Dec ‘11
15
Q&A with Dave Durenberger: The New Wyden/Ryan Medicare Overhaul Plan
Q: What is your take on the new Wyden and Ryan Medicare Overhaul Plan?
A: First, the involvement of Ron Wyden means bipartisanship and bicameraliship in Congress is so unusual as to add credibility to a product that to date has had only Republican sponsors and them divided. Even though the history of reform has some bipartisan demonstrations of the success of the principles involved.
Second, the timing of it means that Republicans are losing confidence in Repeal and Replace as an appropriate response to Obama’s policy efforts as they approach a presidential an congressional election. The involved health care community and the informed citizenry would like a chance at really improving quality and access and lowering costs. Not another four years debating the pros and cons of private vs. public insurance, national vs. state government, markets vs. government, rich vs. poor.
Third, it’s a Washington policy answer to a systemic problem and, like so many policy “solutions” in which I was involved in the 1980s especially, it’s a good cart ahead of a mediocre to bad horse. As former CMS administrator Don Berwick has pointed out, Medicare isn’t the problem, health care payment and delivery policy is the problem and, right now, Obamacare, appropriately implemented by the insurance and health care industry, with some policy reform help from Republicans working with Democrats in Congress and state legislatures and governorships, is more important than privatizing Medicare.
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