Remember when Paul Ryan voted against earmark reform?

It's all too funny watching Paul Ryan pose as a tribune of fiscal rectitude. It's not just because he voted for Bush's budgets, it's not just because he voted for the deficit-financed Medicare drug benefit.

It's also because, just three short years ago, Paul Ryan voted against earmark reform and responsible budgeting:

Most Republicans supported the curbs on earmarks but opposed the other key piece of the package: restoring a "pay-as-you-go" rule requiring that any new tax cuts or entitlement programs not add to the deficit. That means such measures would have to be "paid for" by raising revenue or cutting spending elsewhere in the budget.

"This will have the back-door effect of simply raising taxes," said Janesville Rep. Paul Ryan, now the top Republican on the House Budget Committee.

Ryan argued that the pay-as-you-go provision wasn't tough enough on spending (it applies only to new entitlement programs, not discretionary programs such as education and defense), and that it shouldn't apply at all to tax cuts.

"We don't have a tax revenue problem in Washington, we have a spending problem in Washington," Ryan said.

Paul Ryan has no problem with voucherizing Medicare and turning it into a program that doesn't keep up with rising health care costs. He has no problem with balancing the budget on the backs of poor seniors. But sunsetting the Bush tax cuts is a matter of grave concern.

Cross-posted at Brew City Brawler.

Paul Ryan wants to shift risk -- to you

When Paul Ryan talks about empowering individuals and individual choice, reach for your wallets.

Mother Jones lays it out:

The biggest problem with Ryan's plan is that it doesn't actually control health care costs. It simply shifts the burden of paying for them from the public sector to individuals. Instead of the government going bankrupt trying to pay for medical care, it'll be individuals. That's all well and good for the rich, who might be able to pay for their own health care. But people who would have relied on Medicare are going to be out of luck. Medical costs wil rise much faster than the value of the voucher will. Ryan's plan seems to pretend that the problem isn't medical costs—it's just that the government is trying to pay for them. James Kwak is good on this:

The implicit premise [of Ryan's plan] is that we have to screw ordinary people–or at least make them bear a high degree of risk–in order to save the government budget. But what is the government budget? It’s a pile of money that we contribute and that our representatives are supposed to spend on things we can’t buy for ourselves individually. I know that those representatives make mistakes, are borderline corrupt, etc. But Medicare is exactly the kind of program that we want government to provide–a program that shifts risk from individuals to the government, and thereby the country as a whole–and that’s why it’s so popular.

Other countries manage to keep their citizens healthy at a much lower cost than we do. They don't have to dismantle their social insurance programs to do it. Why should we?

Matthew Continetti is sad that Dems are being mean to Paul Ryan

Matthew Continetti writes for the Weekly Reader:

Key fact: Ryan's plan preserves the current entitlement system for everyone over the age of 55. The rest of us will see dramatic changes in the structure of Social Security, Medicare, Medicaid, and the tax code--changes the CBO says will solve the long-term budget problem, in ways that increase individual choice and limit government's scope. If nothing is done, America faces high interest rates, inflation, and economy-crushing tax rates. Is this the future Democrats prefer? After all, they have provided no alternative way to achieve the Roadmap's outcomes.

Key fact: Paul Ryan balances the budget on the backs of poor seniors. Then again, it's questionable whether Paul Ryan balances the budget at all given some of the assumptions in his Road Map to Ruin.

George Will hearts Paul Ryan

He focuses on the most important thing in Paul Ryan's Road Map to Perdition: Tax cuts!

Ryan would eliminate taxes on interest, capital gains, dividends and death. The corporate income tax, the world's second-highest, would be replaced by an 8.5 percent business consumption tax. Because this would be about half the average tax burden that other nations place on corporations, U.S. companies would instantly become more competitive -- and more able and eager to hire.

Medicare and Social Security would be preserved for those currently receiving benefits or becoming eligible in the next 10 years (those 55 and older today). Both programs would be made permanently solvent.

Will, however, fails to note how Paul Ryan will balance the budget on the backs of poor seniors.

Paul Ryan's plan is all pain, little gain

Jed Lewison:

Although Republicans have not formally embraced Ryan's plan, Ryan is the top House Republican on budget issues and is a rising star in the GOP. Nonetheless, the radical plan -- which effectively calls for the privatization of Social Security and Medicare -- seems to be exactly what the GOP's teabagging base is demanding.

The funny thing is that even though the plan endorses far-right ideas like privatization, it wouldn't bring the budget into balance until 2050 and it wouldn't put the budget on a sustainable path until 2080. In other words, it's almost all pain...and very little gain.

Paul Ryan's choice

Matthew Yglesias revisits Paul Ryan, following write ups by two conservatives (including Ross Douthat):

In essence, there’s a choice facing the country. We can maintain something like the tax rates that have prevailed for the past 40 years, which is what Ryan does, or else we can maintain something like the policy status quo that’s prevailed for the past 40 years, which is what Ryan doesn’t do. I think it’s pretty much inevitable that the future will involve some “give” on both points—higher taxes and changes to Medicare, in other words. What you mostly hear from the right, though, is the idea that we can make taxes lower and basically leave the country in the same place if we just cut down on earmarks. Ryan’s proposal inches toward conceding that that’s not the case, that the only way to keep taxes low is to radically revise not just the nature of Medicare as a program but the underlying principle that there’s a responsibility to ensure that seniors’ medical needs are taken care of in a comprehensive way.

