A reader writes:
I know John Cole is being harsh, but come on. If you read the very next sentence of his post (beyond the end of your quote), you see that he isn't suggesting that ending the Bush tax cuts will solve the fiscal crisis. He merely says that we will be better off – with that simple step – than under Ryan's plan. Yet you intentionally misrepresent his point as saying "he seems to believe this will actually end our looming fiscal crisis." I don't read your blog to see unfairness responded to with misrepresentation. Do you disagree with his point?
When we have the kind of fiscal meltdown in the future that we face, offering nothing but an end to the Bush tax cuts for the wealthy is not serious. And Cole offers nothing else but bile, ad hominems and class hatred. Another writes:
Distributionally, the Ryan plan is a monstrosity. The rich would receive huge tax cuts while the social safety net would be shredded to pay for them. Even as an opening bid to begin budget negotiations with the Democrats, the Ryan plan cannot be taken seriously.
Bolding mine. That's not John Cole or "The Hard Left." That's Bruce Bartlett. Andrew, you blog in real-time and you let us see your reaction to events more or less the same time you do. That's why I've been visiting the Dish for so long. But, is it possible that maybe you just saw that Ryan was willing to target entitlement spending and that was enough for you to call his proposal "courageous" and "serious"? You didn't really take time to study it in depth or reflect on it?
I was 17 in 1984, so I missed Reagan. Since then, my presidential voting record has been Bush, Bush, Clinton, Bush, Kerry, Obama. I only regret one of those votes – you can probably guess which one. I'm not "Hard Left." I'm not angry at Paul Ryan for his proposal – today's GOP will be today's GOP. There was a time, in my view, when the GOP was the party of realism and pragmatism, but that time is long gone. Clinton and the New Democrats co-opted that ground and the GOP has been moving further and further to the right ever since. So no surprise there – a dog's gonna bark. What is outrageous, not just to liberals, but to moderates like me, is that pundits like you swallow this stuff every single time they serve it up.
You keep insisting that tax increases won't do the trick, that Medicare is simply unaffordable, that the math simply doesn't work. But, Andrew, you never actually do the math and show it to us! The fact is, you can pretty much eliminate deficits in the 10-year budget window (Ryan's plan actually increases them) simply by allowing income, investment, and estate taxes to revert to Clinton levels. You can completely eliminate them if you also withdraw from Iraq and Afghanistan and scale back defense spending to pre-Bush levels, and cut the projected 2030 deficit in HALF.
That's your "budget crisis" in a nutshell. Now, long-term, we have a health care cost crisis. That crisis exists whether we try to pay for it with public or private dollars. Privatizing Medicare takes the costs we don't like off the Federal budget, but it doesn't mean those costs go away – it's just that private individuals have to pay those costs out of pocket. The well-off will be able to, and the poorest and sickest will not. Whether we ultimately decide to pay for it out of pocket or with tax dollars, we have to restrain health care costs: we need to get healthier, and we need to be more efficient in delivering health care. Full stop.
That's the serious discussion we need to have. Paul Ryan's budget proposal doesn't advance it. The Affordable Care Act did; today's GOP screamed "DEATH PANELS!" and Paul Ryan decried the Medicare cuts in the plan – cuts his bold, courageous, serious budget proposal quietly retains while repealing its revenue increases and cost controls. And again, that's fine. That's Paul Ryan and the GOP. But it's pretty freaking hard to take when Andrew Sullivan cheers this fraud and simulataneously attacks the president for being "unserious."
If you seriously believe that the cost-control plans in the ACA will solve the mounting fiscal crisis, then I think you're dreaming. There's no guarantee any of them would make a real systemic difference – although I heartily support them. Even your ideal solution sustains huge deficits and no balanced budget, let alone a surplus, in 2030. And giving elderly consumers some level of choice in their healthcare is precisely the kind of mechanism that could control costs. Individuals cannot borrow in the same way governments can. And so patients will try and get the best for their assigned money, and healthcare providers will have to compete for it. We've seen how good government is at restraining costs. I suspect consumers will be better. Which is, of course, the logic of the ACA. If you support ACA, why oppose giving seniors the same options from similar health insurance exchanges.
More importantly, I cannot see, given the extraordinary advances in medical science, healthcare and pharmaceuticals, how it is a reasonable answer to say: "we need to get healthier, and we need to be more efficient in delivering health care." No shit. But the cost of healthcare is a moving target which if left to government control will drag us all into collective bankruptcy. So, yes, at some point, we are going to have to admit that we simply cannot provide the best medicine for all because it will bankrupt us in ways that will also primarily hurt the poot. Rather than government picking who wins and who loses, I favor the market picking. That means, I know, that above a minimal threshhold, the rich will tend to be healthier than the poor. As long as we provide a safety net, I can live with that. I can certainly live with it better than some government board making decisions about how gets what and when.
And yes, I am largely glad that the Ryan plan, for all its blindspots, is on the table. Because, as my reader points out, it does actually tackle entitlements. That alone elevates it above the usual political fray. So far, Obama has proposed nothing adequate to grapple with entitlements' metastasizing costs in an era of technological miracles and a fast-aging society. The same can be said of the Tea Party. I've acknowledged and aired many valid criticisms of Ryan's proposal. But my core point is: we cannot say the same about the president's or the Democrats' plan to solve the problem. Because they have none.