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The Right Prescription
Paul Ryan as the Great Destroyer
How a young congressional policy wonk was transformed into the Shiva of Medicare.
The White House, “news” media and progressive blogosphere have many faults — mendacity and collusion, to name the most obvious — but they cannot be accused of being unpredictable. Thus, when Mitt Romney announced that Paul Ryan would be his running mate on the GOP presidential ticket, it was hardly necessary to consult one’s Vedic astrologer to know that the Wisconsin congressman would again be denounced for his dark desire to deprive Granny of health care. And, sure enough, even as Ryan was introduced by Romney as his choice for VP in a series of Saturday appearances, he was being depicted as Ryan, Destroyer of Medicare.
The first and most irresponsible attacks came from bought-and-paid-for purveyors of White House talking points like the stooges at Media Matters, whose super PAC released a 290-page slander manual that claims Ryan would “essentially end Medicare.” Likewise, Think Progress opened fire before lunch with a tweet declaring, “If you hate Medicare, you’ll love Romney’s pick for VP.” Then, the “legitimate” outlets began to parrot the Obama campaign’s message of the day. ABC News, for example, ran a piece early Saturday afternoon advising that “Critics have called Ryan’s 2011 proposal the ‘end of Medicare as we know it,’ and that’s true.”
The obvious purpose of these tweets, posts and “news” stories is to scare seniors into voting against Romney and Ryan in November. Ironically, it is Obama’s misbegotten health care law, the Patient Protection and Affordable Care Act (PPACA), that should terrify seniors. As Avik Roy points out, “According to the latest estimates from the Congressional Budget Office, ObamaCare will reduce Medicare spending by approximately $743 billion between 2013 and 2022, relative to prior law.” Unlike Ryan’s Medicare plan, which even ABC admits won’t affect anyone over age 55, PPACA’s cuts will hit current Medicare beneficiaries.
It should further terrify seniors that Obama has offered no serious plan for reforming Medicare, which is on a fiscal trajectory that actually will destroy the program if something isn’t done soon. As Ryan himself told the President in February of 2010 during the charade billed by the White House as a bipartisan Health Care Summit, “Medicare right now has a $38 trillion dollar unfunded liability, that’s $38 trillion in empty promises to my parent’s generation, our generation, and our kid’s generation.” Yet the Obama administration has all but ignored the looming Medicare disaster, essentially pretending that the status quo is somehow sustainable.
In fact, when last April’s report from the program’s trustees predicted that the whole house of cards would begin to collapse in 2024, Obama’s delusional Secretary of Health and Human Services said, “Medicare is in a much stronger position than it was a few years ago, thanks to the Affordable Care Act.” This assertion by Commissar Sebelius is preposterous, of course. As former director of the Congressional Budget Office Douglas Holtz-Eakin wrote at the time, “Medicare’s cash position makes Enron’s business model look downright reputable. The reality is Medicare is bleeding cash, a fact disguised by creative accounting.”
All of which suggests that ending Medicare “as we know it” is a pretty good idea. How then, would Paul Ryan go about cleaning it up? The first step, as he has often said, is to repeal Obamacare. Contrary to Sebelius’s Orwellian claims, PPACA exacerbates Medicare’s multiple ills. He would also utilize some of the market-based features of a program that has often been denounced by conservatives. As he put it in a June interview, “Our reforms draw upon the lessons of Medicare’s prescription drug program (Medicare Part D), in which patients have the freedom to choose among competing Medicare-approved coverage options.”
More specifically, as outlined in a pamphlet released when Ryan partnered with Democrat Ron Wyden to create the latest, bipartisan version of his plan, “Starting in 2022, a new Medicare program will begin offering seniors a choice among Medicare-approved private plans and the traditional Medicare plan.… Coverage will be guaranteed through a new ‘premium support’ system that encourages plans to provide high-quality care more efficiently.” The plan will “encourage” efficiency by forcing traditional Medicare to compete with private plans for patients, and this competition will drive down costs just as it did with Part D.
