Kill Medicare

Paul Krugman reports that Paul Ryan wants to balance the budget by taking people's Medicare away:

Well, Rep. Paul Ryan’s Roadmap for America’s Future calls for the eventual elimination of Medicare as we know it, replacing it with a system of vouchers that would, eventually, account for a steadily declining share of GDP. But what about the next decade? Mr. Ryan’s release says that it

Strengthens the current program with changes such as income-relating drug benefit premiums to ensure long-term sustainability.

What does that mean? The CBO, helpfully, translates (pdf):

People who are age 65 or older in 2020 and other existing enrollees at that time would continue to be covered by the current program, although some higher income enrollees would pay higher premiums, and some program payments would be reduced.

In other words, Medicare would face cuts. And the CBO’s detailed analysis provides an estimate of those cuts. I’ve taken the table comparing projected spending with baseline as a share of GDP (xls), and scaled it up using the CBO’s projections of GDP. What I get is an estimated cut in Medicare spending over the next decade of about … $650 billion.

I believe that Ryan has exactly the right idea here. Medicare should die, for two reasons.

Reason 1: Medicare has made it impossible to implement true national health care. The existing system - government health care for 40% of the population - has created a bloc of vested incumbents who know that universal national health care would end up cutting their benefits so that others could be covered. This is why you see all these Tea Partiers shouting "Keep the government's hands off my Medicare!" Kill Medicare - let people see how a completely privatized health insurance industry works in practice - and in a decade or so they'll be clamoring for a National Health Service. Sadly, this will involve a bunch of poor and old people dying in the short run, but in the long run many lives would be saved.

Reason 2: Cutting health care costs is absolutely necessary in order to control our federal debt - and avoid a disastrous sovereign default - in the long term. Assuming we restrain defense spending and don't cut taxes, killing Medicare will put our government in the black (as Paul Ryan noticed), although private health spending will of course soar. In the long run, if killing Medicare leads to people demanding true national health care, that will massively control health care costs in the economy as a whole. It's a win-win (except, again, for all the old people who will die in the interim).

In summary, the best way to make people believe in the power of government to improve their lives is to show them what happens without government. Support Paul Ryan: kill Medicare.

P.S. - Is this post sarcastic? To be honest, I'm not entirely sure...