Not to distract from the day of (ex) Osama (in which I’m wallowing as much as the next fella)…but just in case anyone wants just a touch of variety in their bloggy diet, here’s a peeve I picked up from this a.m.’s breakfast reading.
The piece is actually a good one by Jamer Surowiecki, describing how the long term budget issues facing the US are not those of deficit spending, per se, but of health care costs running consistently ahead of inflation GDP growth [per Acontra below]. It’s a fair account, accurate as far as I can tell on a quick read, and Surowiecki captures the nub of the matter precisely when he writes:
The ideal system, for most voters, would guarantee all seniors reasonable health care, stop the debt from getting out of control, and keep paying health-care providers as before. The problem is that you can only do two of those things at once.
Obama, as Surowiecki correctly notes, opts for door number three — choosing to change the payment structure for health care.
He gets it a bit wrong, IMHO, when he implies that Ryan similarly preserves his own two out of three options. In fact, the Republican blueprint neither guarantees all seniors reasonable care, nor does its voucher plan control costs, as Surowiecki does say, given that the private insurers the GOP wants to feed (how’s that for a mandate?) have already been shown to be crappier at cost control than Medicare. But if he is a little too kind to the feckless Ryan — a bit too fair and balanced, as it were — that’s not what gets my goat.
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Rather the fault lies in what is otherwise a pretty devastating passage describing of some of the flaws in Ryan’s prescription. That section concludes with this line:
…Indeed, the Congressional Budget Office estimates that Ryan’s plan would actually increase the amount of money Americans spend on health care, since private insurers aren’t as good at curbing costs as Medicare. But taxpayers would pay less. (Italics added.)
Well…no. As Surowiecki does say in the same damn sentence, Americans will spend more on healthcare under the Ryan rationing scheme, even as less of that sum would be covered by federal disbursements of tax receipts. Nonetheless, last time I looked, just about every American is a taxpayer and even those who pay no income tax fork over something to Uncle.
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And with that slip, Surowiecki trips right into the wingnut meme-trap. Under the Ryan plan taxpayers would pay more — much more — for health care, or else they would die of what a doctor I knew years ago termed “financial arrest.”
That some of the money would come out of that which they spend on taxes, and some directly out of their bank accounts, their home equity, their funeral plot funds doesn’t alter the basic fact: the Republican party has endorsed a plan in which Americans will spend up for care, or get less (and die sooner) or both.
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And in using the term “taxpayer” where he meant “the federal government” Surowiecki allows a false notion to stand. The substitution gives the Republican plan a shiny veneer — that for all that the effects on health care will be pretty catastrophic (as Surowiecki says), the scheme will still have the virtue of saving the taxpayer money.
Again: Surowiecki knows it won’t. He’s not a bad guy — quite the reverse, in fact, usually a very smart economics correspondent. But this lapse of language, especially from one so generally on the ball, is revealing as hell.
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We have to reclaim the frame of the argument, and remind everyone that when the Republicans transfer the power from public to private, from a social insurance approach to health care system to private profit maximizing insurance companies and fee-for-service business models, Americans, taxpayers all, lose much more than money.
Image: Vincent van Gogh, Ward in the Hospital in Arles, 1889.
Paul Gauguin, The Spirit of the Dead Keeps Watch, 1892
WereBear
Lee Atwater should come back. Just long enough to have a reality show.
Martin
Ryan’s plan is insurance company welfare. Every senior will be walking around with a check for $12,000, payable only to insurance companies.
It’s a corporate welfare plan and we should call it such.
acontra
A quibble: the problem is not health costs running ahead of inflation, it’s health costs running ahead of (nominal) GDP growth.
JCT
Actually I’m waiting for some pundit to ask the magic question about pre-existing conditions.
Might as well wait for Godot I guess, but it is a central question given that the repeal of ACA seems to be implied in the complete Republican approach.
Nutella
Someone from the UK recently asked me why Americans were so obsessed with health care as a political issue, since it’s only 7% of the economy and was shocked to hear that here in the US it is 16% and rising.
It’s not health care per se that is the problem. That’s been solved reasonably well by the UK and all the other first-world countries who manage to keep their systems going at 7% of GDP or thereabouts. Our problem is the out-of-control costs that the Ryan plan only makes worse.
It drives me crazy that we never look into all the many successful plans that other countries have. They’re all different and all better than ours but we’re determined not to learn from them.
Omnes Omnibus
The van Gogh is stunning. That is all.
CJ
As a mostly lurker I have to say how much I enjoy your analysis. The art gives it character.
Anyway, I think Surowiecki is intending to say that the Ryan plan is less burdensome on the taxes side. Quite obviously any individual person is going to be spending more as you point out, but if the percentage of that spending that goes to taxes is lower than I guess he’s technically true but collectively an idiot.
KG
I’ve asked this question to a few people who are (or were) opposed to health care reform, and rarely got a satisfactory answer:
What difference does it make if you pay money to the government or a private company? What if that private company had a vested interest in not paying for your healthcare?
