Ryan’s Graphics: Geeks Bearing GIFs

June 7th, 2011 at 11:35 pm

The Republican House Budget Committee has a snazzy YouTube video up featuring Rep. Paul Ryan defending his plan to voucherize Medicare.  It looks good but, alas, misleads.  Supporters of his plan have been stressing this argument of late, so let’s be very clear about why it’s very wrong.

The basic flaw is that Ryan and his video pretend that the R’s Medicare plan gives consumers the power to negotiate directly with health care providers, who can thus use their voucher-driven bargaining clout to hold down prices.  But, in fact, that’s not how his plan works at all.  Under his plan, seniors get to negotiate with insurance companies, not service providers (doctors, hospitals, etc.).

(Some of you may be wondering at this point why any of this negotiating over health coverage or care is a selling point…if so, you don’t understand the “power of the marketplace”—enroll in Chicago University Econ, do not pass go…oh, it’s also the case that the voucher loses value relative to health costs over time.)

A few minutes in, the graphic complains that under the Affordable Care Act, a panel of “15 unelected, unaccountable bureaucrats decide how much, or how little, Medicare will pay doctors and which services Medicare will, or will not, pay doctors to provide for their patients.”

OK, that’s the IPAB, and it’s the most important mechanism in the ACA to control costs.  We can and should debate how effective it will be.  But it will be medical professionals and patient advocates suggesting cost effectiveness measures to slow cost growth.  If Congress doesn’t like their ideas, they must come up with their own, or the IPABs will be enacted.

Ryan’s video creates the impression that his plan is different in that it lets Medicare recipients decide what health care services to pay for, and thus control costs through that old market chestnut, consumer sovereignty (“No my good sir, I shall not pay $16,549 for that appendectomy!”)

But in fact, his plan is to let seniors choose which set of unelected, unaccountable insurance company bureaucrats they want making decisions about their care, not the actual service providers.  Here’s the money line:

“…insurance providers, competing for patients’ business, will look to lower the costs and increase quality for their services – the way it always works when the consumer is in charge.

Now, private insurance companies already have every incentive to lower costs and increase quality.  If they could do so we wouldn’t be in this mess.  But they can’t because the private health insurance market doesn’t work like a normal market.

A good example of this is the Medicare Advantage program—over to Ezra:

“…this isn’t the first time we’ve tried to let private insurers into Medicare to work their magic. The Medicare Advantage program, which invited private insurers to offer managed-care options to Medicare beneficiaries, was expected to save money, but it ended up costing about 120 percent of what Medicare costs.”

So sure, Ryan is a budget geek and his video is a nice use of Graphics Interchange Format.

But I shouldn’t have to remind you: Beware of geeks bearing GIFs.


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14 comments in reply to "Ryan’s Graphics: Geeks Bearing GIFs"

  1. foosion says:

    Private insurance isn’t working very well today with employers as buyers. Employers have a lot more bargaining power than individuals and a lot more ability to research (and negotiate) features of plans. What possible reason is there to think that individuals, let alone elderly individuals, would do any better?

    There are widespread reports of hospitals not giving individuals prices in advance and of doctors being bound by insurance contracts that forbid giving anyone better pricing. Not a good atmosphere for negotiating.

    People generally don’t have the expertise to decide which medical procedures are best and most cost effective. They generally hire others to do that for them, for example, doctors.

    >>Chicago University Econ>>

    Goolsbee was and will be an economics professor there. Obama taught in the law school for 12 years, likely encountering econ faculty, through the law and economics program if nothing else. Hmmm

  2. UncommonSense says:

    I disagree with only one thing that you wrote:

    “So sure, Ryan is a budget geek and his video is a nice use of Graphics Interchange Format.”

    Ryan is not a budget geek. When it comes to the budget, he has no demonstrable expertise of any kind. To the contrary, he has no idea what he’s talking about.

