Soon we can get back to insurance industry death panels the way Thomas Jefferson intended


It only took pretty much until the last few months of Barack Obama's term, but the Republicans have finally offered an actual real alternative to the Affordable Care Act, if by "alternative" you mean "a vague plan that doesn't actually have any details, but throws in every healthcare notion from the GOP Wish List ever." It's such a terrible hash of empty nonsense that Yr Wonkette recommends President Obama immediately endorse it and demand Congress pass it. That should pretty much guarantee it dies quickly and mercifully.

[wonkbar]<a href="http://wonkette.com/602672/lets-delve-into-paul-ryans-fabulously-detailed-plan-for-a-better-america"></a>[/wonkbar]The "plan" -- like Ryan's solution to poverty a couple weeks back -- is a little short on details, like how much it would cost, how it would be paid for, and what exactly it would do. But as many a college writing teacher has said, it's very neatly typed. In the document itself, Ryan tries to make a virtue of its lack of specificity:

This Report is the beginning of the conversation, not the end. In contrast to Obamacare, our plan will serve as the foundation for multiple pieces of straightforward legislation, not a comprehensive, overly complex, and confusing 3,000 page bill.

Translation: This isn't really a bill, or even a plan. As New York magazine's Jonathan Chait says, it's "at best, a plan to create a plan later." So what's in the plan for a plan one of these days?

Obviously, the first priority is to eliminate Obamacare, regardless of whether anything is actually in place to replace it. Because the ACA is such a monumental "failure" that it can't even be fixed, it has to be wished into the cornfield to save America right now. And if you lose your health insurance, don't worry, you might get a nice tax credit to replace it:

They would repeal the Affordable Care Act and replace it with some cheaper and more loosely regulated alternative. There would be tax credits, though it doesn’t say how much, and it would be funded by limiting the tax deduction for employer-sponsored insurance, though it doesn’t specify that either.

But there are the usual miracle market-based miracles that will make everyone rich and healthy forever: Allowing insurance to be sold across state lines, so companies based in states with the weakest regulations can sell crap plans that are "affordable" but don't cover much of anything, bringing back the very junk insurance plans eliminated by the ACA. But we like cheap junk that doesn't work! And of course the "plan" includes liability limits and health savings accounts and tax credits, so people who already can't save enough for retirement will have the option of also not saving up for medical emergencies. Medicaid would be replaced by block grants to the states, which would of course be wise, innovative, and efficient (not to mention more susceptible to lobbying). And the retirement age for Medicare would rise from 65 to 67, which should save oodles, but don't ask about the details, because there aren't any.

In one of the most misleading bits of magic, the Ryan outline would replace the ACA's protections for people with expensive conditions -- the elimination of insurance company annual and lifetime coverage caps -- with a "high risk pool" that tosses out one of the ACA's most effective mechanisms: with everyone mandated to buy coverage, the cost of the sickest, most expensive patients' coverage is spread out through the entire insured population, which is simply how insurance works. Segregating out those patients would make costs for average rate-payers go down, but dumping them in a high risk pool won't suddenly make them profitable to insure. High risk pools, Chait notes,

already exist, and they work extremely badly, in large part because providing insurance to people with very high medical expenses is, well, expensive. The main trick to making such a mechanism work is funding it. But enacting new taxes to pay for social benefits for the socially vulnerable is not exactly a passion for the Republican Party or Paul Ryan.

But hey, by avoiding any specifics about what this thing will cost, who'll be hurt and who'll benefit, there's no need to actually do anything unpopular.

[New York / WaPo / NationalMemo]

Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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