Paul Ryan explains problems with public plan

Paul Ryan offers amendment to strike the government-run plan
House Ways and Means Committee Markup
July 16, 2009

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Let me walk us through what decisions will be faced by employers. Employers are going to will be looking at a situation where the insurance they have will becoming more and more expensive. One study says that right now with Medicare and Medicaid cost-shifting is $88.8 billion a year. Another study says that if this passes, the cost-shifting will increase private insurance for a family plan by an average of $3,628.

So employers will be faced with a situation where more people will go on the public plan, the public plan underpays providers, they make it up by overcharging private payers. CBO doesnt think there is much cost-shifting, everybody else you talk to does.

Just think about it. Ask any doctor or any hospital in your district. They will tell you cost-shifting occurs. And so as this cost-shifting occurs, employers see their insurance going up and up and up at unpredictable rates. They make a choice. I can keep paying this high expensive, high increase cost insurance that the government tells me exactly what I have to buy or I can just pay an 8% payroll tax indexed at inflation predictable and dump my employees in the same kind of health insurance that I have to buy them anyway but this one is for 8%. You dont think they are going to make that decision?

Some people say well in a tight labor market they are going to be competing for workers and so they will want to offer this. We dont have a tight labor market. Weve got 10% unemployment. What employer is not going to dump their employee on the public plan as soon as the price of their insurance exceeds 8% of payroll where it already does?

The problem is this, Mr. Chairman: it is impossible for the private sector to be able to compete fairly with the government with all of its muscle and all of its tools. And at the end of that process, we will see a situation where people will have lost their choices. Employers will not be offering insurance to their employees. They will be saying I am paying the payroll tax, you are going into the public plan. And you know what the payroll tax rate at the end of the day in America will be? It will be 23%. We will have a 23% payroll tax in this country. 23% of wages going to payroll taxes to pay for this public plan.

This is not a good idea. And if you come from places like where I come from, where Medicare underpays hospitals and doctors substantially, who is going to want to continue offering these services? So I would just urge my colleagues get rid of the public plan and lets work at fixing the private health insurance market so that it works better. And lets not take away all of these insurance products that people currently enjoy. I yield.

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[79barkingspider]

@79barkingspider ...And I never said the US was the "worst". Why do you keep attacking straw men? As I admitted, I just have to fold my cards and accept everything Paul Ryan says: The US is ggggggreat. Oh wait a minuted, that was Tony the Tiger. They both sound the same to me.

[79barkingspider]

@regelemihai Man, you just won't quit. My quote doesn't say "generally receive better care," it says insured people are TWICE as likely to be diagnosed and treated." Don't try to hide a camel under a handful of straw. I'm really happy you can afford insurance. I can too, and that's one reason I want to see EVERYONE have it. Finally, I granted in my first post that cancer is the star in the US and why it shines. OK, I always forget that the US is the best at everything. Get a clue.

[regelemihai]

...than the European average; for breast cancer, it is 14 percentage points higher-- "Cancer Facts & Figures 2007," American Cancer Society.

This is just a sample. Fact is, both of us can use stats to support our contentions, but this ridiculous nonsense about how the US system is one of the worst in the world(demonstrably false) is a tad annoying.

I do hope you survived your cancer and that you're healthy again.

[regelemihai]

@79barkingspider

Yes, those who have insurence will genrally receive better care than those who don't--go figure. I'm not rich; I'm barely middle class and I can afford medical coverage.

You want data, okay. American women have a 63 percent chance of living at least five years after a cancer diagnosis, compared to 56 percent for European women--"Recent cancer survival in Europe", Lancet Oncology, 2007. the survival rate among Americans for bladder cancer is 15 percentage points higher...

[79barkingspider]

@regelemihai I guess I'll have to wait to hear from all the cancer patients (I was one of them). I'll just give you one citation on diabetes: "In the US, people who had insurance were twice as likely to be diagnosed and effectively treated for diabetes as those who did not have insurance." (Institute for Health Metrics and Evaluation 2011) Let's see, "people who had insurance" = rich people (or "job creators" as the right whimsically calls them. Respond with some data or give it up.

[regelemihai]

@79barkingspider

Among those "everyone" are many cancer patients who would say otherwise. Besides having better rsults for cancer survival rates, waiting time is shorter, chronic diseases are treated better, there is a much better access for preventive care, as I already mentioned. It's unwise to just handwave all of this casually. A lot of the horseshit many people go through is also because of government involvment-- I don't dispute that.

[Meade556]

@79barkingspider Also I think I commented at the wrong person, what you said I agree with entirely.

[Meade556]

@79barkingspider I am saying how dare he destroy the system that allowed his family and himself to be successful and enjoy the life he had. Let there be no mistake these attacks will close off opportunities for advancement resulting in a far more stagnant society. Try the Soviet Union in the 1980s, except there was more argument at the top in the Soviet Union. No Gorbachev could ever come to power if Ryan gets his way.

[Meade556]

@xXxDANMANxXx People not spending so much on healthcare will result in this money being released for spending in other areas helping the economy, try at least $900 billion of it.

[Meade556]

@xXxDANMANxXx Yeah so Social Security can be guaranteed forever and ever amen if we create more jobs, one way is by writing heavy punishments into tax and tariff laws for outsourced jobs, second by everyone pay into Social Security. Second on Medicare, allowing it to be available to everyone would result in a flurry of buying, pumping money into the system and ensuring in the short term at least that there is more than enough money for the baby boomers