Ryan To Unveil Budget Proposal The Republican who heads the House Budget Committee unveils his proposal for a 2012 budget Tuesday. And Rep. Paul Ryan is not merely tinkering around the edges. While the battle over this year's budget has focused on a narrow slice of federal spending, Ryan's plan tries to reshape the whole pie — including health care. Ryan told Fox News over the weekend his plan would replace the government-run Medicare system for workers under 55. When those workers retire, they would receive a government subsidy to shop from a menu of private insurance plans. Michele Norris speaks with NPR's Scott Horsley for more.
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Ryan To Unveil Budget Proposal

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Ryan To Unveil Budget Proposal

Ryan To Unveil Budget Proposal

Ryan To Unveil Budget Proposal

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The Republican who heads the House Budget Committee unveils his proposal for a 2012 budget Tuesday. And Rep. Paul Ryan is not merely tinkering around the edges. While the battle over this year's budget has focused on a narrow slice of federal spending, Ryan's plan tries to reshape the whole pie — including health care. Ryan told Fox News over the weekend his plan would replace the government-run Medicare system for workers under 55. When those workers retire, they would receive a government subsidy to shop from a menu of private insurance plans. Michele Norris speaks with NPR's Scott Horsley for more.

MICHELE NORRIS, Host:

He told Fox News over the weekend his plan would replace Medicare for workers under 55. When they retire, they would receive a government subsidy to shop from a menu of private insurance plans.

PAUL RYAN: Medicare puts a list of plans out there that compete against each other for your business, and seniors pick the plan of their choosing, and then Medicare subsidizes that plan. Doing that saves Medicare.

NORRIS: Joining us now to talk about the Republican budget is NPR's Scott Horsley. And, Scott, whatever else you might say about Congressman Ryan, you can't say that he's timid.

SCOTT HORSLEY: No. This is a bold plan. It attempts to cut trillions of dollars from the federal budget, and, as you say, unlike the debate we've been witnessing for the past few months, which is focused on this narrow piece, the discretionary nondefense spending, this plan does go after the big-ticket items, and that includes Medicare and Medicaid.

NORRIS: So how exactly would this plan save money on health care?

HORSLEY: Now, the government's payouts would increase year by year, according to a formula but, as budget maven Alice Rivlin, who served with Ryan on the president's deficit commission, points out, the growth in government spending would not keep pace with what we've been seeing in health care inflation.

ALICE RIVLIN: It is slower than health costs have been growing recently, but that's the point. We have to find a way to slow the growth of health costs generally, not just in Medicare, but unless we do, we're in real trouble. The current system is not sustainable.

HORSLEY: So we can say with some certainty that Ryan's plan would save the government money on health care relative to the current system. What's less clear is whether the overall cost of health care would be cut, or if cost would just be shifted onto the backs of retirees.

NORRIS: And can we also say with some certainly that under this plan, seniors might end up paying more out of pocket for their health care?

HORSLEY: What would help is if private insurers or the government could figure out and pay for the kind of care that actually makes us healthier and stop paying for the kinds of care that doesn't.

NORRIS: Preventive care and that kind of thing. Now, what are the changes to health care we'll see in the Republican budget?

HORSLEY: But as with Medicare, this might produce real savings, or it might just result in a cost shift onto the states, onto the backs of poor people or onto the backs of everyone else who has to pay for insurance coverage.

NORRIS: Scott, I've got only few more seconds. Would likely to be met with applause or a robust debate about this?

HORSLEY: It's certainly going to be a robust debate. The White House was guarded in its response today. They say they welcome an adult conversation.

NORRIS: Scott, thank you very much.

HORSLEY: My pleasure.

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