The GOP's Medicare headache: Opinion Focus with Eugene Robinson

May 24, 2011

Washington Post columnist Eugene Robinson discusses his recent columns and the latest news in a live Q&A. In his most recent column, "The GOP's Medicare headache," Robinson writes, "What should worry Republicans is that the biggest issue in the campaign -- practically the only issue -- is Ryan?s Medicare plan. Corwin supports it, Hochul opposes it, and the GOP may well lose a race that shouldn?t even be close."

Have a question about Rep. Paul Ryan's Medicare plan and more? Ask now.

Hi, everybody. The President is visiting the Queen; voters in suburban Buffalo are holding a referendum on the GOP's plan to turn Medicare into a voucher program; and extreme weather is devastating the heartland. A busy Tuesday. Let's get started.

Gene, I call myself a (jaded) moderate, so my assessment of what needs to happen to bring down the deficit is 1) raise taxes on EVERYONE, the wealthy and middle class alike, 2) seriously revamp and/or flat out eliminate the entitlement programs (Medicare, Medicaid, Social Security), and 3) raise the debt ceiling until the debt starts to come down. Having said all this, I realize that all three options are so unpopular that they entail political suicide for anyone who actually enacts these changes, but from my standpoint, we don't have a choice anymore. It's either do a shared sacrifice on a grand scale, or default on our debts and risk worldwide economic meltdown. Do I have that about right?

Two out of three ain't bad. I agree that taxes are going to have to go up, first for the wealthy but eventually for the middle class as well. I also agree that the debt ceiling has to be raised. The entitlements need revamping, but the three biggies are not the same and don't require the same solutions. And I think the revamping will and should continue the basic promise of guaranteed support for senior citizens and the poor.

Why didn't the House Republicans listen to their staffers and pollsters who predicted that his plan would be anathema to the public?

Ideology, hubris... take your pick, I guess.

The GOP House moved fast on the "repeal" of new health law. If they have offered any alternative to "replace", I must have missed it. Ironically, as Boehner himself noted, their proposed Medicare replacement of mandated purchases of subsidized private health insurance looks remarkably like the new law for those under Medicare age. Any way to explain the cognitive dissonance?

There is one striking similarity between the Ryan plan and the health reform implemented by President Obama and the Democrats, in that both effectively have an insurance mandate that will/would be enforced by the IRS. There are also a lot of differences, though. One is designed to secure coverage for more people, while the other...

I know is stupid to ask, but do you see any path EVER to universal healthcare in the USA? I have fabulous employer provided coverage, and I'm still a HUGE single payer supporter because I realize we ALL gotta pay eventually...Keep up the great work!

"Ever" is a long, long time. Just because I don't see that path, at the moment, doesn't mean it's not there. At some point, I have to believe that we'll get so tired of soaring medical costs that we'll take another look at systems -- like those in Germany or Japan, for example -- that deliver better results for much, much less. Someday.

I'm now hearing some of the cable TV blowhards saying that the entire Ryan plan was conconcted by Democrats and they duped Paul Ryan into promoting it. This way they can entirely shift blame to the Democrats for an unpopular policy. Are there any facts to back these allegations up from the party of "personal accountability"?

I hadn't heard that one. Note to any "blowhards" who might be tempted to promote this theory of mental jiu-jitsu: Just stop it, you're embarrassing yourselves.

From my general understanding, I do not support Congressman Ryan's budget proposal (at least specific components). However, I appreciate that it is out there if for no other purpose than to help define the scope and boundaries of the argument. And - I take him at his word that he believes in it and is not concerned with polling. Simply put: He thinks it's a good idea and he invested much of his professional/political capital in its development. Again - I disagree with the proposal and his political views, but isn't this moment perfect to reboot and elevate out political discourse. No worries - I already know the answer... <sigh>

This is a great time to reboot and elevate, and I respect Paul Ryan's thoughtfulness and sincerity, both of which are genuine. But I sincerely believe his idea is a bad one, and it doesn't debase the discourse to point that out.

