BUILDING A BETTER WELFARE STATE:

Ryan has no second thoughts. "It is morally right," he says, "legally right, politically right." And he is armed with more than confidence. Despite the criticisms of Ryan's budget, it is simply correct on the biggest matter. By the 2030s, federal health-care commitments, along with interest on the debt, will consume just about all government revenue. Federal health spending is expected to grow from 5.6 percent of the gross domestic product (GDP) to nearly 20 percent -- about the modern average for the whole federal government. Maintaining "Medicare as we know it" and other unreformed health entitlements will make every other function of government as we know it impossible.

Ryan's proposals to move toward a premium-support system in Medicare and a block-grant system in Medicaid are controversial, and he has modified them in response to criticism. But their seriousness stands alone. "President Obama has given us four budgets," Ryan says, "and four times he has punted on the debt problem." The Democratic strategy has been "to wait for Republicans to propose solutions, then attack them."

Ryan bristles at the notion that he is unraveling the social safety net. He sees it unraveling of its own accord. "The poor would be hurt worst in a debt crisis," he says, when spending cutbacks would be sudden, drastic and indiscriminate. Reform is required to "make the safety net work, to make it sustainable." 

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