Paul Ryan: Marching Backwards on Medicare

Let's get one thing perfectly straight:  Paul Ryan wants to end Medicare.

His 2012 proposal is less straightforward about it than his 2011 proposal.

It would, nevertheless, end Medicare. And the Affordable Care Act.

Single payer/Medicare for All?  Fuhggedaboudit.

Here's  quick back-of-the-envelope on how it shapes up:

Features	Medicare Now	Old Ryan Plan	"New" Ryan Plan
Age you are eligible	65	67, increase starting 2023	67, complete by 2034
Privatization initiatives	Drug plan, Medicare Advantage	Vouchers for everyone	Vouchers phased in
Extra costs to seniors	Baseline	$6,000 a year	?
Medicare as % of Federal expenditures	6.5%	?	4.5%
Savings mechanisms	ACA: IPAB, primary care,  EMRs, ACOs	Vouchers: Individual seniors control costs through purchases	Vouchers: Individual seniors control costs through purchases + Insurance industry competition

Do we need to do more to improve and expand Medicare? Indeed. But Ryan would double down on disaster.

On Medicare for All, he had this exchange with reporter Sam Husseini, published June 13, 2011:

Sam Husseini: If you’re a fiscal conservative and you want to provide a safety net, why wouldn’t you be for something like a single-payer health care system?

Paul Ryan: I think a single-payer health care system would be a disaster for people who need health-care the most. I think it would cause rationing, waiting lines. I think it would be a fiscal house of cards, I think it would help accelerate a national debt crisis and hurt the economy.

Husseini: Wouldn’t it save a lot of money and cover everybody?

Ryan: Absolutely not. I totally and fundamentally disagree with it. I believe that you can have affordable access to healthcare for all Americans, including people with pre-existing conditions, without a government takeover of the healthcare sector. If we actually have government-run healthcare, what I think you’ll have is government managing, government-rationing healthcare. I think that will be a fiscal disaster, I think that it would accelerate a debt crisis that would slow our economy and take jobs and economic growth from those people that need it the most, which are people who are out of work.

Husseini: Doesn’t Medicare have a much lower — 2 or 3 percent — overhead compared to the insurance companies? Which — insurance companies –

Ryan: — That’s an apples and oranges comparison. If you take a look at Medicare itself, Medicare is going bankrupt.

Husseini: That’s the healthcare system in general that’s going bankrupt.

Ryan: There are three facts about medicare that you simply can’t dispute: 10,000 seniors are retiring everyday with fewer workers going into the workforce to pay for them; healthcare costs are skyrocketing at about four times the rate of inflation, which threatens medicare’s ability to give affordable care; and number three, the non-partisan experts agree that Medicare is going bankrupt. So Medicare’s status quo is bankruptcy and that threatens healthcare not only for current seniors but obviously for future seniors, so I believe a patient-centered healthcare system — reforms that put the patient at the center of the healthcare system, not the government — are the best for people who need healthcare and they’re best for the economy, and they’re the best way to avert a debt crisis.

Husseini: But isn’t the problem with healthcare fundamentally the corporate structure? I mean your biggest funders are a who’s who — Northwestern Mutual –

Ryan: — Which is a big employer in Milwaukee by the way —

Husseini: — Aurora Health Care, Abbott Laboratories, Credit Suisse — the insurers — [see "Paul Ryan's Health Industry Ties..." Humana Inc., Blue Cross/Blue Shield and Aetna]

Ryan: — Government-run healthcare doesn’t work. Wherever we’ve seen government-run healthcare, it’s failed.
Husseini: You think that people are worse off in France and Canada?

Ryan: I think we’re worse off if we go with a government healthcare system that will cost us jobs, it will increase our deficit and our debt and I do believe, and I put ideas on the table that show, that we can get to a patient-centered healthcare system that helps create jobs, that helps get healthcare costs under control, and gives everybody affordable healthcare coverage for everyone regardless of income or pre-existing conditions.

Husseini: You think poor people in Europe are worse off than poor people here?

Ryan ends questioning here.