(Recent) History Repeats Itself


Kevin Drum notes "if it walks like voucher, talks like a voucher, and quacks like a voucher, then it's a voucher."

That should be obvious but when asked about it during his press conference on Tuesday, House Budget Committee chairman Paul Ryan responded, incredibly (but not surprisingly), "this is a different proposal."

Oh, sure it is. The plan would not harm people currently on Medicare or nearing retirement age, most of them being aware of how well Medicare works and how necessary it is to keep them alive. But individuals who turn 65 years of age in 2021 or thereafter would receive money to purchase health insurance on their own. Princeton University economist Uwe Reinhardt explains

Under the Rivlin-Ryan Plan, as it has come to be known, Medicare would be changed from the defined-benefit plan it has been since its inception to a defined contribution plan.

Under the defined-benefit plan, the government promised to procure specified medical goods and services for Medicare beneficiaries, as medical necessities assessed by the beneficiary’s physician. That puts the risk of escalating costs for that health care mainly onto the shoulders of taxpayers, although Medicare beneficiaries share in these costs through premiums for Part B of Medicare (chiefly physician services) and co-payments at the time of service.

Under the defined contribution approach envisaged by the Rivlin-Ryan plan, most of the risk of future health-care cost increases would be shifted onto the shoulders of Medicare beneficiaries. This feature makes the proposal radical.

"Radical" or not (and it is), this is a classic voucher scheme. But where have we seen such message manipulatization in service of privatization before? A year ago, when as then-ranking Republican on the Budget Committee Paui Ryan proposed the Roadmap for America's Destruction, Paul Krugman recalled

Ryan’s claim that diverting a substantial share of payroll taxes receipts into individual accounts does not constitute partial privatization of Social Security You see, there’s a history here.

Back when the Cato Institute first began pushing for individual Social Security accounts, it called its push, well, The Project on Social Security Privatization. As the Bush administration got ready to make its privatization push, however, it became clear that “privatization” polled badly. So the project was renamed The Project on Social Security Choice. And Republicans began bristling at any suggestions that they were proposing privatization, calling that a slander. Really.

Wait, it gets better. Cato engaged in Orwellian tactics — deleting the term “privatization” from older web posts and even from records of old conferences. But they were sloppy; there were traces of the true history throughout. I don’t know if they’re still continuing the practice.

In any case, Ryan’s attempt to deny that what his own movement used to call privatization is, in fact, privatization should settle the question of his sincerity

Thirteen (13) months ago, Krugman was onto the Wisconsin Republican, recognizing "Ryan’s attempt to deny that what his own movement used to call privatization is, in fact, privatization should settle the question of his sincerity." Now Ryan has a scheme to privatize health care for the elderly.

This shouldn't have been surprising, really, and not only because of the Roadmap of a year earlier. His campaigns for Congress have included $209,184 from the real estate industry, $226,745 from commercial banks, and $301,949 from the securities and investments industry.... and $460,901 from his biggest benefactor, the insurance industry. So Representative Ryan is not only misguided about the needs of the elderly and ignorant about economics. He is also marvelously self-serving.

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