April 6, 2011

A MAN, A PLAN....:

Good Plan!: Republican Paul Ryan's budget proposal is brave, radical, and smart. (Jacob Weisberg, April 5, 2011, Slate)

The Wisconsin Republican's genuinely radical plan goes where Ronald Reagan and Newt Gingrich never did by terminating the entitlement status of Medicare and Medicaid. (It doesn't touch the third major entitlement, Social Security, though Ryan has elsewhere argued for extending its life by gradually raising the retirement age to 70.) Ryan changes Medicare into a voucher, which would be used to purchase private health insurance. He turns Medicaid into a block grant for states to spend as they choose. Though his budget committee isn't responsible for taxes, Ryan includes the boldest tax reform proposal since the 1980s, proposing to lower top individual and corporate rates to 25 percent and end deductions. While he's at it, Ryan caps domestic spending, repeals Obamacare, slashes farm subsidies, and more.

If the GOP gets behind his proposals in a serious way, it will become for the first time in modern memory an intellectually serious party—one with a coherent vision to match its rhetoric of limited government. Democrats are within their rights to point out the negative effects of Ryan's proposed cuts on future retirees, working families, and the poor. He was not specific about many of his cuts, and Democrats have a political opportunity in filling in the blanks. But the ball is now in their court, and it will be hard to take them seriously if they don't respond with their own alternative path to debt reduction and long-term solvency.

And before they reject everything in Ryan's plan, liberals might want to consider whether some of what he proposes doesn't in fact serve their own ultimate goals. Ryan's proposal to turn Medicare into a voucher provides an easy political target. But it's hard to make a principled liberal case for the program in its current form. To do so, you have to argue that government-paid health care should be a right only for people over the age of 65, and for no one else. Medicare covers doctor and hospital bills at 100 percent, regardless of income. This gives doctors and patients an incentive to maximize their use of the system and waste public resources.


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Posted by Orrin Judd at April 6, 2011 2:03 PM
  
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