Paul Ryan Rejects Fiscal Plan Because Fiscal Plan Accepts “Obama Care”

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The House Republicans’ best-known budget big-thinker, Paul Ryan, is saying he finds the new proposal from President Obama’s fiscal commission an unacceptable step “backwards.” Unlike some other conservatives, who are focusing on the specter of possible tax hikes, Ryan’s big complaint has to do with health care. He’s right that the budget’s most voracious program is Medicare, whose costs are increasing at an unnerving pace: The program is projected to nearly double in cost, from $519 billion to $929 billion, over the next ten years. Recognizing that, the Bowles-Simpson plan offers a bundle of new cost controls.

Now, it’s fair to ask whether the notion of implementing such cost controls anytime soon is an idea that comes from too many bong hits. Tackling Medicare anytime soon will be excruciatingly difficult–partly because everyone is exhausted and all compromised-out from the endless health care reform debate. And partly because Republicans just finished savaging Democrats in the midterm elections for what they count as $550 billion in reform-related Medicare cuts.

Ryan’s complaint is broader, though. He’s upset that Bowles and Simpson take the Affordable Care Act’s survival as a given:

“It doesn’t even take a step in the right direction. It takes many steps in the wrong direction from my perspective. It accelerates and entrenches the Obama care system, which to me is a huge step in the wrong direction.”
This is going to be a problem for any serious effort to tame the budget. Health care is the real fiscal Daisy Cutter. Washington just spent about a year trying to address it through health care reform, an effort which wound up doing more to help the uninsured that it does to save costs. (Even many Democratic supporters of health reform aren’t sure it will lower long-term health expenses.) Republicans, meanwhile, have built their political platform around repeal of the health care law–something Democrats that will understandably fight to the death.
In other words, we still need a tough and honest debate about fixing Medicare. But we probably can’t even get there until we’ve resolved the political showdown over repealing Obama’s health care reform. Which is bad news if you believe–and some people don’t, mind you–that a European-style fiscal crisis is a near-term possibility.
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