Paul Ryan Doesn’t Want to Cut Medicare (Yet)

In the often-maligned new Aaron Sorkin TV show, The Newsroom, news anchor Will McAvoy, played by Jeff Daniels, takes it upon himself to deliver objective news with Murrow-like commentary as a public service to his viewing audience. While it remains unclear what effect this show has had on real-life news anchors, Wolf Blitzer ostensibly heeded McAvoy’s call earlier this week. Democratic National Committee Chairwoman Debbie Wasserman Schultz appeared on Blitzer’s usually liberal-friendly The Situation Room to attack Paul Ryan’s budget plan, the Path to Prosperity, and more specifically, its consequences for Medicare. Wolf Blitzer questions her on some of the details of the plan and her critique and Wasserman Schultz fails to provide satisfactory answers:

While conservative blogs are already hailing Blitzer for his “take-down” or “destruction” of Wasserman Schultz, such language is missing the positively McAvoyian (Sorkian?) aspect of Blitzer’s interview. He deserves credit not for “destroying” a guest on his show but, rather, for increasing public awareness about a subject of critical importance to our democracy. In this coming election, Americans are effectively choosing between two radically different approaches to government. Although the final budget proposals will probably look slightly different than what we have already seen from either side, we do have an idea of the rough outlines of the debate. This is especially true in the case of specific policy areas (health care) or sub-areas (Medicare).

With that in mind, it is worth examining in greater detail the specific debate between Blitzer and Wasserman Schultz (I consider it beyond the scope of this post to consider the full health care debate). First and foremost, as Blitzer mentions and Wasserman Schultz presses, the Ryan plan (PDF/bullet-points) aims to combat the rising costs of Medicare by essentially replacing Medicare with a voucher program that allows citizens to purchase a “Medicare certified plan” on a private market place. Though vague on specifics, this voucher would begin at $11,000, adjust to inflation and rising Medicare costs, and be skewed toward those with lower incomes. However, as Blitzer emphasizes repeatedly, the plan does not affect anyone 55 or over. In other words, seniors remain unaffected by the policy.

The unfortunate truth about the current state of Medicare is that its costs are spiraling out of control. Reform is needed. Ryan’s plan provides one way; the Affordable Care Act, in effect, provides another. These are differences in ideological preference for reform, not in substantive efficacy of policy proposals. Democrats are not giving Ryan and the voting public enough credit by deriding his ideas for Medicare reform as overly radical. Matt Miller put it well in a Sunday op-ed in the Washington Post:

Ryan deserves credit [on Medicare]. Ryan leaves Medicare on its current outsized trajectory for the next decade, as spending soars from $560 billion to $950 billion. Because of our uniquely inefficient health-care sector, which leaves us spending twice per capita what other wealthy nations spend, the voucher he calls for thereafter would suffice to buy seniors terrific care everywhere but here. Even if his approach is imperfect, Ryan is right to challenge our Medical Industrial Complex to change.

To be perfectly clear, I don’t mean this post as an endorsement of the Ryan plan or even this small part of the plan. Indeed, there are many parts of the plan that I would question both ideologically as well as substantively. I am merely suggesting that we should debate Paul Ryan’s plan on the actual merits of its ideas, not on vague conceptions of what the plan does or does not do. My endorsement is of Wolf Blitzer and his contribution to the marketplace of ideas–keeping it honest and making sure we pay attention to the ideas our policymakers present.

For more of his thoughts on the Presidential race, follow William on Twitter.

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3 thoughts on “Paul Ryan Doesn’t Want to Cut Medicare (Yet)

  1. I think with Ryan on the ticket, Jacob Hacker’s book “The Divided Welfare State” becomes even more essential reading. The essential argument relevant here is that public vs. private on welfare state policy is more than just an ideological difference. There is an enormous substantive difference. Private social insurance is less traceable, it usually can’t compel participation, and it is enormously less progressive in distribution. The upshot is that, almost without fail, with private social insurance your risk coverage increases with your economic standing in society. The less risk coverage you need, the more you have.

    One could debate such a structure’s costs and benefits to society overall, and I’m sure that privatization proponents have well-thought out defenses, but it is certainly not hyperbolic to say that the Ryan plan is radical. It is ENORMOUSLY radical.

  2. I am still not sure you have described anything more than an ideological difference. My point is that Ryan’s plan shouldn’t be treated as one which cuts Medicare immediately for the sake of cutting. It doesn’t cut Medicare at all for anyone who has it and makes a serious attempt at reform starting in 2024. Ridiculing it, as Wasserman Schultz does here, is dishonest. Countering it with intelligent rebuttals about the need for public Medicare is a better way to go about it.

    • I believe that the statement that private social insurance radically changes the distribution of benefits and the traceability/accountability of the process is entirely about substance, not ideology. Saying that distribution goes from progressive to much less so is a substantive policy statement. Saying that this is a good or a bad thing is an ideological statement. I used Hacker’s work only to make the former statement. (For now.)

      Whether or not one thinks Ryan’s proposed contraction of the public welfare state in favor of the private is good for the country, nobody can deny that it would be a radical step in the history of the American welfare regime. It puts a policy alternative on the table that goes way further than anything else out there. That’s the sense in which I’m using the term.

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