Ten Years?: Ryan proposes the political coward's timing for his proposal. End Medicare in ten years. If a Republican President is elected in 2012, even if he serves two full terms he'll be out of office by the time the plan hits the fan. For that matter, no matter who succeeds President Obama, the next President will either be out of office or into his second term before the plan takes effect.
Grandfathering Grandparents?: Privatizing Medicare is supposedly an opportunity for the private insurance market to shine. Never mind the history that tells us that private insurers require subsidies in order to compete with Medicare. If Ryan believes this plan will do anything but slash coverage and benefits, why does he grandfather into the system anybody who qualifies for Medicare before 2022? Why not let them enjoy the benefit of the "free market" along with the rest of us?
Procrastination: For that matter, if the cure to the problem comes from the (not particularly) free market for health insurance, why wait ten years? Why not propose that this plan take effect immediately? It's not as if private health insurance companies have no foundation for offering insurance to seniors - they have their experience with the (heavily subsidized) Medicare Advantage program to draw from.
Lots of Time for a Full Retreat: Ryan leaves the door wide open for a full retreat by the Republican Party if his "reform" proves unworkable - and insulates two, and quite possibly three Presidents from having to take responsibility for that retreat. So again, why not put the nation's money where his mouth is?
What About Inflation?: Although it would be a good thing to find ways to make the provision of health care less expensive, the crisis in the making comes from healthcare inflation. Ryan's plan does nothing to influence inflation and, in fact, could worsen inflation by diminishing economies of scale in the healthcare market.
E.J. Dionne gives Ryan a certain benefit of the doubt,
But while I am assailing his ideas, let me put in a good word about Ryan himself: He is, from my limited experience, a charming man who truly believes what he believes. I salute him for laying out the actual conservative agenda. Here’s hoping he is transparent in the coming weeks about whom he is taking benefits from and toward whom he wants to be more generous. If he thinks we need an even more unequal society to prosper in the future, may he have the courage to say so.I have no reason to doubt Ryan's charm, although I don't think we need to wait and see if he'll have the courage to admit his actual agenda. I'll be pleasantly surprised if he proves himself to be honest, and willing to absorb the consequent political price, but... it won't happen. A word from Paul Krugman:
Oh, and for all those older Americans who voted GOP last year because those nasty Democrats were going to cut Medicare, I have just one word: suckers!The same goes, I think, for anybody who believes that the GOP is sincere about this budget plan - at least in the sense that they won't flee from Ryan's ideas like proverbial rats from a sinking ship if these reforms threaten their chances in future elections.
Update: Michael Grunwald at Swampland takes a look at Paul Ryan's cowardice:
So by all means, let's have an adult conversation about deficits. A good place to start would be the origins of our current predicament. President Clinton left behind a huge budget surplus. As Joe pointed out, it was wiped out by President Bush's tax cuts, the wars in Iraq and Afghanistan and the Medicare Part D prescription drug benefit.Grunwald also reminds us that the Republicans misrepresented and savaged every cost-saving mechanism proposed for or included in the Affordable Care Act, and yet pundits who gush over Ryan never got around to describing the President's or his party's advancement of those policies as "courage".
All of those budget-busters went on the national credit card. And all of them were supported, no doubt courageously, by Congressman Ryan.