Would you vote to save the Bernie Madoff scheme? Me neither. And when you get down to it, that’s why you can mark me down as a failure when it comes to the latest Beltway-conservative litmus test for commentary deemed worthy of adults. No, I won’t be gushing praise for the Ryan plan to save Medicare, nor reserving a seat at the coronation of its author as the most courageous, fiscally responsible Washington politician ever — or, at least, ever to vote for the prescription-drug entitlement, TARP, Keynesian “stimulus” spending, and the auto-company bailout.
Concededly, as creatures of Washington go, Rep. Paul Ryan (R., Wis.) is among the most admirable. I daresay that of all the Beltway pols who want to add trillions to the already unfathomable national debt, Mr. Ryan is among the best — his proposal is a veritable bargain at “only” $5.1 trillion more over the next decade. (And, putting aside the funny Washington math that discounts tens of trillions in unfunded liabilities, would someone please explain to me how House Republicans rationalize their admirable opposition to raising the $14.3 trillion debt ceiling with their votes in favor of the Ryan plan, which would increase the debt to over $15 trillion next year and nearly $20 trillion by 2021?)
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We’re all sinners, and Congressman Ryan’s past walks on the wild side do not render hollow his earnest plea that we deal with the entitlement cancer metastasizing in our body politic. But his prescription is not a cure. It’s an aggressive treatment of symptoms that leaves the cancer in place, under the delusion that Dr. Government can be trusted to manage it.
Representative Ryan buys the foundational premise of Medicare: to wit, health care is a corporate asset — not a commodity subject to the assumptions of ordinary commerce (i.e., individual choice, controlled by one’s personal resources and priorities), but a fundamental right to which the central government must ensure access. This is the plinth of the entitlement edifice — the “second Bill of Rights” — that began construction in the New Deal, under the direction of designers who knew full well that it was financially unsustainable.
Sadly, this is the standard Beltway conservative position, too, as evidenced by the ablest of Ryan’s defenders, James Capretta of the Ethics and Public Policy Center. Writing in the May 2 issue of National Review, Jim explains, “The government plays an important oversight role in Ryan’s Medicare-reform plan, as it should.” That is to say, rest assured that we would never suggest scrapping Medicare, or that the government doesn’t have an essential supervisory role to play in the market for medical services — a role we somehow managed to do without for the first century and a half of the nation’s existence. And what is that role? Ensuring that “participating insurance companies must offer transparent pricing and meet minimum-benefit and -quality standards.”
Says who? If by “transparent pricing” Jim means insurers must be discouraged from engaging in fraud, there are already civil and criminal laws against that, and, as an additional prophylaxis, the states heavily regulate insurers. But why should the government be involved in setting standards for coverage, and what on earth does government know about quality when it comes to medical care? In a free society, those are matters for the market. At most, government’s job is to keep the market clean, not to dictate the inputs in the dreamy hope of controlling the outputs.
Medicare was a scam from the start. It had to be a scam because its ostensible purpose — providing health insurance for the elderly — was never the objective of its proponents. Instead, Medicare was a stepping stone to a utopia its champions dared not acknowledge: A compulsory universal-health-care system administered by government experts. FDR’s Committee on Economic Security initially intended to issue a health-care plan in conjunction with its universal, compulsory Social Security proposal in 1934. As Cato’s Charlotte Twight recounts, the former was dropped due to fear that pervasive opposition among the public and the medical profession would jeopardize passage of the latter. But Roosevelt got right back to it the day after he signed the 1935 Social Security Act, empowering the new Social Security Board to study the “related” area of health insurance.
I am very thankful for our health insurance, and even more thankful that we found an affordable one through "Penny Health Insurance" online. It has been 6 years that they have not increased my premiums. Having health insurance gives us a peace of mind
Mr McCarthy, you have hit a home run with this one. What is to be the solution, one asks? The Entitlement Mentality has become too deeply ingrained for any politician to propose, much less implement, the necessary steps.
What an excellent article! This is the kind of fact based, non kiss up to the Republican party line things that I would like to see more of on this and other conservative web sites. If it wasn't for Andy, Mark Steyn and Kevin W. I doubt if I would even come here anymore.
The entitlement, over spending train wreck is coming down the tracks and I would really like to see more Republicans telling this to the American people and proposing real, honest to goodness free market reforms. As the article says, the Statists are going to demonize conservatives no matter what we do, so we might as well be truthful so that the rest of this country can see the clear and distinct differences. If they choose collapse, then at least they had a warning.
