Politics and Public Opinion, Elections

The Paul Ryan veep pick — and the truth about his Medicare reform plan

Image Credit: Tony Alter (Flickr) (CC BY 2.0)

Image Credit: Tony Alter (Flickr) (CC BY 2.0)

Do I think Rep. Paul Ryan is a good vice presidential pick on substance? Absolutely—in fact, I can’t think of a better one. He’s among the very brightest Republicans in Washington today, with a strong philosophical core and a keen understanding of the fiscal issues that will determine our economic future. And, just as importantly, Ryan has the ability to explain and defend his views, speaking in terms of values as cogently as numbers. This GOP ticket is anything but the tongue-tied Republicans we’ve come to expect over the years. With Ryan and Gov. Romney, I no longer fear television interviews or a presidential debate.

But the political risks shouldn’t be underestimated. Many conservative commentators welcomed the Ryan pick, arguing that it will elevate the fundamental policy debate over the future of entitlements to the center of the election. They’re right on that, but unless you’ve been involved in an entitlement reform debate—I got more than my fill in President Bush’s 2005 push to fix Social Security—you may overestimate the American people’s desire for a thoughtful discussion.

The short story is that, no matter how unsustainable or inefficient our entitlement programs may be, the burden of proof is absolutely on the party that wants change. Back in 2005, we constantly asked our opponents, “Where’s your Social Security plan? When will you put something on the table.” Had they done that, President Bush’s plan would have appeared in a far better light. But Nancy Pelosi’s answer— literally, according to Time Magazine—was, “Never. Is that soon enough for you?” And guess what? She paid zero political price. The public doesn’t care if the other side doesn’t have a plan. They do care if your plan appears to threaten them.

That’s why the Romney campaign needs to come out strong. They need to point out that it was President Obama, not Romney, who cut $700 billion from Medicare to fund other priorities. Listening to Democrat Debbie Wasserman-Schultz on the Sunday shows, you’d think it was the other way around.

Next, Romney’s campaign needs to proactively head off false attacks on Ryan’s Medicare plan. Voters needs to know three things about Ryan’s Medicare reform proposal co-sponsored with Oregon Democrat Ron Wyden. First, no one over the age of 55 would be affected in any way. Second, traditional Medicare fee-for-service would remain available for all. “Premium support”—that is, government funding of private insurance plans chosen by individuals—is an option for those who choose it. No senior would be forced out of the traditional Medicare program against his will. And third, overall funding for Medicare under the Ryan-Wyden plan is scheduled to grow at the same rate as under President Obama’s proposals. Is this “gutting Medicare” and “ending Medicare as we know it”? In reality, it’s the market giving seniors cheaper, higher quality choices they can take if they wish, with the traditional program remaining an option.

But the Romney campaign needs to hit these points early and often. Waiting to respond, as they too often did regarding the baseless and scurrilous attacks on Gov. Romney’s business record, wins them no points. The Romney campaign rightly expected a street fight, and in the primaries showed they can throw a punch as well as take one. But they might not have expected how quickly President Obama’s supporters would drag the campaign into the gutter. If Romney and Ryan are aggressive, they’ve got a good chance to win not only the election, but a mandate to put the federal budget on a sustainable track while reversing the slide toward ever-increasing government control over individuals’ lives. But these arguments won’t make themselves. Romney and Ryan need to be assertive.

15 thoughts on “The Paul Ryan veep pick — and the truth about his Medicare reform plan

    • Mario, if I understand it correctly…You can either stay in the traditional Medicare program or you will be given choices of health insurance options. If you choose the most expensive plan then the new Medicare program will pay the full premium cost (voucher). If you choose the less expensive option you yourself will receive a check for the difference. This will give you better quality options than the traditional Medicare. Plus, it’s just my opinion but I believe it will lower the premiums because the insurance companies will then be compeating for you. It sounds good to me to actually have a choice for once:)

