Ryan Plan “V” Word: A Voucher By Any Other Name…
When President Obama met with congressional Republicans this week, GOP leaders were particularly incensed about Democrats using the word “voucher” when describing the Republican plan to end Medicare. Paul Ryan and others prefer “premium support,” and consider the Dems’ rhetoric to be “demagoguery.”
There are two main problems with this rhetorical disagreement. The first is that the GOP plan really does rely on vouchers, whether the party cares for the word or not. The second is that plenty of far-right Republicans are inclined to ignore their party’s talking-point instructions.
Here, for example, was Sen. Ron Johnson (R) of Wisconsin, a Tea Party favorite, explaining one of the things he likes most about his party’s Medicare plan.
“What I like about the Paul Ryan plan is it’s trying to bring a little bit of free-market principles back into Medicare.
“If you need subsidized care, we’ll give you vouchers. You figure out how you want to spend. You select what insurance carrier you want to use. It’s a start.”
It’s not just Johnson. Last week, GOP presidential hopeful Herman Cain argued, “Nobody’s talking about the fact that the centerpiece of Ryan’s plan is a voucher. Now, a lot of people don’t like to use that term because it has a negative connotation. That is what we need.” Even Fox News has referred to the Republican plan as being built around “vouchers.
If conservative Republicans are using the word, why is it outrageous when Democrats do the same thing? Are Johnson, Cain, and the Republican cable news network all secretly siding with the left?
As for the substance behind the claim, it’s worth noting that this isn’t just about semantics — the GOP claim that their scheme doesn’t include vouchers is just wrong. Paul Krugman explained yesterday:
[T]he ACA is specifically designed to ensure that insurance is affordable, whereas Ryancare just hands out vouchers and washes its hands. Specifically, the ACA subsidy system (pdf) sets a maximum percentage of income that families are expected to pay for insurance, on a sliding scale that rises with income. To the extent that the actual cost of a minimum acceptable policy exceeds that percentage of income, subsidies make up the difference.
Ryancare, by contrast, provides a fixed sum — end of story. And because this fixed sum would not grow with rising health care costs, it’s almost guaranteed to fall far short of the actual cost of insurance.
This is also why Ryancare is NOT premium support; it’s a voucher system. No matter how much they say it isn’t, that’s exactly what it is.
Given this reality, why do Republicans throw such a fit about the use of the “v” word? Because vouchers don’t poll well. For the right, the key is to come up with phrasing, no matter how deceptive, that persuades the public. If GOP leaders throw a big enough tantrum, they’re hoping everyone — Dems, pundits, reporters, even other Republicans — will use the words they like, rather than more accurate words that make the party look bad.
No one should be fooled.
By: Steve Benen, Contributing Writer, Washington Monthly Political Animal, June 4, 2011
Gov. Rick Scott May Personally Benefit From New Law That Hands Medicaid Program Over To Private Companies
Florida Gov. Rick Scott (R) signed “a landmark Medicaid overhaul” yesterday that will put “hundreds of thousands of low-income and elderly Floridians into managed-care plans.” The proposal “gives managed care companies more control over the program that’s paid for with federal and state money,” a shift the state GOP claims will “hold down spiraling costs in the $20 billion program.” However, as TP Health editor Igor Volsky pointed out, a five-county pilot program in Florida already revealed that such a plan produces “widespread complaints and little evidence of savings.” Under managed care, states “have to ensure that private payers aren’t looking out for short term profits by denying treatments or reducing reimbursement rates” and — given what occurred during the pilot program — the results “are already less than promising.”
But Scott may have another reason to push a dubious bill into law. As Mother Jones reported, one of the private managed-care companies that stand to gain from the new law is Solantic, “a chain of urgent-care clinics aimed at providing emergency services to walk-in customers. Solantic was founded in 2001 — by none other than Rick Scott:
The Florida governor founded Solantic in 2001, only a few years after he resigned as the CEO of hospital giant Columbia/HCA amid a massive Medicare fraud scandal. In January, according to the Palm Beach Post, he transferred his $62 million stake in Solantic to his wife, Ann Scott, a homemaker involved in various charitable organizations.[…]
“This is a conflict of interest that raises a serious ethical issue,” says Marc Rodwin, a medical ethics professor at Suffolk University Law School in Boston. “The public should be thinking and worrying about this.”
