Throw Medicare From The Train—Part Deux

Here’s the basic outline of House Budget Committee Chairman Paul Ryan’s 2013 budget in one sentence: Ryan’s budget funds trillions of dollars in tax cuts, defense spending and deficit reduction by cutting deeply into health-care programs and income supports for the poor.”

Ezra Klein

The Associated Press story in today’s Joplin Globe (the paper’s version was shortened for publication) summed up the Ryan budget plan nicely:

Mixing deep cuts to safety-net programs for the poor with politically risky cost curbs for Medicare, Republicans controlling the House unveiled an election-year budget blueprint Tuesday that paints clear campaign differences with President Barack Obama.

The AP also reported Mitt Romney’s rather enthusiastic support for the plan:

The House Republican budget rejects the out-of-control spending and higher taxes proposed by President Obama in his budget last month. By proposing prescriptions that will strengthen Medicare for generations to come, it also highlights President Obama’s failed leadership on entitlement reform.

So, now that we know where Romney stands (a rare achievement), let’s look at some of the Ryan plan in broad strokes, as presented by the AP: (follow the link for the details):

The Republican proposal…would wrestle the federal spending deficit to a manageable size in short order, but only by cutting Medicaid, food stamps, Pell Grants and a host of other programs…

The plan calls for steep drops in personal and corporate tax rates in exchange for clearing away hundreds of tax deductions and preferences. It would eliminate oft-criticized corporate tax boondoggles but also tax deductions and credits claimed by the poor and middle class.

To cope with the unsustainable growth of Medicare and the influx of retiring baby boomers, the GOP budget reprises a controversial approach that would switch the program — for those under 55 today — from a traditional “fee for service” framework in which the government pays doctor and hospital bills to a voucherlike “premium support” approach in which the government subsidizes purchases of health insurance.

If that all sounds familiar, that’s because we saw this movie last year. The difference is that this year’s sequel is even gorier (aren’t they always?) than last year’s spine-chilling offering.  And it was meant to be that way, according to Paul Ryan:

We are sharpening the contrast between the path we are proposing and the path of debt and decline that the president has placed us upon.

Sharpening, indeed.

Perhaps most appalling—considering all the cuts in the rest of the budget and the change in Medicare—is this:

The GOP measure also would replace $55 billion in Pentagon spending cuts and $43 billion in cuts to non-defense appropriations set to take effect in January with at least $261 billion in other savings over the coming decade, including curbs to food stamps, federal employee pensions and further cuts to federal health care programs.

As The Hill reported, not only does Ryan’s plan “shield the Pentagon from nearly $500 billion in automatic cuts and roll back some of the $487 billion reduction” already approved, the plan,

also increases national defense spending to $554 billion in 2013, an increase of $8 billion over the $546 billion that was agreed to under the Budget Control Act.

Get that? The GOP budget actually increases defense spending over what was agreed to last year!

All of the above is from neutral journalists. If you want to read progressive takes on the Ryan plan, go to the Washington Post and read Ezra Klein or to the Center for American Progress, which has a series of articles presenting the details of the plan. It ain’t pretty. And there is, as always, the Center on Budget and Policy Priorities here and here.

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As for a short, non-partisan analysis of the “premium support” plan for “saving” Medicare, go to Kaiser Health News. Here is part of that analysis:

All plans, including traditional Medicare, would submit bids for how much they would charge to cover a beneficiary’s health care costs. The government would pay the full premium for the private plan with the second lowest bid, or for traditional Medicare, whichever is lower. Beneficiaries would have to pay the difference if they chose a plan that set rates higher. There could be one less expensive plan option, and beneficiaries who chose it would get a rebate for the difference…

But some critics are already arguing that the government-administered option would not be affordable and that it could cause doctors to leave the program. Critics have argued that the government-run plan would attract the sickest people, driving up its costs, while private plans would lure the healthiest.

This plan is the so-called Wyden-Ryan “compromise.” If you have wondered why a Democrat with liberal bona fides—Oregon Senator Ron Wyden—would team up with a right-winger like Paul Ryan to develop a plan to “protect Medicare,” go here and read Senator Wyden’s explanation. (You might be surprised; I was. But it is still unconscionable to give Ryan and the Republicans some political cover at a time like this, when so much is at stake.)

For a readable critical analysis of that Wyden-Ryan plan go here and here and here to get educated. It is essential to know what may happen to a vital social program.

Finally, in case any of us might think the White House will get wobbly-kneed on the Medicare proposal in the Ryan budget, remember this initial statement from Obama’s Communication’s Director Dan Pfeiffer:

We are concerned that Wyden-Ryan, like Congressman Ryan’s earlier proposal, would undermine, rather than strengthen, Medicare. The Wyden-Ryan scheme could, over time, cause the traditional Medicare program to “wither on the vine” because it would raise premiums, forcing many seniors to leave traditional Medicare and join private plans. And it would shift costs from the government to seniors. At the end of the day, this plan would end Medicare as we know it for millions of seniors. Wyden-Ryan is the wrong way to reform Medicare

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1 Comment

  1. ansonburlingame

     /  March 21, 2012

    “Go here, here and here” to see objections the the new GOP/Ryan plan. You can bet your pension it is from liberals, as would be expected. Frankly I did not bother the go “there, there or there”.

    Ask yourselves, progressives, do the cost of entitlements need to come down? Really a simple question and if you say NO, then I ask should they intsead go UP. Answer YES and I will ask for details in real dollars in terms of deficit spending.

    Say NO, the deficits will NOT go up, we will simply cut defense spending, and I will ask very specifically HOW MUCH.

    Let’s not confuse the isse over the “automatic cuts in the deal” of last August. Let’s talk about it in terms of future carrier battle groups, nuclear submarines or for sure nuclear deterrence. Show me you cuts in such areas, beyond the current spending, and we can have a good debate. For example, should we “bring the troops and bases” home from Europe, Yes I will say and sound like Ron Paul. Should we have the forces to prevent Iran from going “nuclear” and I will say YES, which is NOT a Ron Paul position.

    You can bet your bottom dollar that the “new” Ryan Plan will stir debate. Must Medicare costs go DOWN. I say YES and you say NO. How to achieve either one is subject to debate, not “one liners” in a blog. Want Medicare costs to go UP, and forget “universal care”, then show me your arguments WHY it should go up, year to year as it is doing so right now. Want more HC, for “all” then show me what it costs and how to pay for it.

    That is what I would call “pragmatic conservatism”. How much does it cost and where to do we the nation, get the money to pay for it?

    Tax only the “rich”. Jezz!!

    Anson

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