Tuesday, April 05, 2011

PPACA and the Ryan Roadmap

Paul Ryan is set to unveil his plan to reform Medicaid and Medicare. I think his proposals have a snowflakes chance in hell of passage but they might get the debate headed in a positive direction. Ryan's plan basically comprises of two elements: Block granting medicaid and providing those currently under 55 with vouchers to purchase health insurance once they are eligible for Medicare. One of the criticisms that has annoyed me regarding the voucherization of Medicare has been the discussion that by setting the growth of Voucher at CPI+1 that the vouchers over time will cover less care as it will not keep pace with medical inflation. My complaint is not that this isn't necessarily a valid criticism but rather a hypocritical one. Many of the same critics have champion IPAB which is the major driver of cost savings for Medicare in PPACA. The reason they champion IPAB and the reason it would save money if the proponents of IPAB are correct, is that IPAB will be successful in reducing access to care. If that is a virtue of IPAB it cannot be a weakness of vouchers.

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