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FiredUp! has done an excellent job of detailing Sarah Steelman’s efforts to have her cake and eat it too when it comes to the topic of Paul Ryan’s plan to kill the Medicare program that has served us so well. Her spokesperson, Rick Wilson, has attempted to throw her a lifesaver as she grapples with the dilemma of how to avoid the poison apple that Ryancare represents, claiming that she doesn’t need to commit to Ryan’s plan or disavow it because “The test here is between people who are serious about reforming Medicare and people who are not.”

This response is, of course, silly since Steelman was asked to evaluate a very specific plan to “reform” Medicare, and her answer indicates that she is either not intellectually equipped to do so, or is afraid to come down on either side of the issue. It does, however, suggest that the real question is actually whether or not Medicare needs to be reformed and suggests further that Steelman believes it does. (Of course, last February she seemed to believve that Medicare was unconstitutional – ground she doesn’t seem to want to revisit right now.)

Perhaps the next question Steelman should be asked is why Medicare needs to be reformed. Contrary to the impression that all the current banter about entitlements suggests, Medicare is currently solvent and will be so for a number of years. It is also considerably more efficient in terms of its cost-to-service ratio than the private health care sector, which suggests that the issue to be addressed is not structural.  

The real risk to Medicare is rising health care costs that will cause demands on its resources to grow significantly. These costs have nothing to do with Medicare itself, but with our national health care delivery system. If the GOP would only stop their tantrums about “Obamacare” and assist its implementation like responsible adults, we would soon know if the Affordable Care Act (ACA) provisions that were designed to control costs were going to be effective and adjust them if needed. Of course, that would require a commitment to the real work of governing, rather than to ideology.

Remind me now, where does Steelman stand on the ACA? Oops! She wants to repeal it. Since our only real choices right now are between the models suggested by Obamacare or Ryancare, cutting health care costs or gutting a successful health care delivery system, I think we can guess where she stands.