The speech has three sections, with the end being an appeal to comity and shared sacrifice and the beginning a balancing act where he juggles American exceptionalism and an uncomfortable degree of “we screwed up and if we don’t change course the debt will eat our children” pro-austerity framing. In the middle you have the policy details, which start halfway down page 5, after he shits all over the Ryan plan in order to put his own ideas in context.
What I’m concerned with here are the claims that’re at least halfway measurable, verifiable, etc. Kind’ve hard to decide exactly where to draw the line; when he says he won’t allow Medicare to become a voucher program, that’s impossible to misinterpret. “We will invest in new roads and airports and broadband access,” is less clear but we can at least watch for these things to happen. On the other hand, rhetorical ornamentation like “I will preserve these health care programs as a promise we make to each other in this society” could mean almost anything. Paul Ryan wants to turn Medicare into a promise that old people will fuck off and die, for instance.
Having read this, my biggest concern are the spending cuts and the harm they’ll bring at both the human and economic levels. I’m not comfortable at all with the “efficiency and accountability from medicaid” stuff, but the entitlement stuff is actually really solid overall. I’m not sure what’s up with the bit about a trigger for meeting projections by 2014, as it seems to be phrased to imply that the plan would provide a binding mechanism to force the President and Congress to get together and… figure something else out. I’m guessing I’m not going to like the finer details on that one, but we’ll see.
– $750 billion over 12 years cut from domestic spending
– invest in medical research, clean energy, roads, airports, broadband, education, job training
– “additional savings” in defense. Pretty vague, but refers to $400 bn already achieved in “current and future” savings and says “we can do that again” via “Fundamental review” of military “missions, capabilities, and our role in a changing world”
– lower healthcare costs by reducing “wasteful subsidies” and “erroneous payments”
– allow Medicare to use its “purchasing power to drive greater efficiency and speed generic brands of medicine onto the market.”
– “demand more efficiency and accountability from Medicaid”
-Pay doctors to “prevent injuries and improve results” rather than by quantity of treatment
-Medicare: setup “an independent commission of doctors, nurses, medical experts and consumers who will … recommend the best ways to reduce unnecessary spending while protecting access to the services that seniors need.”
-Medicare/Medicaid reforms will save “$500 billion by 2023, and an additional $1 trillion in the decade after that.”
-“will not allow Medicare to become a voucher program”
-“strengthen Social Security for future generations … without putting at risk current retirees, or the most vulnerable, or people with disabilities; without slashing benefits for future generations; and without subjecting Americans’ guaranteed retirement income to the whims of the stock market.”
-save $320 bn / 10 years by limiting itemized deductions for top 2%
-“reform our individual tax code”
-“[reduce] tax expenditures [new framing for cuts / deductions] so that there’s enough savings to both lower rates and lower the deficit”
-“reform our corporate tax code”
-“reduce the deficit by $4 trillion over the next 12 years.”
-“If, by 2014, our debt is not projected to fall as a share of the economy … require us to come together and make up the additional savings with more spending cuts and more spending reductions in the tax code.”