If we agree that Paul Ryan's proposals for Medicare more-or-less amount to turning it into ObamaCare, then the stage is set for a potential bargain. That would be—Republicans stop trying to repeal the Affordable Care Act and in turn Democrats agree to phase Medicare out on Ryan's schedule. You can further sweeten the deal by throwing in a public option and the replacement of ACA's Medicare tax hikes with something more regressive.
This is basically "everyone takes a shot of poison" and I don't expect it to happen, but it would better-align policy with the things people claim to care about. The underlying principle would be to shift to a system where the US government subsidizes your consumption of health care services according to how poor and sick you are, rather than primarily according to how old you are.
(PS: This is not optimal policy in my view, but it would be better than the status quo and much better than endless rounds of fights over ACA repeal).
Published on December 18, 2010 15:29