Paul Ryan has just made three strong points:

• If there are going to be cuts to Medicare, the savings should go to shore up Medicare rather than to a new health-care entitlement.
• There are significant philosophical differences in approach; the Democrats want a government-run program, and the Republicans want to give people more freedom and more choices.
• To the extent that there are areas of agreement, we should start over and work on something from scratch.

The president replied by trying to put the Republicans on the defensive about Medicare Advantage, but Ryan did not get to respond for the GOP.