Jonathan Cohn is among the few who are now buying into the absurd meme that Paul Ryan’s plans for Medicare and the budget in general are “courageous” and “serious”. Telling it like it is, Ryan to 32M Americans: No Insurance for You
…about 32 million fewer nonelderly people would have health insurance in 2019, leaving a total of about 54 million nonelderly people uninsured. The share of legal nonelderly residents with insurance coverage in 2019 would be about 83 percent, compared with a projected share of 94 percent under current law (and 83 percent currently).
Nothing has changed from Ryan’s Road Map To Death. Ryan’s proposal drips with irony. Is it “courageous” to have the audacity with which he and his supporters display their contempt for life. Republicans tried to pass off President Obama’s non-existent death panels as a threat to grandma, while Ryan’s plan is an actual death sentence for many children, disabled and seniors. GOP Moving To Dismantle Medicare
The idea to privatize Medicare is a significant part of Ryan’s “Roadmap for America.” As we previously reported, Ryan claimed in his book, Young Guns (written with Reps. Eric Cantor and Kevin McCarthy), that his “Roadmap” will “secure the future of Social Security and Medicare.” However, according to the Center on Budget and Policy Priorities (CBPP), his plan would actually dismantle Medicare:
The Ryan plan would eliminate traditional Medicare, most of Medicaid, and all of the Children’s Health Insurance Program (CHIP), converting these health programs largely to vouchers that low-income households, seniors, and people with disabilities could use to help buy insurance in the private health insurance market.
But as the AP article notes, “The amount of the voucher would be based on total current Medicare spending and indexed to grow year by year thereafter. But that growth would be less than the torrid pace of health care inflation now.” So basically, each year the vouchers would be worth less and less coverage and “by 2080, Medicare would be cut 76 percent below its projected size under current policies.”
Ryan’s plan says you can use your little voucher to shop for insurance. Your health care costs are $14k for the year, but your plan has a $12k per year limit. You can’t sell enough blood to make up the difference. Let’s put aside labels for the moment about where people fit in on the working poor, blue-collar, middle-class scale. Half of all working households make less than $55k a year. These are not lazy people. According to the census they are the vast majority of the people who live in my and surrounding districts. They are air-craft maintenance workers, office administrators, teachers and construction workers, cab drivers – the people who make up America’s work force. They tend to think they’re going to be OK. Between their savings, Medicare and Social Security they will, if the worse happens, have a basic buffer against the worse of times, House Budget Committee Chairman Republican Paul Ryan’s Plan Gets Roughly Two-Thirds of His Huge Budget Cuts From Programs for Lower-Income Americans
That half of Americans and those slightly above the median better hope that Wall St and Washington does a better job of managing the nation’s economy than they did during the Reagan and Bush 43 years, because they are a breath away from depending on the “bold” and “brave” ideas of Ryannomics for their survival. Everyone fighting for survival on the island usually means someone does not survive, The 2022 Medicare Crisis
Matt Yglesias has a very good point: the supposed transition strategy under the Ryan plan, in which everyone currently over 55 gets Medicare as we know it, while everyone younger than that gets vouchers that won’t be enough to buy adequate insurance, sets up an unstable political dynamic. In fact, we can be sure that whatever happens, it won’t be what the plan says will happen.
If the Medicare Advantage precedent holds, what will happen in 2022 or a bit later is that Congress will react to the fury of younger seniors — who see that those born just a few years earlier have vastly better benefits than they do — by increasing the vouchers. And the end result, in that case, would be that the Ryan plan substantially increases Medicare costs; remember that the payment increases that were part of the 2003 Medicare bill, introduced to rescue failing Medicare Advantage programs, have resulted in large overpayments, adding hundreds of billions to the program’s costs.
Alternatively, if the benefit cuts stick, you’ll have a lot of furious people realizing that they are paying high taxes to support lavish medical care for older Baby Boomers, while being themselves condemned to pleading with insurance companies to provide coverage in return for an inadequate voucher.
Just as conservatives have tried to divide the working class over unions and the perception of unearned compensation, conservatives are using divisions between age groups to cultivate resentment. You get enough resentment going between groups – the Southern Strategy anyone – and those groups can do a pretty good job of helping you tear down the programs and progress conservatives have long hated. All the numbers and percentages are great up to a point. In addition to the numbers America might ask itself some fundamental questions. How is it that the U.S. is still the richest country in the world and cannot or will not provide health insurance and health care to every American that needs it. Is it possible that we practice a perverted brand of capitalism that always seems to do right by the plutocrats, but one major political party genuinely does not care whether you live or die. Isn’t there a better more moral capitalism that looks out for everyone. What kind of system has contempt for children, the sick, the disabled and the retired or the unlucky and unemployed. While there are some long-term structural issues that need to be worked out, what is the immediate problem. Ryan and the extremists on the Right, and a few Democrats to boot, say it is a huge federal debt. The most generous thing one can say about that view is that it is a con. What is not sustainable an economy where the wealthiest corporations pay little to no taxes and the wealthiness 2% are living like Robber Barons. Never rising taxes on the rich is the crisis. This country has plenty of money to have a sturdy morally imperative safety net. Giving the majority of the population it’s fair share is not welfare, it is he fair and equitable thing to do. Medicare, Medicaid, Social Security and programs such as Children’s Health Insurance Program (CHIP) are insurance and payback for services rendered. There is no federal budget crisis that is so dire (what there is of a crisis is one that Republicans created) that we need to steal from the poor to give to the rich, there is a crisis of leadership and a well informed public.
The Citizens for Tax Justice (pdf) notes,
Rep. Ryan’s House GOP Budget Plan
Federal Government Would Collect $2 Trillion Less Over a Decade
and Yet Require Bottom 90 Percent to Pay Higher Taxes
And can you guess who gets a tax break? The richest one percent.
Republicans such as Wisconsin Governor Walker and Florida’ Governor’s Scott are laboratories in progress of Ryannomics. Walker is not fairing too well and Scott is in trouble, Florida Voters Turn Thumbs Down On Gov. Scott, Quinnipiac University Poll Finds
Voters disapprove 55 – 36 percent of the way Scott is handling the budget. They say 52 – 41 percent that Scott should not have pledged to balance the budget without raising taxes and by 64 – 24 percent they say he will not be able to keep that no-tax pledge.
Florida voters are not wild about the idea of tax increasing, who is in the general, but they are against a package of essential service cuts and corporate tax cuts. This is going to play out on the national level. Should the government gut Medicare or rise the Koch brothers taxes a few percent.
update: A new CBO look at Ryans’ plan,
Ryan is proposing huge (and largely unspecified) spending cuts; but he’s also proposing very large tax cuts, mainly, of course, for those with high incomes. And as you can see, a large part — roughly half — of the spending cuts are going, not to deficit reduction, but to finance those tax cuts.