Deficit Commission

I read that Congressman Paul Ryan, a member of the deficit commission, did not vote for the proposed plan, even though it has generally been described as "center right", for two reasons:  (1) it retains the Health Care Reform Act, instead of proposing repeal, and (2) it doesn't adopt his pet proposal to turn Medicare into a voucher program under which beneficiaries would be given a set amount to go out and purchase medical insurance from private insurers.

The concept of this sort of commission is that members get in a room, hammer out compromises and reach a consensus based on everyone giving a bit.  It would appear that, because Ryan didn't get others to endorse 2 items on his agenda, he won't go along.  In other words, Ryan was looking for the commission to adopt his proposal, and he had no intention of compromising.  It may well be that other commissioners were equally unwilling to compromise; I don't know.  Presumably, the HCA was a political "third rail" issue for Ryan, whatever he or other commissioners may feel about its deficit-reducing efficacy; he can't be seen as supporting the law in any fashion.  I understand that.  However, making Medicare into a voucher system (essentially, privatizing it) a sticking point seems incredibly inflexible.

The truth is, since the proposal includes certain tax increases, Republicans were never going to support it.  The whole exercise seems designed to emphasize Republican intransigence rather than to actually come up with a plan that would have any chance of bi-partisan support. 

I have to say that I don't understand how turning Medicare into a voucher system improves the system.  I get that privatization and the preference in all circumstances for private sector activity over public sector activity is an article of religious faith for comtemporary conservatives  and, therefore, facts don't reall matter to them here.  However, it would seem logical that, if you build in an additional level of private sector profit-taking (which would be the case of health insurance for the elderly were moved into the private insurance market) you will either increase the cost of the insurance or reduce the benefits; someone--and that would be the consumer and/or the taxpayer--will have to pay for the private companies' profits.   Would the extra cost represented by private insurers' profits be balanced out by increased efficiencies/savings resulting from the movement to the private sector?  Possibly, but I doubt it.  Medicare surely has some inefficiencies--a significant amount of fraud on the part of private sector health care providers being one of them--but these can be reduced by better administration and a relatively modest investment in enforcement and anti-fraud resources.  Private health insurers will, undoubtedly, run somewhat more efficiently, but we all have seen the other significant way in which private health insurance companies cut costs-by denying coverage, delaying payments, underpaying, underresourcing customer service, etc. 

I don't mean to demonize private health insurers (they don't need me to do that).  But it's just a fact of life that the profit motive pushes large consumer volume businesses to "cheat" on expenses/payouts, whatever other cost-cutting measures they may adopt.

This religious mania for privatization proceeds regardless of the facts (see school vouchers as an example), because Republicans and conservatives are unwilling to accept that in certain circumstances, the government may be a more desirable provider of services than the private sector, even when the evidence points to such a result.