If Obamacare is ruled unconstitutional or repealed, the country will have a second chance to reform healthcare sensibly.

We need to get it right if we get this chance.

A Democrat and a Republican (this sounds like the set up of a went-into-a-bar joke) have put forward a plan to reform Medicare. Carrie already has written about the plan that is known as Wyden–because it comes from Reps. Paul Ryan, a Republican, and Ron Wyden, a Democrat.

Carrie's piece acknowledges that this plan may not have much chance any time soon but that it is a good place to start a serious discussion that can lead to genuine reform.

Michael Barone has an interesting piece on it today. Michael Barone writes that Wyden “gives hope that the Medicare entitlement can be rendered sustainable.” Here is the gist of it (from Barone):

The Ryan-Wyden proposal provides for continuation of the current Medicare program for those now over age 55. For those younger, it would introduce in 2022 a "premium-support" system that would allow Medicare recipients to choose between the current program and a Medicare-approved private plan.

Those plans would be presented in competitive bidding and would have to be as comprehensive as traditional Medicare and would have to accept anyone who applied. There would be subsidies for low-income seniors.

Private insurers would thus have an incentive to design plans that would offer more generous benefits and lower costs than current Medicare. This kind of market competition has proved effective in the Medicare Part D prescription drug program enacted in 2003. Costs have been lower than government projections, and beneficiary satisfaction has been high.

Unlike the plan Ryan offered last spring, this one allows people to use the current Medicare system, if that is what they prefer.

Grace-Marie Turner of the Galen Institute hails Ryan-Wyden as a positive development:

The Ryan-Wyden plan would move Medicare to a more modern defined-benefit program and give seniors a choice of competing plans — plans that would have an incentive to innovate and produce the best care at the best prices. Seniors would be guaranteed coverage, including traditional Medicare, and lower-income seniors would get extra help, including a funded account for out-of-pocket expenses.

Prices would be determined by the marketplace, not Washington’s price controls. It also creates a path to a more seamless transition from job-based private insurance to Medicare.

Importantly, Ryan-Wyden plan builds on the structure that has had bipartisan support for more than a decade and which virtually everyone who has studied Medicare reform agrees is the platform to save the program from bankruptcy and from bankrupting the federal government.

If  Obamacare is allowed to stand, get ready for the perils of government medicine of the sort sick people in the U.K.  live with (or, often unnecessarily die on account of). An item on Powerline deals with U.K. patients left to die by starvation (hey, they say it’s a painless way to go!).

A Telegraph story reports that a class action suit against Alexandra Hospital has been filed on behalf of 23 plaintiffs who claim members of their family were left to die. The Telegraph reports:

They believe the families who have contacted them so far about care at Alexandra Hospital, in Redditch, West Midlands, may represent "the tip of the iceberg".

The number of potential claims make it the biggest group action of its type since hundreds died in appalling conditions at Stafford Hospital, leading to a public inquiry which is expected to criticise the wider failings of the NHS and of regulators' failures to protect patients, when it reports next year.

Here are some of the cases:

A 35-year-old father-of-four who his family say wasted away because staff did not know how to fit a feeding tube

* A retired NHS worker who died after allegedly being left without food or crucial heart medication

* A man who fell into a coma after contracting E.coli, apparently from a filthy catheter

* The claims include allegations that vulnerable patients were left to starve when trays were left out of reach, while others left in soaking bedsheets

The U.K.’s Health Service Ombudsman found in a report earlier this year that government hospitals are failing to meet basic standards of treatment for the frail elderly.

Chilling stories such as these remind us that Obamacare, in part patterned on the U.K. system, is potentially harmful to the sick and elderly.