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Ryan Would End Medicare and Medicaid: Where’s Noem?

Remember last year when Kristi Noem said she thought privatizing Medicare, Medicaid, and Social Security were a good place to start with cutting the federal budget? Remember when she denied she ever said any such thing once pressed on the issue during the general election?

The South Dakota Congresswoman is about to face more hard questions on that very issue. The man on whose budget she so crassly flip-flopped, Rep. Paul Ryan of Wisconsin, is proposing eliminating Medicare and Medicaid as we know them. Ryan's bold proposal would cut $5 trillion from the federal budget... and likely shift every penny of that cost to individuals.

The Ryan plan deviously dodges some political opposition by leaving Medicare in place for everyone currently 55 or older. The rest of us will keep paying for Medicare benefits for our parents and grandparents, which is fine by me. But when we young'uns get ready to retire, the Ryan plan won't give us Medicare. It will privatize our coverage, handing us a subsidy and turning us loose to fend for ourselves on the individual insurance market.

Ryan ignores the fact that Medicare uses healthcare dollars more efficiently and provides better health care access than any private insurer. Ryan waves the magic wand and says competition for those senior dollars will drive prices down and save everyone money. Um, Rep. Ryan? Private insurance premiums have outpaced Medicare. We're talking about old people, the biggest consumers of health services, the least attractive customers a health insurer can imagine. If you think competition will work in that market, you're seriously out of touch. Heck, I'm a young and healthy customer in the individual insurance market, and all that great competition hasn't stopped my premiums from jumping 23% two years in a row.

Sure, Medicare faces a serious fiscal challenge as we have a smaller workforce paying for a larger retirement population. But Ryan's privatization plan shifts costs to senior citizens with less earning power. The likely outcome: my wife and I and everyone younger than we will never retire. We will work until we die, as our savings will never keep up with health insurance premiums, which will rise even faster for older consumers. The only silver lining: we may not have to work as long as we fear, since lots of us won't be able to afford elderly insurance, and we'll just die sooner.

Ryan at least isn't privatizing Medicaid. he's just shifting to states the cost and risk of insuring poor folks. That's not really balancing the budget; that's just the Olson-Daugaard trick of dumping responsibility for social programs on someone else.

So we all had better start working third jobs, adding on spare bedrooms for Grandma and Grandpa and poor cousin Louie, and whipping up mustard poultices: under the Ryan plan, health care is going to be do-it-yourself.

The big question: what does Kristi Noem think? (I know, some of you see a bigger question if we remove the what from that line.) Is the Ryan plan the kind of specific budget cut she'll say she supports? Or will she continue to speak in vague slogans and never lead a conversation about real budget priorities?

How about I save Rep. Noem and her beleaguered staff some trouble and write her answer right now: at some point in the next few weeks, after several dodgy answers and gentle encomia about high school sports and Kassidy's prom dress, our Congresswoman will say something folksy about herself and Bryon sitting down at the kitchen table to balance their checkbook. She'll babble a little about self-reliance (it sounds good when Dennis says it) and free-market competition... and then she'll vote for the Ryan plan to end Medicare and Medicaid. Grandma and Grandpa, you're safe. The rest of us—screwed.

Related: Rep. Noem's latest Facebook update: "The House GOP is holding the line on spending. We need real cuts, no gimmicks." I ask "real cuts like...?" No response.

Related: The good Dr. Blanchard has been persuaded that the health care mandate is unconstitutional. Could he beat back our mandated payments into Medicare on the same grounds?

Update 10:46 CST: Rep. Noem's first quasi-response, from her Facebook page: "You don't have to agree with every detail to acknowledge Rep. Paul Ryan is the only leader in Washington, DC who has laid out a realistic budget plan." Kristi says everything and says nothing.


Rep. Kristi Noem Calls Rep. Paul Ryan's Medicare-Killing Budget Plan "Realistic"
...because we all know how realistic Republicans think it is to throw Grandma under the bus. Screen cap, Facebook, 2011.04.05, 10:45 CDT


  1. Eve Fisher 2011.04.05

    My husband and I have been paying almost $1,000 a month for health insurance for over ten years - that's $12,000 a year, folks. That's a lot of money. Medicare is a heck of a lot cheaper, even including Medigap insurance. So don't tell me that private insurance is cheaper - it isn't.

  2. Tim Higgins 2011.04.05

    Never mind the 500 Billion Obama care cuts from Medicare

  3. caheidelberger Post author | 2011.04.05

    Tim, the cuts to which you refer are reductions in growth. Spending still increases annually. And they certainly aren't the dismantling of a wildly successful program Ryan is proposing with his Rube-Goldberg vouchered private system.