The plan also “guarantees” that costs will be kept under control: “In the event that these efforts do not stem the rising tide of Medicare spending, beginning in 2023 there will be a cap on cost growth of 1 percent over Gross Domestic Product, plus inflation.” The plan would also expand means-testing beyond that which already exists for Part B and Part D to the new premium support payments. The basic idea of Ryan-Wyden, then, is to allow the market to work as much as possible without disrupting the coverage of current beneficiaries or damaging the safety net. In other words, the notion that Ryan would destroy Medicare is absurd.
If the Romney campaign succeeds in defeating Obama, the plan will evolve further pursuant to the political conditions that prevail after January 2013. The new President will probably want a few changes, though he has already praised Ryan-Wyden. And Congress isn’t simply going to rubber stamp what comes out of the White House, even if the Republicans retain their majority in the House and gain control of the Senate. So, if the new VP suddenly drops his clever disguise as a Wisconsin policy wonk and reveals himself as Ryan, Destroyer of Medicare, Romney will just send him to the funeral of some foreign head of state.
About the Author
David Catron is a health care revenue cycle expert who has spent more than twenty years working for and consulting with hospitals and medical practices. He has an MBA from the University of Georgia and blogs at Health Care BS.
Letter to the Editor View all comments (48) | Leave a comment
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DTOM| 8.13.12 @ 7:45AM
Paul Ryan is one of the few who will speak clearly and intelligibly through the media smoke screen and connect with regular Americans with a message that shows that he is not the Destroyer, it is those who paint him as such who are the enemies of Americans' freedom and property.
Go Mitt! Go Paul! Go!
old fashioned| 8.13.12 @ 8:16AM
Medicare!
I have NEVER used Medicare to pay for any of my medicines or hospital stays, which have cost me over $1,000,000 since I became eligible for Medicare back in 1998. I was a successful business man, and I chose to pay my own way--to pay out-of-pocket for my medical expenses.
And I would like to say to you readers who have used your Medicare card you are all HYPOCRITES!
If you do not tear that card up today and throw it in the trash can, you are subscribing to socialist handouts, and you are NOT conservative.
You're socialist through and through--Medicare card-totin' socialist with no shame.
Evelyn @ 77| 8.13.12 @ 8:33AM
Well good for you, Mr. old fashioned. Lucky you are so rich.
I will NOT vote the Romney/Ryan ticket. Here's why:
Ryan is trying to kill Social Security and Medicare. His position as chair of the House Budget Committee has been his primary platform to introduce reforms that frighten millions of the nation’s seniors, including me. Ryan has proposed getting rid of the guaranteed benefits of Medicare and instead giving vouchers to those who need them in order to pay for medical insurance.
The plan is considered risky for seniors, since the cost of healthcare could very easily outpace the rise in the value of the vouchers. Ryan also wants to privatize social security as well.
Ryan| 8.13.12 @ 8:41AM
And these things are bad because....
Case in point - my Dad had SPECTACULAR medical coverage through Exxon. Can't use it because of medicare. He was covered by the private sector, with no need to use the public dole.
DTOM| 8.13.12 @ 11:28AM
Oh, Evelyn!!!!
Honey, I just got a call from Ms. Sebelius, over at HHS. She said don't worry about your healthcare costs. Just get your affairs in order and take the one pill in the prescription the Department of HHS sends you in the morning. Good luck!
Evelyn are you so un-informed?
Obama steals 80% of Medicare's funding for his pet project to socialize medicine; Paul Ryan tries to put it on back on a paying basis and of course, bright girl you are, you believe the unrepentant socialist who has not told the truth once in four years.
Honey, you deserve what you get - we all are just trying to save you from your own ignorance.
Ev' Ignorance is curable - stupidity is not. So are you ignorant or stupid? Please let us know.
