Romney picks Paul Ryan as his running mate **official thread**

[Torie]

No, NYC, the amount of the "guaranteed benefit" is now a function of government fiat. The insurers will be/are told what to insure, and that can either expand - or contract over time. Everybody knew that health care needed to be rationed, and this will be the mechanism - far after the election is over of course, with granny being shoved off the cliff probably not happening until after 2016.  Team Obama is not stupid. Don't underestimate them.

[Marston]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

[Southern Senator North Carolina Yankee]

No, NYC, the amount of the "guaranteed benefit" is now a function of government fiat. The insurers will be/are told what to insure, and that can either expand - or contract over time. Everybody knew that health care needed to be rationed, and this will be the mechanism - far after the election is over of course, with granny being shoved off the cliff probably not happening until after 2016.  Team Obama is not stupid. Don't underestimate them.

Who do you define as everybody?

Indeed and politcally Obama will benefit, but if it is his campaign that renders reforms difficult/impossible, he will take the blame in the history books reflecting back on when a chance to change course was missed, and why it was.

[Southern Senator North Carolina Yankee]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

Under the current status quo, the guarrantee itself as presently constituted no longer exists as a going concern in the future. That is why Wyden and Rivlin and other Democrats have embraced some form of premium support system.

[Torie]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

Just one more time - the Medicare "guarantee" is effectively dead - as it should be. And yes, of course, everybody should get some basket render in a logical and cost effective way, everybody, regardless of ability to pay. The pre Obamacare system was itself an epic fail, which deserved to die.

There is one thing I really resent about Obamacare, if I understand it correctly. But I am saving that for an essay on a larger topic of which this is but one iteration - which is what I think really underlays (underlies?-  my mother worked so hard to get me to use lay and lie correctly, and I just never really adequately internalized it) much of the disagreement between the sane Left and the sane Right (the nutters you just try to quarantine), but is never spoken about out loud. Well damn it, it is time that it should be!  

[Torie]

No, NYC, the amount of the "guaranteed benefit" is now a function of government fiat. The insurers will be/are told what to insure, and that can either expand - or contract over time. Everybody knew that health care needed to be rationed, and this will be the mechanism - far after the election is over of course, with granny being shoved off the cliff probably not happening until after 2016.  Team Obama is not stupid. Don't underestimate them.

Who do you define as everybody?

Indeed and politcally Obama will benefit, but if it is his campaign that renders reforms difficult/impossible, he will take the blame in the history books reflecting back on when a chance to change course was missed, and why it was.

Those with a shred of intellectual honesty and knowledge = "everybody." Hope that helps.

[Southern Senator North Carolina Yankee]

No, NYC, the amount of the "guaranteed benefit" is now a function of government fiat. The insurers will be/are told what to insure, and that can either expand - or contract over time. Everybody knew that health care needed to be rationed, and this will be the mechanism - far after the election is over of course, with granny being shoved off the cliff probably not happening until after 2016.  Team Obama is not stupid. Don't underestimate them.

Who do you define as everybody?

Indeed and politcally Obama will benefit, but if it is his campaign that renders reforms difficult/impossible, he will take the blame in the history books reflecting back on when a chance to change course was missed, and why it was.

Those with a shred of intellectual honesty and knowledge = "everybody." Hope that helps.

So that doesn't include the average voter in say Florida who is say 70 years of age and goes bonkers at the slightest mention of Social Security and Medicare by politicians?

[Torie]

No, NYC, the amount of the "guaranteed benefit" is now a function of government fiat. The insurers will be/are told what to insure, and that can either expand - or contract over time. Everybody knew that health care needed to be rationed, and this will be the mechanism - far after the election is over of course, with granny being shoved off the cliff probably not happening until after 2016.  Team Obama is not stupid. Don't underestimate them.

Who do you define as everybody?

Indeed and politcally Obama will benefit, but if it is his campaign that renders reforms difficult/impossible, he will take the blame in the history books reflecting back on when a chance to change course was missed, and why it was.

Those with a shred of intellectual honesty and knowledge = "everybody." Hope that helps.

