“Playing The Victim”: Paul Ryan’s Attempted Clarification On “Takers”
Paul Ryan exhibited some chutzpah today in a cry of foul play aimed at the president’s shot at those who divide Americans into “takers and makers,” which until it got him into trouble in 2012 was one of the Wisconsin Randian’s favorite rhetorical devices.
According to the Weekly Standard, Ryan went on television this morning and perhaps having read Michael Gerson’s WaPo op-ed accusing the president of creating a “raging bonfire of straw men, played the victim his own self:
Wisconsin congressman Paul Ryan knocked President Barack Obama for “shadowbox[ing] a straw man” in his inaugural address. Speaking Tuesday morning on the Laura Ingraham Radio Show to guest host Raymond Arroyo, Ryan responded to Obama’s statement that Medicare, Medicaid, and Social Security “do not make us a nation of takers, they free us to take the risks that make this country great.”
Ryan called Obama’s insinuation that he and other reform-minded Republicans consider recipients of these benefits “takers” a “switcheroo.”
“It’s kind of a convenient twist of terms to try and shadowbox a straw man to try to win an argument by default,” Ryan said.
“No one is suggesting that what we call our ‘earned entitlements’, entitlements you pay for, you know, like payroll taxes for Medicare and Social Security, are putting you in a ‘taker’ category,” Ryan continued. “The concern that people like me have been raising is we do not want to encourage a dependency culture. This is why we called for welfare reform.
Note first off that Ryan conveniently omits mentioning Medicaid in his self-defense against Obama’s alleged calumny, for the good reason that it is not an “earned entitlement” based on payroll tax deductions. For that matter, Ryan is advancing an interpretation of Medicare that he knows is completely erroneous, because over 40% of Medicare expenditures come from general revenues rather than payroll taxes or premiums. Who knows, maybe Ryan thinks Medicare beneficiaries are “takers” just three days out of every week, or is telegraphing a future intention to limit benefits to payroll taxes paid.
But in fact, Republicans deploying the taker/maker dichotomy, most especially Paul Ryan, are almost always referring to people who receive more federal government benefits, regardless of their type or justification, than they pay in federal taxes. Here’s an example from Ryan:
Republican vice presidential candidate Paul Ryan said in 2010 that 60 percent of Americans receive more financial benefits from the government than they pay in taxes, making them “takers,” rather than “makers,” according to a 2010 video of Ryan speaking with Rep. Walter Jones (R-N.C.).
“Right now about 60 percent of the American people get more benefits in dollar value from the federal government than they pay back in taxes,” Ryan said. “So we’re going to a majority of takers versus makers in America and that will be tough to come back from that. They’ll be dependent on the government for their livelihoods [rather] than themselves.”
Ryan has been making similar statements for years. His 60 percent comment to Jones was not a one-time gaffe, but an iteration of a point Ryan has repeatedly made while arguing for his plan to replace Medicare with a voucher system.
Who’s actually engaging in a “switcheroo” here?
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, January 22, 2013
“The Real Deficit Argument”: Only Politics Of A Very Degraded Kind Can Keep Us From Moving Forward
Should our politicians dedicate themselves to solving the problems we face now? Or should they spend their time constructing largely theoretical deficit solutions for years far in the future to satisfy certain ideological and aesthetic urges?
This is one of the two central choices the country faces at the beginning of President Obama’s second term. The other is related: Will the establishment, including business leaders and middle-of-the-road journalistic opinion, stand by silently as one side in the coming argument risks cratering the economy in an effort to reverse the verdict of the 2012 election? Yes, I am talking about using the debt ceiling as a political tool, something that was never done until the disaster of 2011.
My first questions are, admittedly, loaded. They refer to a difference of opinion we need to face squarely.
It is entirely true that in the wake of two budget agreements, in 2011 and the just-passed deal on the “fiscal cliff,” we have not reduced the deficit enough. The issue is: How much is enough?
Contrary to all the scare talk you keep hearing, Robert Greenstein, president of the Center on Budget and Policy Priorities, notes that we could put the deficit on a sustainable path for the next 10 years with one more deficit-reduction package equal to about $1.2 trillion, plus the resulting interest savings.
