Rep. Ryan On Republican Budget Blueprint

Rep. Paul Ryan (R-WI) has put forward a plan for taking on the federal budget. President Obama says he has read the proposal and agrees with portions of it. Congressman Ryan discusses the plan.

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From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.

MELISSA BLOCK, host:

And I'm Melissa Block.

In two weeks, assuming it ever stops snowing here in Washington, President Obama will convene his bipartisan summit on health care. Republican leaders in the House want the current health care overhaul bill scrapped, and they want the discussion to start over. The president said yesterday he's willing to start from scratch in the sense that he'll be open to new ideas, but he does not want what he calls another year of partisan wrangling.

We're going to hear now from a Republican member of the House who's put forth a sweeping proposal for fiscal overhaul on everything from Social Security to the tax code, Medicaid and Medicare. He is Paul Ryan of Wisconsin, ranking member of the House Budget Committee.

I asked Congressman Ryan if he agrees with the Republican leaders that the health care debate needs to be reset.

Representative PAUL RYAN (Republican, Wisconsin; Ranking Member, House Budget Committee): The premise of the bill, sort of the policy architecture of the bill, in my opinion, is something that ought to be scrapped and we have to start all over from scratch. If you really want bipartisanship, then you got to have collaboration from the beginning. That never occurred last year.

So if you do want bipartisanship, that means the party in power has to be willing to collaborate with the minority party. We have yet to see that to this moment. And hopefully we could see that if we start over and put our heads together and come up with a good plan.

BLOCK: Congressman Ryan, when you think about health care costs stretching over time, what's your vision of the sort of fiscal apocalypse that's looming?

Rep. RYAN: Well, it is a health care problem and that's where the president, his budget (unintelligible) agree with one another, which is our debt crisis and our budget crisis is really a health care cost crisis because our health care programs, namely Medicare and Medicaid, are the primary sources and reasons why the federal government goes bankrupt. And that's why we got to address this now, sooner the better.

The way I would do it and the way I propose to do it is, look, people who are currently on these programs, you shouldn't pull the rug out from under them. If you are 55 and above, meaning in or near retirement, you're going to get the Medicare program you got right now and it's not going to be changed.

Right now, it's going bankrupt in just a handful of years so let's preserve that and then let's make changes in the future for future generations so that's it's more sustainable.

And the way I propose doing that, in a nutshell, is basically have Medicare replicate the exact same health care plan I've got in Congress. I get a payment from the federal government, I get a book from the federal government with a list of health care plans that are pre-certified, and I select the one that's best for my family and myself and I apply my payment to that.

BLOCK: The basic idea here is you'd be giving seniors money to buy health insurance in the private sector. Some people call this turning Medicare into essentially a voucher program. The Congressional Budget Office ran the numbers on your plan and they concluded that beneficiaries would face higher premiums in the private market. They'd end up with less comprehensive health plans, fewer services.

In other words, the money that seniors would be getting would not be keeping pace with the growth in health care costs.

Rep. RYAN: That's going to happen under any scenario in the future, because the status quo is unsustainable. Right now, Medicare has a $38 trillion unfunded liability. And if you if government actually tried to pay all of that, the tax increases, the borrowing that would occur would bankrupt our country, kill our economy. So under any scenario going forward, you will not have the kind of Medicare spending in 20, 30, 40 years that is being projected right now.

So I'm basically saying let's go with what works. And what works pretty well is the plan I've got in Congress and federal employees have, but more to the point is I do other reforms to the health care system itself to try and go at the root cause of health inflation. So let's not just accept that health care costs are always going to go up at eight percent a year forever, and we just have to accept that. No, I don't accept that.

Let's bring down health care costs so that those dollars we give seniors stretch a lot further so that they do get comprehensive health care.

The alternative to this path that I've provided here is basically the government has to become a big health care monopoly and then it will have to ration through bureaucratic formulas which deny people the kind of customized care that they and their physicians expect they're going to get.

BLOCK: You know, President Obama has talked about the political vulnerability of doing anything that tinkers with Medicare. And I wonder, wouldn't voters back home in Wisconsin there be looking at this and saying, you're trying to cut my benefits, you're trying to privatize my care, I don't trust these health insurance companies?

Rep. RYAN: I introduced this bill two years ago. I ran for re-election on it in the last election cycle. I'm very clear with the people who hired me as to what I'm proposing, that they understand this.

Number one: I am saying no changes for people above the age of 55. Number two: I'm saying let's convert the system now so that people can plan for it, that's compassionate, that works, that's sustainable.

I would argue that it is really not a privatization any more than the federal employee health benefit plan that federal workers and members of Congress have is a privatized system. So I simply am saying let's go with common sense ideas that work, that have proven over time to actually do the job that we're trying to do. And that to me is what I think the people who hired me want me to do.

Look, I don't think people sent me to Washington from southern Wisconsin to just be a part of the problem, to point fingers, to just jump on the partisan bandwagon. I think they sent me there to try and solve problems, to put ideas on the table to get ourselves out of the debt and the deficit and the fiscal crisis we're approaching. And that's exactly what I'm trying to do.

BLOCK: Congressman Ryan, thanks for being with us.

Rep. RYAN: You bet. Nice to be with you.

BLOCK: That's Congressman Paul Ryan, Republican of Wisconsin. He's ranking member of the House Budget Committee.

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