So that doesn't include the average voter in say Florida who is say 70 years of age and goes bonkers at the slightest mention of Social Security and Medicare by politicians?

You do know I hate Florida right? Everything about the place sucks - everything - except South Beach.   

[Southern Senator North Carolina Yankee]

No, NYC, the amount of the "guaranteed benefit" is now a function of government fiat. The insurers will be/are told what to insure, and that can either expand - or contract over time. Everybody knew that health care needed to be rationed, and this will be the mechanism - far after the election is over of course, with granny being shoved off the cliff probably not happening until after 2016.  Team Obama is not stupid. Don't underestimate them.

Who do you define as everybody?

Indeed and politcally Obama will benefit, but if it is his campaign that renders reforms difficult/impossible, he will take the blame in the history books reflecting back on when a chance to change course was missed, and why it was.

Those with a shred of intellectual honesty and knowledge = "everybody." Hope that helps.

So that doesn't include the average voter in say Florida who is say 70 years of age and goes bonkers at the slightest mention of Social Security and Medicare by politicians?

You do know I hate Florida right? Everything about the place sucks - everything - except South Beach.   

Well, since your state doesn't seem to be to inclined to vote Republican these days, those pesky 29 electoral votes are damn near necessity for a Republican to stand even a chance.

[anvi]

The letter the CBO sent to Ryan analyzing his budget proposal predicts (page 4) that the contributions of Medicare voucher recipients make toward private premiums featuring the "basket" of Medicare-covered procedures and meds would increase rather precipitously under Ryan's parameters between 2022 and 2030.

http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/121xx/doc12128/04-05-ryan_letter.pdf

Tying medical reimbursements, not Social Security CoLA adjustments, mind you, but medical reimbursements, to the CPI makes the "basket" of covered services shrink fast once it does come into effect, owing to the fact that recent estimates by the Health Care Cost Institute have health care cost inflation rising at twice the rate of general inflation...
http://www.healthcostinstitute.org/2010report
...and because the MLR's associated with private insurers are fairly low compared to those of government plans.

There's a difference between medical rationing, which under every realistic scenario of budget planning going forward is absolutely necessary, and exponential rationing which is necessitated by the Ryan plan not distributing cost cutting measures across the the entirety of the federal budget

The last point leads me to other important issues I myself have with the Ryan plan, among which the unfoundedly optimistic projections for increased revenue levels on the basis of downward adjusted tax rates, the lack of specificity on which tax deductions will be subject to elimination, the plan's refusal to cut defense spending and the associated quite stark reductions in discretionary and Medicaid spending, as both of the latter two will leave states remarkably cash-strapped.  

Looks like an economy-busting brand of austerity that Mitt just went in for a pound of, it seems to me.

[Torie]

Did I ever say life was perfect? You know, I pump iron for more than one reason.  

Anvi, what is the projected cost increase under Obamacare, so we can put some percentages next to what is "Draconian" and what is necessary fiscal prudence even for those who are not social Darwinians? 

I don't know all of the details of the Ryan tax ideas, but from what I know - they are just silly, and DOA to boot. But let's focus on one thing at a time, preferably something where I don't think I am some dude running up Cemetery Hill without the slightest cover straight into the cannons and repeating rifles (those damn Connecticut Yankees were just so good at fashioning deadly munitions bless them) for close to half a mile, as opposed to the guy behind the berm squeezing the repeater.

You do know that I like to win rather than lose don't you? 

[Southern Senator North Carolina Yankee]

Did I ever say life was perfect? You know, I pump iron for more than one reason.  

If this was an election between the two of you, that statement would have just elected anvi, most likely.

[Marston]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

Under the current status quo, the guarrantee itself as presently constituted no longer exists as a going concern in the future. That is why Wyden and Rivlin and other Democrats have embraced some form of premium support system.

