Ron Wyden Achieves no Compromise

    His recent proposal with Ryan accomplishes nothing assuming he's a Democrat and that means anything as opposed to what it means to be a Republican. As Ezra Klein argued in his aptly title post, "Ryan-Wyden is not a compromise proposal."

    http://www.washingtonpost.com/blogs/ezra-klein/post/wyden-ryan-is-not-a-compromise-proposal/2011/08/25/gIQAtAh9vO_blog.html

    There isn't much compromise as there never is between Democrats and Republicans. On the Affordable Care Act (ACA) Democrats negotiated with themselves yet the GOP still wasn't happy:

    "But this is the core disagreement between liberals and conservatives. Conservatives think that the government stands between us and cost control. Liberals think that the government is the only force capable of cost control."

    "As you can see, there’s not an obvious midway point between those two positions. So in recent years, conservatives and liberals began discussing an asymmetric compromise. Liberals want cost control, but they really want universal coverage. The deal they offered conservatives was a system that had a) universal coverage but b) a competition-based approach to cost control. Wyden’s Healthy Americans Act was, perhaps, the purest incarnation of this deal."

    "But Republicans never took that deal. Funnily enough, it turned out they didn’t need to. When Democrats amassed enough political power to muscle a health-care bill through on their own, the party’s conservatives demanded a private, choice-based structure anyway. Republicans loathed the final product, but the reality is that it looked quite similar to proposals they had been friendly to throughout the years."

    Now the Republican presidential candidates run against ACA though it was literally their proposal-the individual mandate was Romney's bill in Massachusetts, Gingrich had intitally proposed it back in 1993.

    " Paul Ryan and the Republicans continue to work to repeal the Affordable Care Act, and they have not proposed an alternative approach to achieving universal coverage."

     In truth Klein may be close to the mark in suggesting that the reason there is no compromise is there is little to compromise about-Wyden is essentially on board with Ryan here.

    "So it’s not clear to me exactly what Ron Wyden is getting in this trade. When we spoke last night, Wyden argued that this proposal represents a substantial concession on Ryan’s part when compared to the Medicare reforms in the GOP budget. But a compromise with an extreme-right proposal that will never pass is no compromise at all."

     What seems clear is that competition may not be the answer in health care. Klein is anguished and laments this fact:

     "we have tried competition-based structures before — the Federal Employee Health Benefits Program, Medicare Advantage, Massachusetts, etc — and they’ve never lived up to the high hopes of advocates. I hope that we just haven’t cracked the code yet, as I think there are important reasons to prefer a competition-based system to one in which the government simply sets prices. But I’m not optimistic."

     Krugman is more blunt:

     " Looking both within the United States and across countries, if you ask which systems are best at cost control, the ranking looks like this:

      "Government provision as well as financing (socialized medicine) > single payer > market competition"

       http://krugman.blogs.nytimes.com/

       Klein never explains why there are important reasons to prefer a competition-based health care plan to one in which the government sets prices. There seems to be no proof competition works in health care as insurance companies make money by maximizing their number of healthy patients who don't need health care insurance. So why prefer it?