So I’m watching the Gingrich/Cain debate thing. I don’t think I’ll make it all the way through. The Medicare discussion is tough to watch. Gingrich is doing better, but I’m liking Cain more the more I watch. Gingrich is trying to dig out from the wreckage he caused by calling the Ryan budget Medicare reforms “right-wing social engineering.” He is actually doing a good (if deceptive) job. He is talking about making the Medicare “premium support” in Ryan’s budget optional and letting people stay in traditional Medicare if they want. He doesn’t talk about how to equalize government contributions to the two programs. If the government is offering 12,000 of premium support but is funding Medicare at larger rate, then you aren’t having real competition. Premium support (whether some version of Medicare FFS continues to exist or not), is a way to, over the long-term, cut projected spending and (hopefully) contribute to an increase in medical productivity that means we buy more health care for the same amount of money. Gingrich doesn’t talk about that. He talks big about cutting fraud. That’s the thing that makes Gingrich so attractive at first hearing. He must have used the term “radical” at least three times in the first half hour of the debate in relation to himself and his ideas. He talks the big transformative conservative, free market, private sector, blah, blah and that sounds cool. And then he offers a free lunch. And that’s even better! He gives you the sense of intoxication from making you feel part of an ideological vanguard, but he also doesn’t ask hardly anyone to give up anything (well, other than Medicare chiselers.) He is really doing a good job with this act tonight.
At one point, Cain was asked if he preferred premium support or defined benefit Medicare reform. Cain obviously had no idea what he was being asked and asked Gingrich to answer the question first. No, I’m not kidding. Gingrich went off on a rant against the government “defining” what government subsidized benefit should be. This to go along with his earlier skepticism/weaseling on premium support. It sounded good until you thought about it. Cain got himself together and said some stuff about defined contribution plans.
Here are a couple of serious people on how to use premium support to fund a defined benefit version of Medicare and get competition between different plans.
We are in so much trouble.
