Talking about health costs vs. addressing health costs

TALKING ABOUT HEALTH COSTS VS. ADDRESSING HEALTH COSTS…. Paul Ryan’s Republican budget plan is popular with a few too many pundits, at least in part because of the goal of reducing health care costs. Ryan’s admirers credit him for taking the issue seriously and putting a plan on paper, and challenge Democrats to do the same.

It’s important to realize how backwards this is.

Ezra Klein has a terrific item this morning explaining the issue very well. Ryan’s alleged cost savings are largely an illusion, while Dems don’t need to present a plan or a vision — they already passed the Affordable Care Act.

“If this is a competition between Ryan and the Affordable Care Act on realistic approaches to curbing the growth of spending,” the Urban Institute’s Robert Reischauer, who ran the CBO from 1989 to 1995, told Ezra, “the Affordable Care Act gets five points and Ryan gets zero.”

For the criticisms of the ACA, it’s never really got the credit it deserves, especially on the issue of cost savings. Democrats threw just about every idea they could think of — except a public option — into the law, including a wide variety of measures intended to strengthen Medicare while cutting costs, without sacrificing care.

No one who knows health-care policy will tell you that the Affordable Care Act does everything we need to do in exactly the way we need it done. That’s why Resichauer gave it a five, not a 10. But it does a lot of what we need to do and it sets up systems to help us continue doing what’s needed in the future.

Ryan’s proposal, by contrast, does almost none of what we need to do. It appeals to people who have an ideological take on health-care reform and believe we can make Medicare cheaper by handing it over to private insurers and telling seniors to act like consumers. It’s a plan that suggests health-care costs are about insurance, as opposed to about health care. There’s precious little evidence of that, and when added to the fact that Ryan’s targets are so low that even his allies can’t defend them, the reality is that his savings are largely an illusion. […]

[T]he irony of everyone demanding Democrats come up with a vision for addressing the drivers of our deficit in the years to come is that, on the central driver of costs and the central element of Ryan’s budget, Democrats actually have something better than a vision. They have a law, and for all its flaws, their law actually makes some sense. Republicans don’t have a law, and their vision, at this point, doesn’t make any sense at all.

If some of the pundits lauding — and “loving” — the Ryan plan could think this through, the next several months will be less exasperating. Republicans talk about tackling health care costs, while Democrats actually addressed the issue, but it’s worse when one realizes even the GOP talk is based on numbers that don’t add up.