JONATHAN CHAIT APRIL 6, 2011
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Slate's Dave Weigel deftly skewers Paul Ryan's political persona:
Two products made their debuts in Congress on Tuesday. The first was "The Path to Prosperity," House Republicans' budget resolution for the next fiscal year. The second was the budget's author: Honest Paul.
Honest Paul is the heroic persona of Rep. Paul Ryan, the chairman of the House budget committee. He's like the regular Paul Ryan, except he must pause regularly to accept plaudits for his candor, heroism, and courage. This persona had been in beta-testing for several years, at least since the Weekly Standard profiled him as one of the GOP's rising stars in October 2007 (headline: "The Thinker"). Honest Paul got a good, long trial run in 2010, when Ryan introduced—after plenty of Democratic goading—the budget-cutting"Roadmap for America's Future." The trial run was a success, because for all of the bashing Democrats and liberal-leaning think-tankers did, it didn't stop the Republicans from taking the House.
And so Tuesday belonged to Honest Paul. David Brooks wrote a column praising Ryan for "the most comprehensive and most courageous budget reform proposal any of us have seen in our lifetimes." When Ryan appeared on MSNBC's "Morning Joe," he was interrupted several times to accept more praise. "Let us stop right now and commend him," said host Joe Scarborough, who served with Ryan in the House from 1999 to 2001.
Another good example Weigel could have quoted, but understandably chose not to, is his colleague (and former TNR staffer) Jacob Weisberg, who writes, "more than anyone else in politics, Rep. Ryan has made a serious attempt to grapple with the long-term fiscal issue the country faces." In my forthcoming TRB column I take issue with the plaudits for Ryan's fiscal seriousness. But let me focus on a specific argument Weisberg makes about Medicare:
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.
This is a really strange argument. It seems like it was written in the 1990s and placed in a time capsule. We do have government-paid health insurance for everyone. It's called the Affordable Care Act. It was signed last year, there were a lot of protests, it was kind of a big deal.
Moreover, even if it that had never happened, making a principled liberal case for keeping Medicare in its current form does not require you to believe in government-paid health care as a right only for the elderly. You can believe it should be a right for everybody, and that eliminating that right for senior citizens moves you farther away from that ideal rather than closer.
Weisberg makes a general argument for restraining the cost of Medicare, and he's right about that. But his endorsement of Ryan's proposal to do so is misguided. Privatizing Medicare is expensive. You add a layer of cost with no corresponding savings. You also introduce all the adverse selection problems that make insuring the elderly so difficult, and which required the establishment of Medicare in the first place. So the liberal case for keeping down Medicare costs ought to rest on beefing up the cost controls in the Affordable Care Act -- Ryan, by the way, would eliminate those, too.
Weisberg argues that Ryan's Medicare voucher is actually pretty generous:
starting with a value of $15,000 per year, per senior—the amount government now spends on Medicare—Ryan's vouchers should provide excellent coverage. His change would amount to a minor amendment to the social contract, not a fundamental revision of it.
Well, sure. That's because the starting value does not actually save any money. It only saves money over time as the value of the voucher slowly falls below the cost of health insurance. Weisberg might argue for Ryan's policy of slowly withdrawing the government commitment to provide health care for the old, but then he can't really argue that it provides "excellent coverage."
23 comments
Unreal. And once - just freaking once - I want to see a few Dem Senators or senior House members stand up in front of a microphone and plainly say that any long term plan to get our budget in order that does not substantially lower military spending simply should not be taken seriously.
- Tristan
April 6, 2011 at 10:48am
Tyler Cowen at Marginal Revolution acknowledged yesterday that medical vouchers won't save money. Paul Ryan's plan is the wrong way to go. In addition, he is calling for a huge tax cut, at a time when there needs to be revenue increases. The Ryan plan is not impressive and it will further redistribute wealth upward. What is Jacob Weisberg thinking?
- liberalref
April 6, 2011 at 10:49am
"It's called the Affordable Care Act. It was signed last year, there were a lot of protests, it was kind of a big deal." One might even call it a big f***ing deal.
- Jbryan
April 6, 2011 at 11:01am
As Ezra Klein and others have noted, Ryan's plan repeals the cost controls in the ACA (along with everything else), which Republicans campaigned against in 2010, but then goes on to assume that the cost controls actually stick! The hubris and hypocrisy of Ryan and the GOP should be breathtaking, but these days, it's just another day at the office.