DTOM| 8.13.12 @ 11:37AM
Do you remember the question a woman asked Obama in 08 by the woman about whether the government would consider quality of life in deciding whether her 91 year old mom should get a pacemaker. And Obama said no, we don't care about her attitude or zest for life, she should just take a pill, a pain pill. AND DIE of course.
Evelyn please show us the death panels in the changes to Medicare and Medicaid Ryan's plan includes. When you can't find them look in OBamacare that's where they are - in Obama's plan, not Ryan's.
Kingofthenet| 8.13.12 @ 12:26PM
Yeah, I'm going to need a citation for that....
DTOM| 8.13.12 @ 1:06PM
Yo, King,
Obama didn't need any stinking law to tell bondholders of GM bonds that he was unilaterally re-writing bankruptcy laws because his buddies at the UAW needed the money more than the legally entitled bondholders.
Obama didn't need any stinking law to rip out the duly passed work requirements in the welfare reform act that Bill Clinton signed.
Obama didn't need any stinking law to stop prosecuting illegal immigrants.
So screw your "I'd want to see a citation on that."
I have an idea - you love the law so much, go here, download it and tell us how the Independent Medicare Advisory Act on page 983 does not establish panels that will decide that at a certain age, certain expensive treatments will be unavailable to patients above a certain age.
http://www.healthcare.gov/law/.....ection.pdf
And of course, no one has ever heard of any patient in the Canadian or British national health services has ever been denied treatment because of limited service capabilities.
Don't be a jackass.
DTOM| 8.13.12 @ 1:07PM
And frickin' Obama said it, you dolt!
Who are we going to believe, you or our lying ears?
You lose.
DTOM
fmm| 8.13.12 @ 9:22AM
Unfortunately you are ignorant of the facts and are just the kind of person Obama and his socialist buddies rely on to destroy the country. Obamacare is about 100 times worse than the Ryan plan, the latter solves the problems which are driving the program into the dirt and makes Medicare affordable in the future to everyone. Please grow up.
Drunken Sailor| 8.13.12 @ 9:47AM
Evelyn,
If you are a senior already as you state, then Ryans plan will never touch you. Nice hysterics though!
DTOM| 8.13.12 @ 11:41AM
Obama's plan will touch her, but good. Her doctor will be forced to tell her that she is old and a burden on society and that she needs to forget about medicine. Just take the pill Ms. Sebelius over at HHS will send you. And he will be forced to keep telling you that until you take it.'
Good luck with that, dear. This is not a joke it is real Evelyn. You'd better learn who is REALLY looking out for you - and who's lying to you.
It AIN'T an Irishman from Wisconsin - It is a community organizer from, well, somewhere.
squalis| 8.13.12 @ 10:00AM
Evelyn, apparently you are incapable of thinking beyond the Dem talking points. Which part of the $38,000,000,000,000 unfunded liability part did you not understand?
Bushiite| 8.14.12 @ 1:13AM
As a solid Bush fan, I would like to point out that the Bush Prescription Drug Plan hasn't added a single penny to the unfunded liability. That is why free market champions and TARP supporters like Congressman Ryan voted for prescription drugs.
Pecos Pete| 8.13.12 @ 11:09AM
E@77:
Aw, come on. Give up the D talking points and look at facts. Fact #1: There are millions of seniors who understand that ObamaBadCare will relegate them to the back of the line for health care. These same millions of seniors despise ObamaBadCare and enjoy, currently, good coverage at reasonable cost with supplemental insurance.
Your talking points prove you are a troll with no other purpose than to attempt to steal the election for Obama with lies and deceit.
Kingofthenet| 8.13.12 @ 12:29PM
Evelyn, your right to be scared, 5.98+a Paul Ryan voucher will get you an Ace Bandage from Walmart.
DTOM| 8.13.12 @ 1:09PM
You'll get it from Walmart a hell of a lot faster and cheaper than from the USPS.
Wouldn't you?
Are they still in business, this week?
