Clipboard: Paul Ryan sharpens attack on Affordable Care Act

Republican vice presidential candidate Paul Ryan took the convention stage last night, making some of his strongest criticisms of the Obama administration about the national health law the president signed in 2010. But Ryan’s attack was attacked this morning, called deceitful or misleading by some analysts.

First, an excerpt from Ryan’s speech:

Obamacare comes to more than two thousand pages of rules, mandates, taxes, fees, and fines that have no place in a free country.

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The president has declared that the debate over government-controlled health care is over. That will come as news to the millions of Americans who will elect Mitt Romney so we can repeal Obamacare.

And the biggest, coldest power play of all in Obamacare came at the expense of the elderly.

You see, even with all the hidden taxes to pay for the health care takeover, even with new taxes on nearly a million small businesses, the planners in Washington still didn’t have enough money. They needed more. They needed hundreds of billions more. So, they just took it all away from Medicare. Seven hundred and sixteen billion dollars, funneled out of Medicare by President Obama. An obligation we have to our parents and grandparents is being sacrificed, all to pay for a new entitlement we didn’t even ask for. The greatest threat to Medicare is Obamacare, and we’re going to stop it.

In Congress, when they take out the heavy books and wall charts about Medicare, my thoughts go back to a house on Garfield Street in Janesville. My wonderful grandma, Janet, had Alzheimer’s and moved in with Mom and me. Though she felt lost at times, we did all the little things that made her feel loved.

We had help from Medicare, and it was there, just like it’s there for my mom today. Medicare is a promise, and we will honor it. A Romney-Ryan administration will protect and strengthen Medicare, for my mom’s generation, for my generation, and for my kids and yours.

So our opponents can consider themselves on notice. In this election, on this issue, the usual posturing on the left isn’t going to work. Mitt Romney and I know the difference between protecting a program, and raiding it. Ladies and gentlemen, our nation needs this debate. We want this debate. We will win this debate.

Factcheckers at Politifact analyzed Ryan’s comments about the billions taken from Medicare as exaggerated and “mostly false”:

Ryan said Obama “funneled” $716 billion out of Medicare “at the expense of the elderly.” This gives a very misleading impression.

In fact, the law limits payments to health care providers and insurers to try to reduce the rapid growth of future Medicare spending. Lawmakers said they hoped the measures would improve care and efficiency. Those savings, spread out over the next 10 years, are then used to offset costs created by the law (especially coverage for the uninsured) so that the overall law doesn’t add to the deficit.

Ryan himself proposed similar Medicare cost-saving measures. That’s something that Sally Kohn, a Fox News commentator, pointed out in her analysis, calling the speech both dazzling and deceiving.

A Wall Street Journal editorial lauded the Republican strategy of attacking the national health law: “The Romney campaign deserves credit for staging an Inchon landing by skillfully using ObamaCare to go on offense against Mr. Obama on Medicare. Liberals and the reporters they dine with still can’t bring themselves to believe that their historic achievement is unpopular, so they and the press corps refuse to admit that the Affordable Care Act has changed the entitlement debate.”

I asked Joshua Archambault, director of health care policy at the conservative-leaning Pioneer Institute, for his take on Ryan’s comments. Yes, Ryan calls for cuts in Medicare. But Archambault said in an e-mail, the Democrats’ “Ryan did it too” argument, as Yuval Levin described it, is weak:

The best way to understand the differences in the competing Medicare plans is by examining the different approaches to get to $716 billion. As Washington Post and left leaning blogger Ezra Klein has written “The difference between the two campaigns is not in how much they cut Medicare,” he writes, “but in how they cut Medicare.”

Romney and Ryan want to build off the success of competition in Medicare Part D for a prescription drug benefit and apply many of those lessons to the wider Medicare program. Of course the devil is in the details, and many folks want to know exactly how this program would be set up.

The approach taken in Obamacare is to cut reimbursement rates to hospitals, doctors and nursing homes, gut the Medicare Advantage program, and let IPAB make some funding decisions in the future. Two related but significant differences between the two plans is that the ACA cuts would kick in earlier and impact those over the age of 55. Romney’s plan would only impact those under 55 and the savings would take longer to be realized.

Meanwhile, New York magazine writer Jonathan Chait was incisive in his commentary. On Ryan’s health care comments he wrote, “Here was Ryan actually assailing not the method but the goal, implicitly conceding his position that health insurance is not an entitlement but a nice thing everybody would like but not everybody can have, like a beach house.”

Kaiser Health News has a look at what others had to say about the law during convention speeches last night.