One of Michael Kinsley's many sins was bringing us Fred Barnes. Now he has driven Austin Frakt into shrill madness:
How voucherizing Medicare is not like Part D : Fred Barnes, executive editor of the Weekly Standard, wrote an opinion piece for NPR earlier this week in which he made the case for voucherizing Medicare. To the extent that I find the competitive bidding version of vouchers a sensible idea, I agree with Barnes. However, that’s not what he’s talking about.... There are some things Barnes and I seem to agree on too. Let’s start at the beginning. His column opens,
Social Security’s looming deficit can be handled, for the time being, by adjusting benefits a tad downward. Medicaid’s runaway spending can be restrained by giving state governors more flexibility in administering the program. These are modest solutions. Medicare is different. It needs a big solution.
OK, I agree that Social Security is an insignificant problem relative to Medicare. No doubt it could be solved by tinkering with benefits, though that is not the only way to solve it.... I’ve written a lot already about Medicaid, but Harold Pollack has written more, and specifically on what “flexibility” will do.
Medicare is different and it does need a big solution. No argument there.
But what is the solution? Barnes says the only solution... [is] voucherization. Well, it isn’t the only solution, but it is a solution....
[Barnes] points to a voucher plan within the current Medicare program that works very well, Part D.
What has worked is competition. The Medicare prescription drug benefit program, enacted in 2003, has cost 40 percent less than projected. This is due to competition among providers for the business of millions of seniors.
Yes. Yes. One thousand times, yes! Part D is a good model, with protections for taxpayers and beneficiaries. Guess what it has that Medicare Advantage and the Ryan-Rivlin plan do not. (Wait for it …) Competitive bidding. That’s the source of its protections. That’s the crucial way in which it differs from other voucherization ideas.... No such bidding system would exist under the Ryan-Rivlin plan. Thus, Barnes preferred method of voucherizing Medicare is not like Part D. Yet he points to Part D as a justification, a model, for it. Well, if Part D is so laudable, let’s follow that model.
How voucher levels are set is the most important aspect of a premium support plan. It’s crucial to understand the mechanics. Is it by declaring, “Thou shall not raise subsidies faster than GDP + 1 percent,” or is it based on an apolitical market mechanism? Don’t be fooled by the sleight of hand Barnes has employed. Competitive bidding is different. Part D does it. Medicare Advantage and the Ryan-Rivlin plan do not.
Why oh why can't we have a better press corps?