Who Do They Work For?

Theoretically, members of Congress work for us–for “we the people.”

Whatever the theory, it’s clear that many of them think they work for those whose campaign contributions put them in office. To take just one recent example, ask yourself who would benefit from Paul Ryan’s much ballyhooed new budget proposal to replace Medicare with subsidies allowing the elderly to purchase insurance in the private marketplace? It doesn’t take a genius to answer that one: the beneficiaries of those subsidies would be the insurance industry.

I’m sure it is simply coincidental that insurers are among the most generous of campaign contributors.

As the Congressional Budget Office analysis pointed out,

A private health insurance plan covering the standardized benefit would be more expensive currently than traditional Medicare. Both administrative costs (including profits) and payment rates to providers are higher for private plans than for Medicare. Those higher costs would be offset partly but not fully by savings from lower utilization stemming from two sources. First, private health insurers would probably impose greater utilization management than occurs in Medicare. Second, private plans might restrict enrollees’ ability to purchase supplemental insurance plans; enrollees would thus face higher out-of-pocket costs than they do in Medicare, and that increased cost sharing would encourage lower utilization. On net, for a typical 65-year-old in 2011, CBO estimates that average spending in traditional Medicare will be 89 percent of (that is, 11 percent less than) the spending that would occur if that same package of benefits was purchased from a private insurer.

In other words, this plan would cost the government more money. To the extent there would be any “savings,” they would come from shifting costs to the individuals covered.  Protecting the disabled and elderly from those costs, of course, was the original purpose of Medicare. Essentially, this program would screw over the recipients and give a windfall to the insurance companies.

What is amazing to me is how utterly bald-faced this proposal is. Have we really convinced the American people that giving more and more to the “haves” at the expense of the most vulnerable is in the national interest? I was never a fan of the Robin Hood theory of government–robbing the rich to give to the poor–but I am appalled by the current “reverse Robin Hood” ideology, where we rob the poor to benefit the rich.

Well, we certainly know who Ryan works for. And it isn’t us.