tag:blogger.com,1999:blog-2938311055760665357.post13680222644226701..comments2024-03-04T23:12:52.952-08:00Comments on Ed Dolan's Econ Blog: What Can We Learn about the Ryan Medicare Plan from German Experience?Ed Dolanhttp://www.blogger.com/profile/08757995049056872214noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-2938311055760665357.post-41089491901591425002011-08-20T20:51:58.102-07:002011-08-20T20:51:58.102-07:00As cost is shifted to individuals that necessarily...As cost is shifted to individuals that necessarily reduces demand for some things. Lower demand, ceteris paribus, leads to lower prices.<br /><br />Reducing the amount of money people can spend freely reduces pricing. The marginal consumer foregoes some consumption and moderating demand.<br /><br />Ultimately this is a supply and demand question, and cost shifting to individuals is a demand management approach.<br /><br />Your analysis assumes no effect there, which I think misses the point.<br /><br />One element of the Ryan plan should be refundability. If you underutilize consistently you should get a premium refund on a portion.<br /><br />That would encourage some economizing.<br /><br />Further, I am fairly sure the Ryan plan meets the standard of premium support. The support level is progressive with level of need, as far as I know.<br /><br />The only major difference from the Rivlin-Ryan approach was the ability to opt back into an actuarily similar plan offered by Medicare.MidPointManhttps://www.blogger.com/profile/13126418421444294086noreply@blogger.comtag:blogger.com,1999:blog-2938311055760665357.post-37505726945738453932011-05-07T10:40:43.222-07:002011-05-07T10:40:43.222-07:00There must be some kind of Medicare reform put in ...There must be some kind of <a href="http://www.medicaresolutions.com" rel="nofollow">Medicare</a> reform put in place in the near future.renee albertshttps://www.blogger.com/profile/02156400024779061914noreply@blogger.comtag:blogger.com,1999:blog-2938311055760665357.post-89183342820862439352011-04-26T14:53:55.650-07:002011-04-26T14:53:55.650-07:00Ed, this is a most excellent post. I have similar ...Ed, this is a most excellent post. I have similar thoughts about the Ryan Medicare plan. Structurally it's not really all that radical, as you point out, but the lack of real cost control measures combined with the CPI indexing makes it unworkable.<br /><br />If we want market forces to work in health care, I suspect we'd have to get rid of insurance altogether and make patients pay for health care directly. Health insurance suffers from moral hazard, as the presence of a third-party payer means that patients and doctors don't have any incentive to choose efficient treatments that could save money. In theory, insurance companies could force providers to organize in a way that changes those incentives, but in practice they don't seem to have the leverage to do so.<br /><br />Perhaps some combination of mandatory health savings accounts combined with government subsidies and even a single-payer system for certain treatments could do the trick. Even then, additional cost control regulations would probably be necessary.Alexander Hudsonhttp://www.partisans.orgnoreply@blogger.comtag:blogger.com,1999:blog-2938311055760665357.post-88841648201282491792011-04-25T15:23:23.269-07:002011-04-25T15:23:23.269-07:00Ed: Can you clarify on healthcare cost growth pre-...Ed: Can you clarify on healthcare cost growth pre-medicare (pre-1965) vs. CPI inflation at that time - was it also excessive?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2938311055760665357.post-36462745260395743992011-04-23T06:32:36.529-07:002011-04-23T06:32:36.529-07:00Clarification: Yes, certainly costs for specific p...Clarification: Yes, certainly costs for specific procedures have fallen after an experimental procedure becomes routine, or after a technological advance (sometimes), or after a patent expires allowing generics. By "sector" I mean, not in the employer group sector, the Medicare Advantage sector, the individual policy sector, etc.Ed Dolanhttps://www.blogger.com/profile/08757995049056872214noreply@blogger.comtag:blogger.com,1999:blog-2938311055760665357.post-80962537957137174342011-04-22T22:21:30.198-07:002011-04-22T22:21:30.198-07:00"it would be unrealistic to rely on unregulat..."it would be unrealistic to rely on unregulated market competition to hold the rate of growth of health care costs to the rate of CPI inflation. That has never happened anywhere [...] not in any sector of the US health care system where competition has been tried."<br /><br />Lasik surgery?Anonymousnoreply@blogger.com