Rep. Ryan’s “Mediscare” rebuttal

What Austin Frakt says about the Ryan plan.

I’ve been tied up with other matters. So I’ll just say “What Austin Frakt said” regarding Paul Ryan’s speech in our fair city today.

Robert Costa over at National Review Online cites the following lines from Ryan’s prepared text:

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.

Austin seems unimpressed:

There are two things odd about these sentences. First, the Republican plan has nothing to say about providers, like hospitals or physicians. It’s a plan for insurance reform under Medicare, not a plan for provider organization or payment reform. Second, the ACA has nothing in it to deny care to seniors. In fact, Medicare is not permitted to do anything of the sort.

So, this segment of the speech seems like a rebuttal, but not of the arguments that have been offered against Rep. Ryan’s plan and not in support of what that plan actually is [italics mine].

For Austin, this is pretty rough stuff. If the Ryan plan were a true premium support program based on the defined benefit rather than defined contribution framework, there would be more to talk about.

One more thing. Costa includes the following additional comments from Ryan’s speech:

A key passage will underscore Ryan’s disgust with class-warfare politics. “Class warfare may be clever politics, but it is terrible economics,” the congressman will say. “Social unrest and class envy make America weaker, not stronger. Playing one group against another only distracts us from the true sources of inequity in this country — corporate welfare that enriches the powerful and empty promises that betray the powerless.”

Like the admittedly-clever Jonathan Chait, I believe Ryan richly deserves the criticism he is getting. Ryan and other Republicans are getting knocked around for their obvious hypocrisy in Medi-scaring seniors in 2010–only to propose quite drastic Medicare cuts as soon as they won the majority.

Yet hypocrisy is really the smallest problem here. Representative Ryan proposes a program in which an estimated 2/3 of the budget burden falls on low-income people. He proposes deep cuts to Medicaid, and he supports many cuts happening right now within discretionary programs for low-income people.

The programs he seeks to cut are not “empty promises” made to seniors or to anyone else. At least these don’t have to be. They become empty promises when politicians refuse to fund them or refuse to support appropriate taxes or required program adjustments (e.g. IPAB and reduced subsidies to Medicare Advantage) that keep these programs sustainable.

Ryan’s support for punishing budget cuts affecting poor people provides quite the contrast with his support for key fiscally irresponsible measures, including the poorly-structured and unfunded Medicare Part D program and vastly excessive tax cuts for wealthy Americans, who are after all the major owners of firms receiving government giveaways in the first place.

All in all, the terms “class warfare” and “corporate welfare” apply nicely to Representative Ryan’s own proposals.

Author: Harold Pollack

Harold Pollack is Helen Ross Professor of Social Service Administration at the University of Chicago. He has served on three expert committees of the National Academies of Science. His recent research appears in such journals as Addiction, Journal of the American Medical Association, and American Journal of Public Health. He writes regularly on HIV prevention, crime and drug policy, health reform, and disability policy for American Prospect,, and other news outlets. His essay, "Lessons from an Emergency Room Nightmare" was selected for the collection The Best American Medical Writing, 2009. He recently participated, with zero critical acclaim, in the University of Chicago's annual Latke-Hamentaschen debate.

2 thoughts on “Rep. Ryan’s “Mediscare” rebuttal”

  1. That second passage would stand as one of the finer examples of unintended irony in current political speaking, were it not knowingly false.

  2. I particularly like these passages:

    “As the University of Chicago’s John Cochrane recently wrote: “No country ever solved a debt problem by raising tax rates. Countries that solved debt problems grew, so that reasonable tax rates times much higher income produced lots of tax revenue. Countries that did not grow inflated or defaulted.” Higher taxes are not the answer.”

    And also…
    “America’s corporate tax rate is the highest in the developed world.”

    Can we solve our problems by taxing more and spending more? Can we solve our problems by increasing taxes on the rich? Has this ever worked? Examples please.

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