I don't think anybody is advocating the status quo. The simple fact of the matter is that Medicare reform cannot be done without comprehensive systematic reform. Something must be done to address the over-utilization of health services in this country. Yes, some form of rationing will have to exist, regardless of the system in place - as it should. Also, the abhorrently high administrative costs associated with health insurance (which ironically range from 5-20% in the private health plans Ryan advocates throwing everyone in.) needs to be addressed. Medicare's administrative costs are only roughly about 2%, btw. The lack of focus on preventive medicine/care, the large uninsured population that waits to obtain care until their condition becomes acute and the fact that the U.S. Congress is PHrMa's whipping boy require a cure, as well. The list goes on and on, sadly.

Ryan is just attempting to reduce federal liability, not solve the actual problem. I thought it was obvious but perhaps not.   

[Southern Senator North Carolina Yankee]

The letter the CBO sent to Ryan analyzing his budget proposal predicts (page 4) that the contributions of Medicare voucher recipients make toward private premiums featuring the "basket" of Medicare-covered procedures and meds would increase rather precipitously under Ryan's parameters between 2022 and 2030.

http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/121xx/doc12128/04-05-ryan_letter.pdf

Tying medical reimbursements, not Social Security CoLA adjustments, mind you, but medical reimbursements, to the CPI makes the "basket" of covered services shrink fast once it does come into effect, owing to the fact that recent estimates by the Health Care Cost Institute have health care cost inflation rising at twice the rate of general inflation...
http://www.healthcostinstitute.org/2010report
...and because the MLR's associated with private insurers are fairly low compared to those of government plans.

There's a difference between medical rationing, which under every realistic scenario of budget planning going forward is absolutely necessary, and exponential rationing which is necessitated by the Ryan plan not distributing cost cutting measures across the the entirety of the federal budget

The last point leads me to other important issues I myself have with the Ryan plan, among which the unfoundedly optimistic projections for increased revenue levels on the basis of downward adjusted tax rates, the lack of specificity on which tax deductions will be subject to elimination, the plan's refusal to cut defense spending and the associated quite stark reductions in discretionary and Medicaid spending, as both of the latter two will leave states remarkably cash-strapped. 

Looks like an economy-busting brand of austerity that Mitt just went in for a pound of, it seems to me.

I thought the Ryan plan did specify some of the changes to deductions? Indeed it isn't enough and he did state that the details would be up to Camp's Ways and Means Committee to sort out, a committee which he is a member of I beleive.

[Torie]

Did I ever say life was perfect? You know, I pump iron for more than one reason.  

If this was an election between the two of you, that statement would have just elected anvi, most likely.

And the nation would be far better for it! 

[anvi]

Anvi, what is the projected cost increase under Obamacare, so we can put some percentages next to what is "Draconian" and what is necessary fiscal prudence even for those who are not social Darwinians? 

I didn't make comments about "Draconian" cuts and "social Darwinism," and I'm not handing out political endorsements to the people who did either.  As to your question, you mean the health care cost inflation increases under Obamacare?  I don't know, but I suspect they will continue apace.  Nobody wants to touch health care cost inflation in the U.S. very deeply as far as I can tell at the moment.  If someone comes who will, I will personally pound in lawn signs in every state on behalf of their campaign. 

But I'm fairly unelectable, so no one needs to worry about me either.

NYC, if I remember correctly, Ryan has made verbal pledges to end all deductions and loopholes--even though, predictably, that sort of pledge ticks off both sides.  He did leave those decisions, as you rightly note, to committee in the end.

[Torie]

Well anvi, if Obamacare advertises its funding will go up at a rate not much different than the Ryan projection, then just what is the functional difference again per the marketing flyers at least?  Or does Obamacare now have no projections of what it will cost going forward, although it projected something for 10 years to do that reconciliation finesse?

The Darwin thing was just my colorful language. I certainly didn't mean to suggest you would use such characterizations - or believe such things. I was just "communicating," to make the point more clearly, or try to.

[Southern Senator North Carolina Yankee]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

Under the current status quo, the guarrantee itself as presently constituted no longer exists as a going concern in the future. That is why Wyden and Rivlin and other Democrats have embraced some form of premium support system.

