...and why you can't blame reluctant Republicans for taking positions that, well, insure themselves against a risk like Ryancare
Rep. Paul Ryan's budget has taken a beating this month. Newt Gingrich outright rejected his Medicare plan on NBC (before recanting his objection). A handful of Republican senators voted against it this week. And the official interpretation of New York's special House election, which turned surprisingly against the GOP, fingers Ryancare as the culprit.
That's the politics. Now to the policy. Ryan's YouTube defense of his Medicare plan is both a masterful revelation in public policy explanation and also a clear explanation why the public, and the GOP, is running away from it. Watch and keep reading.
Ryan's diagnosis of the Medicare crisis is spot on. In a fee-for-service system, taxpayers pay the government to reimburse doctors to treat patients, (Confusing? See the pic below.), putting the patient and the payer on opposite ends of the system.
This creates a quality problem and a cost problem. It's a quality problem because if doctors know they're going to be reimbursed based on the volume, rather than the quality, of their coverage, they have little reason to contain costs. To understand why this is a cost problem, think about what kind of car you would drive if you knew taxpayers were going to pay for two-thirds of the lease. On your dime, you might get a Camry. On everybody's dime, you might demand a Porsche. The "Porschification" of health care is slowly bankrupting the government.