By sustainable, I mean keeping the debt from growing as a share of gross domestic product and holding it at around 73 percent of GDP for the next decade. This is a more than reasonable number by international standards. To put it in perspective: According to the International Monetary Fund, in 2011 Canada’s debt was at 85 percent of GDP, Germany’s was at 81.5 percent — and Greece’s was at 163.3 percent.
Holding the debt ratio in the low 70s is well within our sights. It could be achieved through a combination of $600 billion in cuts and $600 billion in additional revenue through tax reform — or through modest taxes on carbon or on financial transactions. (Okay, for now, I am dreaming on the last two, but they are still good ideas.) The cuts could be made without wrecking Medicare, Medicaid or Social Security, and without eviscerating government’s capacity to invest in the future.
We could then shelve our deficit obsession for a while and confront the problems that should be center-stage over the next few years: restoring shared economic growth, spurring the creation of good jobs, dealing with gun violence, reforming immigration laws, improving our education system, and taking steps on climate change.
But there is the other side of this debate, pushed not only by conservatives but also by a deficit-reduction industry that sees the only test of seriousness as a willingness to slash Medicare, Medicaid and Social Security for those who will retire 10, 20 or 30 years from now. They want to be able to admire nice predictions on a computer screen that show the debt dropping to 60 percent of GDP.
There is no objection in principle to discussing the modest changes that could improve the long-term stability of Social Security. But when it comes to health-care cost projections, there is so much we don’t know that it is truly foolish to make decisions now for, say, 2040.
Health-care cost inflation has been dropping. We can’t be sure how sustainable this trend is, but economists who study the matter think the cost curve may be bending downward for the longer run. The Affordable Care Act contains measures that could further restrain health expenditures.
Is it either sensible or humane to decide in 2013 on the basis of such limited knowledge to toss future seniors and low-income Medicaid recipients under the bus? Health-care costs are something we must keep working on. We can buy time for this difficult undertaking by getting the deficit down to a sustainable level.
And that brings us to the debt ceiling. The central weakness of a largely helpful fiscal cliff deal is that it did not save us from a debt-ceiling fight. It would be colossally stupid — there is no other word — to derail an economic recovery that is slowly but steadily taking hold with another battle over a silly provision in our law. Will all the respectable people who know this sit on the sidelines and let it happen, or will they speak out now?
We are finally on a promising path. Only politics of a very degraded kind can keep us from moving forward.
By: E. J. Dionne Jr., Opinion Writer, The Washington Post, January 6, 2013
“People Are More Than Numbers On A Page”: The Healthcare Lessons Mark Kirk Learned From His Stroke
Walk a mile in someone else’s shoes.
But how many of us actually do that? At least by choice?
Over a year ago Sen. Mark Kirk suffered a debilitating stroke. And his medical condition has sparked his interest in the experience of people on Medicaid. Kirk reminds me of the character William Hurt played in the movie The Doctor, a tale of a physician with no bedside manner who suddenly cares about his patients, once he himself becomes the patient, suffering with cancer.
Well D.C. isn’t Hollywood and Senator Kirk’s stroke was not something manufactured by Hollywood studios. The Illinois Republican had an opportunity he now realizes not everyone who suffers a stroke has: the opportunity to get his life back. Senator Kirk had that opportunity this week as he returned to Capitol Hill for the first time in a year, joining the new 2013 Senate.
Kirk’s illness made him realize that the unlimited medical care, access, and not to mention ability to have as many rehabilitation sessions as he needed to have a complete recovery from the stroke he suffered, is not available to most people, especially the poor—those who are on Medicaid. In the state of Illinois, if you are on Medicaid, you are only eligible for 11 rehab sessions following a stroke.
In an interview with the Chicago Sun Times, Senator Kirk said, “Had I been limited to that [referring to the 11 rehabilitation sessions], I would have had no chance to recover like I did. So unlike before suffering the stroke, I’m much more focused on Medicaid and what my fellow citizens face…I will look much more carefully at the Illinois Medicaid program to see how my fellow citizens are being cared for who have no income and if they suffer from a stroke.”
Senator Kirk has, by no choice of his own, walked a mile in another’s shoes…but not entirely. As a senator, he benefits from the very best medical care. He had undoubtedly the best doctors and access—and that access included unlimited rehabilitation sessions—as many as he needed. Each of us is unique and individual—our bodies respond differently one from another, even if we share the same illness or injury.
