WASHINGTON -- Republican presidential candidate Mitt Romney proposed overhauling Medicare to allow beneficiaries to enroll in private health care plans on Thursday, a step in the direction of Rep. Paul Ryan's controversial plan for the entitlement program.
"Tomorrow's Medicare should give beneficiaries a generous defined contribution and allow them to choose between private plans and traditional Medicare. And lower-income future retirees should receive the most assistance. I believe that competition will improve Medicare and the coverage that seniors receive," Romney wrote in a USA Today op-ed published online late Thursday afternoon.
It was the only mention of Medicare in a longer op-ed by Romney about his plan for reducing government spending and debt, and the policy was only mentioned at the end of the piece. But it is new ground for Romney, who as late as last Friday gave no indication that he was considering such a move, when asked by a voter in New Hampshire.
A Romney adviser said the former Massachusetts governor held back details of his proposal last week to wait until he was ready to unveil it this week. Romney was set to discuss the proposal Thursday evening in New Hampshire and also plans to address it in a speech on Friday in Washington.
Rep. Ryan (R-Wis.), House Budget Committee chairman, is the foremost Republican leader on the issue of overhauling Medicare, Medicaid and Social Security. Ryan is at the vanguard of a movement within conservatism to reduce health care costs through price transparency and competition between health care providers. Liberals and progressives oppose the policy in favor of prioritizing and protecting the program as it currently exists. President Obama's health care overhaul included a range of changes to health care practices and would regulate health care prices under covered plans through an Independent Payment Advisory Board.
Whatever the means, if health care costs are not brought under control, the government's entitlement programs threaten to consume most of the federal budget. The three big entitlement programs are the main contributors to the mandatory spending portion of the budget, which already accounts for almost two-thirds of annual government spending.
Ryan met with Romney last week, and told the Weekly Standard that Romney "gets the situation, and I think he's serious about fixing it if elected."
"I think [Rick] Perry's the same way," Ryan added. "I know Herman [Cain]'s the same way."
Romney knows he is taking a political risk by embracing substantial changes to government benefits that go largely to the elderly and the poor. Some Democrats have accused Ryan of trying to destroy the programs, and will do the same with Romney. Ryan has fired back that his plan changes nothing for seniors currently in the program or soon to be enrolled, and that if nothing is done to make the programs solvent they will collapse under their own weight.
The Ryan plan does represent a completely different direction for the programs that drastically shrinks the role of government and puts more faith in free market forces. Liberals and progressives vehemently oppose Ryan's plan, and argue it would force Americans to pay too much for medical care out of their own pocket. Therein lies the fundamental difference between the conservative and liberal visions for the future of health care and government benefits. It is in large part a battle over how and to what extent American government will interact with the individual in the years to come.
UPDATE: 6:28 p.m. -- The Washington Post's Jen Rubin pointed out that Romney's approach would differ from Ryan's plan in one significant way: it would make the private sector path optional and preserve the traditional Medicare program for those who want it.
Romney said as much during an interview with the Las Vegas Review-Journal earlier this week.
Rubin writes that Ryan has said does not "have a problem" with the optional approach, though some conservatives are skeptical that such an approach would work.
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