Can you imagine Medicare being enacted by a zombified Congress that takes a worthless doodysack like Paul Ryan seriously?

July 30, 1965: With former President Harry Truman looking
on, President Lyndon Johnson signs Medicare into law

"After reading Atlas Shrugged, [Paul Ryan] said, 'Wow, I've got to check out this economics thing.' "

-- as told to The New Yorker's Ryan Lizza, this week
in "Fussbudget: How Paul Ryan captured the G.O.P."

by Ken

We'll come back to the egregious Representative Ryan. First let's pause to ponder the lead story today from history.com's "This Day in History," which my friend Paul kindly passed on: Jul 30, 1965: Johnson signs Medicare into law.

On this day in 1965, President Lyndon B. Johnson signs Medicare, a health insurance program for elderly Americans, into law. At the bill-signing ceremony, which took place at the Truman Library in Independence, Missouri, former President Harry S. Truman was enrolled as Medicare's first beneficiary and received the first Medicare card. Johnson wanted to recognize Truman, who, in 1945, had become the first president to propose national health insurance, an initiative that was opposed at the time by Congress.

The Medicare program, providing hospital and medical insurance for Americans age 65 or older, was signed into law as an amendment to the Social Security Act of 1935. Some 19 million people enrolled in Medicare when it went into effect in 1966. In 1972, eligibility for the program was extended to Americans under 65 with certain disabilities and people of all ages with permanent kidney disease requiring dialysis or transplant. In December 2003, President George W. Bush signed into law the Medicare Modernization Act (MMA), which added outpatient prescription drug benefits to Medicare.

Medicare is funded entirely by the federal government and paid for in part through payroll taxes. Medicare is currently a source of controversy due to the enormous strain it puts on the federal budget. Throughout its history, the program also has been plagued by fraud--committed by patients, doctors and hospitals--that has cost taxpayers billions of dollars.

Medicaid, a state and federally funded program that offers health coverage to certain low-income people, was also signed into law by President Johnson on July 30, 1965, as an amendment to the Social Security Act.

In 1977, the Health Care Financing Administration (HCFA) was created to administer Medicare and work with state governments to administer Medicaid. HCFA, which was later renamed the Centers for Medicare & Medicaid Services (CMS), is part of the Department of Health and Human Services and is headquartered in Baltimore.

As it happens, today is also the day that The New Yorker unleashes on the world an embarrassingly toadying paean to the increasingly egregious Paul Ryan by the increasingly alarming Ryan Lizza. With one or two fleeting exceptions, of which I doubt that Lizza himself grasps the significance, the piece reads as if it came straight out of Frankenryan's PR shop. It's pretty much PRyan's own view of himself and the world he lives in, faithfully transcribed by RyanL as if it were true.

The coincidence of the Medicare anniversary is oddly ironic, because as we all recall from the 2010 election season, Medicare is a program that all the Teabagging cretins managed to forget as they blithered their imbecilic diatribes against government. And the egregious PRyan is one of the more immediate threats in the land to the future of Medicare as well as Social Security.

Early on in RyanL's puff piece, there's a surely unintended glimpse of his status as a made-to-order mark for a self-importantly earnestly geeky self-promoter like PRyan:

Unlike most members of Congress these days, Ryan is relatively accessible to reporters. "The key to understanding me is really simple," he said. "I am not trying to be anybody other than who I actually am." Even his ideological foes comment on his friendliness and good nature. After his sophomore year in high school, back in 1986, he worked the grill at McDonald's. "The manager didn't think I had the social skills to work the counter," he said. "And now I'm in Congress!"

RyanL appears so enthralled by his access to PRyan that he appears to completely miss the chill of that declaration, "And now I'm in Congress!," coming from a man who historically lacks the social skills to work the counter at McDonald's.

We do learn some interesting things about PRyan, like the big-fish-in-a-small-pond world of entitlement he was born into:

Janesville, Wisconsin, where Ryan was born and still lives, is a riverfront city of sixty-four thousand people in the southeast corner of the state, between Madison and Chicago. Three families, the Ryans, the Fitzgeralds, and the Cullens, sometimes called the Irish Mafia, helped develop the town, especially in the postwar era. The Ryans were major road builders, and today Ryan, Inc., started in 1884 by Paul's great-grandfather, is a national construction firm. The historic Courthouse section of Janesville is still thick with members of the Ryan clan. At last count, there were eight other Ryan households within a six-block radius of his house, a large Georgian Revival with six bedrooms and eight bathrooms that is on the National Register of Historic Places.

PRyan makes an enormous effort, and it's completely successful with RyanL, to portray himself as an aw-shucks ordinary feller, a true man of the people. The reality, it appears, is that he has always had an inborn sense of entitlement -- the unearned sense of self of a born princeling.

We learn too that, at age 16, PRyan suffered a trauma from which it seems likely he's never recovered:

[T]he summer of 1986 brought a life-changing event. One night in August, he came home from work well past midnight, and he slept late the following morning. His mother was in Colorado visiting his sister, and his brother, who had a summer job with the Janesville parks department, had left early. Paul answered a frantic phone call from his father's secretary. "Your dad's got clients in here," she said. "Where is he?" Paul walked into his parents' bedroom and thought his father was sleeping. "I went to wake him up," he told me, "and he was dead."

