VP Debate: Two Visions For Medicare

Vice President Joe Biden and Rep. Paul Ryan laid out their parties’ competing visions for Medicare at the vice presidential debate in Danville, Ky., on Thursday.

A transcript follows.

MARTHA RADDATZ: Let’s talk about Medicare and entitlements.

Both Medicare and Social Security are going broke and taking a larger share of the budget in the process. Will benefits for Americans under these programs have to change for the programs to survive, Mr. Ryan?

PAUL RYAN: Absolutely. Medicare and Social Security are going bankrupt. These are indisputable facts.

Look, when I look at these programs, we’ve all had tragedies in our lives. I think about what they’ve done for my own family. My mom and I had my grandmother move in with us who was facing Alzheimer’s. Medicare was there for her, just like it’s there for my mom right now who’s a Florida senior. After my dad died, my mom and I got Social Security survivors benefits. Helped me pay for college. It helped her go back to college in her 50s, where she started a small business because of the new skills she got. She paid all of her taxes on the promise that these programs would be there for her. We will honor this promise.

And the best way to do it is reform it for my generation. You see, if you reform these programs for my generation, people 54 and below, you can guarantee they don’t change for people in or near retirement, which is precisely what Mitt Romney and I are proposing.

Look at Obamacare does. Obamacare takes $716 billion from Medicare to spend on Obamacare. Even their own chief actuary at Medicare backs this up. He says you can’t spend the same dollar twice. You can’t claim that this money goes to Medicare and Obamacare.

And then they put this new Obamacare board in charge of cutting Medicare each and every year in ways that will lead to denied care for current seniors. This board, by the way, it’s 15 people. The president’s supposed to appoint them next year. And not one of them even has to have medical training.

And Social Security, if we don’t shore up Social Security, when we run out of the IOUs, when the program goes bankrupt, a 25 percent across-the-board benefit cut kicks in on current seniors in the middle of their retirement. We’re going to stop that from happening.

They haven’t put a credible solution on the table. He’ll tell you about vouchers. He’ll say all these things to try and scare people.

Here’s what we’re saying: Give younger people, when they become Medicare-eligible, guaranteed coverage options that you can’t be denied, including traditional Medicare.

Choose your plan, and then Medicare subsidizes your premiums, not as much for the wealthy people, more coverage for middle-income people and total out-of-pocket coverage for the poor and the sick. Choice and competition — we would rather have 50 million future seniors determine how their Medicare is delivered to them instead of 15 bureaucrats deciding what — if, where, when they get it.

RADDATZ: Vice President Biden, two minutes.

JOE BIDEN: You know, I heard that death panel argument from Sarah Palin. It seems that every vice presidential debate, I hear this kind of stuff about panels. But let’s talk about Medicare.

What we did is we saved $716 billion and put it back — applied it to Medicare. We cut the cost of Medicare. We stopped overpaying insurance companies when doctors and hospitals — the AMA supported what we did. AARP endorsed what we did. And it extends the life of Medicare to 2024. They want to wipe this all out. It also gave more benefits. Any senior out there, ask yourself: Do you have more benefits today? You do. If you’re near the doughnut hole, you have $600 more to help your prescription drug costs. You get wellness visits without copays. They wipe all of this out, and Medicare goes — becomes insolvent in 2016, number one.

Number two, guaranteed benefit — it’s a voucher. When they first proposed — when the congressman had his first voucher program, the CBO said it would cost $6,400 a year, Martha, more for every senior 55 and below when they got there. He knew that, yet he got it — all the guys in Congress, and women in the Republican party to vote for it. Gov. Romney, knowing that, said, I would sign it were I there. Who you believe, the AMA? Me? A guy who’s fought his whole life for this? Or somebody who had actually put in motion a plan that knowingly cut — added $6,400 a year more to the cost of Medicare?

Now they got a new plan. Trust me, it’s not going to cost you any more. Folks, follow your instincts on this one.

And with regard to Social Security, we will not privatize it. If we had listened to Gov. Romney and the congressman during the Bush years, imagine where all those seniors would be now if their money had been in the market. Their ideas are old, and their ideas are bad, and they eliminate the guarantee of Medicare.

RYAN: Here’s the problem. They got caught with their hands in the cookie jar turning Medicare into a piggy bank for Obamacare. Their own actuary from the administration came to Congress and said one out of six hospitals and nursing homes are going to go out of business as a result of this.

BIDEN: That’s not what they said.

RYAN: Seven point four million seniors are projected to lose the current Medicare Advantage coverage they have. That’s a $3,200 benefit cut.

BIDEN: That didn’t happen.

RYAN: What we’re saying –

BIDEN: More people signed up.

RYAN: These are from your own actuaries.

BIDEN: More people signed up for Medicare Advantage after the change.

RYAN: What they’re –

BIDEN: No, nobody is getting shut down.

RYAN: Mr. Vice President, I know –

BIDEN: No — no –

RYAN: Mr. Vice President, I know you’re under a lot of duress  to make up for lost ground, but I think people would be better served if we don’t keep interrupting each other.

BIDEN: Well, don’t take all the four minutes, then.

RYAN: Now let me say this. We are saying, don’t change benefits for people 55 and above. They already organized their retirement around these promises.

BIDEN: They already are –

RYAN: But you want to — these programs for those of us –

RADDATZ: Let me ask you this: what is your specific plan for seniors who really can’t afford to make up the difference in the value of what you call a premium support plan and others call a voucher?

RYAN: A hundred percent coverage for them.

RADDATZ: And what –

RYAN: That’s what we’re saying.

