Uwe Reinhardt has a very clear post on the difference between vouchers and premium support and how it applies to the Ryan-Wyden plan. You might may say that the labels are arbitrary, but there is still a substantive difference between the two in where the risk lies.
15 thoughts on “Vouchers vs. Premium Support”
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The Baseline Scenario 
As will always be the case, the wealthy, healthy ones, will insist that life changes be made to reduce the overall cost of a currently unsystainable health care system. Sort o like no breaking bones on purpose just because you want to be the next Evil Kenevil. Then way before your prime time, you are used up, and not ready to finance or meet your reward. Some complainers might want to consider another country to live in, or is that where you came from and can’t afford to go back for some reason?
That is an interesting article, and my main comment is that it would seem obvious, at least intellectually, that either vouchers or premium supports will erode markedly over time, thus leaving the insureds holding the bag. My perspective on health care is that it should be viewed as a right, as it is in most of the developed world. There are many effective approaches to the problem of providing this entitlement at a reasonable cost and to assure its effectiveness. During the health care reform debate, I was struck as to how little time was given to talking about effective approaches from pursued by other countries. Of course, the view is that they all can be labeled “socialist” because they essentially are at least controlled free markets. It is obvious that this is the only rational approach to the problem, which leaves me believing that the Ryan-Wyden approach, as with all others, is completely bogus when viewed as intended to fulfill the entitlement to health care which is presently answered by Medicare. In the long run, the entire burden is shifted to the individual, and therefor does not satisfy the objective it pretends to address.
«how little time was given to talking about effective approaches from pursued by other countries. Of course, the view is that they all can be labeled “socialist”»
Which Real American wants to live in a Communist tyranny like Denmark, a hellhole of lack of choice and poverty where the jackbooted thugs of an oppressive Gulag regime steal 50% of GDP in taxes?
Haven’t you seen the harrowing documentaries from Denmark, with the sad, desperate faces of the malnourished population, the ever present tax inspectors roughing up random citizen in a regime of deliberate terror?
That’s what radical left fanatics like Obama want to achieve in America using the communist technique of socialization of medicine.
:-)
pg, your mind has misfunkshond here and intermingled with your voice. I have heard that because they have no oil there, that they place a 100% tariffs on any vehicle that is not electric. That’s means you pay twice the dealer cost. This is/was done in an attempt to perfect the electric car, they have battery swap out stations every 100 miles so you can travel the whole country without gas or diesel. It things like that keep independents country’s, independent. Here in the US we bully other country’s citizen, wreck their environments or economy’s, all in the name of free doom, and then he/you (to pay for it) puts the bill to off till tomorrow while destroying your bank account to make you act like him/you today. There is a timer on it so i’m not worried, and he’s too arrogant to think about worry, when he has a printing press and a military to do his dirty work.
More bang for the buck should be the priority with all health care plans. Here is a link http://tinyurl.com/brcn48r to an article on physician Jim Yong Kim, president of Dartmouth, who brings decades of experience working in global health to build both a training program and a collaborative program between a dozen hospitals across the nation. The latter is to share results of best practices on diabetes, asthma, heart failure, depression and others. The former is because “there is no one solution or discipline that can tackle effectively the enormous complexity of the American health system.” This is the type of leader who may just bring some positive results to this issue!
I guess that could be a solution, other than not needing care at all, to have the best and brightest working on the best and brightest[?], and the duller knives working on the duller minds. There must a word for it, but I always turn back half way and use the proven, Moral Sense path.
More fallacy of distinctions and distraction from Universal Health coverage. We will get nothing new under the sun with concessions and omissions the rules of the game under the false flags of Obama.
Here’s the real start for true Democratic recovery and reform across the board:
http://www.politico.com/news/stories/1211/70623.html
New Hampshire voters should draft Hillary
We argued in a recent Wall Street Journal op-ed piece that President Barack Obama should stand down and let Secretary of State Hillary Clinton run as the Democratic presidential nominee in 2012.
We are now calling on Democratic voters nationally — particularly in New Hampshire — to organize a write-in campaign for Clinton
Read more: http://www.politico.com/news/stories/1211/70623.html#ixzz1haNrKLue
Dr. William Hsaio says Vermont can reduce healthcare costs by 25%.