Germany manages to have universal health insurance coverage without the equivalent of the Medicare program,using private health insurance even for the elderly. They seem to be doing OK.
Does the continuation of the American experiment require that that our citizens become destitute if they become ill?
I'm glad Mr. McCarthy has let the cat out of the bag, but he shouldn't be so hard on Paul Ryan. Radical capitalists can't unravel the social safety net in a single stroke.
RyanCare is designed to be spectacularly inadequate, thereby turning Americans against the very idea of government intervention in the free market. The idea is to condition people into accepting the necessity of unfettered corporate power.
Mr. McCarthy is right on points, but the fact is we live in a nation of 300 million and Ryan can barely get any support even from conservatives to do primarily one thing, and that is introduce competitive shopping for MediCare services via "voucher-then-buy-it-yourself". How many of the 300 million does McCarthy have on board with him and are likely to get on board? McCarthy should gain traction with his idea in the halls of congress before criticizing Ryan. See how easy that is to do compared with writing an editorial. Maybe Ryan understands you can't take away an entitlement as easily as McCarthy thinks. McCarthy can theorize free-markets, but it's a fools exercise unless you have a chance of winning. I think Ryan recognizes that in this day we are never going to be without a government safety-net, so his plan tries to do the best with it. McCarthy's ideals are right, but do no good as words on paper, try to move the needle in the political world. Ryan is.
McCarthy rips the pretense of compassion from conservatism and tells it like it is: Let 'em die in the street!
Government's role in health care is something "we somehow managed to do without for the first century and a half of the nation’s existence," McCarthy reminds us, wistfully.
Why, oh why, did things have to change?
Because back then people who had heart disease simply died of it. People who had cancer simply died of it. Two of the three primary causes of death in the US by and large simply didn't get treated. No coronary bypasses. No stents. No chemotherapy. Now and then a little radiation. That's all essentially late 20th Century stuff, treatments that were crude, haphazard and experimental back in 1961 and widespread and routine today. It's not the good old days anymore, darn it.
Nowadays we can decide, as a nation, that only those with family resources* can get Dad his bypass of Mom her chemo. And that's where the Andrew McCarthys say: That's the way it should be! For those families who can't afford the $250,000 triple bypass, or the $1 million series of cancer surgeries, chemo and radiation my best friend has endured over the past decade, McCarthy would say: "Too bad. Let 'em die in the street."
This is indeed the choice, and McCarthy lays it out quite nicely. Either we all take a chunk of ourselves and lay it out there to extend the lives of literally tens of millions of people, or we go back to the good old days and let them die in the street once they're diagnosed.
You McCarthys out there feel quite put upon as a result of the choice the rest of us have already made through our elected representatives. We have picked our pockets -- and yours -- for the sake of bypasses and chemotherapy and the vast array of really effective treatments for all sorts of problems (not just heart disease and cancer, although I focused on two big ones for obvious reasons). The difference between 2011 and "the first century and a half of the nation's existence" is that we can keep lots and lots of older Americans alive, provided we're prepared to spend lots and lots of money. Death panels? Let the market be the death panel. That'd be ok with you, right?
*Surely insurance companies won't be stupid enough to offer 65 year olds insurance at affordable prices -- that's when heart disease and cancer become real threats. Any 65 year olds out there try to buy term life insurance? It ain't the $20 a month you hear in commercials. My $770k term policy jumps to a $69,000 annual premium at age 69, for instance. Market economics.
Can someone point me to a real world example of a single payer system that costs less AND has a lower rate of healthcare inflation? What I find so amusing about conservatives argument for "controlling costs" is that nothing controls costs better than a single payer system.
The Absolute Hypocracy of the Left is that if Medicare and Social Security are so sacred, then why don't Liberals complain when these funds get raided?
"Medicare is a scam. The people who designed and perpetuated it would be serving more jail time than Bernie Madoff if they pulled a fraud like it in the private sector."
That would be Wilbur J. Cohen who passed away in 1987!!!
"Look at welfare reform, which took Republicans years to achieve but took the Obama Democrats a relative nanosecond to dismantle with their stimulus spending."
What are you talking about? That is a completely baseless claim. What affect did the stimulus bill have Aid for Families with Dependent Children/Welfare? I dont think there was even a temporary increase in benefits, let alone Republican reforms being dismantled. Idiot.
"Ryan’s essential point is that health care is increasingly expensive because it is not permitted to function as a regular market commodity — one with sentient consumers shopping carefully, spurring competition, driving down prices, and encouraging innovation."
