No big deal taking 800 billion out of medicade or is it???

According to Paul Ryan, vice president hopeful, gutting 800 billion is 'no big deal'. After viewing the short video found here, respond to the following: What impact will the cuts make to do you believe? Who wins/loses as a result of the cuts? Should Canadian's facing high debt loads like the States take this kind of action as well? Would love to hear your thoughts on this!