The first thing to note about the budget presented this week by Rep. Paul Ryan is that he didn’t learn much from the budget he produced last year, which helped cost Republicans the White House and seats in the Senate and House of Representatives. Once again, his plan seeks to turn Medicare partly into a voucher system that is bound to leave many Americans without health care and that most Americans don’t seem to want.
The second thing is that the entire proposal is based on a false premise, namely the repeal of the Affordable Care Act. With Democrats controlling the Senate and the presidency, the signature measure of President Obama’s first term is here for the duration.
That makes the budget proposal not a serious financial document from which to launch negotiations, but a political statement of principle, which is fine except for the problem of last November’s elections. There seems little chance that voters will change their minds on preserving Medicare between now and the 2014 midterm elections, but if this is the way Republicans want to roll the dice, that’s their call.
The idea, which is too sketchy to be called a blueprint, envisions a balanced budget in 10 years without raising taxes. To do that, it embraces the recently enacted tax increases that the party resents, proposes a tax reform that doesn’t reveal what deductions would be sacrificed, and seeks $4.6 trillion in spending cuts, mainly from programs that benefit the poor.
Ryan says turning Medicare into a voucher program would save it from collapse, and that may be true. But it would almost certainly do so at the expense of seniors who would be priced out of the market.
It is plain that Medicare needs to be reformed, and Republicans aren’t alone in dealing with that in an irresponsible way. Democrats, with the occasional exception of Obama, have stuck their heads in the sand and refused to deal with the arithmetic of a program financially unprepared to handle the onslaught of retiring baby boomers. Medicare’s Hospital Insurance Trust Fund is projected to be depleted in 11 years.
It is possible something better than either party has proposed will occur in the coming months, as the mindless cuts of the sequester take hold and Republicans and Democrats start to consider more seriously each other’s positions.
Whether that occurs or not, those who care about preserving Medicare can be thankful the Ryan plan won’t go anywhere. They can also hope that Washington finally gets serious about restructuring a program that cannot survive in its current condition but that tens of millions of Americans are counting on for the future.