Today, Rep. Paul Ryan (R-WI), the ranking members on the Budget Committee, is re-releasing his ‘Roadmap For America’s Future’, a Republican guide to “tackle our nation’s most pressing domestic challenges — updated to reflect the dramatic decline in our economic and fiscal condition.” The document closely resembles the GOP’s April Fools budget or a McCain-Palin 2008 press release. It relies on the traditional partisan prescription of tax credits, spending cuts and privatization of public services.
The Roadmap’s health care plan “provides a refundable tax credit — $2,300 for individuals and $5,700 for families — to purchase coverage” and establishes “state-based high risk pools will make affordable care available to those with pre-existing conditions.” Rather than strengthening the existing Medicare program, Ryan moves “those under 55” into a private “Medicare certified plan” outside of the current Medicare system.
The plan ensures universal access to affordable health insurance by restructuring the tax code, allowing all Americans to secure an affordable health plan that best suits their needs, and shifting the control and ownership of health coverage away from the government and employers to individuals.
It’s what Jacob Hacker calls The Great Risk Shift. Republicans are slowly dismantling the New-Deal era institutions that spread economic risks “across rich, and poor, healthy and sick, able-bodied and disabled, young and old” and shifting all of the economic costs and risks onto individuals (or as Ryan calls it, freeing Americans from the “relentless expansion of government and a new culture of dependence”).
In the wake of the Great Depression, “political and business leaders put in place new institutions designed to spread broadly the burden of key economic risks, including the risk of poverty in retirement, the risk of unemployment and disability.” “These public and private institutions did not let the individuals off the hook they required contributions and work and proof of eligibility” and they provided all Americans with a guarantee that if they paid into the system, they would later benefit from it.
But under Ryan’s alternative, the economic costs and risks of insurance are spread across a party of one — the individual. If that individual falls sick or a family loses its breadwinner, she is only empowered to lose. As Hacker explains, “The next frontier in the Great Risk Shift is the transformation of existing programs — Medicare and Social Security chief among them — from guaranteed benefits defined by law to individualized private accounts that leave workers and families shouldering more and more of the risks that these programs once covered.”
This Republicans message about personal responsibility and individual liberty resonates with the American experience and forms a powerful and convincing political narrative. But rather than creating “a nirvana of empowered owner” as Republicans would like, the Great Risk Shift leaves many Americans to face economic risks and insecurities on their own.