Republican scare-mongering of Democratic health reform has officially come back to bite them -- hard -- in a rather juvenile ad from an independent Democratic group.

The ad, by advocacy group The Agenda Project, depicts a man in a black suit, ostensibly a stand-in for Rep. Paul Ryan (R-WI), pushing an elderly woman in a wheelchair off a cliff.

It evokes all the worst images from 2009's summer-long health reform debate, in which Republicans on Fox News insisted for months that offering insurance coverage for "end-of-life care" was somehow akin to establishing what they called "death panels" that would decide who was worthy of saving.

Agenda Project's ad is a response to Rep. Ryan's plan to end the public health program Medicare, which currently supports the well-being of more than 46 million Americans. Ryan's plan would convert Medicare into a coupon program over the next decade and force many seniors to seek care from the more costly private market.

The Ryan budget has been criticized by Democrats as extremist, and even fellow Republican Newt Gingrich suggested it was "right-wing social engineering" -- although he backtracked after that remark triggered a torrent of fury from the right.

While the Republican-dominated House of Representatives did pass the Ryan budget, it is a non-starter in the Senate and President Obama has promised to veto the bill, should it make it as far as his desk.

A recent poll found that most Americans, including Republicans, do not want to see Medicare eliminated.

The video below is from The Ed Show, broadcast by MSNBC.