During a sleeves-rolled-up, down-to-brass-tacks presentation Thursday arguing for the House’s Obamacare repeal plan, Speaker Paul D. Ryan (R-Wis.) briefly discussed the economic problems at the heart of the existing health-care structure. Depending on your view of Ryan and his efforts, the comments could be read either generously or ungenerously.

Here’s what he said.

The fatal conceit of Obamacare is that ‘We’re just going to make everybody buy our health insurance at the federal government level; young and healthy people are going to go into the market and pay for the older, sicker people.’ So the young healthy person is going to be made to buy health care, and they’re going to pay for the person, you know, who gets breast cancer in her 40s. Or who gets heart disease in his 50s.

So take a look at this chart. The red slice here are what I would call people with preexisting conditions. People who have real health-care problems. The blue is the rest of the people in the individual market — that’s the market where people don’t get health insurance at their jobs where they buy it themselves. The whole idea of Obamacare is the people on the blue side pay for the people on the red side. The people who are healthy pay for the people who are sick.

It’s not working, and that’s why it’s in a death spiral.

Take a moment to consider those comments outside of the debate that erupted afterward. Now, click on your choice: Are you sympathetic to Ryan’s overall position or not? (Then, click on the other one.)

I am unsympathetic to Paul Ryan’s position.

I am sympathetic to Paul Ryan’s position.


The philosophy major in me would like very much to opine on Wittgenstein and the challenges of fully conveying our thoughts and beliefs through the artificial constraints of language. The geek in me would like to instead overlay some thoughts on taking snippets of arguments and sharing them on social media as stand-alone encapsulations of someone’s worldview. The writer in me would like to spend a bit of time noting ways in which Ryan might have made his point — assuming it overlaps with Buck’s — a bit more clear.

But instead the person who has been on television before me will simply say that we’re going to leave it there.