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Health care debate offers market medicine

By Matt Pommer

“The miracles of modern medicine are simply outrunning the public’s ability to pay for them.”

Almost a quarter-century has passed since then-Colorado Gov. Richard Lamm made that statement. Soaring private health insurance and looming growth in Medicare in intervening years may seem to some to underline the view.

“You can’t afford to do everything to everybody,” said Lamm, a native of Madison and an accounting graduate of the University of Wisconsin-Madison. “So we have to make some decisions. I know that’s difficult, but I also know that’s possible.”

Fast forward to 2010. A Democratic-controlled Congress and a Democratic president have enacted provisions to assure everyone has access to health insurance. The law includes improved benefits for Medicare, the program of health care for senior citizens.

Republicans contend it’s too expensive and will drive up the federal deficit. Their federal candidates are calling for repeal of the Health Care Reform Act. The GOP-voiced concern about federal deficits seems to conflict with Republican demands that tax cuts enacted under President George W. Bush be extended for everyone, including the very rich. President Obama wants the tax cuts for the incomes to expire.

Letting the tax cuts expire for the wealthiest would generate an estimated $700 billion in federal revenues in the next decade. That would seem good medicine for debt-worried folks.

U.S. Rep. Paul Ryan, R-Janesville, has issued what he calls a “Road Map for America” plan involving taxes, Social Security and Medicare.

In recent weeks, attention has turned to Ryan’s ideas on Medicare. An opponent of government-controlled programs, he suggests future generations of senior citizens just be given vouchers to buy their health care from private insurance companies.

The theory is competition for insurance purchases by senior citizens would limit medical costs. The insurance companies would lean on physicians and other health care providers to curb fee increases. That might be difficult. Doctors already complain about the size of their Medicare fees.

The Wall Street Journal editorial page loves Ryan’s health care ideas.

“A larger transition to market place medicine could turn out to be as smooth as the private sector shifts to 401k (plans) from defined-benefit pension plans,” according to a mid-August editorial. “Taxpayers need someone like Mr. Ryan to expose the emperor’s naked budget.”

What happens if insurance companies decide to bid for senior health insurance purchases by limiting the services that would be provided? As Lamm said, decisions have to be made and you won’t do everything for everyone.

Lamm, a Democrat who served 12 years as governor of Colorado, always has been controversial. “I believe clearly that the United States must ration medicine,” he said in a 1986 speech.

Matt Pommer worked as a reporter in Madison for 35 years. He comments on state political and policy issues.

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