Vice presidential debate gets prickly on healthcare

In a discussion that got prickly and personal, Vice President Joe Biden and Rep. Paul D. Ryan on Thursday night clashed over their competing plans for Medicare and Social Security, two topics of deep concern to older voters.

As the candidates for vice president parried, Ryan accused the Obama administration of “getting caught with its hand in the cookie jar,” and Biden charged that the plans proposed by Ryan and former Massachusetts Gov. Mitt Romney would privatize Medicare and wind up cutting benefits for younger people as they approached retirement age.

“Look, these guys have not been big on Medicare since the beginning,” Biden said, adding that the same was true of Social Security. “Folks, use your common sense.”

Ryan called the vice president’s argument “completely misleading,” and said the plan that he and Romney support would reduce benefits for the wealthy in order to maintain benefits for the poor and middle class.” “More for low-income people and less for high-income people,” he said.

TRANSCRIPT: Read Biden, Ryan’s arguments

Romney and Ryan support a plan that would eventually provide an option for Medicare recipients to purchase private insurance using a government stipend. The plan would not apply to people who are at least 55 now. The Republican candidates say both Medicare and Social Security cannot be sustained at current levels. President Obama and Biden oppose that “voucher” plan -- a name the GOP does not use -- saying it would ultimately result in a cut in benefits.

The debate on the topic -- like just about every other issue the candidates discussed -- grew heated at times, with Biden frequently laughing at Ryan and interrupting him, and Ryan showing some annoyance.

“Mr. Vice President, I know you’re under a lot of duress,” Ryan said at one point after he was interrupted. Biden laughed. “But,” Ryan continued, “I think we’ll be better served if we don’t interrupt each other.”

Ryan also repeated a criticism that Romney has made -- that the president’s healthcare plan would empower a 15-member appointed panel to make decisions about individuals’ care.

“We would rather have 50 million future seniors determine how their Medicare is delivered to them instead of 15 bureaucrats deciding what -- if, where, when, they get it,” Ryan said.

The panel he speaks about would negotiate treatment protocols with insurers; it could not decide individual cases.

DEBATE QUIZ: Who said it?

Biden shot back: “You know, I heard that death panel argument from Sarah Palin. It seems that every vice presidential debate, I hear this kind of stuff about panels.”

The two also clashed over the administration’s plan to cut $716 billion in Medicare costs by negotiating lower rates, in particular for so-called Medicare Advantage plans -- a type of Medicare sold by private companies that contract with the federal government. Ryan’s budget made the same $716-billion cut, which he would use to reduce the federal deficit. Romney and Ryan have said Obama and Biden simply want to use the money to fund Obamacare.

“What we did is, we saved $716 billion and put it back -- applied it to Medicare,” Biden said. “We cut the cost of Medicare. We stopped overpaying insurance companies when doctors and hospitals -- the AMA supported what we did. AARP endorsed what we did. And it extends the life of Medicare to 2024. They want to wipe this all out.”

That led to one of the most spirited exchanges of the debate:

“Here’s the problem,” Ryan said. “They got caught with their hands in the cookie jar turning Medicare into a piggy bank for ‘Obamacare.’ Their own actuary from the administration came to Congress and said 1 out of 6 hospitals and nursing homes are going to go out of business as a result of this.”

PHOTOS: Paul Ryan’s past

Biden cut in: “That’s not what they said.”

Ryan: “7.4 million seniors are projected to lose the current Medicare Advantage coverage they have. That’s a $3,200 benefit cut.”

Biden: “That didn’t happen.”

Ryan: “What we’re saying -- “

Biden: “More people signed up.”

Ryan: “These are from your own actuaries.”

The exchange went on like this until Ryan said: “Mr. Vice President, I know you’re under a lot of duress” -- Biden laughed heartily -- “to make up for lost ground -- but I think people would be better served if we don’t keep interrupting each other.”

“Well,” Biden said, “don’t take all the four minutes then.”

Follow Politics Now on Twitter and Facebook

mitchell.landsberg@latimes.com

Twitter: @LATlands