Ezra Klein finds it “baffling” that Rep. Paul Ryan (R., Wis.) says:
We do not have a choice as to whether Medicare will change from its current structure. It is being driven to insolvency. An honest debate requires a serious discussion of how Medicare will avert its collapse and be made sustainable. Unfortunately, but not surprisingly, the Democrats’ political machine has attacked my contribution to this debate, making the false claim that the only solution put forward to save Medicare would “end Medicare as we know it.”
Klein responds:
There’s nothing false about the claim that Ryan’s plan would end Medicare as we know it. In fact, it’s unambiguously true. Currently, Medicare is a government-run insurer that pays the health-care costs of all senior citizens. Under Ryan’s plan, senior citizens would be given vouchers that they could use toward private insurance. Poor seniors would get more-generous vouchers, and rich seniors would get less-generous vouchers. The way Ryan saves money is by holding the growth of the vouchers beneath the growth of health-care costs, so as care costs more and more, the vouchers cover less and less.
I don’t think any one can credibly say that Rep. Ryan has been reticent to spell out the details of his plan for Medicare — which, pace Klein, does fundamentally change the nature of the entitlement. But context matters. Klein quotes only the bolded part of the above from Ryan, leaving out, I think, the core of Ryan’s beef with the Democratic smears about his plan. Namely: “We do not have a choice as to whether Medicare will change from its current structure. It is being driven to insolvency.” Quite right.
Contrast with what Speaker Pelosi’s office said, obliquely, about the Ryan plan:
“Forty-five years ago today, Democrats and Republicans came together to create Medicare and Medicaid. Unfortunately, that bipartisan tradition has now been lost, as Congressional Republicans not only oppose improvements to our seniors’ health care system, but pledge to repeal them and end Medicare as we know it – leaving seniors on their own to negotiate with insurance companies for coverage. Democrats will not let this happen. We will stand with America’s seniors to protect and strengthen Medicare now and in the future.”
What’s conveyed here is that Democrats have saved Medicare while Ryan — and by extension the Republicans — want to “repeal” it and leave seniors to the wolves. No word of Medicare’s continuing structural imbalances. No mention that, under Ryan’s plan, Medicare would stay as-is for Americans to which we’ve already made promises. No mention that, moving forward, seniors would be “negotiating with insurance companies for coverage” using government bucks. No suggestion that there is any daylight between Ryan and the GOP at-large on the issue (if only!). So why isn’t Ryan right that Democrats are pushing “the false claim that the only solution put forward to save Medicare would ‘end Medicare as we know it?’”