This is basically a dodge. First, he changed the countries: He moved to Canada and the United Kingdom rather than the examples I mentioned. And Canada and the United Kingdom, though more successful than we are, are not particularly successful health-care systems. But even so, Ryan’s wrong to draw an equivalence between our costs and theirs. In 2008, Canada spent about $4,000 per person, per year, on health care. The United Kingdom spent a bit more than $3,000. We spent about $7,400. They want to get their health-care costs down and we want to get our health-care costs down, but suggesting that we’re all facing the same sort of pressure is flatly wrong. ...
nd saying this is all about “who should make the decision” is too simple by half, or perhaps by three-fourths. Under Ryan’s plan, the relevant decisions are made by whether you have the money to pay for what you need, whether your insurance provider says “yes” or “no,” and whether Congress decides to increase or decrease the size of the subsidies. As he says elsewhere in his response, his plan is all about making Medicare less generous, about finishing off the open-ended, fee-for-service model he believes is driving costs.
Similarly, there are a mix of people making decisions in, say, the French system. You can purchase whatever you want if you have the money. If you don’t, you’re somewhat at the mercy of private insurers because there’s a lot of supplementary private insurance. The government plays a big role financing basic care and bargaining down prices. And, as we’ve seen, the result is a system that the French people quite like, that holds costs down much better than ours does, and that gets similar or better outcomes.
In both of his major arguments, Ryan focuses on the wrong numbers. When defending Medicare Part D, he argues that it came in cheaper than expected, ignoring both the reasons behind that performance and the fact that growth in the program was nevertheless much faster than his plan could bear. When attacking the systems in other countries, he cherrypicks numbers to demonstrate they want to save money in the health-care systems but ignores the numbers showing that they spend half as much as we do. The result is that he gives people the wrong impression of both Medicare Part D and health systems across the world.
The reality is that if Ryan’s plan held growth to the same rate as Medicare Part D, it would implode, while if it closed 50 percent of the gap between our system and the Canadian system, it’d be a wild, unmitigated, unbelievable success. But unhelpfully for Ryan, that points to the fact that the approach he’s trying has never controlled costs as dramatically as he suggests, while the approach he’s eschewing has working in a dozen other countries. As he says in his introductory remarks, we both agree that controlling health-care costs is an urgent priority, that maintaining and improving quality a necessary task, and that none of this will be easy. But that just underscores how important it is for us to be realistic about what we can do, clear-eyed about what has and hasn’t worked elsewhere, and open to ideas that don’t fit with our philosophical preferences.
Ryan had a good couple of weeks when Wall Street and GOP p.r. were lionizing him as "courageous" and "brilliant." Now, only other Ayn Rand acolytes take him seriously-- and, of course, men who worship the ground he walks on. And as Eric Sapp pointed at at Huff Po this morning, the Republican Party is going to have to chose between two irreconcilable world views, Ayn Rand's and Jesus Christ's. They can't have it both ways. Ryan openly admits she was the inspiration for his interest in politics. Her adolescent novels are also the inspiration for his dystopian budget-- what he calls his "cause." Christian conservatives have started recognizing what that really means.
Chuck Colson is one of the lions of the Christian right and the head of Prison Fellowship, which, all politics aside, is the best thing coming from the Christian right and a powerful ministry to a segment of society even progressives often ignore. But Colson condemned the strong support of Rand in Republican and conservative circles and urged his followers not only to stay away from the new film of Rand's book Atlas Shrugged, but to "stay away from anyone who intends to watch the film." Colson goes on to say Rand and her followers were precisely the types of "cranks" and "crypto-cultists" that his friend Bill Buckley had fought to purge from conservative ranks. He says the "real problem with Rand is the world view her novels and other writings sought to inculcate in her readers... it's hard to imagine a world view more antithetical to Christianity."
So what is Colson talking about? A week before his statement, American Values Network released a damning memo with a large number of Rand quotes where she says she is out to destroy the Church and Judeo-Christian morality. She argued that people had to choose between following her teachings or those of Christianity and other religious traditions. Rand said religion was "evil," called the message of John 3:16 "monstrous," argued that the weak are beyond love and undeserving of it, that loving your neighbor was immoral and impossible and that she was out to undermine the idea that charity was a moral duty and virtue.