So much attention has been drawn by the proposed substitution of "vouchercare" for Medicare that many voters have overlooked a companion disaster bearing down on them.

As middle class voters on the wrong side of the farcical 55 year old safe harbor (below which age your future at the tender mercies of the Ryan budget is bleak indeed) weigh the pros and cons of changing a defined benefit Medicare program for a defined contribution vouchercare program ( cf. exchanging a pension for a 401k) they probably cluck their tongues but fret little over the planned trillion dollar cut in Medicaid. They think it will not impact them--after all, they are financially troubled but not yet so poor as to qualify for Medicaid.

This is a very short sighted analysis. Many of those on either side of the 55 year old line will end their days in a nursing home. When they do, whether they have "spent down" so as to shift the backbreaking 5-8k/month cost to Medicaid or not, the aides who change their diapers will be shared with the multitudes who are on Medicaid.

In 2005, for instance, Medicaid paid 52% of all revenue flowing to support nursing homes. Slash Medicaid and you slash the ratio of aides to patients.

Those who are forced to shop for a nursing home are frequently advised to take a good sniff of the air just inside the front door. The resulting olefactory encounter will provide a good index to the level of staffing and quality of care. Not to put too fine a point on it, the interval between diaper changes will become immediately discernible.

Thus, we can say without hesitation that voting for Ryan/Romney is a vote to have your loved one sit longer in a soiled diaper, pushing (if she has that much mobility and presence of mind) a call button and praying for some relief.

We know, then, what a Repugnant victory smells like-It smells like shit, and your mother is sitting in it.