  4. Wayne B. 2011.04.05

    "That’s not really balancing the budget; that’s just the Olson-Daugaard trick of dumping responsibility for social programs on someone else."

    Cory, these aren't exclusionary activities. If I stop paying for my kid's college tuition to balance my budget, I ~have~ balanced my budget. I've also stopped supporting my child's education. Is that the right thing to do? Hard to say.

    Here's the deontological vs teleological debate - if we value a balanced budget, do we care only about the end, or the means (or both)?

    Seems no matter how you slice it, Baby Boomers and what's left of the Greatest Generation are going to slide by, passing an uncomprehensible debt to you, me, and our children.

    Rep. Ryan's plan wouldn't be so terrible if insurance premiums weren't skyrocketing (where the heck can I invest in futures of insurance premiums? That should be my 401(k) plan...). Fix the system, and you fix a lot of problems.

  5. mike 2011.04.05

    What I respect about Paul Ryan is that he wants to have a debate and a conversation. I think that shows courage and I respect that. Maybe we agree or don't but at least we can see what he wants to do...

    Ryan is likely to get thrown under the wagon by the GOP if he pushes too hard but at least he isn't just concerned about getting reelected in 2012. They guy has ideas and brings them to the table.

    Give me a liberal or a conservative with bold ideas any day rather than someone who waits to hear what plays best during an election.

  6. caheidelberger Post author | 2011.04.05

    Mike, I will agree with you there. I heard Ryan on Charlie Rose one night. he's willing to ptu the big idea on the table and take lumps for it. Meanwhile, our own Rep. goes mincing around the edges, waiting for her cue from the leadership.

  7. mike 2011.04.05

    I agree Cory. Frustrating that she sold herself as a take no prisoners congressional candidate and is actually more timid than Thune this year. (from her sales pitch I thought Kristi was Wild Bill Janklow in female form - turns out she is afraid to bite the hand that feeds her)

    We can't have "adult conversations" without specifics.

    Now Paul Ryan would have made the Mitchell interview exciting!

  8. Ken Blanchard 2011.04.05

    Cory: I love your "Sure, Medicare faces a serious fiscal challenge...". Sure, the Titanic faced a serious aquatic challenge... Medicare is out of control. That program, Social Security and interest on the Federal Debt, will soon begin to crowd out all other Federal Spending. Like the sinking of the Titanic, this is a mathematical certainty. You are obsessed with what Noem thinks. I would like to know what Obama thinks. He has certainly offered no solutions. The Democrats in Congress couldn't even pass a budget for this year.

    If you really want to save Medicare, you might want to come up with some solutions. So far Ryan is the only one who has had the courage to do so. We know what happens next. Democrats will attack him for destroying Medicare and Social Security without bothering to offer any solutions of their own.

  9. caheidelberger Post author | 2011.04.05

    You bet, Ken: Obama should cowboy up and put single-payer back on the table. Medicare for Everybody is a nobler and more efficient system than health care rationed to those who can afford it. Bring on that debate: Paul Ryan's radical proposal versus Dennis Kucinich's radical proposal... which is providing better, cheaper healthcare in most other industrialized nations.

  10. Ken Blanchard 2011.04.06

    Maybe Obama should put single payer back on the table. That, I gather, is your sole interest in the issue. But he ain't gonna, is he? The Democrats in Congress ain't gonna, are they?

    I am not sure that a single payer plan wouldn't be a lot more rational than ObamaCare, but given the fiscal realities that would require that a lot of Americans will have to do with less. Are you ready to announce that? While you are worried about what Kristi Nome thinks, what about Senator Johnson? Is he speaking truth to power (=the people)?

  11. caheidelberger Post author | 2011.04.06

    No, Ken, I'm ready to argue to Americans, as I have previously, that they would save money under a single-payer system. They would pay more to Uncle Sam, but they would no longer be saddled with the cost of private insurance with its higher overhead. Hospitals would also save money from the simplified claims/payment system, dealing with one agency rather than dozens of separate private companies. Even if we spent the same percentage of our GDP on health care, we'd spend it more efficiently and get more service for the dollar. President Obama and the Dems may not have the courage to wage that argument, but Ryan's radical proposal offers them the best opportunity yet to do so. When the old folks revolt over Ryan's plan, it will be the perfect time to say, "Hey, Medicare is this important for old folks, why not adopt the same moral and fiscal imperative for all Americans?"

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