Editore"s Note
Tilting at Windmills

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August 15, 2010

A 'ROADMAP' TO GUTTING MEDICARE.... This was the week I started getting a little tired of the media's interest in Rep. Paul Ryan (R-Wis.) -- the NYT ran yet another profile on Thursday -- but I suppose it's worth noting that the far-right lawmaker had an op-ed in the Washington Post the other day on Medicare.

For context, keep in mind that Republican rhetoric on the seniors' health care program has been hard to grasp. For many years, the GOP goal was to cut Medicare. When Democrats proposed cost-saving measures in the same program as part of health care reform, Republicans pretended to be outraged that Dems would try to cut Medicare.

Soon after, Ryan, the ranking member on the House Budget Committee and the media's new conservative darling, unveiled his budget "roadmap," complete with deep cuts to Medicare. It this strikes you as an incoherent message, then we're on the same page.

This month, however, we learned that the savings from the Affordable Care Act will strengthen Medicare by extending the Trust Fund for 12 years. Ryan was unimpressed.

We do not have a choice as to whether Medicare will change from its current structure. It is being driven to insolvency. An honest debate requires a serious discussion of how Medicare will avert its collapse and be made sustainable. Unfortunately, but not surprisingly, the Democrats' political machine has attacked my contribution to this debate, making the false claim that the only solution put forward to save Medicare would "end Medicare as we know it."

I'm not sure why Ryan considers this characterization "false."

Ryan's approach isn't particularly complicated. Under his "roadmap" plan, Medicare funding would be overhauled and replaced -- seniors would get vouchers to purchase coverage from private insurers, offering unregulated, pre-ACA insurance, without the Democrats' consumer protections.

The value of those vouchers would not be designed to keep up with escalating health care costs -- coverage would cost more than the benefits, and seniors on a fixed income would be expected to make up the difference.

Would this "end Medicare as we know it"? That seems more than fair as a description. Stephanie Cutter had a good item on this published at the White House's blog:

The bottom line under the Ryan plan: Costs would continue to rise, the value of benefits provided to seniors would continue to fall, and seniors would be stuck with fewer benefits and bigger bills. And, according to outside analysts, his plan would substantially increase the deficit in the medium-term.

We won't go down Rep. Ryan's road.

I sure hope not.

Steve Benen 9:35 AM Permalink | Trackbacks | Comments (14)

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Posted by: jian on August 15, 2010 at 9:55 AM | PERMALINK

Krugman is right: the audacity of dopes.

Posted by: Joel on August 15, 2010 at 9:57 AM | PERMALINK

Paul Ryan is a Deep Thinker the same way the Newt Gingrich is a Deep Thinker.


Posted by: Zorro on August 15, 2010 at 10:11 AM | PERMALINK

The only reason Republicans are upset about the cuts in Medicare is because they are using those savings to pay for something that benefits the middle class.(Health care reform)

They only want the cuts in Medicare to pay for tax cuts for their friends.

Posted by: atlliberal on August 15, 2010 at 10:59 AM | PERMALINK

Things are always cheaper when the free market is allowed to add a profit to the equation. Voodoo economics is the math for the 21st century.

Posted by: qwerty on August 15, 2010 at 11:11 AM | PERMALINK

Leave to a Republican to actually come up with a plan that keeps the government's hands off Medicare.

Posted by: 2Manchu on August 15, 2010 at 12:08 PM | PERMALINK

At least they are consistent. Republicans have hated Social Security and Medicare since they started.

Posted by: Mark-NC on August 15, 2010 at 12:48 PM | PERMALINK

Steve's two paragraphs... then
Would this "end Medicare as we know it"? That seems more than fair as a description.
Looks like a duck, quacks like a duck. Must be a duck. Unless you're Paul Ryan and a host of other idiots.

Posted by: Hmmmm on August 15, 2010 at 1:16 PM | PERMALINK

My parents are on Medicare. Neither would qualify for private insurance (they're old, and that's a pre-existing condition) and of course they're retired so have no group insurance access.