  3. readerOfTeaLeaves says:

    Jared, Jared, Jared… (pulling out hair, grimacing…)
    Okay, this is quick, dirty, and simplistic.
    But you have insulted code slaves **everywhere** AND ALSO (&&) you have been pwded into the bargain.

    This is what drives me bananas about the Democrats and it is **maddening**. You give ninnies the cache of being ‘geeks’. This is not accurate.
    Paul Ryan is the furthest thing from a geek that I could watch on any YouTube, apart from a variety of cats.
    Do not provide him with cache that he does not merit.
    When you do things like that, it is:
    1. Deeply insulting to someone like myself who has slaved over code and can spot a poseur like Ryan at 500 miles, and
    2. Gives Paul Ryan an authority he neither possesses, nor deserves.

    WHY do the Dems continue to do this stuff?
    The man made a YouTube. That does NOT make him a geek!

    Simplistic geekspeak below, followed by translation:

    geekness = BOOL;
    bernsteinPwned = BOOL;

    if (bernsteinPwned) {
    BOOL geekness = [ryan createsGifs];

    — geekness is a True-False thing; you either have ‘geekness’ or you do not (in other words, this thing we call ‘geekness’ is Boolean: T/F)
    — bernsteinPwned, which roughly translates to ‘bernsteinLetHimselfGetOWNED’ is also a Boolean. It either happened, or it didn’t. (T/F).

    **IF** (conditional) Paul Ryan gets to be called ‘geeky’ because he createsGifs, **THEN** bernsteinPwned

    In other words, **if** bernstein gives paul ryan the cache of being a ‘geek’, simply because the guy can create a GIF, **THEN** bernstein is ‘owned’ [pwned -see Urban Dictionary] by ryan.


    Okay, this post is now taking up 20 minutes of my morning because I’m FOTFLMAO at this Ryan video.

    As my kids would phrase it:

    You got pwded.
    STOP IT!!!

    My 81-year-old mother can create a gif.
    My cousin’s 7 year old creates gifs.

    I hope that I have made my point, and made it in a way that will at least bring a chuckle for Bernstein.

    Do NOT let your kids know that you got pwned by Paul Ryan.
    My kids would just about throttle me if they ever thought that I got pwned by Ryan.

    I’m <55, so I very much have a dog in this fight, and it is well worth half an hour of my morning to write blog comments relevant to this whole Ryan train wreck.

    First rule of engagement: Do. Not. Get. Pwned.
    Especially by the likes of Paul Ryan.

  4. PeonInChief says:

    In what alternative universe do seniors get to negotiate with insurance companies? In our universe, I purchased health insurance for a small non-profit and, I assure you, we did not get to negotiate with insurance companies. We got to choose from a very small plate (no grains, no vegies, a little protein and some fruit), and I would swear that there was a good deal of price fixing. How are seniors going to do better than I did, or alternatively, how do we get to that nicer universe?

  5. ManOutOfTime says:

    I don’t even need to read this post. The title is so AWESOME everything in it must be true!

    Okay … read it. Post is right on: Ryan is a charlatan, a liar, and a buffoon.

    • readerOfTeaLeaves says:

      Yes, its wickedly funny.
      But my cousin the roofer? He’ll believe that YouTube of Paul Ryans.

      The roofer is a functional illiterate. Paul Ryan knows how to communicate with him.

      The Dems?
      Not so much.

  6. readerOfTeaLeaves says:

    Second comment, because I sometimes shake my head in despair about how Dems perceive the propaganda that the GOP swills out.

    As near as I can tell, Dems watch this stuff straight through and then get all dissonant and worried.

    Dems need to watch this stuff FRAME BY FRAME.
    Jon Stewart unpacks this nonsense, because he looks at this kind of video as a bunch of elements, then he takes them apart and unpacks them, piece by piece.

    First, I’ll say that as propaganda goes, I have to give Ryan and the GOP props for this. It’s a very, very well done piece.