Scott’s office dismissed the conflict of interest concern as “incorrect and baseless.” However, Scott’s history of fraud with entitlement programs (in that case Medicare) should certainly raise a red flag here. And it is not as if Scott is completely clean when it comes to the mix between professional office and personal interest.
Incidentally, Scott also just signed a bill that will require anyone applying for welfare benefits to pay for a drug test to qualify for benefits. They will only recoup that fee if they pass. One company that provides such drug tests? Solantic.
By: Tanya Somander, Think Progress, June 3, 2011
Bad News For Americans Who Eat Food
In December, Americans who eat food received some very good news. A sweeping overhaul of the nation’s food-safety system, approved by both chambers with large, bipartisan majorities, cleared Congress, and was quickly signed into law by President Obama.
The long-overdue law expands the FDA’s ability to recall tainted foods, increases inspections, demands accountability from food companies, and oversees farming — all in the hopes of cracking down on unsafe food before consumers get sick. This was the first time Congress has approved an overhaul of food-safety laws in more than 70 years.
That’s the good news. The bad news is, the Republican-led House is fighting to gut the law.
Budget cuts proposed by House Republicans to the Food and Drug Administration would undermine the agency’s ability to carry out a historic food-safety law passed by Congress just five months ago, food safety advocates say. […]
To carry out the new law, President Obama is seeking $955 million for food safety at the FDA in the fiscal year that starts Oct. 1.
Last week, the House Appropriations subcommittee that oversees the FDA pared back that amount to $750 million, which is $87 million less than the figure the agency is currently receiving for food safety.
“This subcommittee has begun making some of the tough choices necessary to right the ship,” said Chairman Jack Kingston, (R-Ga.).The full committee was scheduled to vote on the proposed cuts Tuesday, and the budget proposal was expected to pass.
Republicans on the House Appropriations Committee approved the cuts yesterday, which are severe enough to prevent the FDA from implementing the new law. Erik Olson, director of food and consumer product safety programs at the Pew Health Group, part of a coalition of public health advocates and food makers, said this week, “These cuts could seriously harm our ability to protect the food supply.”
Boy, those midterm elections really set the country on the right path, didn’t they?
It’s also worth appreciating the fact that these cuts to food safety were made in the name of fiscal responsibility, but it’s a classic example of being penny wise and pound foolish. Indeed, cutting funding on food safety is likely to cost us more money, not less.
I realize this may seem counter-intuitive. I can even imagine some Fox News personality telling viewers, “Those wacky liberals think it costs money to cut spending! What fools!”
But this just requires a little bit of thought. When we cut spending on food safety, we save a little money on inspection, but end up paying a lot of money on health care costs when consumers get sick.
The GOP approach is misguided as a matter of public health, public safety, and budgeting.
By: Steve Benen, Contributing Writer, Washington Monthly, June 1, 2011
“Republican Virtues”: I Don’t Think So
I’ve been mulling over a column by David Brooks on “The Politics of Solipsism” for the past couple of weeks. What he wrote is nervy to say the least. He argues that America has lost the republican virtues on which it was founded, namely, the curbing of self-centeredness in the interest of the public good. I too am a fan of Cicero, but Brooks fails in one of the primary republican virtues by not forthrightly acknowledging that Republicans, the adherents of Ayn Rand, are the ones who have most blatantly deserted these same virtues. Self interest has center stage on their platform.
Brooks praises Truman and Eisenhower, but he fails to mention that it was President Kennedy who repeatedly challenged Americans and asked them to sacrifice. He urged us to go to the moon because it was tough, not because it was easy. And when my father, Robert Kennedy, was running for president and medical students asked him who would pay for more health care for the poor, he quickly answered, “You will.”
Contrary to the Republican philosophy, summed up by Ronald Reagan, that government is the problem, John and Robert Kennedy considered politics an honorable profession and affirmed that government was the place where we “make our most solemn common decisions.”
Both my uncle and my father knew that America is at its best when its citizens are willing to give up something for others. That was the spirit in which they committed themselves to public service. Ultimately they both gave their lives in the service of their country.
Like my father and my uncle, I believe that serving the public good is the essential republican virtue. In fact I led the effort to make Maryland the first and still only state in the country where community service is a condition of high school graduation. I did this because I believe that virtue comes from habits developed, not sermons given. Aristotle said, “we become house builders by building houses, we become harp players by playing the harp, we grow to be just by doing just actions.”
Republican governors are making their mark attacking public servants. They’re laying off citizens who exemplify republican virtues like teaching in inner city schools, fighting drug cartels, and rushing into burning buildings. Why? So that those who make outrageous salaries can pay lower taxes.
