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Paul Ryan Talks 2012, Town Hall Protesters, Medicare, Tax Reform, and More!

8:00 AM, Apr 28, 2011 • By JOHN MCCORMACK
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During the town hall meetings of 2009 and other protests of the national health care bill, then-Speaker of the House Nancy Pelosi tried to marginalize the opposition as "astroturf" at best and "un-AmericanNeo-Nazis at worst.

Paul Ryan

For Paul Ryan, his detractors at the townhall meetings on his budget resolution are simply a normal and predictable part of American politics.

"Like the health care town hall crowds, there’s an effort from various groups to get their people into the town halls to [use] their talking points," Ryan told me Wednesday afternoon. But that doesn't make his opponents' criticism illegitimate.

“This is Wisconsin," Ryan says. "We have divergent political views. We have a lot of political diversity. Any town hall is going to represent that, some more than others.”

"I’ve come away from these town halls encouraged," says Ryan. "I’ve come away from these town halls impressed with how well people have versed themselves in budget problems and issues."

"The crowds have been overwhelmingly positive," he continues. (And you don't have to take his word for it: Just pick up the New York Times.)

Of course, the debate over Ryan's budget proposal has only just begun. In recent weeks, he's faced criticism not only from Democrats, but also from some potential 2012 Republican candidates.

Newt Gingrich suggested that future seniors (those now younger than 55 scheduled to get a Medicare subsidy when they turn 65 under Ryan's plan) should have the option to stay in the current Medicare system. What's wrong with that?  

"I don’t have a problem with that," Ryan replies. "I think it’s a fine idea worth considering. [Bill Clinton's budget director] Alice Rivlin and I have talked about that in the past."

But could his budget achieve the same amount of savings if future seniors had that choice?

Ryan says it's possible "because it wouldn’t be an open-ended fee for service system, like the current one for the under-55 plan. They would get a set amount of money to go toward the traditional fee for service and then, like current Medicare they’d probably buy coverage to supplement it. I would think a person would prefer a comprehensive plan like Medicare Advantage is today, but you can do this in a way that doesn’t have a budgetary effect, that it doesn’t bankrupt the program."

Ryan was dismissive, however, of likely presidential candidate and former Minnesota governor Tim Pawlenty's idea to reform Medicare through "payment reforms" that would incentivize health care providers to produce better health care outcomes.

"Medicare has yet to do this successfully," Ryan told me. "The president wants his IPAB [Independent Payment Advisory Board] to do essentially the same thing. It’s very difficult for a centralized bureaucracy to do that.... When they get these targets, like the president is giving them, you know a half a trillion dollars, they just sort of do indiscriminate cutting across the board, lowering reimbursement to providers, causing providers to drop out of the program altogether."

Indiana governor Mitch Daniels seems to be the potential GOP presidential candidate most supportive of Ryan's plan. "I think that’s accurate," Ryan says. He's talked to Daniels recently about the budget in general but says "your guess is as good as mine" when asked for the odds that Daniels actually runs. 

Ryan continues to have high praise for Daniels. "He understands the issues and the system pretty well," Ryan says. "He understands if we don’t fix this now, people are going to get hurt."

But if no viable candidate emerges to champion real Medicare reform, would Ryan consider making a run for president himself?

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