    But the Dems need to unpack this kind of socially predatory nonsense, if not for me (age theProviders
    4:38: Scarry, scarry bureaucrats…(tinkling piano music and weirdo electronica dissonance)
    4:50: ME!! The patient!! I’m really superSized and I replace those [presumably evil] ‘bureaucrats’ — in comes the uplifting, sweet dulcet tones and symphonic personalEmpowermentSoundtrack


    Please, please stop getting pwned by this kind of nonsense.

    What I would give to watch Jay Inslee, or Maria Cantwell, or Michael Bennet (CO) or one of the Udalls get up on the floor of either house of Congress and have fun with the:

    — scary music score!
    — magicallyEnlargingPatientGuy!
    — circular ‘marketplace’ at the end.

    Honestly, the Dems could have a laugh fest with this GOP nonsense.

    More laughs, please.

  7. John says:

    I apologize if all this noise is somehow my fault… 8^(

    “Now, private insurance companies already have every incentive to lower costs and increase quality.”

    How so? They have every incentive to maximize profits – that’s the whole point of wanting a public option. Moreover, correct me if I’m wrong, but the last I heard, the repeal of McCarran-Ferguson passed the House but not the Senate last year, and thus its still the law and they still have their antitrust exemption.

    That combination is what makes the individual mandate authoritarian: giving a universal mandate to an effective monopoly industry creates for them an entirely captive market, and thus they have even less incentive than they might have had to control costs. Net effect: more harm than good.

    The industry was not just protected last year, it was rewarded. And yes, I’d made this very point to you on TPM Cafe several years ago now.

    (BTW, not to pick nits, but that video is a Flash animation, not a GIF… Unless you know something I don’t about it. But I get it – phonetic pun and all…)

    • John says:

      It would be funny if it weren’t so sad, but a Latin phrase comes to mind – medical doctors internalize this – it’s their ethical point of reference:

      “Primum non nocere.”

      I get the sense the PPACA team didn’t have it so much in mind.

  8. Bob Wyman says:

    Sorry, but if you were a real Geek, you’d know that the title of this story doesn’t make as much sense as you think it does. 🙂 It turns out that the “G” in GIF is soft! Thus, the proper pronunciation of GIF is “JIF”… Note: This isn’t really a debatable subject. The pronunciation of GIF was always and repeatedly explicitly defined in the documentation and code as: “The GIF (Graphics Interchange Format), pronounced “JIF”, was designed by CompuServe and the official specification released in June of 1987.”

    For all the gory details see: http://www.olsenhome.com/gif/

    • John says:

      He’s an economist, not a software developer; he deserves the benefit of the doubt – he certainly affords it to me.

      I wrote my own GIF engine about a decade ago (along with a bit streamer and an LZW codec), but couldn’t use it publicly until the patents expired. So sure, I know you’re right, but I’d not expect Bernstein to have done that much research about it.

      And not to give you the wrong impression, Bernstein, but I agree with your point(s) about Medicare. It just doesn’t do me any good, nor do measures like the high risk pools, for which I qualify but have been rejected anyway. I haven’t had income for 22 months – and am thus 4 months past COBRA – but the HRP rejected my app since I’d not been uninsured for 6 mos. My meds are $700+/mo retail. The HRP premium would be $450/mo. I also priced private policies, and I’m amazed anyone would even cover me with an individual policy, but the cheapest I found was $1200/mo.

      As I’ve mentioned to you before, I have a PhD in computer science, but I was last replaced by an unpaid intern that I trained myself – and that’s the second time it happened to me in the past 5 years.

      Today, Obama (who looks enough like me that I could be his older brother or cousin) was pushing job training. Excuse me while I scream at the top of my lungs and cry for a few minutes.

      I don’t think he gets it. Maybe he learned his love of capitalism from his bank VP grandma – I don’t know, but really and truly, you all would have done better leaving well enough alone. Lots of folks like me are worse off, waiting for 2014, than we would have been had you done nothing at all.

      It all feels like a ruse to me. Sounds on the surface like progress, but really gives private insurers more than they could have ever asked for. Kinda like the Ryan plan, frankly.

      Sanders 2012…