Ryan did a great job. I'm still a little amazed by the nonchalance with which reporters parrot Democratic talking points like "tax cuts for the rich"--that kind of stuff destroys a reporter's credibility in my eyes.

But Ryan handled it exceptionally and answered each question honestly and straight-forwardly--a nice change from the evasiveness and hyperbole on which the White House depends.

Instead of constantly getting leg tingles over Paul Ryan, you guys might try seeing through this deceptions. On Medicare rationing, OF COURSE any plan to save Medicare is going to lead to rationing, and yes, the question is who makes the rationing decision. Ryan's plan proposes to give a voucher to each senior citizen, and then let the market do its work. In other words, rich people will get all the care they need, and poor people will be rationed. Over time, the poor will get fewer and fewer services because Ryan set the vouchers to grow at the rate of inflation, instead of at the rate of health costs. Obama's plan, on the other hand, empowers an advisory board to decide what specific procedures are rationed; namely, those that are deemed too costly. Rich people, of course, will still be able to get whatever treatments they want, just not from medicare. So, pick your poison, and live with it.

Has anyone countered Obama's argument that a person with $15,000 is not going to be able to negotiate with an insurance company? He really does not understand the power of the consumer in a free market.

dan k,

Do you know a less accountable organization than the government? As a physician, I spent 40 years dealing with Medicare and its arbitrary decisions. You just don't know what you are talking about. You can sue an insurance company and some have done so successfully. Try suing Medicare.

Stan D is an honest liberal and worthy of debating. The premium subsidies don't guaranty nirvana for low income seniors, but neither does a Democratic Party promise that can't be backed up. And face it, Medicare is a ponzi scheme worthy of Madoff, and its insolvency has be obvious for over 20 years-- ask Paul Krugman ca. 1996. So as Stan says "pick your poison". My opinion is low income seniors should go with premium subsidies rather than Obama's death panels. First off, the Ryan plan has a much better chance to reduce the rate of medical inflation (especially when coupled with malpractice punitive damage caps and allowing health insurers to sell across state lines), 2 it is more flexible, Congress can increase subsidies to the low income seniors if they fall too far behind, and low income seniors can shape the market to buy medical policies without bells and whistles to meet their particular needs, etc etc , but this is a fair debate I could have with Stan. Notice though, that the Obamaniac and the media don't want this debate -- it's a loser for them politically. Instead it's Ryan is the grandma killer, cat food for the elderly-- Blah Blah Blah-- that's why I detest the Left, but I have no problem with honest liberals such as Stan. Cheers.

I've written before that it's folly for the GOP to put forth a specific, far-reaching budget plan before Obama does. What's the point if it has no chance of passage. We're just providing the Dems with ammunition which they and their adjunct, the MM, will distort and use to beat us over the head.
Anyone who thinks political battles are won via clear-headed, rational decisions needs only to refer to Jefferson:''If you would persuade me, appeal to my emotions, not to my Reason.'' And he didn't face hundreds of media outlets only too glad to lie and smear in support of leftist candidates.

Michael Kennedy - couldn't agree more. My 40 years has been spent in hospital finance and as much as I hated negotiating with Blue Cross,et al, at least we got to negotiate, rather than reading about our rates in the federal register. Blue Cross has to answer to Blue Shield and Kaiser, Medicare answers to no one

As for picking your poison, bear in mind that the top down approach employed by ACA is essentially the same type of price control effort that I also watched for forty years, with absolutely no impact on aggregate spending. As Ryan said, the likely outcome of his voucher system is the growth of programs such as Medicare Advantage. In my career I've set up and run a joint hospital-physician organization to provide service under the Advantage Program's precursor, Medicare +Choice. Our experience was that activity (ie unnecessary testing and procedures) declined so much that we did better financially with that population than we did with those served under Medicare's traditional fee-for-service system. Why? Because we changed incentives. The physicians designed and monitored their own payment system, and held a significant stake in the hospital's financial outcome. (A point that's rarely made is that for the majority of health care expenditures, the physician is the customer -- nothing happens in a hospital until a physician orders it.)

Our experience seems to be at least somewhat common, given the growing popularity of Medicare Advantage. So naturally, Medicare Advantage is targeted for significant funding cuts under ACA. But in one of the great ironic panders of all time, the administration just got wind of that popularity, and to avoid the political blowback that would accompany the impact of those cuts (taking away Advantage from the seniors who like the plans) have reinstated the cuts over the near term through the back door by awarding additional 'quality' bonuses. I guess the quality they're talking about is the quality of Obama's re-election prospects.

Government needs to do it's job, first protecting this Country as defined in the Constitution. Second, stop the spending and reduce both the debt and the Federal Government and agencies and committees that are only spending the tax payers money where a lot of the waste lies. Third, there is a lot of agreement on cuts and reforms but not all. Let's start at the top where the incomes and benefits and perks to cut, EPA regulations hurting our ability to use some of our own resources instead of Obama telling B we want to be their best customer and other programs like this. Medicaid and Welfare Programs have policies which hold individuals and families hostage instead of supporting people so they can become self-sufficient by stripping them of benefits or assistance or cash even when they get employment. The programs goals was intended to help people so they could help themselves and get through the rough times. Not anymore. Social Security punishes women who raised their children and stayed home, it only bases income on the last 10 years so men naturally get more. The Congress has stolen the money from SS and it will never be put back but hopefully, raising the ages will help. Now if you could get the economy to keep older employers employed or hire us because we have value too. Ryan's attempt to come up with a serious plan is the right move and I pray all the time that the cold-hearted and corrupt individuals at the top come to the table and do what is right to but our County back on the road to recovery. I still have a problem with "how can Obama and friends still think putting American in a deeper hole is going to get us out of this drowning pool of debt? What planet on they living on? Are they part of the human race? Maybe they should live on the wages of a single parent or unemployed individual who is supporting a family for several months. Of course none of them can because they spend that much of the taxpayers money without blinking an eye and I feel many don't even have a conscious anymore. It makes me sick to see Obama on the news and posing for the American People while destroying the very thing we all hold most dear, our freedoms and our way of life. Keep up the good fight and don't cave in.

What everyone should remember is that Government Money is the driver of health cost increases. Remove the government (as much as possible & keeping a safety net) and health cost increases will level out to the basic CPI.

Google a graph showing both CPI & health care costs (HC) over time. You will see both lines essentially the same until 1965, when the HC begins to diverge drastically from the CPI.

Gee, whatever could have happened in 1965 to cause such a change?