The Ryan plan, which would give seniors a fixed amount they can use to buy health insurance, would undoubtedly shift the cost burden over time from the government to seniors themselves, making health care far less affordable for millions of people. Ryan says that “empowering” health care consumers will help control costs, but that’s absurd: Medicare itself has far more pricing power than the people who actually need treatment.
The first part of Nocera's critique is correct, the cost of health care is shifted to seniors themselves, but the second part makes no sense (though I have seen this before, see here). I wonder how people can hold such contradictory ideas in their heads at the same time? If you shift more of the costs to seniors, who have limited budgets, they will get less health care. If they pay less for health care, costs will fall. Of course so will the amount of health care provided. But you cannot deny that if people cannot afford healthcare they will buy less of it.
Indeed, that seems to be the biggest problem with the Ryan plan. It controls the costs of healthcare by forcing people to buy less than they need.
But then the confused Nocera argues that we should not scorn Paul Ryan. Because the costs of health care are real he argues that:
It would be nice if we could treat the Ryan plan not as an object of derision but as a launching off point for a serious debate. That way, maybe for once we could avert a crisis instead of acting shocked when it finally arrives.
But this seems odd to me. Why not let the Obama Plan be the start of a discussion to control Medicare costs? You don't want to scorn Ryan who argues that Obamacare destroys Medicare. But we should start the discussion with Paul Ryan?
Nocera is really confused.