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Paul Ryan: A Stiff Upper Lip to Destroy Medicare

Paul Ryan has responded to a series of questions put to him by Ezra Klein, all of them rooted in the belief that senior citizens can do a smarter job of shopping for health insurance and lowering the cost of care than actual experts in health policy. He cherry-picks a lot of facts, offers a pretty rousing defense of Medicare Part D, and denigrates nations which are delivering better care, based on life expectancy and consumer reviews and a host of other factors, at a cheaper price. But really this is a philosophical dispute. He thinks that any effort to rein in the soaring cost of provider payments, who make more in America by a wide margin than anywhere else in the world, is a “price control.” He thinks that “compulsory” care through exchanges is wrong, but “guaranteed” care for seniors on an exchange is fine (show me the fine print in the Ryan plan where a senior is guaranteed health care, by the way; this is the great unmentionable). He thinks that Medicare, whose administrative costs are much lower than any private insurer, simply must be driving rising costs throughout the system even as its costs are low, which goes against the entire concept of free market forces. It’s just a religious belief that government participation is always wrong, and privatization is always right. This has been debunked so many times it’s hard to even count.

The real Paul Ryan does not come through in this wonkish analysis, but in this personality profile with Major Garrett, where he pronounces himself Winston Churchill.

“This is a Churchillian-type of moment in history,” Ryan told National Journal. “The polls are predictable. They are regrettable. But this is a unique time in our history. We can’t go wobbly.” […]

Ryan, in essence, intends to be Churchill and Thatcher as the debate over Medicare’s future intensifies. And Ryan thinks this is his moment.

“I was made and wired for this type of thing,” he said in an interview from his Capitol office late Thursday. “We are on the right side of history. We are ready. I talked to at least 100 Republican members in the last two days. They all told me, ‘We gotta go, we’ve got to defend this.’ They are not queasy. They are all saying, ‘Put me in coach.’ Our members are comfortable.”

This is the part where I pull out Winston Churchill and have him say to Paul Ryan “You know nothing of my work.” For Winston Churchill was the architect of socialized medicine in Britain.

Churchill was renowned as a politician who put country and civilization above party. The government he led during World War II was a broad coalition of the British parties, from his own Conservatives to the democratic socialists of Labor. Midway through the war, Churchill’s government asked Sir William Beveridge, a Liberal Party social reformer and economist to study systems of social insurance that could reduce poverty, disease, unemployment and illiteracy in Britain.

In 1942, Beveridge issued an far-reaching report that proposed a national health service to provide medical care to every man, woman and child, regardless of means — much as the coalition government had done during the medical emergency brought on by the German bombings of their cities, hospitals and clinics.

Although Churchill endorsed the idea of a national health system, his party lost the first post-war general election in 1945, partly because British voters didn’t trust the Tories to implement the Beveridge report. Instead a Labor government established universal care under the NHS in 1948.

Only three years later, the Tories returned to power with Churchill restored as prime minister. At that point, the NHS could still have been killed — and many members of the Tory party, not to mention the British Medical Association, were eager to do so.

But Churchill asked Claude Guillebaud, a Cambridge economist, to head a committee to study the performance and efficiency of the NHS. The Gillebaud committee found that the NHS was highly effective – and needed additional funding to insure that effectiveness would continue. There was no more talk of dismantling the very popular service, and instead the Tories under Churchill and his immediate successors allocated more money to build additional clinics and hospitals. Even Margaret Thatcher, the most ideological Tory prime minister of modern times, promised voters that “the NHS is safe in our hands.”

Churchill basically had the ability to kill off NHS and change the course of British history forever. He responded by doing something very un-Republican: seeking facts. And though the facts didn’t match with many of the beliefs of his party, he went with them.

Churchill said: “Our policy is to create a national health service in order to ensure that everybody in the country, irrespective of means, age, sex, or occupation, shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available.”

Paul Ryan says: “What a socialist.”

UPDATE: Eddie Vale of Protect Your Care sends along this response: “I would say to America’s seniors that you have offered nothing but blood, toil, tears and sweat throughout your careers. These retirement years were to be your finest hour being able to count on Medicare for your health care needs. But Paul Ryan shall fight you on the beaches of Florida. He shall fight you in the fields and streets of the retirement homes. He will never surrender. And he will never, never, give up in his quest to end your Medicare.”

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David Dayen

David Dayen