Viewpoints abound on impact of Ryan plan, government showdown

The New York Times: It's Not Really About Spending
If the federal government shuts down at midnight on Friday — which seems likely unless negotiations take a sudden turn toward rationality — it will not be because of disagreements over spending. It will be because Republicans are refusing to budge on these ideological demands: No federal financing for Planned Parenthood. ... No local financing for abortion services in the District of Columbia. ... No funds for health care reform (4/7).

Related KHN story: Policy Riders And Spending Debate Fueling Govt. Shutdown Fears (Eisenhower and Stapleton, 4/7)

Milwaukee Journal Sentinel: On The Brink
Eighty-seven freshmen Republicans were elected to the House last fall, many of them dedicated to the philosophy that smaller is better. They're getting what they wanted -- and what they should do now is cut a deal, declare victory and move on to the far more important questions of funding Social Security, Medicare and Medicaid. ... Ryan woefully underestimates how much money it will take to deliver the government the people want, but we give him credit for addressing entitlement spending after President Barack Obama took a pass. Republicans and Democrats alike should engage in this larger debate (4/7).

San Francisco Chronicle: Shutdown Looms -- It's Mostly Republicans' Fault 
Ryan's approach -- infused with Tea Party hardliners -- cuts deeply into big-ticket social programs such as Medicare, sidesteps Social Security and keeps tax rates low. It's all cuts -- the kind of disastrous imbalance that shaves down the budget but does nothing about deficit overhang. Credit Ryan with bringing up costly and unsustainable medical coverage. So far, Democrats and Obama have largely dodged the unpopular game of fixing the out-of-whack Washington spending machine. But his plan is far too radical to win and undercuts the causes he favors (4/7).

CNN: Ryan's Plan A Step -- But In Wrong Direction
And as some complain about how many physicians are refusing to accept Medicaid now, is there anyone who thinks that more of them will do so once funding is reduced and reimbursement goes down? This isn't a fix (Dr. Aaron E. Carrol, 4/8). 

National Journal: The Cook Report: Death Wish? 
[I]t's little short of suicidal to drop a Medicare reform package—even a voucher plan that would be optional for those currently older than 55—into tough budget negotiations stymied over Republican demands for deep spending cuts. Democrats have some experience with older voters going ballistic, even with changes that wouldn't affect them. For many seniors, doing anything to Medicare that can't be portrayed as an increase is essentially a cut, and they will fight it to their last breath. From a political standpoint, Medicare reform is very dangerous territory. House Republicans are not just pushing the envelope—they are soaking it with lighter fluid and waving a match at it (Charlie Cook, 4/7).

Fox News: A Common Sense Health-Care Plan
In the next decade, enrollment in Medicare will grow by a third and spending per enrollee will jump 50%. By 2040 -- the picture darkens as boomers age and retire. ... The sources of Medicare's budget -- payroll taxes and premiums -- can't keep up with the costs of the program. ... More government involvement -- as Obamacare suggests -- is not a way to fix the healthcare problems of this country. A common sense plan, like the one pitched by Ryan, is. And one more suggestion, tune out the Medicare talk coming from people who like the status quo and read Ryan's plan for yourself (Geri Willis).

The New York Times: Ludicrous And Cruel
[P]rivatizing Medicare does nothing, in itself, to limit health-care costs. In fact, it almost surely raises them by adding a layer of middlemen. Yet the House plan assumes that we can cut health-care spending as a percentage of G.D.P. despite an aging population and rising health care costs. ... In short, this plan isn't remotely serious; on the contrary, it's ludicrous (Paul Krugman, 4/7).

The New York Times: The Ryan Journey
For decades, academics and think tankers have been proposing plans to avert a fiscal catastrophe. The ensuing debates were always sedate, high-minded affairs. Now Republican political leaders have come up with a bold proposal of their own and the atmosphere is totally different. Liberals are on the warpath. Republicans are aroused. This is great. It's democracy — how change begins (David Brooks, 4/7). 

The Washington Post: Rep. Paul Ryan Has It Wrong On The Safety Net
If you think, as House Budget Committee Chairman Ryan seems to, that the safety net is a comfy chair, consider these facts:  Adults without children get no federal help for health coverage. ... Half of Medicare beneficiaries had incomes less than $21,000 in 2010 (Ruth Marcus, 4/7).

