Monday, May 30, 2011

RyanCare is "Corporate Welfare"

Paul Ryan claims to be for "free markets." His Medicare reform plan is not based on the free market; it is based on the corporatist model akin to ObamaCare and RomneyCare.

Taxpayer's money will be used to subsidize private insurance companies (via premium supports). The government will then decide which companies would qualify for this subsidy. The laws and regulations crafted for this RyanCare will be heavily influenced by corporate lobbyists. Just as in ObamaCare (where we had the Corn Husker Kickback, the Louisiana Purchase, and the Gator Aid), there will be corruption. Ordinary Americans, who do not have powerful lobbyists representing them, will be out of the loop. (The politicians tell lies when campaigning, then break their promises once elected.)

The "corporate socialism" (being espoused by the likes of Paul Ryan, Barack Obama, and Mitt Romney) isn't good for the healthcare consumer. What is needed is more competition. The oligopoly status of the healthcare providers is aided and abetted by regulatory capture, discouraging new players from entering into the marketplace. The powerful American Hospital Association (AHA) does not want competition from the physician-owned hospitals. The ObamaCare bill was written to AHA's favor.

What is needed for the consumer is an unleashing of "charter" hospitals to enter into the healthcare field. This will help break the back of the AHA stranglehold against the new innovators who'd provide us with better care at lower prices.

The corporate monopolies do not want competition. They hate capitalism! These companies want to retain monopoly status and use socialism as a mechanism to thwart smaller businesses from invading their turf (via overly restrictive licensing requirements, for instance).

Another problem is the people's addiction to comprehensive insurance for routine care. Imagine how expensive food would be if we relied on insurance to pay for all our grocery bills. We shoppers wouldn't bother clipping coupons or pay attention to prices anymore. We simply wouldn't care ... because insurance pays for everything! (This would cause price distortions to market behavior -- costs would skyrocket.)

The problem with RyanCare, ObamaCare, and RomneyCare ... is that it further strengthens our addiction to insurance for routine care. And it weakens our empowerment over our own healthcare decisions. The doctor doesn't work for you, the patient -- he works for the insurance company. This undermines the doctor-patient relationship. In corporatized medicine, we simply become "a number."

Personalized care is gone, being replaced by standardized care. This is what to expect for our future. Tragic!

For a related article on charter hospitals:

To read more on the problems with comprehensive insurance (as opposed to catastrophic):

To read more on the problem with RyanCare:


  1. Kelly, sorry this comment keeps coming up as anonymous. I will seeks to end that. Not sure why that is so. My name is KP:

    Your article is brilliant. It is clear that you understand the larger view of the relationships invloving "health", "care" and "cost"; as well, the corruption that follows. Finally, the shrinking doctor patient relationship. Still, hard working docs all over our country struggle to maintain that intimate relationship. Glad I found your blog.

  2. Thanks for your feedback, KP. Actually, the posted comment does display your name (plus your icon, too).

    What has revolutionized my thinking on insurance as it applies to care and cost? ... It happened way back in September of 2009 when I read that **Atlantic** article, "How American Health Care Killed my Father."

    As for Paul Ryan's Medicare Reform Plan ... I am hoping for a **genuine** debate on the topic. The ideas must be examined from all angles. (Partisan spin needs to be minimized.)

    The debate needs to be out in the open -- in the airwaves, town hall meetings, educational seminars, magazines, blogs -- and not limited to behind closed doors. If the elites merely enact "solutions" without the people's consent, we'd have senior furor redux.

  3. A worthy debate. I will read the entire article. I am through two pages now. I have worked in health care for 30 years. The bureaucracy was so unsettling I shut down my office. I tired of insurance companies telling me how to practice.

    My mom has had a stroke and two brain surgeries this past year. I have seen some heroic work by hospital staff (nurses and surgeons) and less that stellar cost vs treatment decisions by administrators -- particularly by administrators at the hospital (top shelf) and a PT director at a nursing home, who conformed to Medical rehab guidelines.

    In their defense, they are under enormous stress from the government to comply. Understanding the system I was able to appeal my mother's post op care to the highest level possible in the state of California and argued her case in front of the state's judge who was assigned to her case.

    At great personal expense (time and money) I secured the treatment she needed with the support of her neurosurgeon while I waited our appeal dates. In the interim I was proved correct. She made major leaps in her condition. It didn't matter that I was correct _or_ that she improved with care as I had insisted on and paid for. We lost on appeal.

    We already have specific limitations on the amount of care anyone can get through Medicare. That are determined by cost analysis. I am not saying the nalysis is bad or good; just that they already exist.

    Be prepared when you enter the system – as an advocate for one unable to advocate for them selves or as a patient. I understand that end of life care is astronomical. That is why I believe a DNR on file is essential.

    As for accidental death under general anesthesia or from in hospital secondary infection, that is an issue. Sometimes death is from ignorance; sometimes because stuff goes wrong. We are all going to be in this system sooner or later -- as an advocate or as a patient. Both suck rotten eggs if things don't go well.

    In the end, things don’t go well; we die. My goal: live the highest quality of life possible and then go quickly. I don’t want to linger and have told my wife as much – very clearly

  4. On your comments about open dialogue; I agree 100%. I think Ryan won some points today in the Obama appeared less willing to debate in an open way. he wants to do the past behind closed doors thing. People are tired of that. Lets get it out in the open and have real debate.

    On a side note, a close friend lost her dad today after he went under general anesthesia for ankle reconstruction. Wow. Second person I know that experienced similar loss this year.

  5. Perhaps my criticism of Paul Ryan has been too harsh. He may very well vindicate himself.

    I wonder about Mitt Romney. Would he be honest to the American people? Or will he merely be the Republican version of Obama?

    We must have public forums on both ObamaCare and RyanCare.

    1) There must be equal protection under the law.

    2)There must be respect for people's individual liberties.

    3) There must not be obstacles in the way (i.e. insurance or government agencies) undermining the doctor/patient relationship.

    4) There must be the freedom to choose one's own doctor.

    5) There must be a break in the linkage between employment and the choice of healthcare and/or insurance.

    6) There must be an increase in competition amongst the healthcare **providers** that will lower prices for the healthcare consumer. (Current regulations restrict competition via the licensing laws, the "ban" on doctor-owned hospitals and the limited number of medical schools.)

    7) There must be the freedom for insurance companies to charge lower premiums to individuals who lead a healthy lifestyle (i.e. for those who keep their weight down, exercise, eat right, etc.)

    8) There must be the freedom for individuals to purchase insurance from across state lines.

    9) There must be tort reform.

    10) There must not be an individual mandate for **comprehensive** insurance. (If there is to be a mandate, it should be in the form of a high-deductible **catastrophic** coverage or in the form of a flat tax.)

  6. There are some good ideas there; we need to icrease competition, allow insurance companies to compete across statel ines, and there must be TORT reform. This may not solve all the problems but it would be a start.
    In Romneycare there is a mandate to buy insurance but some people who have only "catastrophic" type coverage have been told it does meet state regulations and have been forced to buy more expensive insurance or be fined. That make no sense whatsoever.