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

[Torie]

A risky choice I think, with perhaps more upside and downside. But maybe Mittens feels he needs some upside, given his rather rough cruise through July, when he joined the Midwest in his own little drought. It will put more pressure on the Dems to talk about entitlements however, which is the last thing they have shown any interest in addressing.

Atlasians should be happy however, since Ryan had the potential to make the election more interesting.

[Torie]

Muon2 of course sums it all up nicely, but the most compelling reason to pick Ryan is that Mittens endorsed the Ryan Plan, and Ryan can defend - or to put it more appositely - sell - the Ryan Plan far more effectively and compellingly than Mittens. Ryan ties the wonkish numbers bit with a passion about how while the medicine does not taste good, it is essential for your health, and that he really cares about your health, in a way Mittens is simply not capable of projecting.  In a word, Mittens is uptight - and Ryan isn't.

When you get tied at the hip to someone else's policy, and the guy who formulated the policy is a good salesman, you hire the salesman.  KISS.  

[Torie]

Muon2 of course sums it all up nicely, but the most compelling reason to pick Ryan is that Mittens endorsed the Ryan Plan, and Ryan can defend - or to put it more appositely - sell - the Ryan Plan far more effectively and compellingly than Mittens. Ryan ties the wonkish numbers bit with a passion about how while the medicine does not taste good, it is essential for your health, and that he really cares about your health, in a way Mittens is simply not capable of projecting.  In a word, Mittens is uptight - and Ryan isn't.

When you get tied at the hip to someone else's policy, and the guy who formulated the policy is a good salesman, you hire the salesman.  KISS.  

Didn't you say Romney would have to be mad not to pick Portman?

That was the day before yesterday.  I had not quite picked up at that time just how much Romney had embraced the Ryan plan. So it becomes an in for a penny, in for a pound, kind of thing. Plus I realize now, that Ryan is a considerably more compelling speaker, and a better salesman, than Portman.

In short, I just blew it!    In my defense, I was concerned about Ohio, very concerned, but at the end of the day, I doubt that Portman would have moved the dial there much.

[Torie]

Ryan ties the wonkish numbers bit with a passion about how while the medicine does not taste good, it is essential for your health, and that he really cares about your health, in a way Mittens is simply not capable of projecting.  In a word, Mittens is uptight - and Ryan isn't.

When you get tied at the hip to someone else's policy, and the guy who formulated the policy is a good salesman, you hire the salesman.  KISS.  

What about when the product is a piece of crap?

Ryan's plan is just a massive cost-shifting scheme. I mean, it's obvious, isn't it?

No, it is more complicated than that.  In the end, one ends up at the same place regarding how to deal with medical subsidies we cannot afford going forward, and/or go outside of/bust the budget. One approach is that you just by regulation set forth the basket of care the government will subsidize, and when, and trim the basket if you run out of money, or appropriate more money. In the Ryan plan, you set up a budget in advance of how much you get, which is the current cost of care increased by 3% a year or something. If the amount of the sums handed out turn out not to buy enough of a basket of services down the road, just like with the regulatory regime, either you hand out more government dough, or the basket shrinks.  Just what is the real economic difference, putting aside issues of efficiency, and price policing, and more choices, etc? The answer is - none, nada, nothing.

You see what I am saying Marston?

[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]

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.

[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.

[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.   

[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? 

[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! 

[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.

[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.

[Torie]

Here is more to throw on the pile. It seems that if the defined contribution amounts are insufficient under the Ryan plan to cover a basic benefits package, then the amounts go up based on a bidding process. If so, assuming the insurance covers avoiding granny going over a cliff, she won't be. But I see anvi has already noted that aspect above. I have not read the entire article, so it will be interesting to see if the conservative author addresses the .5% cap and soak plank that anvi mentioned. I guess in the end, you either let medical subsidies eat up more of the GDP ad infinitum, or you force folks to pay more, or you ration more. The rest is noise. Probably the most palatable way out of the box is for more "Draconian" means testing, so if you have the means, you are going to pay more - a lot more, no matter how old you are. But you probably can't say that, and carry Naples, Florida. So we aren't going there for awhile.

Putting aside the soak the rich option, in any plan of course, just what is covered and what is not, is going to be an explosive political issue, for a population, most of which, are used to getting it all, and getting it now. I see American politics being caustic and acrimonious for a long time to come, in a nation that seems to be becoming a more zero sum nation.

[Torie]

Yes, the Ryan-Wyden plan is much more palatable. I still don't see the need for the competition between insurers since Medicare currently can get better rates from providers than individual insurers can due to their higher buying power. Indeed the rate Medicare pays is the starting point of insurers when negotiating with Hospitals about reimbursement. And depending on size they pay a little more or a lot more than Medicare. By fragmenting the system further, we increase the power of providers to charge higher rates.

Yes, except docs rip Medicare off. We need price policing by consumers. One little anecdote about this. I asked a doc in BH who supposedly did telephone appointments for a blood pressure meds prescription renewal, but he demanded to see me. Why, when I just want to renew my little blood pressure medicine prescription, and I have my blood pressure taken by a whole array of specialized docs on a seemingly monthly basis between the assorted and sundry gang. Well, I do more than that. I do a cardio exam. A cardio exam? You mean an EKG just to renew a blood pressure pill prescription? Yes, he said. I said that is ludicrous, and no, that won't be happening. You can imagine what it's like under Medicare. So plan B is to hit up my sex doctor for a lisinopril pill prescription renewal. Medicare needs folks like me around as a price and over-treatment avoidance policeman. I'm very good at it!  Lawyers are not afraid of doctors. It is just not in our genes.

[Torie]

Wow that's ridiculous. Since he is based in BH, he is just milking his patient population. Especially for something like blood pressure medication, which once you get on you usually keep taking it for life. All it should take is a simple electronic refill renewal request from your pharmacy.....

It doesn't work that way my friend. Docs want a fee to get your refill ticket punched, and they want to add some other tickets to the pile, and it takes some guts to just say no, I understand I am not following your advice, and accept the consequences, and frankly I think you are just wrong, and I disagree with your opinion, and won't be following it, thank you.  In this case, the doc if he thought I was dissembling, could have asked that I fax over the lab/med sheets showing my blood pressure takings. But no, of course not! (Yes, I always demand a copy on the spot of whatever the docs write on those sheets that are never read again, in the land of Oz where computers are for space aliens.) Our system is broken, totally. Who knew?  

No, it is not a BH problem. Indeed if you don't pay much of anything for your medical care out of pocket - it is all covered by Medicare or your insurance, where you have but a nominal copay, just why would you give an F anyway, how many tickets the doc puts on the pile, other than it wastes your time?

No, I won't tell you about my MRI cf, arising from a vertigo incident, which the neurologist never read or got back to me about. But I looked at my own little brain scan with the technician, and she said I looked great "for an old man," and my neurologist pal,  now a famous finance commentator and adviser and author, told me the technicians can read them better than the MD's. He also told me it was a total waste. That cost about 4K, of which I had to pay about 1.5K. F, just F!  Do you now understand just why I am so dyspeptic about this stuff?

You can trust your lawyer far more than your MD, and that's a fact.