Vermont is doing something smart and decent with its healthcare reform.
Health Care is a constantly increasing capability to treat more and more diseases, afflictions and conditions. When we say the price or cost for health care is going up it is very different than when the price of oil or gasoline or silver or a 500 Gbyte disk drive goes up.
So we can provide more people “health care” if we reduce the scope of what is covered. That is exactly what government run health care programs do in Canada, UK, Europe. How much should taxpayers pay to provide “health care” to a IV drug user who cannot pay for his own “health care”
@buck smith
In Canada our healthcare system pays for HIV / Aids treatment. Everyone qualifies including IV drug users. It’s the right approach because it prevents the spread of the illness.
See this link: http://www.cfenet.ubc.ca/
The BC Centre for Excellence in HIV / Aids is considered one of the best in the world. But still a tragic illness.
Here is Dr. Julio Montaner talking about treatment as prevention of hiv / aids
Markets are heartless. If regulated, markets heartlessness can drive innovation in an endless thrust toward domination. If unregulated markets rapidly shapeshift into oligarchy – wherein a single or few oligarchs dominate markets for wanton profit. Sound products and services honed and trimmed by the engine of regulated competition – are replaced with rigid models of profitmaking controlled by the oligarchs. Products and services grow unhealthy as real competition is eliminated, and the tyrannical dictates of the oligarchs determine the market pricing – regardless of the quality or usefulness of the products and services. The predatorclass wins huge in unregulated systems while consumers are savaged and forced to pay more for inferior or effectively useless products and services that are forced down consumers throats by the favored oligarchs.
Competition is killed!
Innovation is killed!
Products and services are diminished or killed!
Oligarchs reap outrageous fortunes.
Jabber all you want about this or that model to your cold dark hearts content.
If government does not fiecely regulate industry – the result is tyrannical abuse by, and wanton profits for oligarchs – and woefully deleterious products and services imposed upon voiceless and powerless consumers,
There are no free markets!
There is no capitalism,
Newworldorder Amerika is a kleptocracy – wherein thefew rape and pillage themany for imponderable profit – and themany are forced to endure and pay much more for inferior or effectively useless products and services,
Welcome to naziamerika!
Buckleup for 2012 – we’re going pearshaped!
TonyForesta is just a little pessimistic, but I love the passion. It is great to hear from people who have not adopted cynicism as a way of life.
All the problems he highlights are real enough, even if somewhat exaggerated. They have something else in common: They are all problems at the macro level.
I worry that large economies like the USA, don’t reflect citizen values, but only corporate values. Perhaps they can’t. I have sympathy for the idea that expecting Corporate America, (Insurance Companies, say) to accommodate the realities of individual people, is like expecting pigs to fly. It is unreasonable.
One answer is to introduce citizen values at a lower level. Such as perhaps the state, or local district. Family even. Imagine the USA consisting of 100 Singapores. Smaller nations such as Norway, Ireland and others can sometimes get the balance right more easily. No guarantees though.
Perhaps TonyForesta and I can agree that something new should be considered.
Forgive the pessimism Blackeyebart. It’s some that has been etched upon me over the years – but we agree 100%.
The Economist argues that state capitalism is the new wave. They cite China who have used the model aggressively and state that state-owned corporations are now about 60% of the Chinese Stock market. http://www.economist.com/node/21542931
Whatever the advantages or otherwise of State run firms I don’t imagine that would be any better at dealing with the needs of ordinary people than your average Wall Street Bank. We need a form of community capitalism. Large enough to be professionally run – the family firm is seldom a great model to follow – but small enough to be able to retain a connection to their community.
These firms already exist, but are rare. They sometimes get the rough end of the stick in tax law and compliance issues, and almost no-one promotes them as a vehicle for community change and development. To find one look where some community has made rapid economic progress. You seldom find one without the other.
In the age Gordon Gecko it is not fashionable to look for the business that views its contribution in terms of the effect on its neighbours, but they exist, despite academic and political neglect.
TonyForesta should consider starting one. It would be good for your soul!