Don't Knock the Ryan Plan?

Joe Nocera tells us not to knock Paul Ryan. Not that he likes the plan itself:

The Ryan plan, which would give seniors a fixed amount they can use to buy health insurance, would undoubtedly shift the cost burden over time from the government to seniors themselves, making health care far less affordable for millions of people. Ryan says that “empowering” health care consumers will help control costs, but that’s absurd: Medicare itself has far more pricing power than the people who actually need treatment.

The first part of Nocera's critique is correct, the cost of health care is shifted to seniors themselves, but the second part makes no sense (though I have seen this before, see here). I wonder how people can hold such contradictory ideas in their heads at the same time? If you shift more of the costs to seniors, who have limited budgets, they will get less health care. If they pay less for health care, costs will fall. Of course so will the amount of health care provided. But you cannot deny that if people cannot afford healthcare they will buy less of it.

Indeed, that seems to be the biggest problem with the Ryan plan. It controls the costs of healthcare by forcing people to buy less than they need.

But then the confused Nocera argues that we should not scorn Paul Ryan. Because the costs of health care are real he argues that:

It would be nice if we could treat the Ryan plan not as an object of derision but as a launching off point for a serious debate. That way, maybe for once we could avert a crisis instead of acting shocked when it finally arrives.

But this seems odd to me. Why not let the Obama Plan be the start of a discussion to control Medicare costs? You don't want to scorn Ryan who argues that Obamacare destroys Medicare. But we should start the discussion with Paul Ryan?

Nocera is really confused.

Thanks Paul Ryan

Like most Republican initiatives, Paul Ryan's budget proposal is designed for me. Tax cuts for the well-off (which extend to the moderately well off), burden placed on future generations. For example, all the burden of Medicare reforms go to those 54 and younger. I'm 55, so I get off okay. Just like Republican tax policy or environmental policy all the costs are on future generations and I don't have any.

The reason is straightforward as David Leonhart notes in the NYTimes:

Yet there is at least one big way in which the plan isn’t daring at all. It asks for a whole lot of sacrifice from everyone under the age of 55 and little from everyone 55 and over. Representative Paul Ryan, the Wisconsin Republican who wrote the plan, calls the budget deficit an “existential threat” to the United States. Then he absolves more than one-third of all adults from responsibility in dealing with that threat...

The reason is partly political. Older people vote in larger numbers than younger adults. Children, of course, can’t vote at all.

This is the basic issue. All the young Obama voters did not vote in the midterm elections, so the Republicans won. Ryan rewards his constituency. Taxes will be cut. Spending for the poor will be cut. The deficit, well it will be cut if unemployment magically can fall to 2.8%, and if unicorns can fly.

Like all good Republican policies, the benefits go to me and the sacrifice goes to the future -- the young who will be left with the cost of the environmental cleanup and a huge federal debt -- and the poor who live elsewhere. I really don't understand why I should be so lucky.