The Washington Post: After Ryan's Leap, A Rush Of Deficit Demagoguery
The conventional line of attack on Ryan's plan is already taking shape: It cuts poverty programs and "privatizes" Medicare in order to cut taxes for the rich. Major demagoguery on all three counts (Charles Krauthammer, 4/7). 

The Fiscal Times: Ryan's Budget: Hard to Imagine Something Equally as Extreme
Rep. Paul Ryan's, R-Ohio, draft budget resolution is very important, but not because there is any chance it could be adopted. It is so extreme that Senate Democrats appear strongly opposed to it, and there will surely be very little public pressure to eviscerate Medicare and Medicaid, cut taxes even more for higher-income Americans, fast-track cuts to Social Security (Joseph White, 4/7).

The Sacramento Bee: GOP's Medicare Plan Would Hurt Elderly, States
The curtain has lifted. Rep. Paul Ryan, R-Wis., widely touted as an "honest, deeply serious thinker," has been exposed as a fast-talking salesman peddling snake oil. His blueprint for America, embraced by House Republicans, takes a hard whack at health care for the elderly - shifting costs to individuals and the states (4/8). 

The Sacramento Bee: Paying For Health Care Could Bankrupt Us All
Medicare coverage may be one reason seniors are living longer. Ironically, the benefit has cannibalistically created its own fiscal dilemma. But if government can't afford to provide Medicare - and Congressional Budget Office projections are grim - how will seniors be able to afford it?  (Bruce Maiman, 4/8).

The Philadelphia Inquirer: Why Privatizing Medicare Will Cost More And Reduce Seniors' Coverage
Without question, Medicare must be reformed to bring its spiraling costs under control. Congressman Ryan can be commended for provoking needed debate on how best to do it. But no one should hold the illusion that his plan would lower costs by harnessing private sector efficiency. His plan controls costs by leaving seniors will far less coverage, some of which may be lifesaving (Robert Field, 4/8). 

Forbes: CBO Says GOP Medicare Plan Would Double The Cost Of Health Care For Seniors
I know all too well that many of you can't wait to remind me that CBO numbers can't be trusted. ... you certainly trusted them well enough when the GOP was flouting the CBO estimates as proof of the unacceptably high costs of Obamacare. You don't get to pick and choose which estimates you like and which ones you don't like. So, you have to ask yourself - exactly who is coming out ahead in the GOP proposal? Certainly not the taxpayers or the nation's elderly. That only leaves one possible beneficiary of the Republican plan. Insurance companies (Rick Ungar, 4/7).

Des Moines Register: Fix Medicare But Don't Destroy It
When it comes to proposals to fix Medicare, it doesn't get much worse than what U.S. House Republicans unveiled this week.  ... The truth is there must be some rationing in a program projected to cost more and more as the country's population ages. An independent panel -- free from the influence of special interests -- is needed to make tough decisions about health spending. But the House Republicans' proposal would move the program in a different direction: toward complete privatization (4/7).

Minneapolis Star Tribune: Stem Cells 101
My heart goes out to patients and families waiting for effective treatments and cures. I, too, have been waiting, and actively working toward a cure for my paralysis since a 1980 spinal cord injury. ...  successful therapies using adult stem cells have already been used in humans for years, and more treatments are continually being developed. Passing the Human Cloning Prohibition Act will help ensure that limited public resources will not be used for futile, ineffective research purposes, but rather for those that are most beneficial to real people with real medical issues (Jean Swenson, 4/7).

Los Angeles Times: A Remedy For Medical Bill Ills
The obvious solution for making the cost of treatments clear and consistent is to replace individual contracts between insurers and providers with fixed prices determined by a panel of experts (David Lazarus, 4/8).

Minnesota Public Radio: Say What?
I'd finally, at age 56, had a hearing test because, well, for some reason I'd been asking her, or her sisters, or their dad, or quite a few other people to repeat themselves. ... [Hearing aids] cost about $3,000 per ear. A hefty price not covered by insurance. At least not then. Between the time I'd first looked into it and checking again in the summer, health reform had passed. My insurance company informed me they would now pay for hearing devices, as long as I went to a preferred provider (Debbie Duncan, 4/8).