      • Mario and Just me, currently seniors who are already enrolled in traditional medicare will have no changes, EXCEPT for the changes that will happen if, in fact, Romney and Ryan are effective at repealing Obamacare. If that happens, then the donut-hole in the Medicare Part B, Prescription Drug Program, will be reopened, and preventive care screenings such as annual wellness visits, mammograms, etc., etc., will no longer including in their plans benefits but will be put back onto Seniors to pay the out of pocket cost of that portion of the co-pay. Then, for those individuals that will be eligible for medicare in the year 2024 (age 65, which will increase 2 months for every year until it reaches the eligibility age of 67….current law is 65) they will have an option. They can choose to take traditional medicare or opt to purchase insurance from a private insurance company. The “voucher” will be limited to the 2nd least expensive plan in each market (medicare or private) offered and will be indexed to grow at the rate of gdp plus 1%, not inflation or cost of rising health care costs (Traditional medicare costs have risen approximately 8% each year over the past decade, while private rates have risen 131% over the past decade). The recent CBO estimate on Ryan’s 2012 Medicare proposal plan (he tweaked it from the 2010/2011 plan) currently put that voucher amount in the year 2024 to be approximately $8,000. So, in my opinion, here is the problem that may likely arise from this plan. Every person who reaches the age of 65 decides they are healthy, etc., and opt for the private insurance plan…….now those 66 and older are in the traditional medicare plan, yet the pool is now shrinking, with the oldest requiring more and more of the costs. As the years progress and more individuals opt for the private plans and those left in traditional medicare, an ever shrinking pool, are the ones who are considered the “sickest,” which would increase the cost of traditional medicare thereby draining the funds and ending it as we know it. Now, let’s assume that the private insurance company cannot deny any senior coverage due to pre-existing conditions…….will there be limits placed on how much they can increase premiums from one year to the next? (the ACA has these measures in the plan, but of course, it has now been repealed.) Will there be measures in place that requires the private insurance companies (who are required by their Incorporated Status to make a profit for their shareholders) to spend at least $0.85 of every $1.00 they receive in premiums to be spent on actual health care, not administrative, ceo salaries, etc…..(the ACA has these measures in the plan, but of course, it has now been repealed). With the fact that ever other program that I have spent my life paying taxes for….i.e. college education for my children, my social security benefits, medicare, etc., I know have more to be skeptical about than ever. All in the name of extending the Bush Tax cuts to the top earners and then piling on another set of tax cuts for them……I believe we as a nation of ONE can do better. My biggest problem with this plan is this: why should my tax dollars now go to a private, for profit, insurance company? This just seems like another gift to the Insurance Companies just like Medicare Part B and Medicare Part D were. There are solutions other than tax breaks for the wealthy, the trickle down, voodoo, supply side economics which has no evidence that it works and seems to have extremely adverse effects on our ever growing wealth gap, and having someone in a higher tax bracket pay a paltrey 3.9% more on that portion of higher income has also not proven to hinder them from investing more in our economy or creating more jobs. Frankly, no jobs are created if we the middle class have no money for the goods they are business wants to sell us. The higher demand we provide them, the more jobs they are able to create.

      • Another answer to your question, no money will actually exchange hands with you,the taxpayer, and the government. If you opt for the “private insurance plan” you will be entitled to pick the 2nd least expense plan….which ever value is the lowest between private and traditional medicare……and the money will go directly to the private insurance company, or will go from traditional medicare to your doctor or hospital. If you want a higher vale private insurance plan, you will pay for that on your own.

  1. You and other defenders emphasize the harmlessness of Ryan’s proposal. I hope that Ryan will explain why it control the costs of the most out of control entitlement. Alice Rivlin, Clinton’s economic adviser, hasn’t endorsed it simply because it’s harmless.

  2. Your article makes the Ryan-Wyden Plan appear to have fairly benign impact on seniors, current and future. What it fails to address is the Democrat assertion that the donut hole in Medicare Part D gets reintroduced immediately, thereby raising costs to our current Medicare beneficiaries

  3. While I admire Paul Ryan’s philosophical views and the fact that he is one of the few politicians that has seriously attempted to tackle medicare reform and our budget deficit problems, his conservative, small government track record in congress has been less than stellar. He voted for the disastrous no child left behind, medicare part D, TARP and the bank and auto bailouts. Moreover, his budget proposals hardly make a dent in lowering our deficit and attacking our spending problems. Under Ryan’s budget plan, spending as a percentage of GDP would amount to 20% of GDP, slightly lower than obama’s budget, which calls for spending at 22.5% of GDP. Moreover, his budget plan would not balance the budget until 2024. Comparatively, Rand Paul’s budget proposal would balance the budget in five. Paul Ryan’s budget plan and economic policies are a start, but they fall short of what is actually needed.