Tom Kyba| 8.13.12 @ 1:38PM
Imhotep...Imhotep...Imhotep!
spike59| 8.13.12 @ 1:17PM
evelyn, i'm sorry you're frightened. listening to Democrats, and their 'seniorcare arm' the AARP, spouting lies can have that effect; but the FACT is that, at age 77, NOTHING in Ryan's plan affects your care in any way, and if you are under 55, any changes would be voluntary (i bet the AARP and the Democrats forgot to tell you THAT, didn't they? check it out for yourself!)...but ObaMaoCare is already draining hundreds of millions of dollars from Medicare, and he has assured that you are NOW facing the prospect of rationed care, and at age 77, there are a lot of healthcare services that you will have to forgo 'for the greater good'...
Indy| 8.13.12 @ 1:37PM
Obamacare is already destroying Medicare + it includes the IPAB, do you think seniors want that? Ryan's plan will not alter Medicare for those 55+ I suggest you do your homework, as a senior, the IPAB would terrify me, I worry about my loved ones, take your pain pill, that's all many will get.
http://www.nationalreview.com/.....nley-kurtz
Butch| 8.13.12 @ 4:53PM
I hate to tell you this, Evelyn, but--unless Obama is defeated--you are headed straight to a health-care system that will closely resemble Medicaid, with many fewer doctors/hospitals/clinics, very long waits for treatment, and inferior care.
Medicare has already been gutted for Obamacare by Obama and the Democrats in congress in 2009, with no Republican support at all; it is for all practical purposes already gone if Obama remains. And yes, if 77 is your age, know for a certainty that medical care will be rationed according to age; that is, away from you and toward somebody younger. If you are not a taxpayer, forget about it, you'll go before the Death Panel and get a pain pill that probably won't work: can't make a stage 4 cancer patient an addict, you know.
Petronius| 8.13.12 @ 11:50AM
o f
I'm like you even though I have few assets. I don't want Medicare, Social inSecurity or other programs reformed. I want them abolished. No chance that will happen short of total collapse since the weenies want their hands held until they pull their last breath.
Indy| 8.13.12 @ 8:27AM
My disgust for the media continues, they report polls as hard news and spend no time reading and reporting specifics, the Trustees actuarial report summary is enough to tell the story of where we are headed and there are lots of details in the report but the press ignores real news, it just doesn't fit their agenda and 30 second sound bites
MK48| 8.13.12 @ 10:31AM
Indy.......what else would you expect from the SOROS media machine.
nathan| 8.13.12 @ 10:06AM
I said this elsewhere. He's going to destroy it right? So why did he vote to expand it? By voting for and playing cheerleader for Medicare Plan D? The biggest expansion since it was created? I mean he can TALK all he wants. But look at Ryan's ACTIONS (which talk SOOOOOOOO much louder than words) and what do we have here folks? You all tell me. But he voted for Plan D, voted for TARP, and NDAA, three of the worst bills I can think of. I mean if this is how we define "conservative" then I shudder at what we call "liberal". On Plan D and TARP alone he should have gotten a primary challenge.
And the ACTIONS far outweigh all those WORDS he throws at everyone. And when he said Plan D was the best solution at the time? REALLY? How about NOTHING? Why vote for it at all? No. There's a lot of TALK here folks but not a lot of substance.
And once again as with four years ago we are faced with the choice of two really bad candidates. And the country can't survive too many more elections like this.
Pecos Pete| 8.13.12 @ 11:13AM
There is one bad choice: Obama/Biden.
There is one good choice: Romney/Ryan.
DTOM| 8.13.12 @ 11:31AM
NATHAN - We know YOU ARE A SOROS-PAID TROLL WHOSE OBJECTIVE IS TO SUPPRESS THE CONSERVATIVE VOTE.
Only question left, are you a useful idiot or an unrepentant communist?
