Paul Ryan admits  that he’s an “end Medicare as we know it” candidate.
But, somehow, we are not supposed to think that he would actually end the popular and successful healthcare program for the elderly , as well as related Medicaid programs for the poor and people with disabilities.
The “as we know it” part provides a sort of cover, at least in the eyes of a media that is more inclined toward stenography than journalism.
Never mind that Ryan, a rabid reader of government-can-do-no-good fanatic Ayn Rand , goes positively wide-eyed when he starts talking about how desperately he wants to downsize government—and shift control of healthcare and retirement programs to the insurance and Wall Street interests that so generously fund his campaigns. We’re not supposed to talk about the long-term crony-capitalist scheme of certain Republicans to do away with government programs that work so that private sector profiteers can come in and create programs that don’t work—except for private sector profiteers.
Never mind that the Republican nominee for vice president has a long history of decrying Social Security, Medicare and Medicaid  in Randian terms such as “collectivist” and “socialistic.”
Never mind that Ryan has griped that “Social Security right now is a collectivist system. It’s a welfare transfer system.”
Never mind that, as recently as 2010 , Ryan dismissed Medicare and Medicaid as part of a “socialist based system” that needs to be replaced.
The red flags are not supposed to go up until someone actually says they want to, you know, “do away with Medicaid and Medicare.”
Never mind that, even now, Ryan complains about how America is being overwhelmed by “takers ” (citizens who claim benefits to which they are entitled) and the “welfare state ” (Social Security, Medicare and Medicaid).
Only when a candidate starts talking about ending entitlement programs—as in “doing away” with them—can we be serious about the immediate threat those programs actually face.
Meet Tommy Thompson , former Republican governor of Wisconsin, former Bush-Cheney administration secretary of health and human services, former candidate for the Republican nomination for president and mentor to Paul Ryan.
Speaking to a Tea Party group while campaigning for Wisconsin’s open US Senate seat, Thompson recounted how he “reformed” welfare in Wisconsin.
Back in the 1990s, Thompson said he wanted to “end welfare as we know it.” In fact, he replaced the program with a classic combination of high-government spending, lots of patronage appointments and rising poverty.
Now, Thompson has dropped the “end welfare as we know it” pretense. He brags that he finished off “one of the entitlement program.”
And he’s gunning for a couple of other entitlement programs.
You guessed it: Medicaid and Medicare.
Declaring that he wants to “change Medicare and Medicaid like I did welfare,” Thompson asked a May gathering of the Lake Country Area Defenders Of Liberty in Oconomowoc, Wisconsin : “Who better to and who better than me, who’s already finished one of the entitlement programs, to come up with programs to do away with Medicaid and Medicare?”
The video has only now surfaced and its a blockbuster—especially in the aftermath of the release last week of a similar video that saw Republican presidential nominee Mitt Romney dismissing 47 percent of Americans as a "dependent" class unworthy of Republican consideration.
Just to repeat: a top Republican Senate candidate has been caught on video talking about how he would “DO AWAY WITH MEDICAID, AND MEDICARE.”
Just to repeat: “DO AWAY WITH MEDICAID, AND MEDICARE .”
It should be understood that Thompson is no fringe-dwelling Todd Akin. As the longtime Republican governor of a swing state, he’s worked with every GOP president since Ronald Reagan, and he oversaw social programs for the Bush-Cheney administration. This year, he’s one of his party’s premier recruits in the fight to retake the Senate. Indeed, the race between Thompson and Democratic Congresswoman Tammy Baldwin  could decide which party controls the chamber.
Thompson is, as well, closely aligned with Paul Ryan . The Senate candidate’s ties to Ryan’s politically connected family go back to when the Republican vice presidential nominee was a child. Thompson has been a Ryan booster from the very beginning of the younger Wisconsinite’s career in electoral politics—when Thompson was the powerful governor of the state and Ryan was organizing his first Congressional bid.
When Thompson joined the Bush-Cheney Cabinet, he and Ryan kept regular company in Washington. They look forward to working together when Thompson becomes the point man on entitlement debates in a Republican-controlled Senate and Ryan is the Romney White House’s chief liaison to Capitol Hill.
The voters will have something to say about that, however.
If they want to preserve Medicaid and Medicare, they will remember that, while Ryan may add the “as we know it” spin, Thompson gets to the heart of the matter when he says it is the intention of these “reformers” to “do away with Medicaid and Medicare.” 
Tommy Thompson isn't the only extreme Republican who threatens to take a seat in the Senate. Check out George Zornick's coverage  of Todd Akin's run in Missouri.