Tuesday, August 14, 2012

Medicare Nonsense all Around

Ezra Klein:
I’ve got a modest proposal: You’re not allowed to demand a “serious conversation” over Medicare unless you can answer these three questions:

1) Mitt Romney says that “unlike the current president who has cut Medicare funding by $700 billion. We will preserve and protect Medicare.” What happens to those cuts in the Ryan budget?

2) What is the growth rate of Medicare under the Ryan budget?

3) What is the growth rate of Medicare under the Obama budget?

The answers to these questions are, in order, “it keeps them,” “GDP+0.5%,” and “GDP+0.5%.”

Let’s be very clear on what that means: Ryan’s budget — which Romney has endorsed — keeps Obama’s cuts to Medicare, and both Ryan and Obama envision the same long-term spending path for Medicare.
The Republicans have a problem. Their two biggest voting groups are 1) old people  and 2) people who want spending cuts so we can cut taxes. They have tried to appeal to both groups by both attacking Obama's Medicare cuts while promising long-term reform that will hold down Medicare costs. The trouble is, they need Obama's Medicare cuts to fund their tax cut plans, because they don't have any more or better ideas for limiting government health spending in the short term.

There is a real difference between the two plans but it is not is how much money they are trying to save from the projected growth in Medicare. Both plain aim to save the same amount. Ryan's plan does this by converting Medicare into a voucher that people will use to buy private insurance. Obama's plan tries to do this by using government pressure and government incentives to make American medicine work better and more efficiently.

If you ask me, the way to choose the right approach is to look around the world and ask, what sort of plans, private or government, work better to hold down health care costs? The answer, as Mitt Romney observed when he was in Israel, is government controlled plans. So I think Obama's approach is much more likely to work. But it is worth noting that both Obama's health care experts and Ayn Randian fanatic Paul Ryan both aim for the same rate of growth in Medicare.

If Mitt Romney wants to be taken seriously about anything, he ought to start by acknowledging that his budget (such as it is) accepts Obama's Medicare cuts, and Paul Ryan's explicitly does. But then I suppose he wouldn't know what to say to older voters.

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