Obamacare emphasizes government control and central planning. The law empowers a panel of 15 unelected government officials, called the Independent Payment Advisory Board, to make changes to the Medicare program that will reduce Medicare spending: primarily paying doctors and hospitals less, as is done with the Medicaid program. Over time, liberal health-policy types hope that IPAB can be used to introduce rationing into Medicare, using the panel to determine what types of procedures and treatments that Medicare will and will not pay for.
The Wyden-Ryan plan, co-authored by liberal Sen. Ron Wyden (D., Ore.) and Paul Ryan, preserves the Obamacare targets for future Medicare spending, but employs an entirely different mechanism: premium support and competitive bidding. Seniors would enjoy exactly the same benefits that they do now, but along with the traditional Medicare program, they would enjoy the option of choosing among a selection of government-approved private insurance plans.
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