This morning Reinhardt was questioning the value of increased competition amoung insurance plans in Ryans's proposal, because more weakness on the insurance side means more bargaining power for hospitals. The hospitals, of course, often have too much power already.

But this was also supposed to save money in the ACA, through more competition from the government plan. This could worsen inflation of hospital prices, which are bad enoough already.

Of course it's also possible that a big government insurance plan could drive private firms out of business. But then, there are other things to worry about, like the doctor-dominated Medicare boards which permitted so much wealth transfer to doctors in the seventies.

What's more, the ACA is transferring so much money to hospitals (from Medicare to Medicaid), that private equity firms have begun looking into buying them up. So there's even more monopoly trouble on the horizon.

All in all, it seems that there is no reason to be believe that the Ryan plan or the ACA will really help with health costs and the budget problem.

1) The claim that Obama has done nothing to address health costs is all over the media. Don't reporters pay any attention (obviously not)? If nothing else, don't reporters remember the claims that the ACA would kill granny by cutting her benefits?

2) Rachel, the ACA has lots of provisions which should lower the cost of healthcare.

The Ryan plan would greatly increase costs by eliminating the benefits of buying power that Medicare and Medicaid enjoys. His plan hurts us all, while lowering tax payments on the richest.

We need more doctors and lower patent protection, as Dean has repeatedly discussed.

I don't see much that improves health care costs in the ACA. Most of what I see is the sort of thing Rachel refers to - increasing power given to the entities that are making the problem worse.

The Ryan plan would undoubtedly make thing worse, but that's what the Republicans do these days. Obamacare started us down the path to making things worse, and Ryan's just taking the next logical step.

Dana Milbank simply does not give a crap what is in the ACA, and does not give a crap what the Congressional Budget Office projects.

What he does give a crap about is that people like Rachel and Cujo359 think they know more about what's in ACA than the CBO -- not because they have actually read it as carefully as the CBO experts have, but because someone told them there aren't significant savings in the ACA -- and most likely did not tell them what the CBO says.

Dana Milbank says what he says because someone in control at The Washington Post says the organization shall pay more attention to Rachel and Cujo than to the CBO -- or to the other world-class economists who have actually read ACA carefully, and studied the issues inside and out for years and years, and say they believe the CBO is actually being more conservative in its projections than necessary.

I don't know about Dana Milbank's reporting generally, but in this case he is being a world-class hack. Will he change to not being a world-class hack on this subject? No. Would he like to? Maybe, but his bosses will not let him. It seems to be that simple. How do these graduates of these great universities look at themselves in the mirror and not puke?