This episode of "Screw the Poor" brought to you by Paul Ryan [Updated]

According to David Brooks, the Paul Ryan budget proposal will

* Prevent the government shutdown
* Set the bar for "seriousness"when it comes to budget discussions
* Become the republican nominee's budget platform
* Heal the lepers
* and...
"... will put all future arguments in the proper context: The current welfare state is simply unsustainable and anybody who is serious, on left or right, has to have a new vision of the social contract."
Well, well. Fine. Let's look at the top line item of the new vision: phasing out Medicaid Medicare* as we know over 10 years, replacing it with
"... a defined contribution plan. Instead of assuming open-ended future costs, the government will give you a sum of money (starting at an amount equal to what the government now spends) and a regulated menu of insurance options from which to choose." 
Well. Fine. Except that, as Matt Yglesias points out with a handy chart, [Medicaid*] expenditures don't match up with enrollees. Unless that regulated menu of insurance options includes high-risk pools and mandates enrollment  to cover payouts to the elderly and the disabled, it won't work even in the short term.

In the long term, of course, we've got this flat payout replacing our open-ended commitment. Since everybody from Nancy Pelosi to Paul Ryan assumes continuously rising health-care costs, how is this anything other than essentially cutting off access to health care for poor children, disabled people, and the elderly everyone except those that can pay out of pocket what used to be covered by Medicare? While still cutting taxes for the rich?

Stay classy, Republicans!

UPDATE: EPIC BELLMAN FAIL - I've conflated Medicare and Medicaid. 

Ryan proposes to phase out Medicare and replacing it with block grants will do nothing to account for rising costs, just shift the burden for most Americans on to their families. Meanwhile, he will turn Medicaid into block grands so that individual states can decide how and with what vigor they will screw the poor.

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