  4. You leave Medicare alone and repeal Obamacare, let the seniors have some rights. Do not mess with us or next election I will be voteing Independent if we are still a nation founded under God. Remember God should be who you go to for advice and not the politicians. Our nation is spending money we don’t have and taking it from the most needy. Like the first 3 years of Obama we seniors didn’t get a cost of living raise. Only this year we got one. But who’s to say we will get one next year. God is watching our nation and we may be judged before our time if you are not careful.

    • Someone has to pay for all those takes cuts for the wealthy, seniors are ripe for the picking, as well as the rest of the middle class. But hey, blaming Obama feels soooo good doesn’t it? I know I enjoy it! I too look forward to when Obamacare is repealed so that all seniors, including myself, will have to pay more money for our prescription drugs and preventive care, that was a horrible thing in the Obamacare legislation. I cannot tell you how upset I am that he tried to close that donut hole, and the last time I went for my mammogram, and they told me I didn’t have to pay anything, I was outraged. And to think, Obama trying to extend medicare’s solvency by 8 years from 2016 until 2024, what was he thinking, let it go bankrupt. Thank God Romney wants to bring that back to the year 2016. And all that money that we were going to possibly save (CBO’S estimate of medicare savings because of the Affordable Care Act) on fraud, waste, and abuse…..we need to spend more on that, repeal is the only answer for that. And those drug companies and hospitals that agreed to the cuts to their administrative costs that are so bloated, we need to give those back to them, they need a profit. The CEO needs his COMPENSATION. Who needs healthcare, when a great CEO has three homes to maintain. My advice, be careful what you wish for, and get informed.

  5. I am in my 7th decade of living and vowed never to become one of the handwringers in my age group that only remember the last thing they heard on TV or from their neighbor. Anyone with a functioning brain that thinks the current SS and Medicare system is sustainable are in a serious time warp! Vote informed! Yes it is that important…….

  6. Here is one example of frustration:

    “Ryan’s Medicare reform proposal co-sponsored with Oregon Democrat Ron Wyden. ”


    Now please read this to know:

    “Gov. Romney is talking nonsense. Bipartisanship requires that you not make up the facts. I did not ‘co-lead a piece of legislation.’” Wyden said. “I wrote a policy paper on options for Medicare. Several months after the paper came out, I spoke and voted against the Medicare provisions in the Ryan budget.”


  7. Paul Ryan’s Medicare 55+ proposal picks winners and losers with the lives of the people.

    “We don’t change any benefit for anybody 55 and above” (“Citizen 55″) – U.S. Rep. Paul Ryan, R-Wis

    But those under 55 (“Citizen 54″) will suffer a disproportionately large hardship in order to accommodate them. Citizen 54 should not be penalized because people voted for politicians that over promised.

    For your consideration I submit an outcome of Medicare 55+ many years from now. Citizen 54 and Citizen 55 have the same life threatening condition. The coverage afforded Citizen 54 via Premium Support, et al doesn’t cover the condition; traditional Medicare covers Citizen 55. Citizen 54 is further disadvantaged because the treatment price gets driven upward due to the demand created by the high subsidy awarded to Citizen 55. Citizen 55 lives, Citizen 54 dies, because of a politically created benefit gap.

    How does Citizen 54 have EQUAL OPPORTUNITY to health care when they are intentionally disadvantaged under federal law?

    How is Citizen 54s RIGHT TO LIFE protected?

    How is fiscal responsibility demonstrated by promoting a program that will cost $30 trillion to serve only Citizen 55 and then take steps to “strengthen the program”? (Citizen 54 pays the bill and receives less benefit)

    Here’s a simple example of a free market. I like Reese’s cups. You get two in a package for a dollar. If prices go up one day you may only get one Reese’s cup for a dollar. That applies to everyone.

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