The Wyden-Ryan Plan: Déjà Vu All Over Again

 

Uwe E. Reinhardt is an economics professor at Princeton. He has some financial interests in the health care field.

After wrestling for decades and in futility with the triple problems facing health care in the United States – unsustainable spending growth, lack of timely access to health care for millions of uninsured Americans and highly varied quality of care – any new proposal to address these problems is likely to be a recycled old idea.

The widely discussed new proposal from Senator Ron Wyden, Democrat of Oregon, and Representative Paul D. Ryan, Republican of Wisconsin, to restructure the federal Medicare program for the elderly is no exception.

The idea – generally known as “managed competition” — goes as far back as 1971, when Dr. Paul Ellwood and his colleagues at the Health Services Research Center of the American Rehabilitation Foundation injected it into President Nixon’s attempt at health reform.