- ramcat
April 6, 2011 at 11:01am
There does seem to be a new willingness in the Republican Tea-Party side to take on these Social Safety Net issues with the delicacy of a dancing elephant. They KNOW these are "the third rail" of American Politics, but they apparently think they're the "third rail" because of shenanigans. Instead they're the "third rail" because since they were created under the New Deal (and Johnson's Great Society) they have worked. They've provided people with reliable (if low) retirement pay, and reliable medical care. But since they assume shenanigans are involved, it doesn't bother these Tea-Party Republicans to try to privatize and destroy the Social Safety Net. And when they're not instantly struck dead, they brag it's not a "third rail" after all. What they fail to realize is in politics, when you destroy your political position, it takes some time for the dominoes to fall.
- AllanL5
April 6, 2011 at 11:17am
Compare the ACA and Ryan's plan. The ACA made a figurative deal with insurance companies that they will have lots and lots of business for socializing costs if they agree to no caps and no pre-existing conditions. In his Medicare plan, Ryan provides lots and lots of business to insurance companies. Period. What a nice guy. How much did the insurance companies pay him for that?
- Nusholtz
April 6, 2011 at 11:20am
I understand no one hereabouts has one good word to say about Ryan's effort. Fair enough. The fact remains that the current US welfare state is unsustainable and must change. Do you all oppose Bowles-Simpson as well? If so, what is your preferred solution? We're looking more like Greece every day.
- butchie b
April 6, 2011 at 12:04pm
hell yeah it's fair enough. and if we're anything like greece you can thank the president who saved America's economy from the dreaded budget surpluses with brave actions to slash tax rates for everyone, starting two full scale wars, and tossing money at pharmaceutical companies for the promise to think about maybe letting some old folks have some medicine. jack ass.
- GSpinks
April 6, 2011 at 12:18pm
I don't know about others, but yes, I oppose Bowles-Simpson as well. My preferred solutions are: -single-payer, to reduce waste, administration costs, and increase the preventative care that's orders of magnitude cheaper than later care. -means testing of social security and medicare, to prevent the safety net from becoming a wasteful perk. -eliminating the distinction between taxing income and capital gains, because it's a sad joke. -eliminating agriculture subsidies, oil subsidies, and most other corporate welfare. Oh, and raising taxes. In the 1950s, our economy roared with a top income tax bracket varying between 84 and 92%. We might just get by with a top rate of 45%.
- janus
April 6, 2011 at 12:19pm
btw, no shit the current system is unsustainable. that's why they passed the PPACA. duh! it ain't perfect, but it intends to reduce cost without cutting anyone's benefits which makes it a hell of a lot better than Honest Paul's plan, which cut costs by cutting everyone's benefits.
- GSpinks
April 6, 2011 at 12:21pm
...in 10 years. LOL
- GSpinks
April 6, 2011 at 12:22pm
Maybe his former colleagues can explain why Weisberg would pen such an insipid commentary about the Ryan proposal. My view, not so much about Weisberg but the commentariat class generally, is that (1) they aren't nearly as smart as we assume, (2) they are attempting to be clever, the MK contrarian way, or (3) they understand that getting that high paid commentary job that they seek comes with a catch, they have to play stupid in order to appeal to a broad and uninformed audience. An example of someone who fits into all three (or at least (1) and (3)) is David Gregory, who, on a Sunday gabfest not long after the invasion of Iraq and before it became the fiasco it would become, said that GWB is one of the great presidents, up there with Washington, Lincoln, FDR. Of course, Gregory now sits atop NBC News, much admired as an informed, and informing, journalist. I suspect that Weisberg is a quick learner.
- rayward
April 6, 2011 at 12:33pm
Blackton - Let the Bush tax cuts expire. Problem solved.
- IggyPop
April 6, 2011 at 12:49pm
butchie, I"m at least heartened that Ryan put more thought into his (terrible) budget proposal than most Republicans do. Usually it's just "cut taxes for the rich!" At least Ryan festooned his "cut taxes for the rich!" with some other stuff.
- W_Bombay
April 6, 2011 at 1:09pm
The real killer here is what a huge mistake Obama made by accepting the extension of the Bush tax cuts. It would have been a political and policy winner - he could have said: "These billionaires don't spend very much of this extra money that was supposed to help the economy. Instead, it just piles up, which hurts the economy. The effect of returning the rates to what they were prior to the Bush cuts would not hurt the rich (they wouldn't even notice it), would help the economy (because it would put more money into the hands of people who would actually spend it), and would reduce the deficit, which the Republicans claim to care about." It would have been so simple to do that. Instead, we get - what? An appeal to bipartisanship? No actual people care about that - only Cokie Roberts.
