You don’t wait until you have been in a car accident to purchase car insurance; you don’t wait until your house has been flooded to buy flood insurance, and you don’t wait until your home is ablaze to buy fire insurance. That is not how insurance works. And it most certainly is not how health insurance should work. That’s why we have Medicare. Medicare is a program designed primarily for people who are 65 years old or older, most of whom are either retired or working part-time. Their income has gone down at the precise time that their health risks are beginning to skyrocket. These people often don’t have the extra money lying around that they need to pay for either insurance or for prescription drugs and other care. The insurance companies are not interested in insuring the health of the elderly, and if they do offer a plan, it’s going to be astronomically expensive. It’s easy to see why. Someone who needs dialysis at 70 may have paid their insurance company for fifty years by the time they need to make a claim. But someone who has only been a customer since they turned 65 will use up all the money they paid in after only a few treatments. It isn’t profitable to insure old people at any reasonably affordable rate.

So, what we do instead of asking the elderly to go out and buy health insurance is to have them pay into Medicare when they are younger and working full-time. They spread the cost of their health care out over their whole lives, making it more affordable. If they want more coverage than Medicare provides, there are supplemental insurance policies that are much less costly.

But the Republicans don’t like the system. They want to destroy Medicare. If you don’t believe me, take a look at this YouTube of former Bush Secretary of Health & Human Services Tommy Thompson explaining his qualifications to “do away with Medicare and Medicaid.” He’s running for U.S. Senate in Wisconsin.

The real architect of killing Medicare is Mitt Romney’s running mate, Rep. Paul Ryan. He’s the chairman of the House Budget Committee, and he has created two budgets (for fiscal years 2012 and 2013) that would force seniors into the private insurance market. Under his proposal, anyone who isn’t enrolled in Medicare by 2022 will be ineligible to join the program. Instead, they will be given a voucher (i.e., a check) from the federal government to go out and buy insurance on the for-profit market. Actually, you’ll never actually have possession of this voucher. The government will send it to the corporation of your choosing. This is supposed to save the government a lot of money, which is another way of saying that you would receive much less money under Ryan’s plan than you will under current law. Also, the Ryan Medicare plan increases the retirement age from 65 to 67 by 2033. So, many of you would have to wait an extra two years to get your earned benefits.

When the Ryan budget plan came up for a vote in 2011, all but four Republicans voted for it. When his second budget came up for a vote in 2012, all but ten Republicans voted for it. In neither case did any Democrats support the plan. It’s not hard to see why the Democrats voted against it. The American people hated Ryan’s budget, and particularly his voucherization of Medicare. A recent poll of battleground states showed that the American people still hate Paul Ryan’s Medicare plan.

Here in the Philly suburbs, both Rep. Jim Gerlach (6th District) and Rep. Mike Fitzpatrick (8th District) voted for Ryan’s budget both times it came up. They like to pass themselves off as moderates, but as I showed last week with their votes to destroy Planned Parenthood, they have been voting no differently from the most radical and Southern-wing of the Republican Party. Both Gerlach and Fitzpatrick voted to destroy our Medicare program and replace it with inadequate vouchers that make no sense.

And that’s not all they voted for by supporting Ryan’s budgets. They also voted to repeal the president’s signature Affordable Care and Patient Protection Act without replacing it with anything. They voted to vastly reduce the Medicaid program, even repealing acute care services for elderly beneficiaries. They voted to cut discretionary spending in half over the next decade. They voted to eliminate “the Alternative Minimum Tax, cut the 35 percent corporate rate to 25 percent and eliminate taxes on foreign profits.” Although they won’t admit it, the Ryan Budget envisions paying for these tax cuts by eliminating “loopholes” like your home mortgage deduction.

To summarize, the Ryan Plan, which Romney has endorsed and Gerlach and Fitzpatrick both voted for twice, would destroy our Medicare system, slash our Medicaid program, introduce massive new tax cuts for the wealthy while taking away tax deductions for the middle class and cutting the non-entitlement budget in half, even while increasing defense spending.

If that sounds insane, that’s because it is. If that sounds radical, that’s because it would totally reshape our government while massively shifting wealth away from the poor and middle class into the hands of people like Mitt Romney.

But there are no moderate Republicans anymore. Just like Gerlach and Fitzpatrick co-sponsored a bill that redefines rape to only include “forcible” rape, they went along with the radicals in their party on the Ryan Budget.

These aren’t southeastern Pennsylvania values. And that’s why we need to replace Jim Gerlach with Manan Trivedi and Mike Fitzpatrick with Kathy Boockvar.

[The author is a consultant for Democracy for America]