In the column he notes, rather well, a typical Democrats argument for a centralized panel:
Democrats tend to be skeptical that dispersed consumers can get enough information to make smart decisions. Health care is phenomenally complicated. Providers have much more information than consumers. Insurance companies are rapacious and are not in the business of optimizing care.
The trouble is he never addresses these objections. Instead he cites how various studies have been off on the cost or enrollments, and ignored the data in the previous link I added above. That's a pity. My largest complaint about healthcare solutions in the vein of Rep. Ryan's and other Republicans is the failure to address information asymmetries in healthcare. As Matt Yglesias reminds us, buying healthcare is not like buying shoes.
And before someone jumps all over me for failing to think my fellow citizens have the capacity to make good healthcare choices, let me add I don't trust myself to make the right healthcare choices. That's why I go to the doctor. If chicken soup and Advil (or is it Tylenol, I don't know) don't work I go to a doctor and do what he or she says. Would it be better doctors, not insurance companies, were the decision makers in healthcare? Absolutely, but that's not the case in our current system, and that still doesn't put the power with the consumer, because doctors are simply going to know better.
I get so frustrated with the illusion of the discerning senior with the time, energy, and intellect to competently choose the right medical care for themselves and that such a discerning senior can, through aggregate market forces, drive down costs without driving down quality. At the very least a centralized government panel won't be driven to decide a course a treatment by considering profit margins. The same can't be said for private insurance adjusters.