After cutting taxes, Republicans will begin to wail about the deficits that their tax cuts created. Americans can expect Paul Ryan and others to talk about slashing ‘entitlements’ in order to lower this tax cut derived deficit. They will expect sacrifice from working Americans in order lavish government largess on the already wealthy. In essence, Republicans are creating the very problem that they always wanted to have.
Ryan laid out these plans the other day in a remarkable interview with Denver radio host Ross Kaminsky, a conservative and apparently a long-term Ryan supporter. During the companionable 10-minute chat, Ryan identified Medicare and Medicaid as the drivers of “the debt and the deficit.”
Ryan acknowledged that chipping away at Social Security would be difficult with only 52 Republicans in the Senate but appeared more enthusiastic about Medicare and Medicaid reform.
Ryan reminded Kaminsky that “the House passed our entitlement reform bill in May… the biggest entitlement reform bill ever passed by Congress.” He’s referring to the House GOP’s Obamacare repeal bill, which would have killed Medicaid expansion under the Affordable Care Act and slashed $800 billion from traditional Medicaid over 10 years by converting it to a block-grant program. Block granting, as we’ve reported in the past, is merely a tool for cutting benefits, with the carnage increasing over time.
“So we’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit,” Ryan said. He told Kaminsky that Medicare reform “has been my big thing for many, many years, because it’s the biggest entitlement. It’s gotta be reformed.”
Whether he realizes it or not, Ryan's attempt to sell government-run healthcare as the problem and that patients will make wiser decisions if they're footing more of the bill is misguided thinking at best.
Ryan just wants to cut costs, but his prescriptions, such as they are, won’t do that. Medicare and Medicaid can’t actually be “reformed” from within; they’re both prisoners of overall healthcare costs. That’s what needs to be reformed — how we pay doctors and hospitals, how we judge the value of medical outcomes, and how much we allow drug companies to charge patients for their products.