Mr. Ryan, who has proposed a controversial voucher program for Medicare, accused Mr. Obama of being the bigger threat because of savings wrung from the growth of spending in the program contained in the president’s health care overhaul of 2010.  He said a board of “15 unelected bureaucrats” would decide what should be cut, and that “one out of six of our hospitals and our nursing homes will go out of business.”  “The president raids $716 billion from the Medicare program to pay for the Obamacare program,” Mr. Ryan said, to boos from a crowd of more than 1,000 seniors in this vast retirement community.  Left unsaid was that his own budget plan passed by the House in March includes the same $716 billion in savings, to be used to reduce the deficit.  Having Mr. Ryan take the Medicare fight to Florida, a crucial battleground state that Mr. Obama won in 2008, represented an effort by Mitt Romney’s campaign to turn what many strategists predicted would be the ticket’s Achilles’ heel — Mr. Ryan’s detailed and aggressive budget cuts — into an asset.  With his 78-year-old mother looking on, Mr. Ryan, 42, wove a story of generational obligation to personalize the long-term threat to Medicare’s solvency. He described how he and his mother, Betty Ryan Douglas, were the primary caregivers for a grandmother with Alzheimer’s disease who moved into their Wisconsin house when he was a teenager.  “You learn a lot about life,” he said. “Medicare was there for my family, for my grandma, when we needed it. And Medicare is there for my mom when she needs it now, and we have to keep that guarantee.”  To save Medicare for current and future retirees, he added, “you have to reform it for my generation, so it doesn’t go bankrupt when we want to retire.”  President Obama, campaigning in New Hampshire on Saturday, dismissed the Romney campaign’s tactics on Medicare, saying that it was Mr. Romney and Mr. Ryan who threatened the program.  “Now you think they’d avoid talking about Medicare, considering both of them have proposed to voucherize the Medicare system,” Mr. Obama said. “They want seniors to get a voucher to buy their own insurance, which would force seniors to pay an additional $6,400 for their health care.”  Mr. Obama defended Medicare and his health care overhaul, saying the “only changes to your benefits” were that Medicare now covers preventive services like cancer screenings at no cost. The $718 billion in cost savings — or cuts — over the next decade, he said, add about eight years to Medicare’s solvency.  Mr. Obama also zeroed in on the twofer of Mr. Ryan’s budget proposals and Mr. Romney’s tax returns, days after Mr. Romney disclosed that he paid around 13 percent in taxes over the past 10 years.  “He put forward a plan that would let Governor Romney pay less than one percent in taxes a year,” Mr. Obama said of Mr. Ryan, to jeers from the crowd. “And here’s the kicker: he expects you to pick up the tab!”  He called the Romney-Ryan budget proposals “snake oil” — an apparent downgrade from the phrase he was using last week in Iowa to describe the Republican economic proposals, “fairy dust.”  “They’ve been trying to sell this trickle-down snake oil before,” Mr. Obama said.  Mr. Romney spent Saturday in Massachusetts, hopping between high-dollar fund-raisers on Cape Cod, Martha’s Vineyard and Nantucket, including at the homes of the billionaire industrialist Bill Koch and Jeffrey R. Jay, a private equity executive who specializes in health care companies.  Mr. Romney, who has said he would sign the House budget as president, seemed to back away this week from that commitment when he emphasized that he would restore the Medicare cuts incorporated in the budget plan.  And Mr. Romney made clear that his running mate supported his own position. “Congressman Ryan has joined my campaign, and his campaign is my campaign now, and we’re on exactly the same page,” he said in an interview with CBS.  The $716 billion in cuts — or savings — come from reducing payments to providers over the next decade in an effort to control costs. They include lower payments to hospitals and nursing homes, and to providers of Medicare Advantage plans, which are private.  The Romney campaign argued that lower payments would lead to fewer services. “In an imaginary world where government simply controls everything and everyone, this might sound like an effective way to control cost,” Lanhee Chen, Mr. Romney’s policy director, wrote in a memo distributed on Saturday. “In the real world, the result will be fewer providers accepting Medicare payments, and worse care for today’s seniors.”  Speaking before the crowd of seniors on Saturday, Mr. Ryan emphasized that his plan, incorporated into the House budget, would not begin until people who are younger than 55 today become eligible for Medicare.  “Our solution to preserve, protect and save Medicare does not affect your benefits,” he said. “Let me repeat that.”  Mr. Ryan introduced his mother as a snowbird who lived part of the year “just down the road over near Lauderdale.”  “She planned her retirement around this promise” of Medicare, he added. “That’s a promise we have to keep.”  Trip Gabriel reported from The Villages, Fla., and Helene Cooper from Windham, N.H.  This article has been revised to reflect the following correction:  An earlier version of this article said that Mr. Ryanâs plan would not begin until people who are younger than 54 today become eligible for Medicare. The correct age limit is younger than 55.  An earlier version of this article said that Mr. Ryanâs plan would not begin until people who are younger than 54 today become eligible for Medicare. The correct age limit is younger than 55.
Paul Ryan spoke of his care for a relative with Alzheimerâs, seeking to counter President Obamaâs charge that Republicans would âend Medicare as we know it.â