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Paul Ryan: the Dr. Kevorkian of Medicare

By Paul Begala, CNN Contributor
  • Republicans have long opposed Medicare, Paul Begala says
  • He says Rep. Paul Ryan's proposal would essentially kill the health system for seniors
  • Begala says the plan is an attack on the vulnerable in society
  • He says Congress should confront the rich and privileged, not those with few resources

Editor's note: Paul Begala, a Democratic strategist and CNN political contributor, was a political consultant for Bill Clinton's presidential campaign in 1992 and was counselor to Clinton in the White House. He is an affiliated professor at Georgetown University's Public Policy Institute.

Washington (CNN) -- Republicans have always hated Medicare, but most Americans have always loved it. Now, led by Rep. Paul Ryan, the Republicans are trying to kill it once and for all.

When JFK and LBJ proposed and passed it, Ronald Reagan called Medicare socialism and warned that it would lead to the end of freedom. If Medicare passed, the Gipper said, "... one of these days, you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free."

A half-century after Reagan's dire warning, I suspect most Americans see Medicare -- the single-payer health system that covers seniors -- as an essential element of our freedom. But not Congressman Ryan, nor many other Republicans. Ryan would end Medicare as we know it, replacing it with a voucher that seniors would take to insurance companies, upon whose tender mercies their lives and health would then depend.

Establishment big shots hail Ryan's "courage," but ordinary Americans may not see his plan as courageous. More like mean-spirited.

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Only among Beltway elites is it considered courageous to deny ill and infirm seniors the health care they deserve -- while giving oil companies billions in taxpayer subsidies. Most Americans have a different definition of courage. They think courage is taking on oil companies, corporate special interests and billionaire polluters. But that's not in the GOP playbook.

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There is no doubt that Mr. Ryan is bright. He is also engaging and charming. But forgive me if I fail to see the courage in a young and privileged man harming the most vulnerable while rewarding the most wealthy. Born to a family whose 125-year-old corporation boasts that it is "one of the nation's largest site-work contractors," Mr. Ryan won the genetic lottery. There is no doubt that his great-grandfather worked hard to build that company. But a century and a quarter later, young Mr. Ryan -- who estimates his net worth at up to $2.4 million -- has no calluses on his hands. Just on his heart.

The question for Republicans is, will they follow Ryan's plan? The nonpartisan Congressional Budget Office says that under Ryan's plan, "most elderly people would pay more for their health care than they would under the current Medicare system."

A lot more. In fact, under Medicare, a 65-year-old would pay just 25% of the total cost of her or his health care coverage. Under the Ryan Republican plan, that jumps to 68%. (Individuals currently 55 or older would not be affected by the changes.)

If Republicans follow Ryan like lemmings, they should not be surprised when they find they've taken a firm step into thin air. Back in 1995, Newt Gingrich virtually assured President Bill Clinton's re-election by proposing $270 billion in cuts to Medicare.

Clinton famously refused to go along, and the government was shut down twice in late 1995. Clinton's approval rating bounced around a bit during the shutdowns, but the resolve he showed -- and the popularity of the Medicare program he was defending -- placed his poll numbers on a steady upward rise.

Clinton's defense of Medicare was so central to his re-election that the word "Medicare" appears 49 times in his two debates with Sen. Bob Dole.

So Mr. Ryan's proposal is neither courageous nor new. In fact, then-Vice President Al Gore saw it coming. Fifteen years ago, he said of the Republicans: "They want to give health insurance rip-off artists a license to change Medicare, to let this program for our seniors wither on the vine."

Gore served under a president who was willing to stand strong to protect Medicare. I believe Barack Obama will stand just as strong against a GOP proposal that is even more harsh than Gingrich's. Presidential spokesman Jay Carney did not mince words in describing the president's disdain for Ryan's assault on Medicare. "Any plan to reduce our deficit must reflect the American values of fairness and shared sacrifice," he said. "Congressman Ryan's plan fails this test."

And so we know where Paul Ryan stands: He wants to abolish Medicare. And we know where Obama stands: He wants to save Medicare. The question is, where do the congressional Republicans stand? Will they once again succumb to the sirens' song of pseudo-courage and run once more into the Medicare buzz saw? Or will they show true grit and reduce the deficit by taking on billionaire polluters, oil companies and corporate special interests?

The opinions expressed in this commentary are solely those of Paul Begala.

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