However, they get far better medical care (for a minimal amount-- they're on fixed incomes) than I do. In just the last few months, Medicare has paid for probably a dozen different claims: My father got cataract operations in both eyes for free. My mother recently spent several weeks in the ICU for free. My father had a full cardio workup worth thousands of dollars-- for free. They do pay for supplemental insurance and prescriptions, but their premiums for both of those are about half of the premiums I pay for minimal (no prescription, no office visits) insurance. And they get hospital care for free.

(In contrast, a young man I know was sent home one day after surgery for a burst appendix, because his insurance wouldn't pay for additional days... and of course he got septic and almost died.)

Clearly no senior would willingly trade Medicare coverage for "vouchers" on the "free market." But the Republicans keep making inroads, convincing many Medicare recipients that it's the GOP that will protect them.
I don't get it. We see how much they're lying. How can we make other voters see it? It's not working just to point it out. What can Dems do?

Posted by: alix on August 15, 2010 at 2:56 PM | PERMALINK

Someone needs to ask Ryan the critical question: will his plan require health insurance companies to accept all seniors regardless of pre-existing conditions and charge all seniors the same premiums regardless of pre-existing conditions. Republicans like Ryan who believe in the free market should be forced to confront the reality that the overwhelming majority of seniors are in fact uninsurable and, without government mandates, most seniors would be priced out of the insurance market or, more likely, excluded from it all together. You can be sure that the GOP's hostility toward regulation and love of the "free market" will result in sky-high premiums, fewer benefits, and a denial of access to care.

Posted by: ameshall on August 15, 2010 at 2:58 PM | PERMALINK

ameshall, very true. I'm not elderly, but I am like them, excluded probably forever from the insurance market (I have a chronic non-fatal and not particularly incapacitating or expensive illness). I was trying to get insurance recently, and got a NO from 15 companies. i even said I'd forgo coverage for the p-e condition, just go with major medical-- no go. They wouldn't give me insurance even then. I finally exclaimed, "Will NO ONE insure me?" and the agent stopped and said, "Well, pretty soon the government will." He seemed to think that was a bad thing.

Medicare for everyone!

Posted by: alix on August 15, 2010 at 10:14 PM | PERMALINK

Treated properly, this issue could be the one that sinks the Republican hopes this year.

Changes in the allegiance of senior citizens together with their history of high turnout make up the biggest part of the Republican advantage in generic polls of "likely voters" this year. A big part of that change is based on opposition to the Affordable Care Act which in turn is based on fears of how it will affect medicare and Republican lies about "death panels".

An aggressive campaign by Democrats might reverse that trend by making the case that the ACA will help medicare not hurt it, that it does not and never did have any death panels, and most importantly reminding them that the Republican Party opposed the creation of Medicare in the first place, has fought to limit or reverse it ever since and remains committed changing it in ways far more damaging to seniors' interests than anything in the ACA.

IF the Democratic Party spends a significant amount of party election funds making that case and if the mainstream media isn't actively hostile to the message, then Republican hopes for a landslide year, or even modest gains, might turn out to be for naught.

Posted by: tanstaafl on August 15, 2010 at 11:14 PM | PERMALINK

The more these goobers try to dismantle this very popular program by claiming it will become insolvent the more it becomes evident is that the real reason this could occur is because it only covers the most sickly groups...the elderly and the disabled...who have the highest helath care costs and need.

The fix then becomes even more apparent since its popularity alone opposes getting rid of it then to make it even better the risk must be spread out over a larger population...thus Medicare for all. That makes the program solvent, reduces cost while raising services covered. At last the need and necessity for single payer via a well established workable program which the public has a say in how it operates.

It is also more than obvious that all these repubs want is to get their hands on all that insurance money while drooling to get a hold of all our SS funds.

Repubs never have workable policies just big mouths to con with.

Posted by: bjobotts on August 16, 2010 at 1:22 AM | PERMALINK

Oh well, at least there won't be any rationed health care. Everybody will be entitled to whatever they can afford.

Aspirin anybody?

Posted by: mrgumby2u on August 16, 2010 at 12:39 PM | PERMALINK



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