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What's so bad about that? Well, it's a joke or a scam. Most seniors would probably opt to stay in Medicare. And there is no evidence that offering private-sector choices saves any money. Indeed, the government already tried to do that with Medicare Advantage, and it wound up costing more than the traditional, wasteful fee-for-service option.
There are, in the end, two ways to reduce Medicare costs. One is to increase the amount that seniors have to pay for it (which Obama's proposed budget does, modestly, for wealthier seniors). The other is to end fee-for-service Medicare as we know it and replace it with a system in which doctors are not rewarded for performing unnecessary tests and procedures but are paid by straight salary or per patient they see. Ryan actually opposes even the modest step that Obama has taken in that direction: creating a board of experts that will establish guidelines for the most efficient forms of treatment a board that Sarah Palin memorably, and outrageously, called a death panel. The truth is, the savings in Ryan's plan would come, in the end, out of the hides of senior citizens.
This is obviously complicated stuff, but you can bet the debate over the Ryan budget will be simplistic and demagogic on both sides. It's important to see the bottom line, though. Obama could have taken more dramatic steps toward long-term deficit reduction in his budget, but Romney has embraced a cynical, mean-spirited sham.
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