Ezra Klein's early diagnosis of Paul Ryan's dismantling of Medicare and Medicaid. Shock Doctrine on Steroids.

In a recent analysis from Ezra Klein, it looks like Paul Ryan’s Dickensian changes to Medicare and Medicaid will save the government money, but shift the increasing cost of care to seniors:

Washington Post: " what saves money is not the reform. It’s the cut. For Medicare, the cut is that the government wouldn’t cover the full cost of the private Medicare plans, and the portion they would cover is set to shrink as time goes on. In Medicaid, the block grants are set to increase more slowly than health-care costs, which is to say, the federal government will shoulder a smaller share of the costs than it currently does. The question for both plans is the same: What happens to beneficiaries?" 

The current Medicare program would be dissolved and the next generation of seniors would choose from Medicare-certified private plans on an exchange. But that wouldn’t save money. In fact, it would cost money. As the Congressional Budget Office has said (pdf), since Medicare is cheaper than private insurance, beneficiaries will see “higher premiums in the private market for a package of benefits similar to that currently provided by Medicare.” 

I've said all along that Medicare is a socialized government run high risk program, where the public steps in to help seniors where the private sector would not, creating a large enough pool to bring costs down. Ryan pretends there is a market out there waiting to serve the elderly, with affordable simplified plans even the mentally diminished can understand, creating competition and lowering the costs of drugs, doctors fees and hospital care. Crazy isn't it. This is a high risk pool of "costly" seniors, on a fixed income, who are about to have their Social Security reduced.

And if a recession hits and more people need Medicaid or a nasty flu descends and lots of disabled beneficiaries end up in the hospital with pneumonia? Too bad. 

To my knowledge, Ryan’s budget doesn’t attempt to reform the medical-care sector. It just has cuts. The hope is that those cuts will force consumers to be smarter shoppers and doctors to be more economical and states to be more innovative. But all that’s been tried and it hasn’t been enough. That’s why the Affordable Care Act had to go so much further, digging deep into the delivery system … 

Cuts aren’t enough, and if they somehow manage to distract people from the cuts by repeating the words “block grants” and “flexibility” and “premium support” over and over again, they’ll simply end up seeing their cuts ignored when it becomes clear that they’ll mean leaving the old and the poor without health care. 

What Ryan has here isn’t so much a plan to control spending as a plan to cut spending, whatever the consequences.