This year, Republicans addressed entitlements again, in the budget prepared by House Budget Chairman Paul Ryan and approved in the House.

His proposal was to shift Medicare from the current plan to “premium support,” in which seniors would get subsidies to pay for their choice of competing insurance plans. This is similar to the Part D Medicare prescription drug program that has won wide acceptance and has cost far less than projections.

Once again, Democrats have responded negatively. They credit their “Mediscare” tactics for a special election victory in a Republican House district in upstate New York.

What’s interesting is that, in contrast to 2005, we have had nothing in the way of presidential leadership on this issue. Barack Obama, hailed by some conservatives and most liberals as a pragmatic problem-solver, has been happy to play politics on entitlements as well as on the budget.

He blithely ignored the recommendations of his own commission headed by Erskine Bowles and Alan Simpson. He has said since he would take a look at raising the Medicare eligibility age — it’s now lower than the Social Security age.

But anyone can take a look at a proposal. We pay presidents a good salary to lead, not just to look.

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