- dlatto
April 6, 2011 at 1:15pm
There are not a lot of convincing deficit and entitlement hawks on the port side, GS. And, as for the putative cost savings of the ACA, the medical expert Arnold Relman thinks that they will not likely materialize. He wrote eloquently about this a few months ago in The New York Review of Books. I defer more to him than I do to J. Chait because this is his field. These projected savings are an article of faith out here, but I dissent. Bowles-Simpson doesn't appeal to me, b. But we definitely need to confect some sort of plan to deal with (first) Medicare, and then Social Security. This can be done without gutting these programs, pace Paul Ryan. Being a conservative these days means you simply support bad policy because of your ideology, no payment needed, nush.
- liberalref
April 6, 2011 at 1:20pm
Janus has us 90% of the way there. Add some stiff energy taxes and a reduction in payroll taxes to offset the burden on wage earners, an increase in the uppermost bracket rate toward 50% and we are there. Problem solved, forever. Social security is by itself a minor issue, solved by means testing benefits. Case closed. Medical costs are the main problem, a problem for the economy whether we are paying them out of pocket, with insurance premiums, or with taxes. The problem is one of "real" cost, not the stream of payment. If we do not control consumption and price by willingness and ability to pay, as we cannot while providing people with medical care regardless of means, then the only other possibility for controlling consumption and price is government. There does not exist a third way, no clever manipulation of the insurance system that will do. With the government as a monopsonist, we can achieve the same outcome for health care as other industrial economies. The French spend 11% of GDP (and a smaller GDP per capita) and achieve medical outcomes as good or better than ours. We are headed to 20%. It is the real cost of medical care in the US that is unsustainable, not the system of government financing. If we have a manageable cost and sufficient GDP, we can extract the money to pay for it with a properly designed tax system. If the costs are not manageable, as they are not now, then no financial manipulation can solve the problem, including making everyone pay for their own care or insurance. The inevitable consequence of that is simply many people without adequate medical care. Income taxes are not even paying for the cost of government without entitlements. Tax rates must go up. The place to start is by ridding us of the Bush tax cuts, the primary reason we are in this rut. Pre-Bush, surpluses, post-Bush, deficits. How much more obvious a cause and effect do we need than that? They should have been allowed to expire last year, but, failing that, right after the 2012 election will do.
- roidubouloi
April 6, 2011 at 1:54pm
The problem with Bowles-Simpson is that a compromise would be cuts in benefits in exchange for increases in taxes, especially for the rich. Bowles-Simpson, like Ryan, is cuts in benefits (all unnamed) in exchange for even more tax cuts for the wealthy. Basically, the Ryan plan IS Bowles-Simpson with the specifics of benefit cuts made explicit.
- roidubouloi
April 6, 2011 at 1:55pm
Roi and Janus get my votes. Spot on folks.
- jet
April 6, 2011 at 2:26pm
The Enlightenment rationalist pronounces from Mount Olympus yet again. Actually, means testing benefits and lifting the cap on payroll taxes would do it. But where is the constituency for that? The armchair political warriors have it easy; it is the Barack Obamas who have to figure how how to build the political bases to bring policies x, y and z about.
- liberalref
April 6, 2011 at 2:51pm
LibRef, if people are unwilling to implement even the simplest of cost savings reforms, that is a failure of the people not the PPACA.
- GSpinks
April 6, 2011 at 2:59pm
ramcat: "As Ezra Klein and others have noted, Ryan's plan repeals the cost controls in the ACA (along with everything else), which Republicans campaigned against in 2010, but then goes on to assume that the cost controls actually stick!" Of course they will stick. Once we free up the benefits to compete in the free market, people will all act rationally and will inevitably drive down costs, just as it has on the individual market over the years....oh, wait....well, at least it will reduce administrative costs compared to the inefficient government system...oh wait.... The inability of evidence to overcome ideology for some of these people continues to astound me, even though it happens so often now that I should no longer be surprised.
- dsimon
April 6, 2011 at 3:51pm
This issue is way more complex than you make it out to be, GS.
- liberalref
April 6, 2011 at 7:14pm