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So, is there an important difference in the Republican and Democratic approaches to Medicare? For the near term, no. For the long term, there is fodder for attack dogs on both sides.
Democrats courting senior votes can point to the fact that by midcentury the Ryan plan will be spending slightly less on Medicare than the spending level under the 2010 law. Republicans, courting those same votes, can point out that the long-term growth rate for Medicare spending under Ryan is the per capita rate of growth of gross domestic product plus 0.5 percent, whereas the number for the 2010 law is about the GDP plus 0.2 percent. Because the Ryan proposal eventually raises the eligibility age to 67, there will be fewer people in the program — making it difficult to compare projected spending totals decades from now.
If there is a silver lining for the Republicans, it is this: The Democratic approach is spelled out in current law. Because the Republicans have not offered anything like that degree of specificity, they could conceivably take advantage of more promising ideas, including proposals we have made elsewhere. Both sides have the same goal for future Medicare budgets. The Republicans at least allow the possibility of making them less painful.
John C. Goodman is president of the National Center for Policy Analysis, a research fellow at the Independent Institute and author of “Priceless: Curing the Healthcare Crisis.” Thomas R. Saving is an NCPA senior fellow, former Social Security and Medicare trustee and director of the Private Enterprise Research Center at Texas A&M University.