Sep ‘11
13
Consider Taking Cong. Paul Ryan (R-WI) Serioulsy
Wisconsin Republican Paul Ryan takes his position as House Budget chair seriously enough to have put his neck on the political block over the privatizing Medicare combined with a publicly-financed voucher related to the underlying cost of care. From Senators Henry Bellmon (R-OK) and Pete Domenici (R-NM) to Lawton Chiles (D-FL) and Kent Conrad (D-ND), this nation has been blessed with budget chairs willing to bite the budget bullets their colleagues shied away from. Medicare has always been the hardest spending nut to crack. In the bi-partisan Medicare reform days, authorizing committees shared the burden with budget. Since the partisanizing of health policy in 1993, the budgeters have carried the tough load and so it is with Ryan and Conrad this year.
Everyone, including the president and Democrats who passed the 2010 health reform law, know Medicare is a public insurance program which must change the way we pay for healthcare in this country or go broke. Republicans don’t trust government and Democrats don’t trust private insurance companies or individuals paying for high deductible insurance plans with vouchers to do it right, because there’s no evidence they can. As soon as possible someone, like Ryan and Conrad, need to decide there is common ground for reform.
Both come from states in which the actual costs of delivering health and healthcare services are much lower than they are in many other states. And the care quality is generally higher. So why not start now to change Medicare Part B payments to physicians and non-hospital providers in states like WI and ND to provide incentives for reducing supply-driven utilization of diagnostics, surgeries, hospitalization and medical errors? If it works, and it will, then offer similar opportunities to other states or even multi-state regions. Eventually the most efficient way to do this will be through private health insurance and the incentives offered by predictable “insurance premium supplements”. We demonstrated back in 1985 ff that it works for health maintenance organizations from Hawaii to New England, no reason it can’t work today.
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