Brooks says that Republicans want growth, but I see no evidence that they want growth for anyone but the most well off. Where is the commitment to education, to infrastructure, to science?
Brooks commends Paul Ryan for sending the message that “politics can no longer be about satisfying voters’ immediate needs.” And yet Ryan would give the rich even more of a tax break at a time when our taxes are the lowest in three decades.
George Washington, whom Brooks also praises, would be surprised that the rich are being asked to shoulder less of a burden. He supported excise taxes that would fall disproportionately on the wealthy. When he went to war, he brought his wife, Martha, to share the hard, cold winter of Valley Forge along with him.
The wealthy have a special responsibility. From those who have been given much, much will be asked. In a true republic, people of wealth and privilege are first in line to serve in government, go to war, contribute to the honor and glory of their country. They set the nation’s values. If what they value is money, money, money, then the country will follow.
After 9/11, George Bush asked us to shop. At just the moment when he could have called us to a cause greater than ourselves, he (apparently on the advice of Karl Rove) urged us to step up for new TVs and designer bags rather than for the public good.
So if Brooks really wants to put an end to the politics of solipsism, he must take on the Republican party itself, which has done so little to cultivate the virtues of service, sacrifice, and commitment to country.
Please don’t lecture us about solipsism and republican virtues when it’s Republicans who are the ones who have made such a virtue of self interest.
By: Kathleen Kennedy Townsend, The Atlantic, May 22, 2011
Health Reform in Massachusetts: Self-Serving For Mitt But Also True
Mitt Romney’s defense of the Massachusetts health care reforms was politically self-serving. It was also true.
Despite all of the bashing by conservative commentators and politicians — and the predictions of doom for national health care reform — the program he signed into law as governor has been a success. The real lesson from Massachusetts is that health care reform can work, and the national law should work as well or even better.
Like the federal reform law, Massachusetts’s plan required people to buy insurance and employers to offer it or pay a fee. It expanded Medicaid for the poor and set up insurance exchanges where people could buy individual policies, with subsidies for those with modest incomes.
Since reform was enacted, the state has achieved its goal of providing near-universal coverage: 98 percent of all residents were insured last year. That has come with minimal fiscal strain. The Massachusetts Taxpayers Foundation, a nonpartisan fiscal monitoring group, estimated that the reforms cost the state $350 million in fiscal year 2010, a little more than 1 percent of the state budget.
Other significant accomplishments:
The percentage of employers offering insurance has increased, probably because more workers are demanding coverage and businesses are required to offer it.
The state has used managed-care plans to hold down the costs of subsidies: per capita payments for low-income enrollees rose an average of 5 percent a year over the first four years, well below recent 7 percent annual increases in per capita health care spending in Massachusetts. The payments are unlikely to rise at all in the current year, in large part because of a competitive bidding process and pressure from the officials supervising it.
The average premiums paid by individuals who purchase unsubsidized insurance have dropped substantially, 20 percent to 40 percent by some estimates, mostly because reform has brought in younger and healthier people to offset the cost of covering the older and sicker.
Residents of Massachusetts have clearly chosen to tune out the national chatter and look at their own experience. Most polls show that the state reforms are strongly supported by the public, business leaders and doctors, often by 60 percent or more.
There are still real problems that need to be solved. Small businesses are complaining that their premiums are rising faster than before, although how much of that is because of the reform law is not clear.
Insuring more people was expected to reduce the use of emergency rooms for routine care but has not done so to any significant degree. There is no evidence to support critics’ claims that the addition of 400,000 people to the insurance rolls is the cause of long waits to see a doctor.
What reform has not done is slow the rise in health care costs. Massachusetts put off addressing that until it had achieved universal coverage. No one should minimize the challenge, but serious efforts are now being weighed.
Gov. Deval Patrick has submitted a bill to the Legislature that would enhance the state’s powers to reject premium increases, allow the state to limit what hospitals and other providers can be paid by insurers, and promote alternatives to costly fee-for-service medicine. The governor’s goal is to make efficient integrated care organizations the predominant health care provider by 2015.
The national reform law has provisions designed to reduce spending in Medicare and Medicaid and, through force of example, the rest of the health care system. Those efforts will barely get started by the time Massachusetts hopes to have transformed its entire system. Washington and other states will need to keep a close watch.
By: Editorial, The New York Times, May 20, 2011
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