A Question for Paul Ryan

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Earlier this morning I wrote a post about the differences between Paul Ryan’s 2012 Medicare plan and Paul Ryan’s 2013 Medicare plan. My point was simple: the 2013 plan is quite different from the 2012 plan, and if we’re going to attack his plan, we should be attacking the current one.

So here’s the main point of attack: Ryan’s 2013 plan relies on competitive bidding to lower costs. Healthcare providers all bid for Medicare contracts, and seniors get a voucher equal to the second lowest bid. That way, there are always at least two plans they can buy without having to fork out any money beyond the value of the voucher.

But Ryan also includes a “fallback” growth cap. The overall cost of Medicare won’t be allowed to rise faster than GDP + 0.5%.

So here’s the question reporters should be asking Ryan: What happens if all the bidders submit bids that are over the growth cap? Who pays the difference? Seniors?

If not seniors, then who? You can’t just arbitrarily force everyone to lower their bids. Nor can you lower payments to providers for specific services, since you’re just soliciting bids for insurance coverage, not paying providers directly for services. So what happens?

DOES IT FEEL LIKE POLITICS IS AT A BREAKING POINT?

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It sure feels that way to me, and here at Mother Jones, we’ve been thinking a lot about what journalism needs to do differently, and how we can have the biggest impact.

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We aim to hire, build a team, and give them the time and space needed to understand how we got here and how we might get out. We want to dig into the forces and decisions that have allowed massive conflicts of interest, influence peddling, and win-at-all-costs politics to flourish.

It's unlike anything we've done, and we have seed funding to get started, but we're looking to raise $500,000 from readers by July when we'll be making key budgeting decisions—and the more resources we have by then, the deeper we can dig. If our plan sounds good to you, please help kickstart it with a tax-deductible donation today.

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Signed by Clara Jeffery

Clara Jeffery, Editor-in-Chief

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