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Medicare is dying like a tree, slowly from the roots.  As we Baby Boomers get ready to come on line (just three years and less than a month for me), the money is drying up, the status quo unsustainable, the supposed trust fund a fiction.  Representative Ryan has put out a proposal that would not affect me or those currently receiving Medicare, but is intended to save it for people under the age of 55 today, who would ultimately be transferred to a federally subsidized market system approach similar to the successful Part D Medicare. It would also means test, which it seems to me is an essential reform that the usually anti-rich Democrats would embrace.

Instead of a conversation, Ryan was predictably accused of throwing Granny off a cliff—even  though “Granny’s” plan wouldn’t actually change.

Republicans better learn to deal with this utterly unsurprising maneuver.  But so far, the efforts are pretty pathetic.  Ryan points to a set of complicated charts to the sound of general snoring.  And now, a conservative group has a website up demanding to know from President Obama, “Where’s your Medicare Plan?” From the Where’s Your Plan.Com:

Dear President Obama,

We’re the generation with the biggest stake in the Medicare reform debate. Medicare trustees report it will be bankrupt in 13 years. We want Medicare for our generation if we’re going to be forced to pay into the program. You don’t have a plan to make it solvent. The GOP does. Mr. President: Where’s Your Plan? [petition to sign].

That’s sweet, but right out of a high school civics class (is that still taught?) and useless.  President Obama and the Democrats know that people don’t get angry at non-plans. And they also know that the people don’t yet see the Medicare iceberg looming in the dark.

So, he and the Democrats aren’t about to release a plan.  That’s for poor saps who believe in open and accountable governance, you know, idealists.  But our president only talks that talk—his walk is opaque and cynical.  He has already cut $500 billion from Medicare under Obamacare—taken mostly out of Medicare Advantage recipients’ hides.  But that wasn’t a “Save Medicare Plan,” it was a bookkeeping scam to allow the CBO to “score” Obamacare as somehow a money saver.

Obama and the Democrats’ Medicare “plan” is to do nothing substantive, and instead, attack any efforts to change the law going into 2012. And when the iceberg tears the hull of the ship, as I have written, they will let their already effectuated Star Chamber Independent Payment Advisory Board cut, slash, and burn Medicare—and eventually, if the NEJM gets its way, the entire health care system—which will turn the USA’s health system into the equivalent of the NHS Meltdown that I keep reporting about.

The beauty for them politically is that they can always blame others for their mess; the insurance companies for cutting care, doctors as greedy for not taking new patients, bad administrators for the long queues for treatment, conservatives for not allowing enough taxation, and say,  “See, no blood on our hands!”—expecting the public not noticing that Medicare died of thirst.

Conservative commentator, Ramesh Ponnuru, is on the case, and gives Republicans a little advice.  He says, the first step is to give people binoculars so they can see the Medicare iceberg! Then, lead.  From his, ” On Medicare: It’s Ryancare Versus the Bureaucrats” in Bloomberg:
When you’re talking about Medicare, at those town halls or in interviews, don’t say that the alternative is bankruptcy and that the Democrats want to do nothing. No, the alternative is heavy-handed bureaucratic cost- cutting. The Democratic plan is cutting payment rates so that Medicare becomes as lousy a program as Medicaid, with doctors refusing to participate in it. The Democratic plan is letting an unelected board decide which treatments won’t get funded.

If your reform plan is weighed against an impossible dream of keeping Medicare exactly as it is regardless of affordability, voters are going to prefer the impossible dream. If it’s compared to the real alternative, you just might make it. Tell the voters: If someone is going to decide how to spend your health-care dollars, shouldn’t it be you?

That message is hard to get across in Short Attention Span Theater nation, where the emotional narrative is King and Queen.  It is hard to make effectively on Twitter.  But it is the only thing that will work.  Moreover, it has the virtue of verite`.  As Lincoln apocryphally said, you can’t fool all of the people all of the time.  We had better hope not.

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