Ryan misses the mark

Regarding “Exclusive interview: Rep. Paul Ryan discusses need for ‘marketbased’ health reform” (ModernHealth care.com, Aug. 14), Rep. Ryan’s premium support proposal as a solution to Medicare’s financial problems misses the mark. All such subsidies, whether they are premium supports or tax credits, serve to drive prices higher, not lower.

While this proposal has the initial effect of lowering the government’s Medicare outlay from $15,000 per beneficiary to $9,500, it is only a matter of time until inflation adjustments bring the outlay back to its original level, presuming the premium support is not capped at some arbitrary level in the future.

The amount the premium support falls short of providing a Medicare-equivalent benefit shifts cost from the public to the private sector, and a capped premium support would result in a much larger shift as there would be no offsetting inflation adjustment.

Imposing the premium-supported benefit package as the second lowest in a region will set a floor below which few, if any, commer- cial carriers would be willing to go. How does this create market competition?

Premium supports do not reduce health insurance premiums. They neither lower the cost of healthcare, nor avoid higher deficits/taxes. Premium supports are little more than an interesting approach to kicking the can a bit further down the road.

Dave Cluley Grand Rapids, Mich.