I don't think anybody is advocating the status quo. The simple fact of the matter is that Medicare reform cannot be done without comprehensive systematic reform. Something must be done to address the over-utilization of health services in this country. Yes, some form of rationing will have to exist, regardless of the system in place - as it should. Also, the abhorrently high administrative costs associated with health insurance (which ironically range from 5-20% in the private health plans Ryan advocates throwing everyone in.) needs to be addressed. Medicare's administrative costs are only roughly about 2%, btw. The lack of focus on preventive medicine/care, the large uninsured population that waits to obtain care until their condition becomes acute and the fact that the U.S. Congress is PHrMa's whipping boy require a cure, as well. The list goes on and on, sadly.

Ryan is just attempting to reduce federal liability, not solve the actual problem. I thought it was obvious but perhaps not.   

That is because Ryan's plan is designed as a budget and not an all encompassing overhaul of healthcare. He doesn't chair the health, education and welfare committee.

Just like you don't think anyone is arguring for the status quo, well neither do I think that any one is seriously desiring to not address an overhaul of the Healthcare system, primarily focused on addressing those very rising costs you mention. In terms of real details this one is even more difficult to propose in an election year then a budget plan. The good thing is that with two "numbers guys" the chances are likely that both realize what the numbers are telling them have to be done and both Romney and Ryan have experience on the healthcare issue (one from expanding coverage, the other on the federal liability) to be able to tackle that problem. Romney does realize the problem to be sure, in his book he lemented that Romneycare didn't address the overal cost issue (expanding coverage is only a very small piece of solution pie here) and that most of which had to be addressed at the federal level.

[Marston]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

Just one more time - the Medicare "guarantee" is effectively dead - as it should be. And yes, of course, everybody should get some basket render in a logical and cost effective way, everybody, regardless of ability to pay. The pre Obamacare system was itself an epic fail, which deserved to die.

No, no I don't think it is. There are a plethora of mechanisms that could be implemented that could effectively extend Medicare solvency. There just isn't the political will (on either side of the aisle) to do so.

Meh, I just suppose we'll have to agree to disagree on the rest and let the chips fall where they may.

[Southern Senator North Carolina Yankee]

Anvi, what is the projected cost increase under Obamacare, so we can put some percentages next to what is "Draconian" and what is necessary fiscal prudence even for those who are not social Darwinians? 

I didn't make comments about "Draconian" cuts and "social Darwinism," and I'm not handing out political endorsements to the people who did either.  As to your question, you mean the health care cost inflation increases under Obamacare?  I don't know, but I suspect they will continue apace.  Nobody wants to touch health care cost inflation in the U.S. very deeply as far as I can tell at the moment.  If someone comes who will, I will personally pound in lawn signs in every state on behalf of their campaign. 

But I'm fairly unelectable, so no one needs to worry about me either.

NYC, if I remember correctly, Ryan has made verbal pledges to end all deductions and loopholes--even though, predictably, that sort of pledge ticks off both sides.  He did leave those decisions, as you rightly note, to committee in the end.

Who the hell is NYC?

[Marston]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

Under the current status quo, the guarrantee itself as presently constituted no longer exists as a going concern in the future. That is why Wyden and Rivlin and other Democrats have embraced some form of premium support system.

I don't think anybody is advocating the status quo. The simple fact of the matter is that Medicare reform cannot be done without comprehensive systematic reform. Something must be done to address the over-utilization of health services in this country. Yes, some form of rationing will have to exist, regardless of the system in place - as it should. Also, the abhorrently high administrative costs associated with health insurance (which ironically range from 5-20% in the private health plans Ryan advocates throwing everyone in.) needs to be addressed. Medicare's administrative costs are only roughly about 2%, btw. The lack of focus on preventive medicine/care, the large uninsured population that waits to obtain care until their condition becomes acute and the fact that the U.S. Congress is PHrMa's whipping boy require a cure, as well. The list goes on and on, sadly.

Ryan is just attempting to reduce federal liability, not solve the actual problem. I thought it was obvious but perhaps not.   

That is because Ryan's plan is designed as a budget and not an all encompassing overhaul of healthcare. He doesn't chair the health, education and welfare committee.

