Paul Ryan's new budget plan seems complicated, but it isn't. For all the obfuscating talk of vouchers and block grants, he only has one very simple solution to the deficit -- the same solution he's been touting for years now. It's a solution that anyone can understand.
The United States is facing two distinct, but related, long-term problems:
1. Health care costs are rising rapidly.
2. Medicare and Medicaid obligates the government to pay for the health care of the poor and elderly. This means that the rising cost of health care shows up on federal budget projections.
Paul Ryan's new budget proposal solves the second problem but not the first. It does this by dissolving Medicare and Medicaid as we currently understand them. In Ryan's plan, the federal government protects its own coffers by simply refusing to pay for health care anymore.
This obviously fixes the problem with the federal budget. But it does so by taking money the federal government is currently obligated to pay and forcing poor people, and elderly people, and employers, and, well, you, to pay for it instead. Most poor people and most elderly people can't afford to do so, and for a lot of them, consistent access to health care will dry up.
The plan does nothing to address the root problem, the rising cost of health care, so the range of people who can afford to get treated is going to continue shrinking. Employer benefits will continue to get less and less generous. Access to health care will become more and more a privilege of wealth.
It's pretty clear that reducing access to health care will lead to a lot of suffering for a lot of people.
For what gain? That's less clear.
The plan fundamentally misconstrues the relationship between people and government. All things equal, most people would agree that a balanced federal budget is preferable to an unbalanced federal budget. But by making a balanced budget an end unto itself, conservatives have created a sort of myopia over the purpose of government in the first place. Ryan's plan envisions the government as a private actor, working to balance its own accounts at the expense of everyone else. That's ridiculous.
Right now, health care costs are massive and thorny problem facing Americans and their government. No one with a serious grasp of health policy could deny as much.
Ryan's plan sees that problem and cheerfully splits the baby down the middle. If Ryan gets his way, the government makes out like a bandit while the Americans it supposedly represents are forced to cope with tremendous suffering alone. Ryan's plan attempts to decouple the long-term fate of the federal government -- an entity governing the American people and controlled by its elected representatives -- from the long-term fate of Americans themselves.
This is ridiculous. If the finances of the government are unsustainable, it's only because the finances of the body politic are also unsustainable.
At its core, Ryan's plan is an abdication of responsibility. It represents conservatives standing up and saying to America, "We don't know how to solve your problems, and we'd rather not try. So instead, we're going to shuffle you out the door so we can put the federal house in order. Everything's still going to seed, but this way, no one can blame us for anything."
It is simply not acceptable for a government to solve its own problems while -- or rather, by -- ignoring the problems of the governed.
And for all the smoke and mirrors, that's exactly what Paul Ryan wants to do with his plan: create a healthy government for a sickly nation.