Obama completely dismantled the Little CON$ervoFascist Man-Child.
Bold faced B.S. If Obama dismantled anything, it is his ass so that Valerie Jarrett could climb up there and run the country while looking like him. By himself, Obama is Lost In Space.
Why don't you start your own thread on this topic ? That way we don't have to scroll past all your drivel.
From the article:
The other way to control costs is regulation, as embodied in the Affordable Care Act (ACA). One argument for this is that cost savings from vouchers are a statistical mirage.
Harvard health economist David Cutler -- a co-author of the JAMA study and an outspoken supporter of the ACA -- thinks this is possible. Medicare Advantage's lower costs might stem mostly from healthier patients, who use fewer medical services. It's unclear that statistical "risk adjustments" eliminate all these differences, he says.
Lower reimbursement rates are the most common form of cost regulation. The ACA cuts $700 billion from Medicare over a decade by slashing payment rates for hospitals and other providers. But reimbursement reductions don't change the delivery system. Providers often react by increasing the volume of services; the system becomes more wasteful. (The Medicare cuts don't actually reduce health spending; they just transfer funds from Medicare to spending mandated by the ACA.)
As for the ACA's other cost controls, they're mostly fluff. One idea is "accountable care organizations" (ACOs), which link payment to better coordination of medical treatment. The administration says its ACO proposal might save $470 million from 2012 to 2015, a period when projected Medicare spending exceeds $2 trillion; savings would be a rounding error. Then there's the Independent Payment Advisory Board (IPAB), a body of 15 experts charged with limiting Medicare spending if it passes certain targets. But the law handcuffs IPAB. It can't increase patient cost-sharing, restrict benefits, modify eligibility requirements or -- in any one year -- cut spending by more than 1.5 percent, reports the Kaiser Family Foundation.
Limits must be imposed on the health sector. There are no pleasing ways to do this. Still, the increasing evidence from large-scale experience is that market mechanisms offer the best chance of reconciling Americans' desire for personal choice with cost control. If there are better ideas, let's hear them. Otherwise, we shouldn't reject the obvious merely because it's unfamiliar.
Voucher plans are not right-wing, extremist ideas. They enjoy support in both parties. Ryan would permit continuation of fee-for-service; if it's more efficient and effective, it would survive. If not, its decline would be no great loss. The Ryan plan's greatest defect may be that it doesn't start for a decade. We can't wait that long.
