The Romney/Ryan plan for Medicare is vague and keeps changing. But they would make cuts, as would President Obama. The differences are where, why, and how. (More)

The Washington Post‘s Ezra Klein offers a “modest proposal” for those who demand a “serious conversation” about Medicare. The conversation must start with these three questions:

1) Mitt Romney says that “unlike the current president who has cut Medicare funding by $700 billion. We will preserve and protect Medicare.” What happens to those cuts in the Ryan budget?

2) What is the growth rate of Medicare under the Ryan budget?

3) What is the growth rate of Medicare under the Obama budget?

The answers to these questions are, in order, “it keeps them,” “GDP+0.5%,” and “GDP+0.5%.”

That’s right. Despite the Romney/Ryan campaign harping, the latest iteration of Rep. Ryan’s House Republican budget includes the same cuts to the Medicare Advantage program, and both Rep. Ryan’s and President Obama’s budgets forecast the same rate of Medicare spending growth.

So what’s the difference? There are three:

  • Where are the cuts? – Both President Obama’s and Rep. Ryan’s budgets make the same cuts to the Medicare Advantage program. Both budgets also make roughly equal cuts elsewhere in Medicare, but they do it very differently. President Obama’s budget reduces payment rates to Medicare providers (doctors, labs, etc.) while Rep. Ryan’s budget would maintain the same payment rates while shifting more of the costs to Medicare beneficiaries (seniors and the disabled).
  • Why make the cuts? – President Obama’s Medicare Advantage cuts both eliminate a wasteful program and use the savings to offset the costs of protecting more hard-working Americans under the Affordable Care Act. Republicans claim Rep. Ryan’s budget cuts Medicare Advantage to reduce the deficit, yet a Congressional Budget Office analysis found that Rep. Ryan’s 2013 budget increases the deficit. Simply, Rep. Ryan’s budget cuts Medicare Advantage to offset the costs of favors for billionaires and big corporations.
  • How do the cuts limit Medicare costs? – As we discussed last month, U.S. health care providers often charge several times what the same quality care would cost in other developed countries. President Obama’s plan limits Medicare costs by reducing what amounts to price-gouging. Conversely, Rep. Ryan’s plan would let the price-gouging go on and shift more of the costs to seniors and the disabled, on the theory that those who can’t afford the extra costs won’t seek treatment.

Combined with Rep. Ryan’s even more draconian cuts to Medicaid, the result is to squeeze more Americans out of doctor’s offices and hospitals. The Romney/Ryan budget specifically targets hard-working families, as American Enterprise Institute researcher Alan Viard admitted in an interview with The Atlantic‘s Derek Thompson.

James Carville summarized the Romney/Ryan budget well in a video, saying:

There is nothing more courageous than taking away from people trying to make it and giving to people who already have it made. Please have the courage not to be courageous.

Of course, the Romney campaign have denied all this, saying they’re still working on yet another plan and just trust them. Not likely.

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Happy Wednesday!