Now that FDL’s Jon Walker has done the deliciously dirty work of exposing Paul Ryan’s anti-Medicare proposal to force America’s seniors to accept the same flawed mandate and voucher system as ObamaCare, I can’t wait to hear Mitt Romney explain why he thinks this is a terrific idea.
As Jon so subtly hints, a pig is a pig, even if it has Mitt Romney’s lipstick on it. For the affected groups, the basic outline of RomneyCare is the same as the basic outline of ObamaCare is the same as the basic outline of StupidRyanCare. Let’s review the features:
1. Force everyone in the affected group to purchase private health insurance. We’ll call that a “mandate.”
2. Require the private insurers to accept all eligible customers but do little to prevent them from discouraging/screening out sick people via poor service and marketing. Call this “the business plan.”
3. Deprive the customers of any lower-cost public alternatives, like Medicare for all, a public option, etc. Call that “choice” or “keeping the insurers honest.”
4. Allow insurance companies to become so concentrated that in 80-90 percent of the country, only one or two mega insurers control the local market and set prices, while providing minimal oversight to ensure quality of service. Allow the antitrust, anti-price fixing regulators to wither. Call that “free market competition.”
5. Require the affected group to select between this one or two insurers on an “exchange” website that allows them to find the websites for the few eligible private insurance plans. We call this, “using teh Google.”
6. Having stripped consumers of the ability to bargain collectively (via Medicare, a union, an employer) for better, cheaper, more honest private insurance, send individual consumers, including the sick and the elderly, out on their own to “bargain” with the insurance giants. Call this, “leveling the playing field.”
7. Minimize or neglect obvious efforts to rein in the costs of private health care providers, including hospitals, specialist cartels, and big PhRMA, who are allowed to merge and concentrate. Let them be shielded by too-long patents and non-compete agreements and exempt from market or regulatory cost controls or antitrust pressure. Then allow them to fix the prices that private insurers must cover and pass on to their captive customers, plus the insurers’ higher but hard-to-audit administrative costs and profits. Do “homes of the rich and famous” shows on the execs. Call this, “the invisible growing hand in your wallet.”
8. Collect payroll taxes and other revenues via government mandate to help subsidize premiums — we’ll call this “premium assistance” — but provide no mechanism to ensure that the assistance keeps up with rising care costs to make the premiums affordable. If you’re Ryan, make sure it doesn’t keep up (See Dean Baker and CBO on how this screws Seniors). Call that “fixing the budget by shifting the costs to vulnerable people on fixed incomes.”
9. Wait to see how many people die from this stupid system. Call that “fiscal responsibility” or just “evil.” (Note similarity to Wi. Gov. Walker et ilk in shifting budget costs to workers as a means to strip workers’ economic leverage.)
Yes, that’s it. That’s the structure of PaulRyanCare. It’s also the structure of ObamaCare for the non-elderly, non-poor, which is exactly RomneyCare in Massachusetts.
Now my ex-Governor has a slight problem. Massachusetts’ system is called RomneyCare, because he was governor and he signed the bill and then went around the country telling folks what a great system he created. But when another corporate Republican, Barack Obama, embraced exactly the same structure (because he likes Republican ideas), poor Mitt had to come up with a reason why ObamaCare was awful but RomneyCare was, uh, different.
What Mitt Romney has been telling talk shows and crowds for months is that RomneyCare is different because . . . (1) Obama proposed ObamaCare, so it can’t be the same because it’s a government takeover, and (2) ObamaCare is different because it’s one-size fits all, imposed nationally, whereas RomneyCare is tailored to fit the peculiarities of people like me who came from New Mexico and California but happen to live near Cambridge, MA, and (3) that’s the best he could come up with.
But now Paul Ryan has come out with PaulRyanCare, same as ObamaCare, same as RomneyCare, only worse, because Ryan doesn’t make any pretense of covering actual health costs over time. But worse for Mitt, Paul Ryan wants to impose RyanCare on all future seniors (after some date called “the day of forgetting”) across the nation. As in, “one size fits all.”
So I am anxious to know what Mitt Romney says about this. And here it is: (h/t TPM)
I applaud Rep. Paul Ryan for recognizing the looming financial crisis that faces our nation and for the creative and bold thinking that he brings to the debate. He is setting the right tone for finally getting spending and entitlements under control. Anyone who has read my book knows that we are on the same page.
Oh. So Paul Ryan read Mitt’s book. But don’t worry about poor Mitt. Montana Senator Max Baucus has now assured us that he’d never allow anything as stupid, corrupt and cynical as RyanCare to be imposed on Americans. Not on his watch. No siree.
“We are led by idiots.” — Atrios