I'm not sure if this has been included already already or not, but here's one for Brad DeLong's collection of rebuttals to right-wing talking points. I've been hearing somethig along these lines floating around lately:
The Republicans have a plan for Medicare, but the Democrats don't. Where's the president's plan?
... Tragically, Medicare is set to be bankrupt in 2024 and only the House Republicans have presented a plan that restore’ the program’s solvency, leaving youth asking: President Obama, Where’s YOUR Plan?
While we await the President’s plan, that is, if he ever decides reforming Medicare is more important than his golf game, we can almost with certitude conjecture what it would be: a strengthening of ObamaCare’s Independent Payment Advisory Board (IPAB).
In short, IPAB is a board of 15 unelected bureaucrats who are paid $160,000 a year to ration the care of seniors. ...
Ezra Klein has addressed this already:
...“If Democrats don’t like his [Ryan's] budget ideas, they should propose their own,” writes Fareed Zakaria. “The Democrats and Obama now have to offer a response,” warned Andrew Sullivan. “As of this evening, the Democratic policy plan consists of yelling ‘You suck!’” complained Megan McArdle.
I’ve made similar comments. And I think ... Democrats need to step up on taxes, on defense and non-defense discretionary, on Social Security, and on energy. But there’s one huge, glaring exception: controlling health-care costs. There, the reality is that Democrats have a plan and Ryan doesn’t. ...
Democrats don’t just have a proposal that offers a more plausible vision of cost control than Ryan does. They have an honest-to-goodness law. The Affordable Care Act sets more achievable targets, and offers a host of more plausible ways to reach them, than anything in Ryan’s budget. ...
The Affordable Care Act holds Medicare’s cost growth to GDP plus one percentage point... But the target is not really the important part. The important part is how you achieve the target. And the Affordable Care Act actually includes reforms and new processes for future reforms that would help Medicare — and the rest of the medical system — get to where the costs can be saved, rather than just shifted. ...
The bottom line is this: The Affordable Care Act is actually doing the hard work of reforming the health-care system that’s needed to make cost control possible. Ryan’s budget just makes seniors pay more for their Medicare and choose their own plans...
The Affordable Care Act has taken a lot of hits. It’s not popular, and though very few of the political actors confidently attacking or advocating it can explain the many things it’s doing to try and control costs, people have very strong opinions on whether it will succeed at controlling costs. But the irony of everyone demanding Democrats come up with a vision for addressing the drivers of our deficit in the years to come is that, on the central driver of costs..., Democrats actually have something better than a vision. They have a law, and for all its flaws, their law actually makes some sense. Republicans don’t have a law, and their vision, at this point, doesn’t make any sense at all.
Remember that the CBO says the Ryan plan will actually increase Medicare-not-as-we-used-to-know-it costs. And one of the items on Brad's list addresses the "15 unelected bureaucrats" talking point that's been floating around as well:
...Rep. Paul Ryan (R-WI) appeared on Fox News...:
RYAN: ...Obamacare ... creates this 15 panel board of unelected, unaccountable, bureaucrats starting next year to price control and ration Medicare for current seniors.
...It does no such thing. The ACA reduced annual increases in payments to hospitals, skilled nursing facilities, home health agencies, and other institutions to spur productivity and cut overpayments to private insurers that are not delivering value for Medicare dollars. It used that money to expand coverage to 32 million Americans — many of whom were receiving uncompensated care at these institutions — to extend the life of the Medicare program and invest in new demonstration projects that aim to encourage providers to deliver quality care more efficiently. Seniors’ guaranteed benefits are in no way affected.
The “15 panel board,” as Ryan calls it, is actually the Independent Payment Advisory Board (IPAB). It will include individuals from across the health care field, all of whom will have to be confirmed by the Senate. Significantly, their proposal to reduce spending cannot “include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums…increase Medicare beneficiary cost- sharing (including deductibles, coinsurance, and co- payments), or otherwise restrict benefits or modify eligibility criteria” (Section 3403 (page 409) of the Affordable Care Act stipulates.)
Policy wonks believe that the board and the payment reforms can help reduce costs in a transparent process and Ryan himself proposed a very similar commission in 2009... In fact, Ryan’s Patients’ Choice Act (PCA) sought to establish “two governmental bodies to broadly apply cost effectiveness research” and had more teeth than the ACA, including provisions to allow for penalties for physicians who did not follow the guidelines.”