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Brother, can you spare some insulin?

I used to read Clive Crook’s blog and recently came across a post of his on Paul Ryan’s Cat Food for Seniors Medicare repeal proposal that reminded me why: (h/t DougJ)

Ryan not only repeals Obama’s health-care reform (by refusing to fund subsidies and other outlays), he also proposes to convert Medicare into a defined-contribution program and Medicaid into a system of block grants to the states. From the point of view of guaranteeing universal access to health insurance, this goes beyond merely nullifying Obamacare, and further weakens the guarantees, such as they are, in the present system. In my book, that is two steps back.

I think it is fair to criticize Obamacare for failing to take cost control in health seriously. But Ryan’s plan has the same defect. It holds out no more hope of controlling costs than Obama’s. And under Ryan’s proposal, an ongoing failure to economize would simply be passed through to the retired as reduced coverage and/or higher premiums. This is not something that the retired–or people who one day expect to be retired–are likely to embrace. Politically, this plan to privatize Medicare, which is how it will be characterized, is surely suicidal.

The Ryan budget as a whole is a frontal assault on the administration’s priorities. You might say: Mission accomplished. A frontal assault is what the GOP promised. But what, exactly, does this achieve? What hope of compromise does a plan like this allow? The US system of government divides power between the parties, an obvious fact, but one that the contending forces on Capitol Hill lately find hard to take in. How do you get from unyielding, no-surrender proposals like this to workable commonsense reforms that actually confront the problem? In short, how do you get from a posture to a policy? The ongoing shambles over the continuing resolution and the immediate budget impasse suggests one rather disturbing answer. You don’t.

If there is anything that I hate about our current political climate, the persistent need to lie about policy outcomes probably tops the list.  I am happy to have an honest discussion about any topic one can think of, just so long as both sides of the debate are honest about the probable outcomes of their respective policy positions .

In Paul Ryan’s case, we could have a somewhat serious debate about entitlements if he was willing to acknowledge that (as The Economist and the CBO have already pointed out) his plan would both (a) save the government money by paying only a fixed, slowly adjusted amount for senior health insurance vouchers, AND (b) cause millions of seniors to (i) go without health insurance (or scrimp by with the barest coverage possible) due to the enormous (and rapidly inflating) premiums that insurance companies will charge for lots of old, sick people to join the rolls, and (ii) go bankrupt (and likely bankrupt their children) when they do end up getting sick without sufficient insurance coverage to pay for it.

But no, the next few months will be dominated by Republicans desperately messaging on point (a) above, while constantly eliding any discussion of (and, when pressed, blatantly lying about) the real-world ramifications described in point (b).

I guess it will be up to the voters in 2012 to either reward this behavior or do something more noble.  We’ll see.

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