Ryan endorses ObamaCare?

This Medicare debate that Rep. Paul Ryan, R-Wis., is starting for us will be agonizing and essential.

We will be forced to confront realities about how to cut the federal deficit, where the sacrifices will be made, what form the sacrifices will take and what the appropriate role of government will be.

Fine. I'm prepared as we go along to make the case that you may as well raise taxes on all of us rather than redirect the government deficit to the pocketbooks of future Medicare recipients.

But, first, before all of that, could we take just a few paragraphs and roll around in convulsive laughter?

I refer to the take-your-breath irony and contradiction of Ryan, a bona fide fiscal arch-conservative, essentially endorsing the Obama health care reforms that -- for the record and for the tea party grandstand -- he derides from the other side of his mouth as a Ponzi scheme and a house of cards.

We have Ryan trying to do to Medicare what he calls a privatization reform when what he proposes is precisely what he and his right-wing buddies deride as evil European socialized medicine when the president and Democrats try to do it for people not yet on Medicare.

"Exchange is not necessarily a dirty word," Ryan, the Republican House Budget chairman, said last week.


His plan is to tell new Medicare recipients starting in 2022 or so to get off single-payer Medicare and go buy a partially subsidized private health insurance policy, one means tested and costlier for sicker people, that would be part of a government exchange that would protect against discrimination on account of pre-existing conditions.

That is, in one derisive word, ObamaCare.

Yes, it is. Plain and simple.

Ryan wants to remake Medicare, in which Republicans have never believed, into the ObamaCare they deride only for political expedience and rhetorical advantage, not on actual substantive merit.

Alas, we may be getting a little past hilarity and into cynicism. That can be a fine line. It is mostly our choice, to laugh or to cry.

It turns out that Ryan worked up this Medicare remake with Alice Rivlin, an old Democratic deficit hawk who was Bill Clinton's budget director.

Rivlin supports the Democrats' health care reforms. When a reporter asked her last week whether Ryan wasn't essentially endorsing what he and buddies deride, she answered, "I keep talking to Paul and trying to convince him of that. But, even if he agreed with me, he couldn't say so."

Why not? Would it be too honest? Would it be too fair? Would it be too instructive to the needlessly polarized American people? Or would it simply shatter the Republicans' electoral strategy?

Actually, there are two differences.

One is that Ryan wants just about any private health insurance plan to be able to come into his Medicare-replacement exchange and takes its shot at selling coverage.

Obama's plan for the rest of us puts strict government rules on exchange participants.

The other is that old people have a more acute need for universal health insurance than younger people.

Neither of those differences is so great as to warrant all this bitterly divisive and accusatory rhetoric. Neither is so great as to make one man's idea privatization and the other's socialism.

John Brummett is an award-winning columnist for the Arkansas News Bureau in Little Rock and author of "High Wire," a book about Bill Clinton's first year as president. His email address is jbrummett@ arkansasnews.com.