It occurs to me that the Republican party's willingness to back the Ryan Medicare modification might derive from a misunderstanding. Unions and management have spent decades going back and forth on a variety of issues. For the last twenty-ish years, a lot of unions have cut deals with management that were based on seniority, which turned out to be virtually identical to basing them on age. The deals were cut in the auto industry, at Disney, and at a lot of other companies in a lot of other industries, but they all basically amount to: newly hired workers will belong to the union, they will pay dues, they will be part of collective bargaining. However, their pay scale and benefits will be drastically different from the people who had a certain seniority when the new deal was adopted. The young guys, once they have that seniority, will never get those perks.
It's not just for unions, either. For example, my husband will get a 4 week sabbatical that more recent hires will never get because the benefit has been phased out.
These are deals that are relatively uneventful to negotiate compared to attempts to cut benefits/pay scale across the entire union, which can be _very_ eventful.
I think a whole bunch of people got to thinking that Medicare (and probably social security, too) worked the same way, so all you had to do was guarantee the system would stay in place for everyone with a certain seniority, and the newer entrants wouldn't really expect anything anyway and be grateful for what they did get, in much the same way that the tiny number of new recruits to a unionized auto plant, for example, are happy to get the job and in no position to take action to break the deal.
Industries that cut this kind of deal often go through a dire period of no hires and extensive layoffs. New hires are really grateful to get in and there are not very many of them. You get the deal in during a low spot and it's a done deal by the time new people come along. As long as you never get into a position where there's less labor than management needs, the deal won't ever be broken. And this is where the misunderstanding happened. There haven't _been_ layoffs from Medicare (or social security). And for all people about my age, give or take, say they aren't expecting these programs to be around when we're eligible to benefit from them, _we are lying_. We _do_ expect them to be around. Most people my age and younger have very little real plan for how they are going to retire and/or pay their future medical bills -- the plan for many is still work till we drop. But we do NOT expect to be denied health care or to be living on the streets when we drop. If we really believed that Medicare and/or Social Security might really go away (and to the extent that we really do believe that) we would be behaving differently (hint: that's why Bush's efforts to privative Social Security went over so badly, that's part of how Obama got elected, and why health care was such a priority for the Democratic Party).
This is may be a case of a drastically bad choice of analogy when engaging in public policy. On the part of the Republican Party, that is.