This is not complicated. Both Paul Ryan’s plan for Medicare and President Obama’s look to save over 700 billion dollars over ten years, but President Obama seeks it do it on the providers’ side (through cost cutting practices, such as going electronic with medical record keeping) whereas Paul Ryan shifts the burden to the elderly consumer to locate and purchase health insurance with a voucher. If the voucher does not cover the cost of insurance on the open market, it is on the elderly person herself to find a way to make up the difference.
In other words, President Obama’s plan keeps Medicare what it is: a single-payer system. Paul Ryan’s does not. He casts the elderly onto the verities of the market with a voucher which, over time, must necessarily lose its value if health-care inflation exceeds the general rate of inflation.
And what is done with the 700 billion that is saved? President Obama uses it to cover more people through Obamacare. Paul Ryan gives it in a tax break to the rich.
Republicans are trying their best to obscure these straightforward differences, but if Democrats are able to explain them to the electorate between now and November–and this shouldn’t be hard—it’s difficult to imagine the majority of voters going with the Atlas Shrugged ticket (Romney-Ryan).
In a world in which jobs are fluid, it seems that one of the few things that the government can legitimately continue to do for citizens is assure them that, when they are old and no longer able to work or be competitive in a dynamic global marketplace, that they at least won’t find themselves in utter penury and without access to doctors. That’s President Obama’s philosophical view of the matter. It’s not at all clear it’s Paul Ryan’s or Mitt Romney’s.
Here’s a news piece on Ryan’s plan that seems pretty balanced:
And here’s an informative Rachel Maddow segment in which dice-throwing is emphasized (with seniors assuming the risk placed on the gamble):
And here’s an ad from the Obama side that strikes me as politically effective (and with the merit of not distorting things):