Well, cutting payments to providers is indeed sometimes how private insurance cuts costs. Sometimes it finds cheaper alternative providers. Sometimes it also cuts services. Of course, Obamacare creates a list of services that MUST be provided by insurers, cutting out that possibility as a cost-saving mechanism in some cases.
I'm not sure why you think that arguing that Ryan also keeps the cuts in the ACA is an effective argument to me. I have never argued that Ryan supports 'Medicare as we know it'. In fact, it reinforces my point that neither Obama nor Ryan is committed to 'Medicare as we know it.' They're both committed to squeezing providers to save money on health care costs.
This argument needs to take place on its merits of two alternate plans. Claiming that Obama is committed to preserving 'Medicare as we know it" while Ryan is committed to destroying it is as ludicrous as Obama's consistent claims that anyone with pre-Obamacare health insurance would be able to keep their exact plan. These are two different plans for how to pay for healthcare. One pushes more cost onto individuals, and the other attempts to push more costs onto rich people. Both squeeze health care providers. Both attempt organizational cost-saving changes. Either way, the fundamental is unchanging- if a person wants better healthcare, somebody at some point has to pay for it.
As far as the root question of whether Medicare really needs saving, the economic arguments here are deep, complicated, and entangled. The US can keep borrowing money indefinitely to sustain spending programs- until the moment it can't. I can't tell you when that will be. Everybody in Italy and Spain and Greece knew that their spending programs were fundamentally unsustainable, also, but nobody there knew when the piper would come calling. It might be that we get lucky and are able to sustain our super-cheap borrowing rates until we get out of the recession, that the moment of truth won't come until we're in better economic shape and able to confront it less painfully. But if that moment of truth comes and the dollar collapses while we're already in tough economic times, it'll be a lot harder to dig out of if we don't start cutting back now.
My gut suspicion is that because of Europe's trouble, we're good to keep borrowing like this for a few more years. The US treasury bond is going to be considered the safest place to park money as long as China's government is unpredictable and dangerous to Western corporations and the Euro Zone can't figure out how to unify their monetary policy. My desperate hope is that Obama or Romney, we'll be out of the woods in three or four more years. So maybe you're right. Maybe we can keep borrowing like this and just rely on the natural turns of the economic cycle and the US's prime position on the world stage to bull ourselves through our inflating debts until we're in a better position to depreciate them.
But I find that proposition hella scary. Especially since when I try prognosticating further than three or four years down the line, I invariably end up with China more liberal and more economically dominant and the US no longer in a position to keep amassing debt.
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Date: 2012-08-20 08:38 pm (UTC)I'm not sure why you think that arguing that Ryan also keeps the cuts in the ACA is an effective argument to me. I have never argued that Ryan supports 'Medicare as we know it'. In fact, it reinforces my point that neither Obama nor Ryan is committed to 'Medicare as we know it.' They're both committed to squeezing providers to save money on health care costs.
This argument needs to take place on its merits of two alternate plans. Claiming that Obama is committed to preserving 'Medicare as we know it" while Ryan is committed to destroying it is as ludicrous as Obama's consistent claims that anyone with pre-Obamacare health insurance would be able to keep their exact plan. These are two different plans for how to pay for healthcare. One pushes more cost onto individuals, and the other attempts to push more costs onto rich people. Both squeeze health care providers. Both attempt organizational cost-saving changes. Either way, the fundamental is unchanging- if a person wants better healthcare, somebody at some point has to pay for it.
As far as the root question of whether Medicare really needs saving, the economic arguments here are deep, complicated, and entangled. The US can keep borrowing money indefinitely to sustain spending programs- until the moment it can't. I can't tell you when that will be. Everybody in Italy and Spain and Greece knew that their spending programs were fundamentally unsustainable, also, but nobody there knew when the piper would come calling. It might be that we get lucky and are able to sustain our super-cheap borrowing rates until we get out of the recession, that the moment of truth won't come until we're in better economic shape and able to confront it less painfully. But if that moment of truth comes and the dollar collapses while we're already in tough economic times, it'll be a lot harder to dig out of if we don't start cutting back now.
My gut suspicion is that because of Europe's trouble, we're good to keep borrowing like this for a few more years. The US treasury bond is going to be considered the safest place to park money as long as China's government is unpredictable and dangerous to Western corporations and the Euro Zone can't figure out how to unify their monetary policy. My desperate hope is that Obama or Romney, we'll be out of the woods in three or four more years. So maybe you're right. Maybe we can keep borrowing like this and just rely on the natural turns of the economic cycle and the US's prime position on the world stage to bull ourselves through our inflating debts until we're in a better position to depreciate them.
But I find that proposition hella scary. Especially since when I try prognosticating further than three or four years down the line, I invariably end up with China more liberal and more economically dominant and the US no longer in a position to keep amassing debt.