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Paul Ryan Speaks for the Party of 'We Actually Have a Health Care Plan'

2:53 PM, Jun 12, 2009 • By MARY KATHARINE HAM
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So much for the "party of 'no'."

Rep. Paul Ryan (R-Wis.), along with Sen. Richard Burr (R-N.C.) and Rep. Devin Nunes (R-Calif.), this week offered the first, detailed health care reform bill in Congress- the Patients' Choice Act (S. 1099/H.R. 2520). To be fair, Barack Obama is awfully busy doing a campaign swing about health care reform and senate Democrats have their plates full threatening private opponents of their potential plans, so they can perhaps be forgiven for not actually offering any comprehensive plans, yet.

Ryan, whose home state Barack Obama visited yesterday to deliver his platitudinous vision for health care reform, held a conference call on his own plan today- an alternative to what he calls the "false choice" Obama offers between his plan and the status quo. It was his second this week- the first one hosted by The Heritage Foundation, which invited participants via social networks, and claimed 1,300 attendees.

"There are better ways to fix this problem," than the Democrats' proposal for a government-run insurance option, he said. "You can have universal access to affordable health care in American without the government running it. We do this in our bill with innovative reforms that get the market back involved...The nucleus of the system we propose is the patient and the doctor."

Ryan's plan, which USA Today called "a serious proposal that merits serious consideration," would turn the health care market into a freer, more flexible one by delinking health care coverage from one's employment.

Instead of, as Democrats have suggested, equalizing the health care tax structure by raising taxes on businesses, the Ryan plan would give the same tax break employers now receive to all individuals- $5,700 for a family and $2,300 for an individual, whether they're insured by their employer or not.

This plan would use market forces and competition (along with encouraging price transparency and shopping around by consumers) to control costs.

"Spending more money, as the president's proposing, is not the answer," Ryan said. "Let's look at what we're doing already...let's spend it more efficiently, more effectively."

Here's USA Today's explanation, which is pretty straight-forward on the ups and downsides of this idea:

The government would essentially pay for the first $5,700 in coverage for a family through the credit, and the family would pay the rest out of pocket. With the average family plan costing $12,700 now, that is a major cost. An employer could contribute, but with workers having to pay tax on the benefit, the employer might as well convert it to pay.

The upside is that having Americans pay for more of their medical needs with their own money would give people incentive to shop around when looking for insurance or having procedures done, putting pressure on providers to control costs.

The downside is that millions of people who are now covered through their employers could be left on their own.

The policy implications could be sweeping. And so might the political ones. On one level, this is just a group of staunch conservatives girding for a fight. Instead of having no plan, they have one that many Democrats, and potentially some moderate Republicans, see as a frontal assault on employer-sponsored health care.

Of course, the counter-argument is that the floated Democrat plan to offer a government insurance plan, and pay for it by getting rid of the tax exemption for employers is certainly an assault on employer-sponsored health care, in the service of eventually creating a government monopoly on health care. That's what Ryan predicts is the ultimate outcome of a government-run option, as Democrats envision it, and he uses a recent study from health care actuaries, The Lewin Group, to bolster his point.