Healthcare Policy Debate in the U.S. Election Campaign

Paul Ryan's mendacity on his policy priorities continues. When asked why he retained Obama's cuts to Medicare in his proposed budget, he said, as Peter Landers and Colleen McCain Nelson report today in The Wall Street Journal's Washington Wire blog, "It was already in the baseline. We would never have done it in the first place." meaning that the Medicare cuts in Obamacare were taken by Ryan as a fait accompli, something that could not be changed. And yet, "Mr. Ryan assumed in his budget that the Obama law’s subsidies for lower-income people to buy health coverage would be repealed." In other words, Obamacare is immutable when it helps Ryan evade responsibility for his budget, but can be picked and chosen from otherwise!

By the way, the $716 billion cuts to Medicare in Obamacare that Romney and Ryan are cynically exploiting to snooker voters in Florida and elsewhere were obtained by squeezing the providers of medical care -- doctors and hospitals -- and not by reducing benefits. A lot of that spending squeeze was focused on Medicare Advantage, a misconceived George Bush program that allowed retirees to leave Medicare for private health insurance plans at the government's expense. The hope was that the entry of private insurance would reduce the cost of healthcare for the elderly. Unfortunately, study after study found that Medicare Advantage spent a lot more than regular Medicare without delivering better health outcomes. This was why it made sense to cut the flow of Medicare money to the private insurers in Medicare Advantage.

And these are the cuts that Paul Ryan once included in his budget but is now running away from.

While the Romney-Ryan attacks on the $716 billion "cuts" in Obamacare have received saturation coverage -- with little or no reminder that Medicare benefits have been kept intact -- there has been almost no coverage of the massive cuts to Medicaid, the healthcare program for the poor that is run jointly by the federal and state governments, in Paul Ryan's famous budget. Why is this so? Why does Medicare get all the attention and Medicaid none? Today, David Wessel highlights Ryan's Medicaid cuts in his blog post but, alas, not in his column -- on the same general topic -- in The Wall Street Journal. The poor have a pitifully faint voice in corporate media today, and absolutely none in Murdochistan.

Finally, Wessel's column in the WSJ has a chart on government spending, as a share of GDP that can be seen without a subscription. Note the massive increase in government spending during the George Bush years and the smart decline under the Democrats, Clinton and Obama.

Try finding any praise for Obama from "fiscal hawks" on this count. You won't see it. Anywhere.

But once in a while, when the gate keepers are not looking, the truth has a way of sneaking in, as in Wessel's chart.

Update, August 20, 2012. Paul Krugman makes the point in my opening paragraph in his New York Times column today: "Mr. Ryan includes the $716 billion in Medicare savings that are part of Obamacare, even though he wants to scrap everything else in that act."

Update, August 18, 2012. Tomorrow's New York Times carries a long-ish editorial making a sober and strong case against Romney-Ryan's desperate lies on Medicare.