Now seems like a good time to re-up my prediction that we’re headed toward a messy policy convergence on healthcare: a mixed bag I’ve called “Orydencare”—that is, a cradle-to-grave system in which Medicare has undergone premium support reforms along the lines proposed by Rep. Paul Ryan and Sen. Ron Wyden, with Obamacare more or less remaining in place.
This is—very broadly speaking—what conservative healthcare wonk Avik Roy has in mind with his plan to (as he puts it) “transcend,” rather than repeal, Obamacare. In addition to reforms of the Affordable Care Act, Roy’s proposal would shift many Medicare and Medicaid beneficiaries into a new, more tight-fisted universal system of private-sector exchanges.
While lightly praising Roy’s realism on Obamacare’s essential permanence—and he no doubt deserves praise for this—liberals have balked at his provocative companion plan to reform social insurance for the elderly. Michael Hiltzik of the Los Angeles Times, for instance, writes that “Roy is especially hostile to Medicare and Medicaid. This is entirely consistent with conservative hostility to all social insurance.”
But, honestly, what’s so terrifying about moving future Medicare enrollees into a system of managed care? Most baby boomers are covered by such plans right now. Does it make any sense to then move them into a fee-for-service system to which they’re not accustomed—and which everyone, including liberals, agrees is dysfunctional?
Instead of waiting for baby boomers to descend en masse into an outdated system, why not look at this as a rare generational opportunity? Baby boomers relished the chance to rebel against the Greatest Generation. So why not let them rebel against their parents’ overburdened healthcare system too?
Remember you heard it here first. Orydencare for all.