"It was just a big punch in the gut," Ryan said. "I concluded I've got to either sink or swim in life." His mother went back to school, in Madison, and studied interior design; his grandmother, who suffered from Alzheimer's, moved into their home, and Ryan helped care for her. "I grew up really fast," he said.

One can feel sincerely sorry for little PRyan -- though "a big punch in the gut" does seem a curious way of describing it, especially at this remove in time. It suggests that even grown-up PRyan thinks his father's death was all about him. And despite his description of his supposed accelerated growing up, and with all possible allowance for the great stress of those years, it seems more likely that the upshot was that the little brat never did grow up. If you understand him as being emotionally frozen in time at the age of 16, at which point he was apparently a profoundly maladroit social misfit, lacking the social skills for McDonald's counter work, then I think you've got the profile of the adult PRyan. It's a shame no one put him together with the kind of mental help he clearly needed at the time, but that's water under the bridge now.

Naturally that misanthropic loon Ayn Rand makes her appearance:

His father's death also provoked the kind of existential soul-searching that most kids don't undertake until college. "I was, like, ‘What is the meaning?' " he said. "I just did lots of reading, lots of introspection. I read everything I could get my hands on." Like many conservatives, he claims to have been profoundly affected by Ayn Rand. After reading "Atlas Shrugged," he told me, "I said, ‘Wow, I've got to check out this economics thing.' What I liked about her novels was their devastating indictment of the fatal conceit of socialism, of too much government." He dived into Friedrich Hayek, Ludwig von Mises, and Milton Friedman.

My read: He read and read and read, and managed never to get deeper into "this economics thing" than the cartoon world of his beloved Ayn. Howie has written so much here about the breadth and depth of PRyan's economic ignorance that I'm not going to mine that pit here.

Again, there's no indication that RyanL has any clue as to the significance of this next story, set up by PRyan's profession of great hopefulness about developing a good working relationship with the new president, Barack Obama, based on all their similarities. (Well, they're from relatively close parts of the country, and they both like sports, and . . . well, you'll have to read this for yourself.) So imagine his surprise when -- after all those years of savaging Democrats -- poor PRyan finds himself in the president's crosshairs. It's the classic case of an individual with absolutely no insight into or understanding of himself (this is, after all, the man who grew out of the boy who lacked the social skills to work the counter at McDonald's), and doesn't hear a single word that comes out of his ignorant, poisonous mouth.

In mid-April of 2011, in a speech at George Washington University, Obama once again decided to make an example of Ryan. Republicans were finally about to vote on the Path to Prosperity, and the President was eager to offer his opinion. Obama, for nearly the first time in his Presidency, emphasized the ideological divide between the two parties rather than offering bromides about what they shared. The White House invited Ryan to the speech and reserved a V.I.P. seat for him. Obama had personally called Ryan after Republicans won the majority in the House the previous November, and Ryan thought the two might have a rapport. They both liked sports and, because Ryan's district runs along the Illinois border close to Chicago, knew many of the same people. "He's a cerebral guy who likes policy, and he's from my part of the country," Ryan said. "At the beginning, I did have some hope."

Ryan sat in the front row as the President shredded his plan. "I believe it paints a vision of our future that's deeply pessimistic," Obama said. "There's nothing serious about a plan that claims to reduce the deficit by spending a trillion dollars on tax cuts for millionaires and billionaires. And I don't think there's anything courageous about asking for sacrifice from those who can least afford it and don't have any clout on Capitol Hill."

Ryan seemed genuinely shocked. During a radio interview later in the day, he complained that Obama had called him "un-American," and he objected to the charge that he was "pitting children with autism or Down syndrome against millionaires and billionaires" and "ending America as we know it." Ryan told me, "I was expecting some counteroffer of some kind. What we got was the gauntlet of demagoguery."

Alas, poor PRyan, tragic victim of "the gauntlet of demagoguery"!

Finally, there is the one moment when RyanL clearly does see a wee problem with PRyan's self-presentation. Much is made in the piece of PRyan's moving commitment to his home region, and to its bounceback from the devastation of Janesville's abandonment by GM -- no longer as a manufacturing center (nothing is made there now, we're told), but as a distribution center. As we'll see in a moment, even the generally clueless PRyan grasps that such bounceback as Janesville has achieved has been largely attributable to government spending. But . . . .

When I pointed out to Ryan that government spending programs were at the heart of his home town's recovery, he didn't disagree. But he insisted that he has been misunderstood. "Obama is trying to paint us as a caricature," he said. "As if we're some bizarre individualists who are hardcore libertarians. It's a false dichotomy and intellectually lazy." He added, "Of course we believe in government. We think government should do what it does really well, but that it has limits, and obviously within those limits are things like infrastructure, interstate highways, and airports." But independent assessments make clear that Ryan's budget plan, in order to achieve its goals, would drastically reduce the parts of the budget that fund exactly the kinds of projects and research now helping Janesville.

Um, oops!

And this is the man who would at least like to be thought of as the brains, economically speaking, of the House Republican caucus. It's my understanding that PRyan is a lot less popular among House Republicans than RyanL seems to think. Nevertheless, it remains entirely possible, given sufficiently disastrous 2012 election results, that a Republican-controlled White House and Senate as well as House could shove into law some version of PRyan's economic "reforms." If there's anyone who isn't terrified by that possibility, I don't know what it would take.

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