Ryan Plan May Lead to Single-Payer Health Care - Bloomberg

Ryan Plan May Lead to Single-Payer Health Care - Bloomberg:

Instead, they’ve opted to apply their old policy framework -- the one the Democrats stole -- to Medicare. That has left the two parties in a somewhat odd position: Democrats support the Republicans’ old idea for the under-65 set, but oppose it for the over-65 set. Republicans support the Democrats’ new idea for the over-65 set, but oppose it for the under-65 set.

This isn’t quite as incoherent as it seems. Democrats say they would prefer Medicare-for-All for the under-65 set, but they’ll take whatever steps toward universal health insurance they can get. Republicans say they would prefer a more free- market approach for the over-65 set, but that a seniors’ version of “Obamacare” is nevertheless a step in the right direction. For both parties, it’s the direction of the policy, rather than the policy itself, that matters.

There’s an added complication for Republicans. They have assumed huge savings from applying the exchange-and-subsidies model to Medicare (USBOMDCR). But they don’t assume -- in fact they vehemently deny -- that those same savings would result from the identical policy mechanism in the Affordable Care Act. The Democrats haven’t assumed significant savings from the exchange- and-subsidies model in either case. If the concept works as well as Ryan says it will, then the Affordable Care Act will cost far, far less than is currently projected. There’s no compelling reason to believe competitive bidding will cuts costs for seniors but fail among younger, healthier consumers who, if anything, are in a better position to change plans every few years and therefore pressure insurers to cut costs.

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