Romney Gives Medicare Lecture On Tarmac

Mitt Romney took another crack at resetting the Medicare debate today, calling an impromptu press conference on the tarmac of a South Carolina airport. With a black marker in his hand and a whiteboard to his side, the Republican presidential candidate tried to spell out, literally, the differences between his and President Obama's policies.

"You're going to have to take me over here," Romney said, asking the cameras to track along with him as he gestured toward his handy visual aid. "As you can see, there's no change in Medicare for seniors. None, under my plan."

"My plan stays the same. No adjustments, no changes, no savings," Romney said. Next generation retirees," he added, will get "the option of having standard Medicare, a fee for service-type government run Medicare, or private run Medicare."

The comments seemed to run counter to what he said Wednesday night, when in an interview with ABC affiliate WBAY in Wisconsin, Romney argued his and running mate Paul Ryan's proposals for revamping Medicare are "the same, if not identical."

"Ryan is on my ticket and we have the same plan together," Romney said. "He and I have exactly the same policy."

But a closer look at the numbers indicates significant differences in how the two halves of the Republican ticket would go about their reforms. There are also more pointed questions about what they would do with the money slated to be cut from the Medicare bankroll when President Obama's Affordable Care Act goes into effect.

First, there is the issue of the $716 billion the president's health care law will take from Medicare to cover costs across the board. Ryan's budget cuts the same amount from Medicare, but rather than re-investing the money, it is used – or not used – to ease the deficit.

Romney is less clear about where the cuts would go, or if there would be cuts at all.

"Governor Romney believes Obamacare was a terrible mistake and has repeatedly made clear he believes it must be repealed in its entirety. This includes," a campaign official said, "repeal of President Obama's $716 billion in cuts that slash provider payments and Medicare Advantage and threaten seniors' access to care."

But here's the twist: Both Ryan and Obama, in backing the same cuts Romney has said he plans to "restore," have said the reductions will be made in a way that protects beneficiaries while targeting waste, fraud, and abuse in the system.

By that logic, Romney is now promising to re-introduce wasteful and fraudulently-incurred expenses.

Any successful repeal of the health care law would mean the elimination of a bevy of new protections already effectively recouping record-high sums of wasted Medicare cash.

Of the estimated $70 billion of Medicare waste in 2010, regulators have recovered an unprecedented $4 billion thanks to the new measures, according to the nonpartisan Center for Medicare Advocacy.

An even bigger issue facing Romney's plan could be the impact on the solvency of Medicare, which was extended by eight years under the law, to 2024.

Since the bulk of the spending cuts involved reduced payments to hospitals, drug companies and other service providers, restoring the original, higher rates could accelerate the path to bankruptcy, experts say -- at least until a Romney-Ryan plan to convert the program into a fixed-benefit, voucher-style program could be put in place.

"Gov. Romney's plan is to repeal Obamacare and replace it with patient-centered reforms that control cost throughout the health care system and extend the solvency of Medicare," spokeswoman Andrea Saul said. "He will then implement real entitlement reform that places Medicare on a sustainable long-term footing so that future generations of Americans will not have to worry whether the program will be there for them."

Romney has only offered broad outlines of his plan, not yet detailing how it would work or how he would pay for it.

The Obama campaign has scented the confusion and pounced. Spokeswoman Lis Smith says "all we do know about Mitt Romney's plan is that he would end Medicare as we know it by turning it into a voucher system, which could increase health care costs by $6,400 a year."

That so-called "voucher system" is actually a hallmark of the Ryan plan, and Democrats have been working tirelessly to marry Romney to it. In it, Medicare would be privatized for the next generation of seniors (anyone under 55 years old). The government would stop paying doctors directly, instead giving patients money – in the form of vouchers – and allowed to spend it on a private provider of their choosing.

The space between the money allotted to patients and what the government would be projected to pay if Medicare kept on its current form is, according to the Congressional Budget Office, $6,358.97.

For now, Romney appears to be banking on winning the ear of wealthier older folks enrolled in Medicare Advantage programs that provide extra benefits for those who opt-in.

Paul Ryan will campaign in The Villages, Florida, Saturday. The "active retirement community" is one of the largest in the country. It has a heavy Republican population and is an active donor (as The Villages of Lake Sumpter, Inc.) to Romney Super PAC "Restore Our Future."

ABC News' Steven Portnoy, Shushannah Walshe and Chris Good contributed to this report.

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