Paul Ryan as foil

Following Digby, the Sconz discusses Obama's use of Paul Ryan as foil:

The perception that Obama’s health care plan would covertly starve Medicare to pay for increased Medicaid etc. is one of the most important barriers that Democrats need to address in order to win the health care debate. By so generously giving the floor to a Republican who is overtly anti-Medicare (relatively speaking), Obama can remind voters that it is in fact Democrats who wish to protect the elderly.

Paul Ryan's plan to "balance the budget on the back of poor seniors"

The Economist's "Democracy in America" blog weighs in on Paul Ryan's Road Map to Ruin. If you're 54 or older right now -- the teabagger demo -- good for you. "You get caviar, and everybody younger than you has to pay for it." But if you're not in that demo -- and particularly poor -- the freedom Paul Ryan's plan giving you will make life harder -- and shorter.

So Mr Ryan wants to give 65-year-olds a $7,900 voucher to buy insurance that will, under optimistic assumptions, cost $10,800. What every senior citizen currently gets for free, under Medicare, will instead cost them an extra $2,900 a year, if they have it. For most, that will mean giving up benefits and getting less medical care, or going without insurance entirely. And every year, by design, Mr Ryan's proposal will widen the gap between the voucher and the cost of medical care by 0.7%, even after accounting for the effect his proposal will have on holding down medical costs. Every year, seniors will get worse and worse care. This is what the CBO means when it says:

Under the Roadmap, the value of the voucher would be less than expected Medicare spending per enrollee in 2021, when the voucher program would begin. In addition, Medicare’s current payment rates for providers are lower than those paid by commercial insurers, and the program’s administrative costs are lower than those for individually purchased insurance. Beneficiaries would therefore face higher premiums in the private market for a package of benefits similar to that currently provided by Medicare. Moreover, the value of the voucher would grow significantly more slowly than CBO expects that Medicare spending per enrollee would grow under current law. Beneficiaries would therefore be likely to purchase less comprehensive health plans or plans more heavily managed than traditional Medicare, resulting in some combination of less use of health care services and less use of technologically advanced treatments than under current law. Beneficiaries would also bear the financial risk for the cost of buying insurance policies or the cost of obtaining health care services beyond what would be covered by their insurance.

There are two other really interesting things about Mr Ryan's proposal. First of all, if you hit 65 before 2021, you still get Medicare, with all of its current perks. You're grandfathered in. So if you're 54 or over right now, his bill is a great deal for you: you get caviar, and everybody younger than you has to pay for it. Second, Mr Ryan's proposal necessarily sets a flat nationwide amount for each voucher. Medicare, on the other hand, pays variable reimbursement rates in different parts of the country, based on the fact that medical costs can vary by two times or more between, say, Nassau, New Hampshire and Lincoln, Nebraska. According to the Commonwealth Fund, the average individual premium in Nebraska in 2008 cost $4,392; in New Hampshire, it was $5,247. So if you live in Nebraska, under Mr Ryan's plan, you luck out. If you live in New Hampshire, not so much. One could imagine an interesting conversation between Ben Nelson and Judd Gregg regarding Mr Ryan's Roadmap, if there were ever any chance of it actually being voted on.

Mr Ryan has put forward a serious proposal for shrinking medical-cost inflation and hence shrinking the long-term federal budget deficit. It does so by ending America's provision of first-rate health care to all seniors. Rich seniors will still be able to afford high-quality medical care. Poor seniors won't. They will suffer more and die younger. A different approach to solving America's health-care cost problem might involve letting Medicare use its vast bargaining power to negotiate lower rates with the providers of pharmaceuticals; establishing a commission of experts (MedPAC) to rate the effectiveness of medical procedures, to avoid wasteful incentives in the current fee-for-services medical model; and establishing bundled payments for disease management, to achieve Mayo-Clinic-like efficiencies in care while improving quality. Those are the models proposed in the Democratic bills currently in Congress. But they're really complicated and hard to understand—they make for a bill that's 2,000 pages long. And everybody knows the American people hate that. Mr Ryan proposes to simply slash Medicare spending and balance the budget on the backs of poor seniors. That'll work too.

Paul Ryan "might as well just claim gremlins will devour the deficit"

No. 1 Oshkosh blogger The Chief lays out what's wrong with Paul Ryan:

I have the same problem with this year's edition of the Ryan budget that I did with last year's: he takes as givens policies that would require legislative miracles in order to become law. Privatize Medicare? That's the GOP equivalent of creating a single-payer health care system. Same thing with privatizing Social Security accounts. Ryan may as well just claim that Gremlins will devour the deficit.

The big news is that the math potentially works. If that's true, then I've been wrong about criticizing Ryan for relying on the retread GOP think tank ideas with out assembling them in a coherent order that can produce results. The big problem still remains, however, that much of Ryan's budget is still composed of retread GOP think tank ideas that are extremely controversial and don't just materialize with the wave of a wand.