Just like you don't think anyone is arguring for the status quo, well neither do I think that any one is seriously desiring to not address an overhaul of the Healthcare system, primarily focused on addressing those very rising costs you mention. In terms of real details this one is even more difficult to propose in an election year then a budget plan. The good thing is that with two "numbers guys" the chances are likely that both realize what the numbers are telling them have to be done and both Romney and Ryan have experience on the healthcare issue (one from expanding coverage, the other on the federal liability) to be able to tackle that problem. Romney does realize the problem to be sure, in his book he lemented that Romneycare didn't address the overal cost issue (expanding coverage is only a very small piece of solution pie here) and that most of which had to be addressed at the federal level.

Fair enough. I just doubt, given the Romney track-record of running away from anything healthcare related, except for promising to "...kill Obamacare dead on day one", that he'll seriously risk his political capital on healthcare reform given the disastrous effects it had on Obama, Pelosi, Reid and Co. during the 2010 midterms.  

[anvi]

Well anvi, if Obamacare advertises its funding will go up at a rate not much different than the Ryan projection, then just what is the functional difference again per the marketing flyers at least?  Or does Obamacare now have no projections of what it will cost going forward, although it projected something for 10 years to do that reconciliation finesse?

First of all, sorry, NCY.  I've looked at too many abbreviations this evening.  

Well, the last CBO release I looked at had some interesting things in it.  They project that the net budgetary effect of ACA will reduce government health care spending by $84 billion over the next ten years--a period the Ryan plan would make no adjustments to other than repealing the bulk of ACA, which the CBO estimates would add $109 billion to the deficit.  Interestingly, as they note, the first number has been effected at least in part by the recent SCOTUS ruling that states can refuse ACA's Medicaid expansion if they want, which would actually result in federal savings, of course.  CBO also predicts that, over the next ten years, 6 million fewer people will be covered by Medicaid and only 3 million of those people will buy insurance through exchanges with federal subsidies, while the other 3 million will be uninsured.  These figures come out, the report estimates, to something of a wash in terms of federal budget expenditures.  As you expect, the projections of revenues generated from penalty payments are best characterized as wild guesses, and I didn't see anything, after a quick glance through this report, about projections beyond 10 years, whereas the major health care provisions of the Ryan plan only begin to take effect after 10 years.
http://www.cbo.gov/sites/default/files/cbofiles/attachments/43472-07-24-2012-CoverageEstimates.pdf

But, on the basis of your question, I'm not sure which numbers we're supposed to compare to get the comparison you want.  Are we looking for comparisons in overall health care cost inflation under both plans, or a comparison of long term federal budget expenditures on health care--which would be complicated given the fact that ACA and the Ryan plan are scored under different budget outlay assumptions--or a comparison of the benefits received by a Medicare beneficiary under the Obama and Ryan plans in, say, 2035?  The first comparison would, I suspect, lead to roughly equal amounts of grim, the second would only be significant under a similar framework of budgetary assumptions, and the third would, I think, probably feature a somewhat larger basket of benefits under ACA than the Ryan plan because the former does not index federal subsidies to the CPI, but that of course leads to larger federal budget expenditures.

Neither candidate is getting my endorsement, as you know, largely because, when I look at both of these plans, I need a potent alcoholic beverage to bring me at least a tiny smidgin of metaphysical comfort.

[Torie]

Anvi, I just want to know how much dough each approach claims (yes we know, the gap between claim here and reality is perhaps larger than the distance between galaxies) that we will be spending on medical services, and how much of that will be subsidized over 10, 20, 30 years (Ryan baby (he does look like almost a child doesn't he?) at least has long time horizons, so let's man up and match him). We need those numbers, to even begin to masticate in anticipation of the act of chewing, with any ensuing swallowing and then digesting of this piece of raw liver way, way down the line. One micro step at a time is called for here methinks.

[anvi]

Ryan, baby, huh?  Yeah, he was born almost exactly six months before me.  If someone asked me to accept a nomination for the Vice-Presidency right now, I'd run away screaming for my mother, so I give him credit for having the pair to step up to the plate.    I don't even want to be the chair of my department, after all.

I'll see if I can make guestimates at those numbers, but it might take some digging and guessing, as you'd expect.

