Paul Ryan gave his big speech in Chicago today, desperately trying to reset the debate over his flailing plan for Medicare privatization. And he can pretty up the rhetoric as much as he wants, but in the end, it remains a program to get rid of Medicare.
To take the pressure off, Ryan tried to offer a choice between his plan and what he imagined would happen under his adversaries, ignoring actual plans to end corporate welfare payments to insurance companies in Medicare Advantage, bargain down the price of prescription drugs, change the health care delivery system to incentivize whole care rather than individual expensive treatments, expand the pool and reduce costs by allowing Medicate buy-in at 55 or a single payer system, etc.
I call it the “shared scarcity” mentality. The missing ingredient is economic growth.
Shared scarcity represents a deeply pessimistic vision for the future of this country – one in which we all pay more and we all get less. I believe it would leave us with a nation that is less prosperous and less free.
To begin with, chasing ever-higher spending with ever-higher tax rates will decrease the number of makers in society and increase the number of takers. Able-bodied Americans will be discouraged from working and lulled into lives of complacency and dependency.
Worse – when it becomes obvious that taxing the rich doesn’t generate nearly enough revenue to cover Washington’s empty promises – austerity will be the only course left. A debt-fueled economic crisis will force massive tax increases on everyone and indiscriminate cuts on current beneficiaries – without giving them time to prepare or adjust. And, given the expansive growth of government, many of these critical decisions will fall to bureaucrats we didn’t elect.
I don’t know who these politicians are Ryan is talking about, but they sound terrible and Ayn Rand would not approve. The goal was clear – define the opponent before they define you. Ryan’s a little late to the game on that, but he clearly wanted to make anything but his plan to buy insurance sound so gloomy and dystopian that everyone would beg him to end Medicare and give seniors a coupon to buy their own insurance. So it’s an attempt to attack and not defend.
In fact, there’s almost no defense of his plan in here at all. Ryan said that his reforms “save the social safety net” and “strengthen welfare for those who need it” by allowing governors to essentially destroy them and throw millions off the insurance rolls. Solvency is seen as a far more important goal than adequacy.
But when he wasn’t talking about “rules-based monetary policy” or parroting John Boehner on the debt limit or nixing virtually every regulation that passed the last Congress, Ryan was annoyingly vague about his own plan. He merely said this:
Our budget makes no changes for those in or near retirement, and offers future generations a strengthened Medicare program they can count on, with guaranteed coverage options, less help for the wealthy, and more help for the poor and the sick [...]
The disagreement isn’t really about the problem. It’s about the solution to controlling costs in Medicare. And if I could sum up that disagreement in a couple of sentences, I would say this: Our plan is to give seniors the power to deny business to inefficient providers. Their plan is to give government the power to deny care to seniors.
Again, this is a strong coloring of the opponent’s argument, and almost a complete inversion of Ryan’s own. In what universe does Paul Ryan think that an individual senior citizen, needing medicine and treatment as virtually all seniors do and cast off into the individual market to purchase health insurance with a coupon, has LEVERAGE over businesses that provide that service? This isn’t just fantasy libertarianism, it’s contradicted by all known experience in modern-day society as well as health economics. Fracturing the market and diluting the risk pool necessarily increases the cost of health insurance.
Ryan adds some friendly cant about ending corporate welfare and eliminating loopholes that “distort economic incentives,” but that’s of course in service to lowering overall corporate tax rates. Maybe that’s what he’s going to use in his potential Senate run to avoid getting beaten about the head by his budget. But if this speech was supposed to be the reset button for the Medicare privatization plan, I’d say he might as well forget it. Because he didn’t even try.