Klein vs. Ryan

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Mark of New Jersey

Mark is a Founding Editor of The League of Ordinary Gentlemen, the predecessor of Ordinary Times.

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17 Responses

  1. Avatar Will says:

    Paul Ryan is seriously dreamy. Just sayin’Report

  2. If Ryan doesn’t have any hookers or mistresses in the closet or some other scandal…I hope he has the members of his exploratory committee on speed dial.Report

  3. Avatar Kyle says:

    “This is my 12th year. If I lose my job over this, then so be it. In that case, I can be doing more productive things. If you’re given the opportunity to serve, you better serve like it’s your last term every term. It’s just the way I look at it. I sleep well at night.”

    that was my favorite quote, I mean what’s the point of being elected if you’re just a seat warmer, right?Report

  4. Avatar North says:

    Good chat. Nice lines from Ryan.Report

  5. Avatar trizzlor says:

    If this is the Republican proposal then I’m completely at a loss as to how the Democrats couldn’t get their version through. Ryan’s plan takes the bulk of the regulation in Obama’s plan and simply moves it to the state level and within a voluntary exchange. I see two main problems here:

    1) While I like the idea of each state being a little island of competition, Ryan doesn’t offer any evidence that individual states are robust enough for their changes to have measurable impact, without which there’s no evolution

    2) More importantly, the exchanges are completely optional, both on the part of the state and the corporations, so even if the regulatory aspect of Ryan’s plan works, insurance companies can simply leave the exchange. Likewise, there’s no hard mandate for guaranteed access outside the exchange, which all but assures that those plans will be cheaper. Unless he expects the insurance companies to eat the difference and enter the exchange out of the goodness of their heart, this is a non-solution.

    So, Ryan’s built an entire exchange infrastructure that no one will use, and we’re right back to square one. The equation is quite simple: guaranteed access (i.e. allowing pre-existing conditions) requires an individual mandate so that a person doesn’t just join a plan once he gets sick; the individual mandate requires government subsidy so we’re not throwing poor people in jail for not getting insurance.

    I like the guy and I’m glad he gave this an honest shot, but I just feel like way to much of the plan is conjecture. The fact that Klein spent nearly the entire interview talking about things that everyone agrees on just makes me depressed.Report

    • Avatar North in reply to trizzlor says:

      This is not the Republican proposal. This is Ryan’s proposal. The official Republican Party counteroffer to the Dems HCR consisted of: -Health savings accounts, cross state insurance purchasing and tort reform (yes that is all).
      Neither Ryans’ interesting proposal nor the lauded Wyden-Bennet were the official proposals of the Republican Party.Report

  6. Avatar Consumatopia says:

    Yeah, I share trizzlor’s point of view here. On the points Klein and Ryan were discussion–on the effectiveness of markets and the price system–I’m sympathetic to Ryan. There’s probably common ground to be had here–some left of center think tanks have suggested we take a closer look at HSAs.

    But they just kind of off-handedly mentioned that Ryan’s plan will keep letting insurance companies sell insurance outside the exchanges. That should have been the focus of the interview–no liberal is ever going to accept a health care “reform” that still lets insurance companies sell plans that deny coverage or charge higher rates for preexisting conditions. An interview that focused on that would have been less interesting but more informative.Report

    • Avatar Matt C in reply to Consumatopia says:

      Ryan explicitly stated that he supports subsidizing patients with pre-existing conditions, rather than government heavy-handed mandates to provide these same patients with affordable coverage.Report

      • Avatar trizzlor in reply to Matt C says:

        Ryan’s said a lot of things. His proposal, however, is subsidized high-risk pools within the states voluntary exchange. Which means that people will just buy that insurance (or move to a state that has the high-risk pools) when they’re sick, making that category of insurance completely uncompetitive; or the government will have to subsidize such insurance so exhaustively that they might as well just call it Medicaid Jr. and get the competitive advantage of the public option.Report

        • Avatar Kyle in reply to trizzlor says:

          But who moves states for health insurance? Plenty of people don’t move because it isn’t portable but since RomneyCare passed there hasn’t been a mass influx of people heading to Massachusetts. In fact population growth has remained relatively steady and trim.

