Amidst the furor over Rep. Paul Ryan’s new budget proposal , advocates for strong retirement programs appear to be in a bind. On one hand, Ryan subjects Medicare and Medicaid to scathing cuts and a restructuring agenda so radical that they could no longer be called real insurance for America’s workers. On the other hand, on a welcome note for Social Security advocates, the budget largely bypassed direct cuts to Social Security (though it did propose some dangerous fast-track procedures  for ramming through future cuts). So, is it time for at least half a well-earned Hurrah?
As it turns out, not so much. To see why the Republican plan not only violates the promise of Medicare but also of Social Security, we have to zoom out and consider the overarching goal of both these programs. Though passed in different eras, each aims to provide a certain level of economic security for seniors. And they have been wildly successful: Social Security keeps 20 million Americans out of poverty , while Medicare has improved life expectancy and access to life-saving medications across-the-board. Both of these programs are designed to avoid the horror stories of seniors having to choose between food and prescription drugs, skip family visits, or forego things that make for a decent life.
The Ryan plan’s omission of direct cuts to Social Security is no doubt a victory for the program’s advocates, whether it was due to sober electoral considerations (polling shows the vast majority of Americans strongly oppose benefit cuts ) or the messaging efforts of progressive coalitions like the Strengthen Social Security Campaign . But that progress would be instantly negated if Ryan’s cuts to Medicare are enacted, since people would be forced to reallocate their Social Security income (the part that isn’t already dedicated to fixed expenses – food, mortgage payments, etc.) towards medical expenses, which can’t exactly be skimped on. Grandma, can’t that knee replacement wait until next month?
These cuts amount to a direct assault on the purchasing power of Social Security – as well as any other source of retirement savings a person has amassed. The government may as well send seniors their Social Security checks with a forwarding envelope to send right along to the private insurance companies waiting to collect! In the zero-sum world of retirement security programs, cuts in one program necessarily damage the goals of another. The Ryan plan threatens the entire foundation of programs we have established to care for our elderly for three important reasons:
According to the Congressional Budget Office (CBO), seniors entering [Medicare] in 2030 can expect to pay $20,000 out of their own pockets  for health care. If Social Security payments continue to be adjusted at the same rate they were over the last decade, the average person on Social Security will receive a little over $21,000 that year…. Even if we take [the CBO’s] more conservative estimate, the new Republican proposal will use up the average person's entire Social Security benefit within ten years of its taking effect.
COLA or not, the pace of growth of health care will eventually swallow Social Security – but maybe this is Ryan’s plan all along.
The moral of the story is that demolishing Medicare is, in addition to being terrible policy on its own, is just another way of taking a crack at Social Security. They are two sides of the same coin, and the foundation of reliable retirement security is fundamentally damaged if either of these two programs is cut.
There are also political lessons for Ryan’s budget plan, which will be voted on this week. The every-man-for-himself strategy of some groups on the left trying to prevent cuts for their particular program-of-choice has failed, and it will fail again. This is a time for progressive coalitions that revolve around the same sets of values – economic security, prosperity, fairness to our seniors – to come together and articulate a vision of these programs that goes beyond dollars and cents. More than the defensive rationale offered thus far by the White House for opposing Social Security cuts, a vision like this could remind Americans what these programs mean in a way that goes beyond statistics or graphs. Only such a vision can generate the political support we’ll need to carry us through the coming battles.