Paul Ryan's Medicare Plan: A Sweet Deal For Seniors?


Kevin Drum, echoing David Leonhardt of The New York Times, notes that Republican Rep. Paul Ryan's Medicare reform plan, which would shift the seniors health insurance program to a premium support system, excludes both current seniors and anyone who is less than ten years away from entering the program. If shared sacrifice is what's necessary, Drum wonders, why aren't seniors included?

This is a point that few people ever make explicitly: today's retirees aren't merely getting benefits that they've paid for their entire lives. They're drawing way, way more from Medicare than they ever put into it…If it's really true that everyone needs to sacrifice, then why should current retirees, who are getting such a sweet deal from the rest of us, be excluded from the pain?

This next song goes out to Paul Ryan.

Good point! Or it would be if Drum weren't being willfully naive about the politics of Medicare reform. The plan doesn't touch seniors' benefits because it would almost certainly make the already difficult job of selling Ryan's overhaul plan totally impossible. Think of this way: Would expanding the reforms to sweep in current beneficiaries actually increase support for the plan? I doubt it. It's safe to say that Drum and Leonhardt wouldn't suddenly sign on. Neither, I am fairly certain, would anyone else who isn't already on board. Changing benefits for seniors already enrolled in the plan would only lead to decreased public support.

As a smart political commentator like Drum has to know, there's a huge amount of built-in political resistance to any attempt to restructure an entitlement benefit. Any politician who wants to overhaul Medicare—and wants his or her plan to have even the slightest chance of actually passing—has little choice but to offer a proposal that makes changes over time, giving potential future enrollees a chance to plan accordingly. So even the slow-moving changes Ryan's Medicare plan calls for are bound to be an extremely tough sell. Why make it tougher? The trick for someone like Ryan, who has been pushing entitlement overhauls for years and is clearly hoping to create legislation that just might actually pass some day, is to design significant long-term reforms that don't unnecessarily poison public support.

Still, I'm glad to see that Drum and Leonhardt have noticed that Ryan's Medicare plan doesn't touch benefits for seniors or anyone set to enroll during the next decade, and I'll look forward to both of them explaining that fact to the Democrats now warning that the Ryan plan balances the budget "on the backs of seniors" and is akin to "war on the elderly." It's really not. As Drum helpfully reminds us, under Ryan's proposal, current retirees get a comparatively "sweet deal."