicare cuts!!!" to win elections).

Bumping up taxes on the wealthy will bring in more revenue, some of which can be used to preserve Medicare.

The GOP just wants to do away with the thing. Most of them know full well that "competition" in health care for seniors will only produce competition in the sense that a competition will emerge as to whether a person should pay for rent, food, or health care in a given month. Because they sure as shit won't have the money for all three if the granny starver has his way.

[AnneJ]

What I'd like to know is why do republicans think it will be all hunky-dory with those of us who are under the age of 55 working and paying into a health care system we will never be able to get. That is how they try to calm everyone down when they are not deflecting by saying that Obama is cutting medicare as well. I'm tired of republicans constantly trying to insult even my limited intelligence.

[majii]

I disagree with Ezra Klein's claim that "there’s no particularly good evidence for either option." This is why I change the channel when I see Ezra Klein on my TV--his tendency to give equal value to two disparate issues/plans/policies. The data doesn't lie. The current Medicare plan is the most efficient delivery system for providing healthcare to our seniors, and it is cost effective, delivering care for a fraction of the cost of any private plan. IMO, we don't need republican talking points when there's someone like Ezra Klein around to give validity to their nutjob policy ideas using a false equivalency.

[Turgidson]

Semi-agree with you, majii. Ezra usually starts from the premise that Republican ideas have merit. Almost always a faulty premise these days (and for the past, oh, 30 years, really).

His analysis is generally decent, particularly for a journo/pundit. And he does generally take the GOP to task for being wrongheaded morons, but I agree that he inexplicably pulls back from this frank conclusion at strange times (like this one).

I mean, he covered the ACA debate in more detail than pretty much anyone in the mainstream press and knew the dreadfully boring details even political junkies couldn't be bothered to learn. He knows the ACA made some real steps towards improving Medicare's finances. So he should know better than to say there's no good evidence to support the Democratic approach. It's probably fair to say the Democratic proposals to date are inadequate to the long-run budget challenges, but that's another discussion. (And of course, the GOP ideas as we know them, deliberately destroy this country's budget and government.)

[Tim]

Anyone who says there will be a private market that realistically covers senior health care rather than Medicare is dreaming. There is no market for losing lots of money. Even healthy seniors are on the end of the scale of expensive healthcare existence. There is only one option - a single payer like today for seniors - and preferably we end up with such a system for all.