‘RyanCare’ v. ‘The Affordable Care Act’: Bring on the Death Panels for Grandma

By Gregg A. Masters, MPH

Well the ‘repeal and replace’ health reform war is apparently shifting into overdrive via the selection of Congressman Paul Ryan to join the Romney ticket. This is a content rich conversation with something for everyone as we reconcile ‘ACA-esque’ RomneyCare with the voucher based weapon of mass Medicare destruction aka ‘RyanCare’. This will be fun!

My day started with reading an article in Forbes online titled: ‘Yes, Obamacare Cuts Medicare More Than President Romney Would‘ which needless to say caught my attention.

In this day of massive online media fraud, outright manipulation and Citizen’s United fueled disinformation, I usually find Forbes to be a reasonable outlet for quality content. After reading through this mostly ginned up story, I felt compelled to offer the author some facts and historical context, and paste that comment in whole below:

What disingenuous trash! Seriously, you can do better! The only fear mongering and disinformation you omit, are death panels for grandma.

The irony in the dumbed down sound byte attacks from the right, includes the failed stewardship by so called fiscal conservatives that somehow finds the overfunding of the Medicare Advantage program to be consistent with their ‘values’. (For factual recap, click here.)

The Affordable Care Act is an amalgam of a comprehensive series of historically bipartisan approaches to health reform. The public option was sidelined in deference to this pluralistic philosophy emerging from a set of guidelines, vs. narrowly cast top down determinations. Yet, the near term collective amnesia is comical. The consistent efforts (timeline here) of Max Baucus from 2007 to 2009/10 was to work with his Republican colleagues on the Senate Finance Committee even though the ‘manager’s mark’ received virtually no Republican support.

So we get what you proffer, dumbed down, sound byte pejorative appeal to the unreasoned mind, hungry to be fed what they so confidently ‘know’ to be true.

I know this may be a stretch for you, but try to keep your facts straight and contextually aligned.

Finally, to tag Ezra Kelin with the ‘left-of-center’ label vs. the thoughtful and thorough health wonk this man is, is just more red meat diversion of the mind to the lazy corridors of faux rage. We don’t need astro turfed controversy to stir the pot in healthcare, the conundrum is real and problematic for those of us committed to retool its paternalism and over-engineered complexity.

BTW, perhaps if Baucus had held 30 vs. the 29 bipartisan meetings on health reform, things might have been different, right? I think not.

And so it begins! We are going to see a considerable degree of banter and disinformation in the marketplace of ideas around health reform which by definition includes ‘accountable care’, and ACOs, see ‘The ACO is a Child of the ACA‘, so we expect to be busy and on watch as the noise notches up a bit.

As always, we welcome diverse opinions and encourage you to comment and/or submit a guest post which argues in opposition with any of the points made above on on this blog.


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  1. Can we stick to accurate reporting of the ACA before we accuse Ryan of sending granma over the cliff. The facts are ACA (Obamacare) in the contect of an ACO is a capitated model – the physician only receives X dollars for a patient; hence there is a shared risk – can the provider treat Granma’s condition with the funds provided. What do you think a provider will do if they have a patient that won’t follow the care plan? As well, this is why Obamacare is different than what Romney did in MA – the ACA setup a separate police force for the president (has nothing to do with healthcare); it also has langauge about speak toward the president. maybe you should read the bill instead of being a mouth piece for democrats.

    1. Cameron:

      Actually you may want to check with the Act. The MSSP is a budget driven calculation, not a per se capitation. In some private market or commercial negotiations there may be some capitation, but not in the program as envisioned in the Act, unless otherwise authorized by CMMI or a national demonstration or pilot.

      Here’s the link to Section 3022 which details the payment terms of the MSSP program:


      Thanks for your comment.

  2. “Give me Liberty, or Give me Death!” – Patrick Henry

    What a brilliant ruling by the United States Supreme Court on the affordable health care act (Obamacare). Stunningly brilliant in my humble opinion. I could not have ask for a better ruling on a potentially catastrophic healthcare act than We The People Of The United States received from our Supreme Court.

    If the court had upheld the constitutionality of the individual mandate under the commerce clause it would have meant the catastrophic loss of the most precious thing we own. Our individual liberty. Thank you! Thank you! Thank you! Supreme Court.

    There is no mandate to buy private for-profit health insurance. There is only a nominal tax on income eligible individuals who don’t have health insurance. This is a HUGE! difference. And I suspect that tax may be subject to constitutional challenge as it ripens.

    This is a critically important distinction. Because under the commerce clause individuals would have been compelled to support the most costly, dangerous, unethical, morally repugnant, and defective type of health insurance you can have. For-profit health insurance, and the for-profit proxies called private non-profits and co-ops.

    Equally impressive in the courts ruling was the majorities willingness to throw out the whole law if the court could not find a way to sever the individual mandate under the commerce clause from the rest of the act. Bravo! Supreme Court.

    Thanks to the Supreme Court we now have an opportunity to fix our healthcare crisis the right way. Without the obscene delusion that Washington can get away with forcing Americans to buy a costly, dangerous and highly defective private product (for-profit health insurance).

    During the passage of ACA/Obamacare some politicians said that the ACA was better than nothing. But the truth was that until the Supreme Court fixed it the ACA/Obamacare was worse than nothing at all. It would have meant the catastrophic loss of your precious liberty for the false promise and illusion of healthcare security under the deadly and costly for-profit healthcare system that dominates American healthcare.

    As everyone knows now. The fix for our healthcare crisis is a single payer system (Medicare for all) like the rest of the developed world has. Or a robust Public Option choice available to everyone on day one that can quickly lead to a single payer system.

    Talk of privatizing/profiteering from Medicare or social security is highly corrupt and Crazy! talk. And you should cut the political throats of any politicians giving lip service to such an asinine idea. Medicare should be expanded, not privatized or eliminated.

    We still have a healthcare crisis in America. With hundreds of thousands dieing needlessly every year in America. And a for-profit medical industrial complex that threatens the security and health of the entire world. The ACA/Obamacare will not fix that.

    The for-profit medical industrial complex has already attacked the world with H1N1 killing thousands, and injuring millions. And more attacks are planned for profit, and to feed their greed.

    To all of you who have fought so hard to do the kind and right thing for your fellow human beings at a time of our greatest needs I applaud you. Be proud of your-self.

    God Bless You my fellow human beings. I’m proud to be one of you. You did good.

    See you on the battle field.


    jacksmith – WorkingClass 🙂

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