This is exactly correct. Health care is not like a regular market commoditty-one with sentient consumers shopping carefully, spurring competition, driving down prices, and encouraging innovation. Yet it has nothing to do with government. Health care is different because unlike buying a car people do plan on buying health care, cannot go without it, and cannot find inexpensive chemotherapy models that fit their budget. Moreover, America, despite the protests of Mr. McCarthy, have chosen not to let sick people die in the streets simply because they do not possess the means to pay for care.
Mr. McCarthy, do you intend to go without Medicare? If so, I would be very interested in how you will pay your bills. Even if Medicare were hypothetically non-existent do you really believe you would be able to purchase private insurance. In what universe do you think private insurers would sell policies to retired senior citizens? How would they be paid for?
That was one of the most uniformly moronic columns I have ever read. Truly, you propose to end Medicare and make no mention of a possible replacement.
@Mike B; You either willfully or ignorantly miss McCarthy's point. He has no problem helping the truly needy. The point is that, without ubiquitous "Third party payers" involved in health insurance, and without the mounds of regulation that go with a government system like Medicare, we would have a real market, with real prices, and we would be able to get triple bypass surgery and chemotherapy for much less than we now pay, because of efficiencies and market competition. If we all paid for our routine care out of pocket and had insurance only for the truly bad stuff (Cancer, triple bypass, getting run over by a truck), we would be much more price sensitive and so would providers.
To put it another way; imagine if we got groceries like this. We just went into the store, picked up what we wanted, and had the checker send a bill to our food insurance company. We'd all eat filet every night, and prices for everything would be exorbitant.
Excellent column by Mr. McCarthy only to be commented on by the absolute foolishness of MikeB, who again displays his hypocrisy of ascribing bad motives to his opponents.
Could we privatize Medicare? I am asking and expect someone will tell me why not.
If no one could afford to purchase the whole thing, couldn't the federal government sell off parts of the program to private companies that could make the operation profitable to themselves, and through taxes, of benefit to rset of the nation? No private company would dare pull the crazy stuff the federal bureaucrats do. They would have to do a good job.
Too many people are dependent on Medicare for us to be able to trash the whole program. We cannot pull the safety net while people are falling into it. But we could sell the safety net. Medicare is a dubious asset, but it is an asset of the federal government and if run like a business instead whatever it is being run like it could do the job it is needed to do.
There are some things government can do well and some things it cannot do at all and, Mr McCarthy is right, government does not do this well.
Edmund Ruffin and William Yancey would be proud. The fire-eaters did more than most Union generals to win the war for the North. I agree with McCarthy that Medicare is fundamentally broken. I agree with him that is in all honesty a Ponzi scheme. But flaming rhetoric like this that tears down the best conservatism has to offer helps no one but liberals. What is Ryan supposed to do? Propose something that would never pass (which is what McCarthy is advocating) and then throw up his hands as the country continues down the path to destruction?
mikeb: please post some facts to back up you assertions that before the government stepped in to 'save us' people didn't get treatment and just died of various dieases. This is patently false. people could afford medical treatment because it didn't cost nearly as much without the government distortion of the market, and the massive inflation that distortion has introduced into the medical market.
Government can't take care of you. You have to take care of yourself. Socialism doesn't work, never has, never will. for the future of healthcare under your benevolent savior see britian, where your dentist is a pair of plairs.
My dear friend Mike B has, as he has done once or twice before, answered a rational argument with raw emotion.
Calm down, Mike.
Now, that's better...
The cost of health care in this nation is grossly exaggerated by the presence of innumerable third party parasites: insurers, regulators, the fellow in Washington who says my computerized records have to meet his standards and not mine, malpractice attorneys, etc etc etc ad infinitum. That's because every one wants to be healthy, so medicine is where the money is...or rather, where it used to be.
Get the federal government entirely out of paying for health care. Leave the states to regulate their own physicians. Starve the parasites. Reduce govt spending, and government theft from citizens, to compensate for reduced expenditures. Then "The People" will have the money they need to have, safely in their pockets, to pay for their $25 well-child visits, while purchasing private insurance for catastrophic events.
Alternately, put the whole system under government control as a new branch of the military,calling it, say, the National Health Corpses--and we can have British or Soviet or Cuban quality medicine.
The fact that cannot be challenged, O Mike, is that the present system is in fact unsustainable. Mr McCarthy helps us by making this fact plain.
