Paul Ryan’s rousing speech in Tampa has cemented Medicare as the big issue splitting voters
Published: 11:24 BST, 30 August 2012 | Updated: 14:57 BST, 30 August 2012
Will Paul Ryan, the Republican vice presidential candidate, carry his team to victory in November? Judging from his Wednesday address to the Republican convention in Florida, the answer is yes.
Ryan’s attack on President Obama and his defence of Republican principles and the presidential candidate, Mitt Romney, has the Democrats wishing that Hurricane Isaac had hit Tampa instead of New Orleans.
Looking young and vigorous, with a well-fitting suit, he declared, ‘I’ve never seen opponents so silent about their record, so desperate to keep power.’ Obama got all the stimulus he wanted, Ryan continued, but the money was borrowed, spent, and wasted. Taxpayers just got more debt.
Campaigning: Republican vice presidential candidate Paul Ryan attacked President Obama, saying ‘I’ve never seen opponents so silent about their record’
Ryan, speaking in Florida, a state with a larger concentration of older Americans, made a strong defence of his Medicare plan, the program which provides health services for seniors, as they are known in America.
Although his plan has been demonised by Democrats as a voucher program, Ryan pointed out that Obama took $716 billion from Medicare to fund the new health care law, the Patient Protection and Affordable Care Act. The Act, through its pruning of Medicare receipts, is the biggest threat to Medicare.
It’s lucky than Ryan wants to bring up Medicare, because the debate is in full swing.
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Just Saturday, in his weekly radio address, Obama said of Republicans: ‘They want to turn Medicare into a voucher program. That means that instead of being guaranteed Medicare, seniors would get a voucher to buy insurance, but it wouldn’t keep up with costs.’
Obama is wrong. “Voucher” does not appear in the Republican plan. The new plan would only apply to future seniors beginning in 2023. And they would continue to have a choice of traditional Medicare, as well as other plans, too.
Everyone here agrees that Medicare is in trouble. The Congressional Budget Office’s new estimates, released last week, raised projected Medicare spending by $136 billion over the next decade. Since Medicare was established more than 40 years ago, projections have gone in one direction: up.
Attack: President Obama has accused the Republicans of ‘wanting to turn Medicare into a voucher program’
Speech: Paul Ryan made a strong defence of his Medicare plan, the program which provides health services for seniors
Yet Ryan’s plan to reform Medicare, adopted by the House Republicans last spring, is routinely vilified. The budget resolution and Medicare proposals are on the web site of the House Budget Committee. They can be found here.
Voucher programs give beneficiaries a set amount of money to use for a particular purpose—education, groceries, insurance—and to spend for any permitted school, plan, or product they prefer.
Ryan’s new plan is known as ‘premium support’. Modelled after the popular Federal Employees Health Benefits Program, Ryan would let seniors who retire in 2023 and later choose from a variety of government-approved, competing and comprehensive health insurance plans, at different prices with different levels of service, including traditional fee-for-service Medicare.
Unlike food stamps, where recipients go to any store, seniors could only pick a pre-approved plan.
Future: Medicare was established more than 40 years ago, but it is widely considered to be in trouble
The distinction between vouchers and premium support matters because premium support offers more protection for the consumer.
With a voucher, consumers can purchase any health insurance plan. Some critics – I am not among them – are concerned that seniors won’t choose the right plan or insurance companies will take advantage of seniors. With premium support, the government has pre-approved the permitted plans.
The amount of funding, or premium support, would be determined by the second least-expensive approved plan, or traditional Medicare, whichever is less costly.
The advantage of premium support plans such as the Federal Employees Health Benefits Program is the variety of plans at different prices.
With more choice, plans have to compete for customers, and this translates into lower costs than would be the case otherwise. Competition is fierce among government plans during enrollment season for federal health plans. Washington D.C.’s citizens are deluged with radio, TV, and bus advertising with pictures of beautiful people promoting different plans.
Ryan realises that alternatives are needed for bankrupt programs, and he’s willing to have a real debate. As he said, the simple reality is that Americans need to stop spending money we don’t have.
Win or lose in November, just as Europe needs reform of its health and pension programs, we cannot shy away from Medicare.