As a fellow budget wonk, I like Paul Ryan a lot. But his policy proposals fall far short of his winning personality. Ryan, the Wisconsin representative Republican presidential candidate Mitt Romney announced today as his running mate, is both thoughtful and prolific. I could have many policy debates with him on a range of issues. Today, though, Iâm going to focus on health care. Ryanâs approach to health care is somewhat akin to a doctor observing that an arm is finally showing some signs of healing -- and then deciding to amputate it. CBOâs analysis, not surprisingly, confirms that federal expenditures under the Ryan Medicare plan would be reduced sharply. Federal payments for a typical beneficiary by 2030, for example, would be more than 20 percent lower than current projections. But CBO also analyzed a more relevant question: What would happen to total health-care costs, including the extra costs for the beneficiaries as the federal share was reduced? Total costs are what matters, since simply shifting costs around without altering the total does not accomplish much. Costs Shared According to CBO, Ryanâs plan would not reduce total health-care costs. Instead, it would increase the total, because more cost-sharing for consumers doesnât do that much to constrain spending and because private plans have higher administrative costs and less negotiating leverage than the federal Medicare program. You read that right: According to CBO, the Ryan Medicare plan would increase health-care spending. In 2030, total health- care spending for the typical beneficiary would be more than 40 percent higher under the Ryan plan than under existing Medicare. http://www.bloomberg.com/news/2012-08-11/paul-ryan-is-thoughtful-handsome-and-misguided.html