Jost on ObamaRomneyRyanCare

Professor Timothy S. Jost from Washington and Lee Law School has put together a commendably boring comparison of ObamaCare, née RomneyCare and what is, on Jost's account, its new avatar as RyanCare.  As Jost offers, with wonkish restraint:

Exploring the shared elements of the two plans [allows one] to clarify the extent to which consensus has emerged in U.S. health policy may enable us to begin addressing the serious conflicts that remain.

Well it might.  As Jost makes clear, in terms of structure and strategy, the similarities vastly outweigh the differences (Kevin Outterson points out that Ryan even has an individual mandate--query, is the whole package unconstitutional coming out of the gate?).  But I wouldn't hold my breath about "addressing" here:  There are at least two good reasons why this will never happen.  One, the Republican's indisputable first principle that it is more important to destroy Obama than it is to pass any program, no matter how plausible and widely desired. And two, to distract attention away from the point that Ryan's plan is so much more chintzy less generous than Obama's.

I admit that I don't have a firm, unalterable position on the chintzy/generous scale. It still seems to me that we're having far too little discussion about the reasons for the high costs of health care. How would the world change if we could use our Medicare dollars in Bangkok or Bangalore, for example? Is the FDA really moving as fast as it should on the approval of economizing devices? Just in general, I wish I had a better informed view about how the competing plans deal with the matter of competition among health care providers. I'm inclined to suspecct that RyanCare does next to nothing, but it's not obvious to me that ObamaRomney does much better.