DTOM
nathan| 8.13.12 @ 1:46PM
A soros paid troll? Boy do I wish! I could really use the money! LOL Sir, that aside, you did not address the issue at hand. Mr. Ryan has a voting RECORD that if you change the names, looks remarkably like Nancy Pelosi. In the words of the late George Wallace, based on RECORD and again I'm talking solely on voting RECORD, is there a dime's worth of difference between him and her? (50 cents maybe?) BASED ON RECORD? He voted for the car bailouts, the Wall Street bailouts, were there any he DIDN'T like? Based on his VOTES, how much did he VOTE to add to the deficit? A trillion, more?
How does a man who VOTES like he does (actions speak far louder than words) suddenly become this great conservative? Not talking about his ghastly record doesn't make it go away. Pretend all you want but people other than me are suggesting that MR just lost the election with this decision. They may be right.
Nick: Virtually all his "cuts" were pushed into future years where those congressmen can ignore him. And he promised to INCREASE defense spending which in light of the IG report looks highly questionable. So go on telling yourselves I'm the bad guy here.
aware| 8.13.12 @ 5:15PM
You are exactly right. On top of that, a plan that "gives a choice among Medicare-approved private plans and the traditional Medicare plan.." ? WTF?
Can you see the many flaws in that kind of fairy dust? "Medicare approved" means the heavy boot of the State is still to be firmly on the neck of the "private plans". Pure fascism, you own the company, we tell you what to do.
And since the " traditional Medicare plan" won't be subject to market forces as it is backed by the proceeds of legal plunder, it will distort the market to the point that the "private plans" either get out or get heavy subsidies to survive. And they will be backstopped, implicitly at first explicitly later, by the "traditional Medicare plan" just as Fannie and Freddie did for the bad debt of the "private" banks. This is how "private" losses are passed on to you the taxpayer.
It is a typical piece of Republican insider proposal, sound populous and conservative in the generalities, but buried in the details is not only the acceptance of massive government, but opportunities for it to get even bigger.
Bushiite| 8.14.12 @ 1:16AM
I am tired of all these "conservatives" who still hasn't figured out that the only point in elections is whose friends will be running the show and getting rich on government contracts.
markenoff| 8.13.12 @ 8:00PM
Even if Romney/Ryan is a bad choice, Obama/Biden is worse. Romney/Ryan buys us more time to stock up on gold, guns, canned goods and ammo before the zombie apocalypse. And by zombies I mean the welfare recipients who will have to find new, more violent ways of living off the rest of us when their welfare checks become worthless.
Nick| 8.13.12 @ 11:09AM
Let's see what a completely biased, partisan democrat, Erskine Bowles, has to say about Mr. Ryan and his budger plan:
"Have any of you-all met Paul Ryan? We should get him to come to the university. I’m telling you this guy is amazing. Uhh, I always thought that I was OK with arithmetic, this guy can run circles around me. And, he is honest. He is straightforward. He is sincere. And, the budget that he came forward with is just like Paul Ryan. It is a sensible, straightforward, honest, serious budget. And it cut the budget deficit, just like we did, by $4 trillion. [...]
"The President came out with his own plan. And the President as you'll remember, came out with a budget, and I don’t think anyone took that budget very seriously. Uh, the Senate voted against it 97 to nothin'. He therefore, after a lot of pressure from folks like me, uh, he came out with a new budget framework, and in the new budget framework he cuts--he cut the budget deficit by $4 trillion over 12 years. And, to be candid, this $4 trillion cut was very heavily back-end loaded. So, if you looked at it on a 10 year basis and compared apples-to-apples, it really was about a $2.5 trillion cut."
http://hotair.com/archives/201.....super-pac/
DRed| 8.13.12 @ 11:21AM
Medicare Part D is one of the most fiscally irresponsible pieces of legislation that Congress ever passed. Since 2006 the average cost of a part D premium has increased 57%. Really-that's what you call 'driving down costs'?
nathan| 8.13.12 @ 1:50PM
Yeah, the first thing he's going to have to "fix" is undo Plan D which he voted for and played cheer leader for. It would have helped if he had opposed it in the first place?
aware| 8.13.12 @ 5:20PM
And TARP, No Child, auto bailouts, additional "stimulus", NDAA.....
