The New York Times calls it a “delicate pivot.” Or, you could call it blazing hypocrisy.

In short, Republicans are attacking the president’s health care act for both being too expensive and cutting Medicare.

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That is a reprise of Republicans’ mantra of the 2010 midterm elections, which gave them big gains at both the state and federal levels and a majority in the House. Yet the message conflicts not only with their past complaint that Democrats opposed reining in Medicare spending, but also with the fact that House Republicans have voted twice since 2010 for the same 10-year, $500 billion savings in supporting Mr. Ryan’s annual budgets.

The result is a messaging mess, even by the standards of each party’s usual election-year attacks that the other is being insufficiently supportive of older people’s benefits.

Sure. More health care costs more. Dreaming: A more efficient system — single-payer — would provide more coverage for less than a system based on unimaginable profits for insurance companies and medical specialists. It would bring tougher controls on use of the system. Call it death panels if you want. It’s at least rational, unlike the current lottery-like system for haves (including some who’ve made a fetish or hobby of medical diagnostics) and have-nots.

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