Mitt Romney’s choice of a running mate won’t make a lot of difference to voters in this conservative state. He probably could have put Lucifer himself on the ticket and still won Kentucky, as John McCain did in 2008. The commonwealth’s political defiance bucked the mainstream then but might not again if the nation’s swing to the right remains as solid as it was in the congressional elections of two years ago.
Kentuckians, who accept lots of government assistance but still resent it, have new conflicts to resolve in their minds with Romney’s selection of Wisconsin congressman Paul Ryan as his vice presidential candidate. Heretofore, the debate over whether to repeal Obamacare has played off comparisons to Romneycare, which the Republican presidential hopeful brought to Massachusetts. Now there’s Ryancare to make things even more confusing.
Ryan, chairman of the House Budget Committee, is best known for his plan to change Medicare, over time, from a government-managed health care bureaucracy into a privatized program which has Washington issuing vouchers that Medicare recipients would use to purchase private medical insurance. Only those now younger than 55 would be affected, he says – everyone currently over 54 would continue to get the existing Medicare deal when they become eligible, although under Ryan’s plan the “doughnut hole” in Medicare prescription drug coverage which was closed by the Affordable Care Act would reopen. Democrats charge the congressman’s plan would “end Medicare as we know it.” He counters that he’s trying to save Medicare.
Ryan may or may not have the right idea, but somebody’s going to have to do something about Medicare. Government figures project the program will go broke by 2024, nine years before the Social Security trust fund runs out of money. Medicare is unsustainable without service cuts or tax increases. The Affordable Care Act takes $700 billion out of the program, which is generally reserved for those 65 and older. The Associated Press reported that while Romney supports restoring that money to Medicare, Ryan’s House Budget Committee let the cuts stand.
The reality is that demand for Medicare services can only rise as the nation continues to age. Those who were fortunate enough to avoid serious health problems in their youth and middle age generally find they require more treatment thereafter. Unless they’re independently wealthy, they’re hard-pressed to pay these expenses without affordable health insurance. That’s where government steps in, or has.
Ryan’s vision is for the bureaucratic role to diminish even as demand for assistance grows. It’s somewhat analogous to the shift from traditional pensions to 401(k) accounts that have most workers taking big investment risks to save for retirement. More were enamored of this approach during the Clinton boom years when the potential for stock market growth seemed boundless. But the Great Recession that began in 2007 put a big hurt on 401(k) nest eggs. Some who’ve gone through that ordeal are leery of privatized Medicare or Social Security (another Republican theme). But disenchantment with liberal ideology runs deep, and the Republican candidates will persuade many their way is better. Prepare for the mother of all sales pitches.