Although it is admirable that Senator Kirk has woken up to the reality that so many Americans face daily and struggle with so frequently, it’s sad that it took a stroke for him to come to this realization. So we must ponder the question: Does every GOP member of the House and the Senate need to become ill or have a family member become ill to fully understand that it is not only a right, but a necessity that any American have access to not only healthcare, but more so, proper healthcare? What type of society are we if only the rich are allowed to survive such things as a stroke? Or dare I say, only a politician?
Senator Kirk realized this. I know there are those critics out there who feel that Kirk is tapping into a group of potential voters that the GOP has largely ignored, and the GOP largely voted against legislation which would help this group of people.
As a liberal, a progressive, and a Democrat, who is married to a physician and who believes that all of us are truly created equal and should have equal access to the best medical care possible, it saddens me that it seems only when it affects an individual or someone they love, especially those politicians on the right, that they can see what we on the left have been speaking of: fairness.
It isn’t fair that a senator has a stroke and returns to work one year later, when so many in Illinois and elsewhere may not be able to return to work or their lives as they knew them; and some don’t survive at all.
Senator Kirk at one time, as his colleagues, never looked at the people behind the term ‘patient,’ for they were just numbers to slash in cutting spending. Let’s hope that those in the GOP don’t need to suffer as Senator Kirk did to come to the realization that people hurting and in pain are more than numbers on a page.
By: Leslie Marshall, U. S. News and World Report, January 4, 2012
“Setting The Stage”: What The Health Law Will Bring In 2013
Most of the really big changes made by the 2010 health law don’t start for another year. That includes things like a ban on restricting pre-existing conditions, and required insurance coverage for most Americans. But Jan. 1, 2013, will nevertheless mark some major changes.
One of those changes that will affect everyone with private health insurance actually took effect last September. But most people won’t see it until they renew or apply for new health insurance. It’s called a summary of benefits and coverage. The idea is to help people actually understand what’s in their insurance policies.
“One of the big complaints of people in polls or focus groups is that they just … don’t understand either the coverage or the price,” said Jay Angoff, a former official at the U.S. Department of Health and Human Services who worked on implementing the health law.
But with the new document, he says, “there’s a standard format that allows people to compare benefits to make apples-to-apples comparisons, not just on price, but on benefits.”
Health plans will also have to provide consumers a glossary of insurance terms if they ask for it.
“It’s still harder than some people would want,” Angoff says. “It’s still a complicated area. But I think HHS has really done a very good job in making it as simple and as meaningful as possible.”
Later in 2013 will also bring a key launch date for the law, says Angoff: “Oct. 1, 2013, is when open enrollment begins.”
That’s when people can start signing up for their 2014 coverage through the new health exchanges, or marketplaces, that the states and federal government are creating. Angoff, who used to head the office that’s in charge of building those exchanges, says he’s confident that things will happen on time.
“HHS has met all statutory deadlines on this until this point, and I have confidence that HHS will continue to meet those deadlines,” he said.
But the majority of what happens on Jan. 1 is to pay for the changes in 2014. In other words, tax increases and cuts in tax deductions. For example, starting next year, people will only be able to put $2,500 pre-tax into Flexible Spending Accounts that they use to pay for items insurance doesn’t cover.
“For example if they buy eyeglasses, if they pay copays on drug benefits or to their physician, they can submit those claims and be reimbursed from the pretax dollars,” said Marilyn Moon of the American Institutes for Research.
Moon says that while the change may hurt some people with very high out-of-pocket spending not covered by insurance, lawmakers decided this was a fair way to raise some of the money needed to pay for the rest of the law.
“This is a benefit that largely accrues to higher-income individuals who can afford to set aside a certain amount of money every year, to pay towards their health care spending,” she said.
There’s another tax change coming next year for the wealthy. Individuals earning more than $200,000 a year and couples earning more than $250,000 will see a nearly 1 percentage point increase in their Medicare payroll tax. They’ll also have to pay a 3.8 percent Medicare tax on their non-wage income. Moon says that represents a big change.
“The payroll tax usually applies only to wages, and now this law will extend it to investment income as well,” she said.
Those who take deductions for medical expenses on their income taxes will also see a change starting in 2013. Right now, expenses in excess of 7.5 percent of adjusted gross income are deductible. That’s going up to 10 percent for all except the elderly.
