Brad DeLong says Paul Ryan's view of social insurance should get more attention:
Paul Ryan: Socialism Must Be Destroyed, and by "Socialism" I Mean Things Like Social Security, Medicare, Food Stamps, and Unemployment Insurance by Brad DeLong: The Paul Ryan audiotape did not get the same attention as the Romney videotape. Yet I find it as damning:
Social Security right now is a collectivist system. It is a welfare transfer system…. And so what we have coming now at the beginning of this century is a fight…. [A]ll they have to do is to stop us from succeeding. Autopilot will get them to where they want to go. It will bring more government, more collectivism, more centralized government if we do not succeed in switching these programs and reforming these programs from what some people call a defined-benefit system to a defined-contribution system--and I am talking about health-care programs as well--from a third-party socialist-based system to an individually-prefunded individually-directed system. We can do this. We are on offense on a lot of these issues…
In Paul Ryan's eyes, Social Security, Medicare, Medicaid, Unemployment Insurance, SNAP, etc. are all socialist, collectivist systems that must cease to exist in anything like their present form.
And let me stress that shifting health care to an "individually-prefunded individually-directed system" means that poor people die in the gutter outside the hospital when they get sick: if you are unlucky and get seriously ill, then unless you are rich there is no way that you can have individually-prefunded enough to pay for your treatment. ...
Leaving social insurance to the marketplace -- for example assuming that individuals will rationally prefund their future needs -- has never worked. It didn't work in the US before we had a broad social insurance program, and it hasn't worked in other countries either. Are markets suddenly so much better than they used to be that we can now expect them to function in instances where they have always failed in the past? I don't see any reason to believe that's the case. There are good reasons why countries choose to institute social insurance programs, and those reasons haven't gone away.