In relation to David Brooks' column endorsing the Republican voucher plan for Medicare, in which Brooks purports to be addressing "the paradigmatic 'moderate voter'", Scott Galupo notes, it’s bleedingly obvious that David Brooks is talking to himself"
There may be three- or four-hundred voters besides Brooks who suffer from the same perplexities. Maybe a dozen of these live somewhere besides Manhattan or Washington, D.C. The idea that any bloc of voters, let alone moderates, believes that the “priority in this election is to get a leader who can get Medicare costs under control” is ludicrously narcissistic.Basically, the column is typical Brooks - some pretense at moderation before throwing his entire weight behind the Republican candidate. Facts? Irrelevant. Dean Baker observes,
NYT readers must be wondering whether David Brooks believes in Santa Claus. After all, he repeatedly professes his belief in the serious Mr. Ryan. This faith persists in spite of all the evidence to the opposite, including evidence that Brooks cites in arguing his case....Brooks expects his readers to keep up with the Romney/Ryan game of "hide the ball", asserting (without evidence) that the Romney/Ryan privatization plan will bring about savings and efficiencies not seen in either the private insurance markets or through "Medicare Advantage" because... well, because he says so. Is it theoretically possible? Sure. But experience suggests that its unlikely to work.
Since CBO works for Congress, it does what powerful members of Congress want it to do. Thus it wrote down down the numbers that Mr. Ryan instructed them to write down. However CBO was honest and clearly stated that it had just written down numbers given to it by Mr. Ryan and his staff. Unfortunately David Brooks is either too confused to understand what CBO wrote, or alternatively is deliberately trying to mislead NYT readers into believing that CBO scored a Ryan budget when it did not.
This system would provide a basic health safety net. It would also unleash a process of discovery. If the current Medicare structure proves most efficient, then it would dominate the market. If private insurers proved more efficient, they would dominate. Either way, we would find the best way to control Medicare costs. Either way, the burden for paying for basic health care would fall on the government, not on older Americans. (Much of the Democratic criticism on this point is based on an earlier, obsolete version of the proposal.)That, of course, is nonsense. The Romney/Ryan plan doesn't kick in for a couple of decades, so there's no experimentation - only assumption. If Romney and Ryan truly believed in their plan they would be asserting that it should be implemented immediately. That, right here, right now, private insurance companies should produce plans to complete with Medicare and demonstrate that they can offer superior, innovative plans at a lower cost.
Brooks predictably omits from mention the fact that the Romney/Ryan plan relies upon sleight of hand to "save" money - it caps the growth of the government's contribution toward your Medicare voucher. It's simply dishonest to pretend that the new plan would avoid shifting the burden of healthcare costs onto the elderly - Brooks knows better. That's the fundamental purpose of the proposal - to shift the risk that healthcare inflation will exceed the capped rate of growth for Medicare premiums from the government to the retired worker. If Brooks wants to make the case that the shift of risk is appropriate, he has the column in which to do it, but he has no excuse for misleading his readers about the fact that if Ryan truly believed his plan would bring about efficiencies he wouldn't need to cap premiums and shift the risk of loss to elderly individuals.
As if that's not enough, Brooks lies about the Democratic alternative to the Ryan Plan, which is to tackle healthcare inflation and waste as opposed to capping premium growth and calling it a day.
All of which causes you to look over to the Democrats and wonder: Why don’t they have an alternative? Silently, a voice in your head is pleading with them: Put up or shut up.Certainly you can argue that the measures taken are inadequate, but the ACA is the first real effort to tackle the growth in Medicare spending. But you know what? The Republican party has demagogued against cost-saving measures. When it came to counseling the elderly on end of life issues, they spouted nonsense about "death panels". When it came to attempting to determine the cost-effectiveness of medical procedures in order to reduce unnecessary spending and waste, they demagogued about government bureaucrats deciding what medical treatment you would get. And when a number was placed on the projected savings from eliminating inefficiency they - including Mitt Romney and (brave Sir) Paul Ryan - demagogued about the Obama Administration's "raiding" Medicare.
Dean Baker noted something in Brooks' column that struck me as well,
There is one other issue worth beating up on Brooks for in this piece. At one point he says:I suspect that's part of the back-and-forth between Paul Krugman and David Brooks, in which names are rarely mentioned. It's not that Paul Ryan couldn't pick up his phone and arrange to be interviewed by Paul Krugman, Dean Baker, or any other credible economist who takes issue with his fantasy "budget". It's that he doesn't want to. It's easy to see why Ryan will sit down and chat with somebody like David Brooks, who doesn't understand economics and who he knows will reward that access by supporting the Republican Party position in his columns. But it's just as easy to see why he won't sit down with anybody who would take him and his plan to pieces.
"I have enormous respect for Ryan and I regard most of the commentary I’ve read about him by people who’ve never even interviewed him to be ludicrous."
Huh? What planet is this guy on? It's wonderful that Brooks has had the opportunity to interview Paul Ryan. Most of us will not have that opportunity.
Even as Brooks sings his ballad of Brave Sir Ryan, the lyrics he sings give away the game. Ryan doesn't have the courage to face a worthy foe, or really anybody who is half-way conversant with the facts and willing to push him on the basics - such as why, after two years, can't he articulate the spending cuts necessary to make his "budget" work? Or why reforms supposedly essential to "saving" Medicare are pushed off twenty or so years into the future with no assurance that a future Congress will in fact pursue the plan? Bravest of the brave....