It will affect some people who spend a lot on medical care, says Moon. But the new law should also reduce the number of people with those very large bills, “because if everyone has health insurance, many fewer people should have to pay large amounts out-of-pocket on health care. Ten percent will not affect very many people, one would hope, when they get better insurance coverage.”
Finally, there’s a key change made by the health law for 2013 that will affect only the poor. Starting Jan. 1, state Medicaid programs will be required to reimburse doctors who provide primary care at Medicare rates, which are substantially higher. The idea is to get more doctors into the Medicaid program, which will itself expand in 2014.
The Medicaid increase, however, is only for two years.
By:Julie Rovner, NPR, January 1, 2013
“Rejecting Their Own Ideas”: Republicans Are Creating Needless Difficulties For Themselves And The Country
We know that the House of Representatives has been unable to reach a sensible deal to avoid unnecessary fiscal trouble at the first of the year because of right-wing Republicans’ aversion to tax increases.
But there is another issue on which conservatives are creating needless difficulties for themselves and the country: It’s harder and harder for politicians on the right to think straight about health care.
Conservatives once genuinely interested in finding market-based ways for the government to expand health insurance coverage have, since the rise of Obamacare, made choices that are dysfunctional, even from their own perspective.
Start with the decision of the vast majority of Republican governors to refuse to set up the state insurance exchanges required under the law. The mechanisms would allow more than 20 million Americans to buy coverage. They were originally a conservative idea for large, trustworthy marketplaces where individuals and families could buy plans of their choice.
Many liberals preferred a national exchange, in which the federal government could institute strong rules to protect consumers and offer broader options. This was the path the House took, but the final Senate-passed law went with state-level exchanges in deference to Republican sensibilities.
To ensure that governors could not just prevent their residents from having access to the new marketplaces, the bill required the federal government to run them if states defaulted. So, irony of ironies, in declining to set up state exchanges, conservative governors are undermining states’ rights and giving liberals something far closer to the national system they hoped for. As Robert Laszewski, an industry critic of Obamacare, told The Post’s N.C. Aizenman, conservative governors are engaging in “cut-off-your-nose-to-spite-your-face” behavior.
This is one of many forms of conservative health-care unreason. The “fiscal cliff” debate has been distorted because the problems confronting federal finances are consistently misdescribed. We do not have “an entitlement problem.” We have a giant health-care cost problem.
Our major non-military fiscal challenges lie in Medicare and Medicaid. In principle, conservatives should seek to find ways of holding down health-care inflation in both the private and public sectors. In practice, they see most efforts to take on this issue system-wide as examples of big government run wild. They seem to have a vague idea that markets can yet solve a problem that markets have not been very good at solving.
The result is that conservatives would either let government get bigger, or they’d save money by throwing ever more risk onto individuals by undercutting core government guarantees.
Their most outrageous move was the big lie that the original health-care bill included “death panels.” This would have been laughable if it had not been so pernicious. The provision in question would simply have paid for consultations by terminally ill patients — if they wanted them — with their physicians on their best options for their care. Few things are more important to the future of health care than thinking straight about the costs and benefits (to patients and not just the system) of end-of-life treatments. For those of us who oppose physician-assisted suicide, it’s urgent to promote, rather than block, serious, moral and compassionate discussions of the difficult issues raised by high-tech medicine.
Or take the health-care law’s creation of the Independent Payment Advisory Board, known as IPAB. It’s a 15-member body charged with finding ways of cutting the costs of treatment under Medicare. Congress would have the final say, but through a fast-track process. Yet the ink was barely dry on Obama’s signature of the Affordable Care Act (ACA) when a group of Republican senators introduced what they called the Health Care Bureaucrats Elimination Act, to get rid of IPAB. Thus did an innovative effort to save money meet with a slap in the face. Conservatives barely acknowledge other cost-saving experiments in the ACA.
Is it any wonder that our fiscal politics are so dysfunctional? Yes, we liberals are very reluctant to cut access to various government health-insurance programs. With so many Americans still uninsured, we are wary of depriving more people of coverage. But we fully accept the need to contain government health spending.
Yet given the conservatives’ habit of walking away even from their own ideas (the exchanges, for example) and of rejecting progressive efforts to save money, is it any wonder that liberals suspect them of greater interest in dismantling programs than in making them more efficient? We won’t find genuine common ground on deficits until we resolve this dilemma.
By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, December 26, 2012
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