Ryan's Path to Prosperity with RyanCare not only slashes Medicare and Medicaid (on which most Nursing Home patients rely) and requires beneficiaries of these programs to pay more, but actually projects increasing the Federal deficit above the current debt ceiling of $14.3trillion to $16.2trillion in 2012, $19.5trillion in 2016 and $23.1trillion in 2021. Bt voting in lock-step for Ryan's plan, haven't Tea Partiers in effect voted to increase the National debt which they vowed not to do when they ran for election in 2010? Do you think Tea Partiers didn't read Ryan's plan before voting notwithstanding new House Rules by Republicans supposedly allowing enough time to do so?

There is, indeed, a contradiction here. I think the answer would be that it's worthwhile to raise the debt ceiling if, and only if, a plan is in place that would eventually get us out of hock. One problem I have with the Ryan plan is the fantasy that somehow medical costs are going to level off. They won't, and seniors will be left with vouchers that don't pay enough to buy adequate coverage, and -- because seniors always vote -- eventually the federal government will make up the difference, one way or another. Free markets can do many wondrous things, but controlling health care costs, from all evidence, isn't one of them.

I just have a hard time getting my head around the fact that we could have $700 billion more by ending the insane Bush tax cuts, but no, it would be mean to the rich to do that, and we mustn't be mean to the poor ol' rich who work so hard for their income. But somehow the genuinely poor, downtrodden, homeless, un-health-insured,, we have to cut services to them to avoid being mean to the rich. Sometimes I think my head will explode.

Take a deep breath. This discussion is a detonation-free zone. If we let our heads explode, the Forces of Nonsense will have won.

Why are there no concerted efforts in this country to find solutions preventing the devastation caused by storms, floods, tornadoes, hurricanes and earthquakes? Is it because only disaster relief is possible, or is it that Political leaders are too partisan to go for win-win solutions (i.e., no more NASA's)?

I can think of at least a couple of answers, depending on the kind of disaster we're talking about. In terms of earthquakes, we do as well as we could with building codes in quake-prone areas. In terms of floods, we fail to think big enough. In New Orleans, for example, the Corps of Engineers is completing a revamp of the flood-control system that will handle most big hurricanes, at least theoretically, but not all of them.I don't understand why we didn't at least look into a big, Rotterdam-style flood barrier that might secure the city and its surrounding wetlands for decades to come. And in terms of all the weather-related disasters you list, we need to be realistic about what science tells us about climate change. There's an excellent piece by Bill McKibben in our paper today on this subject.


By picking an un-needed fight with Israel, the President managed to obscure and distract most observers from the few positive parts of his middle east speech. I don't understand what he was trying to accomplish with the spech - do you? Why call on Assad to lead Syria to democracy? Why ignore Saudia Arabia in your list of oppressors? No clear policy came through, just some vague principles that will be selectively applied.

I believe there was considerable logic behind the speech, though not all of it comports with my own thinking. The region is changing, and one thing that would encourage those changes to move in a positive direction would be progress toward an Israel-Palestinian agreement. I believe that toward this end, the president was trying to shake things up a bit. In my view, Assad clearly isn't the route to democracy in Syria; and Saudi Arabia is clearly an oppressive state. But the administration clearly isn't willing to bet the farm that Assad is finished. And it finds realpolitik reason for pretending that the House of Saud is not more of a problem than a solution.

I am not crazy about many parts of the Ryan budget, but at least it's out there. The democrats seem to think that governing means never having to make a tough decision - they fialed to pass a budget last year, have yet to put one out for debate so far this year, and in general seem to think maintaining Medicare on the path to bankruptcy is okay, as long as they survive the 2012 election cycle. How about some LEADERSHIP?

I've blasted the Democrats repeatedly for not passing a budget last year, when they should have. And I seem to recall that the Democrats did provide leadership on health care -- the Affordable Care Act -- but were not saluted by Republicans for their courage.

His plan shows little thought. It never added up and he made no attempt to make it add up. Why should I respect that?

He's more thoughtful in person.

Hi Gene. I'm not very knowledgeable about this, but didn't I read awhile back that the Social Security underfunding problem could be fixed with some "tweaks"? For example, eliminate the cap on the Social Security tax so it applies on high incomes, cap the amount of SS income a high earner gets when retired, and raise the age of retirement gradually by a year or two? Does this make it a different kind of problem than with Medicare, where the problem is unfixable as long as medical costs skyrocket?