          I’ve heard this repeatedly, people will just move to states with health insurance so we have to do it nationally but there appears to be zero evidence to support this claim and a fair amount that suggests it won’t happen.Report

      • Avatar Consumatopia in reply to Matt C says:

        Ryan explicitly stated that he supports subsidizing patients with pre-existing conditions, rather than government heavy-handed mandates to provide these same patients with affordable coverage.

        Why are taxes and subsidies not just as much “government heavy-handedness” as guaranteed issue, community rating and mandates? Moreover, if subsidies to those with pre-existing conditions are really enough to solve the problem without mandates, then why not keep guaranteed issue and community rating? If we aren’t planning to leave those with pre-existing conditions without health care, and we’re going to tax everyone to pay for this, then what exactly is the purpose served by allowing insurance plans to deny coverage to these people?

        The only answer I can come up with is that you plan to short change the subsidies. Community rating is simple and transparent–everyone member of each plan pays the same. Determing what subsidies get assigned to which pre-existing conditions not only involves far, far more bureaucratic than a mandate system would, but it’s complicated and opaque enough that there’s no way to really tell whether the system is fair or adequate.

        Community rating and guaranteed issue are ethical requirements.Report

  7. Avatar Michael Drew says:

    I continue to think that Wyden-Bennett still dies a very fast death as soon as any politician starts to go out and really push it as something that’s going to happen rather than just hold it up as teh awesome bipartisan-sauce that we’re not doing. It raises taxes on the majority of working people with insurance in a way that is likely to cause them to have to revisit their health coverage arrangements. Paul Ryan is a very reassuring personality to try to explain why such a thing might make sense on the grand scale, but I just don’t see him escaping the wave of backlash to such an idea from ordinary everyday working people who don’t feel particularly concerned about their insurance and certainly don’t feel they are receiving an unfair tax break form the government that allows them to receive it. But I guess who knows.

    In any case it’s great that a guy from southern Wisconsin(w00t!) is getting all this attention & all (look out Russ Feingold!), but I really think the big point is being missed in all this: it shouldn’t BE remarkable when the opposition comes to the table with a real, workable alternative on major policy issues; they shouldn’t come after the existing legislative process on the issue breaks down (had Ryan done this sooner, he knows Obama could have co-opted many of his ideas); and it shouldn’t come from marginal parts of the party that could not advance the plans were they suddenly handed the majority. Ridiculously low expectations, those.Report

    • While Ryan isn’t in the GOP’s leadership (which is where the real problem is), I wouldn’t call him marginal either – he’s the ranking member on the Budget Committee. Also, he’s had a version of this plan bouncing around for quite some time, having worked with Tom Coburn on the Patients’ Choice Act.

      That said, I agree that it shouldn’t be remarkable when the opposition comes to the table with a workable alternative. That is a sad commentary on the state of the GOP, and especially the GOP’s leadership. Interestingly, in the Douthat piece, Ryan pretty much agrees with that sentiment and discusses how he’s worried that the GOP won’t be ready to govern if and when they return to power because they’re only interested in opposing things. This is a bad state of affairs for everyone, which is why I think it’s important that people like Ryan get promoted so that maybe they can get into that GOP leadership and start maneuvering the party to a point where it’s capable of governing for the first time in a very long time.Report

      • Avatar Michael Drew in reply to Mark Thompson says:

        Yeah, marginal was too strong. But Ryan wouldn’t (yet) be responsible for what was put forward by the caucus if it were vaulted into the majority, and there seems to be something of a gap between the kinds of things he’s willing to put forward right now and those that the leadership would if it were in a position to put things forward with consequences. And I’m suggesting the seats are affecting the stands in both cases here to some extent.Report

      • Avatar Michael Drew in reply to Mark Thompson says:

        Also, I should correct myself: I confused this budget alternative with his earlier health plan, which was delivered in a timely way earlier last year. (But GOP really needs to recruit a few more ideas guys — they can’t all be “the Ryan X Proposal,” “the Ryan Y Proposal,” etc. Mass confusion.)Report

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