[Southern Senator North Carolina Yankee]

Marston, let me be more blunt. Under Obamacare regulations medical services are going to be rationed to death as it were. The basket will shrink. There is no escape.

Having said the above, it would be interesting to see what folks think the cost ramp up for Obamacare will be over time, both per its official numbers (which have lost most if not all of their credibility), and what outside analysts say. Is it more than 3%? 

Torie, medical services are already rationed via the ability to pay for those services. The Ryan-Wyden monstrosity simply exacerbates this for Medicare beneficiaries by gradually pricing them out of any semblance of a comprehensive care plan. In sum, they're taking out the 'guarantee' out of the Medicare guarantee.

Under the current status quo, the guarrantee itself as presently constituted no longer exists as a going concern in the future. That is why Wyden and Rivlin and other Democrats have embraced some form of premium support system.

I don't think anybody is advocating the status quo. The simple fact of the matter is that Medicare reform cannot be done without comprehensive systematic reform. Something must be done to address the over-utilization of health services in this country. Yes, some form of rationing will have to exist, regardless of the system in place - as it should. Also, the abhorrently high administrative costs associated with health insurance (which ironically range from 5-20% in the private health plans Ryan advocates throwing everyone in.) needs to be addressed. Medicare's administrative costs are only roughly about 2%, btw. The lack of focus on preventive medicine/care, the large uninsured population that waits to obtain care until their condition becomes acute and the fact that the U.S. Congress is PHrMa's whipping boy require a cure, as well. The list goes on and on, sadly.

Ryan is just attempting to reduce federal liability, not solve the actual problem. I thought it was obvious but perhaps not.   

That is because Ryan's plan is designed as a budget and not an all encompassing overhaul of healthcare. He doesn't chair the health, education and welfare committee.

Just like you don't think anyone is arguring for the status quo, well neither do I think that any one is seriously desiring to not address an overhaul of the Healthcare system, primarily focused on addressing those very rising costs you mention. In terms of real details this one is even more difficult to propose in an election year then a budget plan. The good thing is that with two "numbers guys" the chances are likely that both realize what the numbers are telling them have to be done and both Romney and Ryan have experience on the healthcare issue (one from expanding coverage, the other on the federal liability) to be able to tackle that problem. Romney does realize the problem to be sure, in his book he lemented that Romneycare didn't address the overal cost issue (expanding coverage is only a very small piece of solution pie here) and that most of which had to be addressed at the federal level.

Fair enough. I just doubt, given the Romney track-record of running away from anything healthcare related, except for promising to "...kill Obamacare dead on day one", that he'll seriously risk his political capital on healthcare reform given the disastrous effects it had on Obama, Pelosi, Reid and Co. during the 2010 midterms.  

I am a person who beleives that success is the road to recovery for the GOP, even if not immediate, but instead long term recognisable successes on important issues will lead people to embrace it long term even if they reject it in the intermediate period. The ideological battles serve a purpose in that they can help effect the process by putting the necessary people in place. At the same time they can be a detriment. In that sense Romney is indeed playing the right and that is going to send shockwaves through most conservatives on here who are more caught up in the platitudes and a dial position regarding government then actually fixing problems with conservative solutions. Most of the correct solutions have their origins on the right and that is why I adhere to them more then not, but I actually want to achieve those things rather than being a loud minority who never gets taken seriously. I would assume from what I know of Mittens that he views these things the same way.

Technocracy has to live within the Democracy and since no system is better the technocrats have work within it to get in a place to fix the problems. Romney probably will be a one term President, if elected. I am fairly certain that Obama's defeat in 2012 would be followed by a President Clinton or Cuomo in 2016. Because in the fine American tradition of say President George H.W. Bush who honed decades of experience in Washington and statemen like qualities to ensure a dramatic transition in the geopolitical world occured as quietly and peacefully as possible, only to be rewarded with the boot in 1992, Romney will probably face the same fate if and indeed he is elected.

What else is a President Romney going to do? He won't be FDR or Reagan, so he either does these things in his likely one term or he doesn't. His fate will likely be the same. This is a man who has sought the Presidency for quite some time, I would think he wants it to do something postive other than to revel in holding the title of President for four years.