That's basically right. At some point, I believe, Social Security will get "fixed" without much trouble. Medicare is a problem of a different magnitude.

So what are the Republicans likely to do/say if Democrat Hochul wins today? You wrote that some say candidate Davis is taking votes from the left while others say he's taking votes from the right. Which do you think it is? Won't Davis be the scapegoat for the losing party regardless?

The spinning and counter-spinning began long before the polls even opened. Here's my bottom line: Davis or no Davis, we shouldn't even be talking about that race. (The Siena College poll suggested that Davis is probably taking votes from both candidates.) Medicare became the central issue, and as a result, what really should be a safe Republican seat is up for grabs.

During the healthcare repeal effort, it was noted that the Republicans were spending too much time on that, and not on job creation, which is what the average American really wants the most. Now they shifted to Medicare reform. Do they have a fixation on healthcare, or do they just have no concrete ideas on jobs?

If the problem is the latter -- no concrete ideas about jobs -- then honesty compels me to include the Democrats as well. I really believe that whichever party develops a compelling message about jobs will do very well in 2012. So far, neither really has.

What can/ will Obama do to come back to the mainstream on Israel. To be honest he isn't that far off but his timing and requests are illogical. A statement refusing funding to Hamas here, a statement about the right of return there and he is back with virtually all of the house and senate on both sides. His donors regain confidence that by most accounts was at least shaken a little (but also by most accounts still remains). The request to rejoin negotiations right as the PA teams up with Hamas seems to be ill timed (as well as extremely unrealistic) and he overshadowed an otherwise great speech on the Arab spring in an a failed attempt to outflank the Israeli PM.

The current leadership of the Palentinian Authority in the West Bank is more friendly to Israel's peace and security than any we've ever seen. I'm talking about facts on the ground. I would think it would be in Israel's best interest to give Abbas some breathing room to try to bring Hamas along, rather than deal with the fundamentalist group -- another fact on the ground -- through repression. Maybe it would work, maybe not. But when would be a better time to try?

I find this line of thought to be very confusing. To oversimplify: the range of health insurance options goes private <-> regulated <-> single payer. The R's like private, the D's like single payer. D's are happy anytime they can move people to the right of this scale (the ACA). R's are happy to move people to the left (Ryan's medicare plan). There is no hypocrisy - the parties aren't happy to be in the middle of the scale, they are just happy the movement is in the correct (in their opinion) direction.

That is an oversimplification, but I get the point. I'd just add, however, that there are data points we can examine as we search for a solution. Are there health care systems that deliver care as good as ours, or better, at a lower cost? Do these systems in fact cover more people for less money? What kind of systems might these be? 

for themselves, staffers, and ALL their family members, especially their parents & grandparents, children? How about including all those pro-voucher lobbyists for good measure? It could be a pilot program. They could go find private insurance and for the next 5-10 years pay out of pocket for whatever isn't covered instead of having access to their current gold-plated cadillac government paid health care plans. For all their families, staffers, etc. But especially for their parents & grand parents. And the grumpy old white men like McConnell et all of course. Also, how can I get a zero-interest half-million line of credit from Tiffany's and American Express?

Funny that I've never heard of members of Congress volunteering to give up their government health care. Also funny that the nice folks at Tiffany's have never offered me a half-million dollars' worth of baubles at no money down. Maybe that's just me.


And that's all for today, folks. Thanks so much for tuning in, and I'll see you again next week, same time, same station.

In This Chat
Eugene Robinson
Eugene Robinson is an Associate Editor and twice-weekly columnist for The Washington Post. His column appears on Tuesdays and Fridays. In a 25-year career at The Post, Robinson has been city hall reporter, city editor, foreign correspondent in Buenos Aires and London, foreign editor, and assistant managing editor in charge of the paper's award-winning Style section. In 2005, he started writing a column for the Op-Ed page. He is the author of "Coal to Cream: A Black Man's Journey Beyond Color to an Affirmation of Race" (1999) and "Last Dance in Havana" (2004). Robinson is a member of the National Association of Black Journalists and has received numerous journalism awards.
Archive of Eugene Robinson's columns
Recent Chats
  • Next: