Rep. Paul Ryan Defends Medicare Proposal: 'Give Seniors The Power'

May 16, 2011

With his proposed changes to Medicare being dinged not just from Democrats but GOP presidential candidate Newt Gingrich as well, Rep. Paul Ryan (R-WI) on Monday defended the GOP plan under which the federal government would give future seniors money to pay for private companies for health insurance coverage.

Chairman of the House Budget Committee, Ryan framed the argument for his plan as a way to shift the balance on who makes health care decisions away from the federal government and towards individuals.

Ryan chose the Economic Club of Chicago in President Obama's hometown to make his speech which was titled "Shared Scarcity versus Renewed Prosperity,"

About Medicare, Ryan said:

There is widespread, bipartisan agreement that the open-ended, fee-for-service structure of Medicare is a key driver of health-care cost inflation. As my friend Jim Capretta, a noted health-care policy expert, likes to say, Medicare is not the train being pulled along by the engine of rising costs. Medicare is the engine – and the rest of us are getting taken for a ride.

The disagreement isn't really about the problem. It's about the solution to controlling costs in Medicare. And if I could sum up that disagreement in a couple of sentences, I would say this: Our plan is to give seniors the power to deny business to inefficient providers. Their plan is to give government the power to deny care to seniors.

Ryan, who is considering a U.S. Senate run, summoned up the same arguments he and other Republicans have used to describe why their approach to reducing Medicare's health care beats that of President Obama and other Democrats.

The president, he said, would rely on unelected bureaucrats to decide which health care therapies would be paid for and which wouldn't, for instance.

The speech was about much more than a Medicare, with Ryan hewing to the GOP call to repeal the health-care law altogether and touching on the topics of taxes, spending and debt.

But it's the Medicare piece of the GOP's fiscal proposals on which Democratic opponents have gained the most traction.

So the question is, did Ryan give fellow Republicans something to fight back with which to fight back against Democrats?

Most voters would prefer to have the power to make decisions over their health care than having the federal government. If it came down to that simple choice, Ryan might be on to something.

But the choice isn't as simple as that. For decades, critics of U.S. health care system have pointed out the same thing Democrats did during the 2009 and 2010 health care debates, that private health insurers have long determined what care was covered and what wasn't.

That's a point Ryan's Democratic critics are likely to make again to counter his call to "give seniors the power." Copyright 2011 National Public Radio. To see more, visit