RADDATZ: How do you make that up?

RYAN: So we’re saying income-adjust these premium support payments by taking down the subsidies for wealthy people. Look, this is a plan — by the way, that $6,400 number, it was misleading then. It’s totally inaccurate now. This is a plan that’s bipartisan. It’s a plan I put together with a prominent Democrat senator from Oregon.

BIDEN: There’s not one Democrat who endorsed this –

RYAN: It’s a plan –

BIDEN: — not one Democrat who signed his plan.

RYAN: Our partner is a Democrat from Oregon.

BIDEN: And he said he does no longer supports –

RYAN: We put it together with the former Clinton budget director.

BIDEN: Who disavows it.

RYAN: This idea — this idea came from the Clinton commission to save Medicare, chaired by Sen. John Breaux. Here’s the point, Martha.

BIDEN: Which was rejected.

RYAN: If we don’t fix this problem pretty soon, then current seniors get cut.

Here’s the problem. Ten thousand people are retiring every single day in America today, and they will for 20 years. That’s not a political thing. That’s a math thing.

BIDEN: Martha, if we just did one thing, if they allow Medicare to bargain for the cost of drugs like Medicaid can, that would save $156 billion right off the bat.

RYAN: And it would deny seniors choices.

BIDEN: Seniors are not denied.

RYAN: Absolutely.

BIDEN: Sorry, they are not denied.

Look, folks, and all you seniors out there, have you been denied choices? Have you lost Medicare Advantage or, if you have signed up –

RYAN: Because it’s working well right now.

BIDEN: Because we changed the law.

RADDATZ: Vice President Biden, let me ask you, if it could help solve the problem, why not very slowly raise the Medicare eligibility age by two years, as Congressman Ryan suggests?

BIDEN: Look, I was there when we did that with Social Security, in 1983. I was one of eight people sitting in the room that included Tip O’Neill negotiating with President Reagan. We all got together, and everybody said, as long as everybody’s in the deal, everybody’s in the deal, and everybody is making some sacrifice, we can find a way. We made the system solvent to 2033.

We will not, though, be part of any voucher plan eliminating — the voucher says, Mom, when you’re 65, go out there, shop for the best insurance you can get, you’re out of Medicare. You can buy back in, if you want, with this voucher, which will not keep pace with health care costs, because if it did keep pace with health care costs, there would be no savings. That’s why they go the voucher. We will be no part of a voucher program or the privatization of Social Security.

RYAN: A voucher is you go to your mailbox, get a check and buy something. Nobody’s proposing that. Barack Obama, four years ago, running for president, said if you don’t have any fresh ideas, use scare tactics to scare voters. If you don’t have a good record to run on, paint your opponent as someone people should run from. Make a big election about small ideas.

RADDATZ: You were one of the few lawmakers to stand with President Bush when he was seeking to partially privatize Social Security.

RYAN: For younger people. What we said then and what I’ve always agreed is let younger Americans have a voluntary choice of making their money work faster for them within the Social Security system.

BIDEN: You saw how well that worked.

RYAN: That’s not what Mitt Romney’s proposing. What we’re saying is no changes for anybody 55 and above.

BIDEN: What Mitt Romney is proposing –

RYAN: And then the kinds of the changes we’re talking about for younger people like myself is don’t increase the benefits for wealthy people as fast as everybody else –

BIDEN: Martha –

RYAN: — slowly raise the retirement age over time.

BIDEN: Martha –

RYAN: It wouldn’t get to the age of 70 until the year 2103, according to the actuaries.

Now, here’s the issue.

RADDATZ: Quickly, Vice President.

BIDEN: Quickly, the bottom line here is that all the studies show that if we went with Social Security proposal made by Mitt Romney, if you’re 40 — in your 40s now, you will pay $2,600 a year — you get $2,600 a year less in Social Security.

If you’re in your 20s now, you get $4,700 a year less. The idea of changing — and change being, in this case, to cut the benefits for people without taking other action you could do to make it work — is absolutely the wrong way.

These guys haven’t been big on Medicare from the beginning. Their party’s not been big on Medicare from the beginning. And they’ve always been about Social Security as little as you can do. Look, folks, use your common sense. Who do you trust on this? A man who introduced a bill that would raise it $6,400 a year, knowing it and passing it, and Romney saying he’d sign it? Or me and the president?

RYAN: That statistic was completely misleading. But more importantly –

BIDEN: That’s — there are the facts, right?

RYAN: — this is — this is what politicians do when they don’t have a record to run on: try to scare people from voting for you. If you don’t get ahead of this problem, it’s going to —

BIDEN: Medicare beneficiaries have more benefits now —

RYAN: We are not going to run away — we are not going to run away –

RADDATZ: OK. We’re going to — we’re going to move on to a very simple question to you both.

RYAN: Medicare and Social Security did so much for my own family. We are not going to jeopardize this program, but we have to save it for the next generation so it doesn’t go bankrupt.

BIDEN: You are jeopardizing the program. You’re changing the program from a guaranteed benefit to a premium support. Whatever you call it, the bottom line is people are going to have to pay more money out of their pocket.

RYAN: The wealthy would.

BIDEN: And the families I know and the families I come from — they don’t have the money to pay more out of —

RADDATZ: Gentlemen, gentlemen –

RYAN: That’s why we’re saying more for lower-income people and less for higher-income people.

RADDATZ: I would like to move on to a very simple question for both of you. And something tells me –

RADDATZ: — I won’t get a very simple answer. But let me ask you this.

BIDEN: I gave you a simple answer: He’s raising the cost of Medicare.