The Republican plan to ‘essentially end Medicare’

THE REPUBLICAN PLAN TO ‘ESSENTIALLY END MEDICARE’…. It seems like quite a while ago, but just last fall, Republicans blanketed the airwaves with campaign ads, attacking Democrats for “cutting Medicare.” The criticisms were substantively ridiculous, but offensive took its toll and contributed to the GOP takeover of the House.

Six months later, those same House Republicans have an ambitious new plan to effectively destroy the entire Medicare system. Sorry, voters, you fell for a con.

Republicans will present this week a 2012 budget proposal that would cut more than $4 trillion from federal spending projected over the next decade and transform the Medicare health program for the elderly, a move that will dramatically reshape the budget debate in Washington.

The budget has been prepared by Rep. Paul Ryan, a Wisconsin Republican and the new chairman of the House Budget Committee, and it represents the most complete attempt so far by Republicans to make good on their promises during the 2010 midterm elections to cut government spending and deficits. […]

The plan would essentially end Medicare, which now pays most of the health-care bills for 48 million elderly and disabled Americans, as a program that directly pays those bills.

After “essentially ending Medicare,” Republicans intend to replace it with a privatized system. It’s exactly the idea Paul Ryan has promised to pursue for quite a while — and precisely why GOP candidates were so reluctant to endorse the radical “roadmap” plan before the election.

As part of the sales pitch, the House GOP will assure today’s seniors that they will continue to enjoy their popular system of socialized, single-payer health care. As Matt Yglesias put it, Republicans will then tell younger workers that they’ll “get to pay the high taxes to finance old people’s generous single-payer health care system, but then we won’t get to benefit from it.”

Paul Ryan told Fox News yesterday that his radical plan is necessary to find cost savings, but even that’s wrong. Paul Krugman explained this morning, “Privatizing and voucherizing Medicare does nothing whatsoever to control costs…. I’m sure that the Republicans will claim savings — but those savings will come entirely from limiting the vouchers to below the rate of rise in health care costs; in effect, they will come from denying medical care to those who can’t afford to top up their premiums.”

And in terms of implementation of such a plan, the Center on Budget and Policy Priorities’ Paul Van de Water explained that, if adopted, this privatization scheme would mean “Medicare beneficiaries would no longer have access to a guaranteed set of health benefits but would instead receive a voucher to be used to purchase private health insurance. Similarly, the federal government would no longer pay a specified share of states’ Medicaid costs but would pay each state only a fixed amount, or block grant. The amount of the Medicare voucher and the Medicaid block grant would grow less rapidly than costs and hence would become increasingly inadequate over time.”

In other words, seniors would get a voucher, but its value wouldn’t keep up with costs. This would save the government money, but screw over those in need of care.

Again, I realize Republicans and the far-right believe there’s a strong public appetite for extremist moves like this one, but there isn’t. The party knows this at a certain level — it’s why they won in 2010, railing against Medicare cuts — but has decided to swing for the right-wing fence anyway.

The politics of this are likely to be fascinating, setting up a critical showdown. Democrats were up to the task in 2005, when conservative ideologues tried to privatize Social Security, and must be similarly prepared in 2011.