Why oh why do Democrats keep attempting to compromise with the Republicans? Ryan's idea, and apparently now Wyden's as well, is that the federal government should pay less for health care for the elderly. None of these bills, plans or compromises deal with the underlying problem, i.e., the continuing rise in the cost of everyone's health care. Until that problem is addressed, they can shift the burgeoning costs onto individuals, states, or the glitter unicorns that live on the moon, but the outcome will be the same: more people who can not afford health care.

Shifting the costs away from the collective and onto individuals is just another way of shrinking the federal government so that it can't do its basic job of caring for its people.

My opinion, based on my impression of previous republican plans, is that this plan will not provide coverage equivalent to current Medicare. The proposal is part of the GOP long term strategy to eliminate Medicare, and Ryan discovered with his first proposal that eliminating it in one fell swoop was not going to be accepted.

I don't get why Wyden signed on to this.

any proposal to modify, change medicare can be touted as preserving medicare

insurance companies seem to be aggressively marketing medicare advantage plans

if they garner 50% of medicare recipients the world turns upside down

With perhaps the exception of catastrophic costs the whole model of paying for healthcare through insurance makes very little sense.
Insurance seems a terribly inefficient way to address the issue of moderating costs. The Wyden/Ryan proposal seems to add another layer of administration and profit seeking. At some point we must come to see health care as a social or public good and find ways to appropriately pay for it under that model.

Mark, The Ryan/Wyden plan preserves fee for service which is another huge problem. Profit seeking is not limited to insurance companies. Even non profit hospitals seek profits. I think a VA style health care system would be the best at containing costs-- better than medicare for all.

Kat, I don't disagree although Medicare for all would probably end up looking much like the VA system. My argument is that insurance is completely the wrong paradigm for health care. We don't insure our cars or homes for routine maintenance but for catastrophe.
Looking at some of the systems that have successfully contained costs - the VA, Mayo, Kaiser and we see two outstanding characteristics, routine and preventative care is a focus along with consistency and follow up. Second we see a real effort to identify and use best practices so that procedures don't become commodities.
I suppose one might argue that insurance companies could act like negotiators to bargain with caregivers for both lower costs and more efficient care. In a single payer it's the government that might play that role.
In either case the demagogues will scream rationing although markets end up doing the same thing with higher costs.
In my view the better way to think of healthcare is as a utility - a needed and useful service, a form of infrastructure that has universality. Understanding it in this way separates it from employers, making them more competitive. In fact, health care as a universally accessed public good improves our national competitiveness just as good infrastructure does.

Mark,
I think you misunderstood me. I was not sticking up for the insurance companies. I just believe that plenty of people feel if we got the for profit insurance industry out of the equation we'd solve the problem of exploding health care costs. I think elimination of fee for service and changing the way we fund research would do a lot to curtail costs.
By the way, a lot of employer health care programs are self funded and insurers only administer the plans.

Nothing to see here, folks. Move along.

Kat wrote,

I just believe that plenty of people feel if we got the for profit insurance industry out of the equation we'd solve the problem of exploding health care costs.

Agreed. While I think single payer would help cut costs, the problem of what is essentially rent-seeking by the medical providers themselves is at least as big a problem.