On Friday, for some reason the custodians of the Washington Post’s op-ed page decided to let Paul Ryan write the following in their paper:
Unfortunately, but not surprisingly, the Democrats’ political machine has attacked my contribution to this debate, making the false claim that the only solution put forward to save Medicare would “end Medicare as we know it.”
As Ezra Klein, previously a defender of Ryan’s integrity, observes people are accusing him of wanting to end Medicare as we know it because his plan would end Medicare as we know it. The existing single-payer system would be scrapped. In its place would be a system of means-tested vouchers to buy private insurance whose value would grow more slowly than the cost of health care. Basically Ryan’s idea is that old people should get medical care if they’re rich, and not otherwise. Meanwhile, since the non-rich won’t be utilizing health care services as many health care services, per unit treatment costs for should decline. This is a pretty standard view of how things ought to work—people should get stuff if they’re rich enough to pay for it, and not otherwise. And it’s Ryan’s view of how health care should be apportioned among the elderly. But for a guy who’s being widely praised for his honesty and willingness to face up to tough choices, he’s incredibly reluctant to describe his plan with any clarity.