But you're just asking for trouble pointing it out. Legs are a tingling.
Bushiite| 8.14.12 @ 1:26AM
Real conservatives like to conserve, especially if it is big government.
Kwan| 8.13.12 @ 12:18PM
Our seniors better wake up to the fact that once the ObamaCare "Death Panels" get activated their possibility of getting life-saving medical treatment will be decided by uncaring government bureaucrats whose total allegiance is to the state. What if any value they have to the "state" will determine if the "Death Panel" members give them a "thumbs-up" or "thumbs-down".
Kingofthenet| 8.13.12 @ 12:28PM
or you can rely on the Generosity of 'for profit' corporations, which SOLE purpose in existing is to make money.
Kwan| 8.13.12 @ 1:08PM
Leftist soothsayers would have us believe that those that pursue profit are in league with the devil. Yet their illogical argument becomes more apparent when you realize that a 'for loss' corporation like Solyndra pays no taxes, the taxes that Obama uses to finance his ever-growing government and welfare programs. The leftist really wants the "benevolent" government to administer a Soviet-style command economy that will equally distribute any and all profits to the citizenry (this fairy tale is designed for the gullible morons in the population).
spike59| 8.13.12 @ 1:19PM
'for profit' corporations can only make money off living people; Washington wants the pennies on your eyes
Kingofthenet| 8.13.12 @ 1:26PM
Seniors aren't 'Money Makers' for Insurance Companies, IF they were there is NO LAW that says a private insurance company can't offer Seniors a plan RIGHT NOW, did it ever occur to you why not? And if NOW isn't a good time to do it, what will be better for insurance companies in the future to make it worth their while?
markenoff| 8.13.12 @ 8:08PM
King of the aquanet.....
Insurance companies can RIGHT NOW offer seniors health insurance plans. But according to a recent court decision, if a senior declines Medicare they also forfeit their social security:
http://www.lexology.com/librar.....98083b9385
Our seniors are already enslaved to the system. Guess whose next?
markenoff| 8.13.12 @ 8:41PM
http://www.csmonitor.com/Busin.....ourt-rules
Kingofthenet| 8.13.12 @ 2:45PM
Here is the commercial, Que little old lady reaching into her purse and pulling out a 'Ryan Voucher' and handing it to a Doctor's Receptionist, Receptionist says, I'm sorry this Voucher doesn't cover your visit, you need to add ANOTHER 75$'s, old lady voice trembling, but I only had to add 50$ LAST month, Receptionist say's sorry Inflation and all...
Nick| 8.13.12 @ 3:19PM
Here's the commercial, KooK: Que little old lady sneaking into her grandchildren's rooms and stealing all the money from their piggy-banks. She then leaves them each a bill for over $50,000. She looks into the camera and says, "Hey, grandma needs her bingo money."
MediScare is not for the poor, anymore. It is a middle-class entitlement. And the debt gets passed onto America's grandchildren & great-grandchildren.
That's okay, though. O'BamaCare guts MediScare by over $700 billion. Why do you support this raping of MediScare, KooK?
By the way, did you see what Erskine Bowles had to say about the Ryan Budget, above?
Bushiite| 8.14.12 @ 1:25AM
I am confused. If Obama will gut Medicare, isn't that a good thing? I thought conservatives wanted to end entitlement. Oh, I forget, that's just campaign slogan and fundraising pamphlets. Conservatives love big government when they are in charge. Got it!
Kingofthenet| 8.13.12 @ 11:46PM
The REAL Paul Ryan plan:
Kingofthenet| 8.13.12 @ 11:46PM
Sorry, here it is:
http://www.youtube.com/watch?v.....r_embedded