Conor Clarke is confused by some of the graphs in the Republican budget. "As near as I can tell," he writes, "Paul Ryan and his staff just took the CBO projections that ended in 2019 and drew a random line, extending upward at about a 45 degree angle, until 2080. There's no real attempt to make it look scientific." It sure is pretty though:
It is a striking graph. But it's a pretty familiar trend line to health wonks: That's what deficits look like if health spending simply accelerates eternally. The math on this is pretty simple: Health costs are increasing much faster than GDP or government spending. Given sufficient time, they will pass GDP and government spending.It looks like Rep. Ryan just let health spending accelerate on the Democratic side of the ledger and slowed it on the Republican side. Indeed, it looks strikingly like a graph that the Center for Economic and Policy Research released late last year. Their graph showed the look of the U.S budget deficit if health spending kept its current course, and also if the United States magically replaced its health system and had the per person costs of a variety of other countries:
Neat, right? And pretty similar trends. Control health spending and the deficit goes down. As Rep. Ryan will tell you, however, those states control health spending by rationing their care: The government arbitrarily decides how much they're willing to spend on health care that year and the system responds. Sometimes, it responds by slowing down the provision of care. And that, Johnny, is why God created waiting lines.So how does Ryan control costs? Well, pretty much the same way. He turns Medicare into a voucher program where seniors "will receive a premium support payment equal to 100 percent of the Medicare benefit." Currently, Medicare's costs rise as the demand, and price, of care rises. No rationing. Under Ryan's proposal, its costs will rise by whatever the federal government says its costs will rise by. The question will simply be how quickly the subsidy grows. And if subsidy growth slows, we'll have...Rationing! It will take the form of individuals being unable to pay for treatments rather than the government making people wait for treatments, but it'll largely be the same thing. And it's nearly the exact same mechanism.
It is a striking graph. But it's a pretty familiar trend line to health wonks: That's what deficits look like if health spending simply accelerates eternally. The math on this is pretty simple: Health costs are increasing much faster than GDP or government spending. Given sufficient time, they will pass GDP and government spending.It looks like Rep. Ryan just let health spending accelerate on the Democratic side of the ledger and slowed it on the Republican side. Indeed, it looks strikingly like a graph that the Center for Economic and Policy Research released late last year. Their graph showed the look of the U.S budget deficit if health spending kept its current course, and also if the United States magically replaced its health system and had the per person costs of a variety of other countries:
Neat, right? And pretty similar trends. Control health spending and the deficit goes down. As Rep. Ryan will tell you, however, those states control health spending by rationing their care: The government arbitrarily decides how much they're willing to spend on health care that year and the system responds. Sometimes, it responds by slowing down the provision of care. And that, Johnny, is why God created waiting lines.So how does Ryan control costs? Well, pretty much the same way. He turns Medicare into a voucher program where seniors "will receive a premium support payment equal to 100 percent of the Medicare benefit." Currently, Medicare's costs rise as the demand, and price, of care rises. No rationing. Under Ryan's proposal, its costs will rise by whatever the federal government says its costs will rise by. The question will simply be how quickly the subsidy grows. And if subsidy growth slows, we'll have...Rationing! It will take the form of individuals being unable to pay for treatments rather than the government making people wait for treatments, but it'll largely be the same thing. And it's nearly the exact same mechanism. 