I’ve come to the conclusion that traditional market forces don’t apply to health insurance (or health care generally). Based on that conclusion, I’ve moved to be in favor of some sort of single payer system. I also think it fits with the Hamiltonan idea of ordered liberty
freelancer
I just saw Rumsfeld on Greta talk about how last night’s attack vindicates the Bush approach towards terrorism as worthy of going to war for instead of taking a “law enforcement approach as you would with bank robbers and murderers and such”.
“How come it took so long?”
“Well, you have a military to fight an army, not really to perform a manhunt.”
Cognitive Dissonance, it’s a known known.
cbear
Tom, I absolutely love your mixing of art and commentary in your posts and always look forward to applying my less than stellar knowledge of art history to attempting to guess the artist responsible for the depicted paintings.
That being said, I think you could reliably use, over and over, almost any of Goya’s “black paintings” in relation to virtually any post regarding Repug healthcare or economic issues. Imho, they capture the very essence of the modern Gooper.
Tom Levenson
@cbear: I love those, and I’ve used some of them already, along with a bunch from Goya’s “Horrors of War” series. I try to spread my sources around, because if I didn’t, it would be back to the same three or four — Goya among them — every time.
Roger Moore
@Martin:
And all it will buy them is the right to pay even more.
Martin
@Roger Moore: Exactly. But Dems would do well to sell it as a welfare program for insurers. If you want to turn independents off of a program, the GOP has demonstrated that its a very effective tactic.
Jman
@KG: What difference does it make if you pay money to the government or a private company? What if that private company had a vested interest in not paying for your healthcare?
Government, provided it is not run by those bastard Republicans, will do it’s best to take care of medical care for seniors. Private for profit corporations will do their best to swindle old people out of every last nickel and dime leaving them destitute to their deaths. It is simply human nature,
public service versus unrestricted greed.
Brian
I think you’re reading a bit too much into it. The sentence should read “But taxpayers qua taxpayers would pay less;” that’d certainly make more sense but could easily have gotten simplified by the editor.
cbear
@Tom Levenson:
The Van Gogh and Gauguin were inspired choices and although they were already two of my favorite artists, seeing those particular paintings caused me to (thru the magic of the internets) revist their works and learn even more about them.
And I’m very glad that you do “spread my sources around” as you very often expand my meager, sometimes nonexistent, knowledge of so many other wonderful artists and their works.
It’s funny, but the older I get the more I wish I knew and regret not having learned.
klem
Your posts suck Tom. So elitist, so vapid, so ordinarily lame. I still have no idea why John Cole allows you to pollute an otherwise phenomenal blog.
Yutsano
@klem: Next time study in his classes. Then you won’t fail and feel the need to lash out anonymously on blogs. Of course it must just burn your soul that Tom writes with both intelligence and eloquence. And BTW get the fuck over yourself.
Susan S
Umm..once again. There is a 4rth solution..expand the tax base that supports Medicare. Under the current system, all wages have a Medicare tax. If you are self-employed, you pay 2x the tax. But no interest, capital gains or dividends are subject to that tax. Why not lower the tax to 1%..and have all income subject to it. Remember, the cancer surgeon pays it on all his/her wages.. the hedge fund manager not. And what will an insurance policy cost an 85 year old? Life expectancy will drop drastically if the Ryan plan passes.
Wolfdaughter
@Tom Levenson:
Munch’s The Scream is also often appropriate, and I believe you have used it before.
Also, when discussing health care, you could think of throwing in the odd Galen or two.
Yutsano
@Susan S:
Feature, not bug. And don’t let a Republican try to tell you otherwise.
Cheryl from Maryland
@Tom Levenson: It is a sad commentary on our times when one’s go to painting is Goya’s “Saturn Devouring His Children.” To quote Wikipedia on Expressionism: “Such art often occurs during times of social upheaval, such as the Protestant Reformation, German Peasants’ War, Eight Years’ War, and Spanish Occupation of the Netherlands, when the rape, pillage and disaster associated with periods of chaos and oppression …”
D. Mason
The hardly mentioned reality of the Ryan plan is the most clogged emergency rooms the world has ever seen — clogged for everyone. When the most health care using demographic can’t afford insurance they will do what everyone else who’s dying and can’t pay for care does, go to the facilities that can’t refuse to help. I hope Republicans love sitting in an emergency room with their little angel screaming for hours with a broken arm, because they’ll be there along with the rest of us if this goes down, which it won’t.
Barry
Tom L: “Again: Surowiecki knows it won’t. He’s not a bad guy—quite the reverse, in fact, usually a very smart economics correspondent. But this lapse of language, especially from one so generally on the ball, is revealing as hell.”
Your paragraph is self-contradictory. Surowiecki is trying aid the extremely comfortable in afflicting the afflicted. The word for that is ‘evil’.