Wednesday, April 6, 2011

The scariest sentence ever seen in the WSJ

Lots of hullabaloo over Paul Ryan's op-ed piece in the Wall Street Journal, you know, the one with the headline that reads: The GOP Path to Prosperity.

Given how devoted the GOP is to their very rich base, I shudder to think about how they define prosperity. And since their path prior to this has led to much of the nation being placed on rickety life boats in danger of being swamped by the wake of the big yacht sailing majestically away on rising tides, I don't have much hope this path will be built for the likes of me.

But the scariest sentence ever seen in the WSJ is not found in Ryan's op-ed piece. Doesn't mean his piece isn't scary - it's actually very scary to think we will get rid of this massive post-recession deficit by apparently gutting Medicare for those of us not old enough to need it right now.  

[Can we really say, as Ryan does, that Medicare has a flawed incentive structure that "rewards states for adding to the rolls?" Or are states adding to the rolls because demographically, the Boomers have reached the age needed to join the plan? And how do private insurers - the ones who refused to cover the elderly in the 1960s - feel about adding an influx of elderly patients to THEIR rolls?]

Scary stuff, yes. But that scariest sentence ever in the WSJ is in another story about the Ryan plan, bearing the headline: New Proposal Hits Old Hurdles of Budget Math. 

And that sentence I find so frightening is:
"The hope is that competition among private insurers will yield hitherto-unrealized efficiencies." 

I don't know that Mr. Ryan has ever tried to purchase insurance without the benefit of an employer subsidy, but if there's one thing I've learned in my life, it's this: the health insurance business model focuses on diminishing payouts as much as it possibly can. 
As someone who's purchased my own insurance for the better part of a decade, I'm fully aware that I am one diagnosis removed from losing health insurance completely.



To profit, health insurance companies dump patients onto Medicaid when they can. They deny claims of covered expenses whenever possible. For those unlucky enough to have a pre-existing condition, they will refuse to cover you or they price a policy far out of your reach or completely rider out the condition for which you need health care. [Yes, that pre-existing stuff is supposed to go the way of the dinosaurs, but not until 2014...]

There is nothing at all efficient about insurance companies today. There is nothing at all in the history of insurance that leads me to believe that if they do discover hidden efficiencies, their "path to prosperity" will include passing those efficiencies on to consumers in the form of reduced costs.  When has that ever happened?

So basing a deficit reduction program in part on this "hope" that competition amongst insurers will inspire "hitherto-unrealized efficiencies" that will somehow help us reduce the federal budget deficit is terrifying indeed. It's an assumption similar to the assumption used until recently in the financial sector - that housing prices would never, ever fall. And we see where that assumption got us - into a very, scary  mess.

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