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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

June 5, 2011 Posted by | Affordable Care Act, Conservatives, Consumers, Democrats, GOP, Government, Health Care, Health Care Costs, Health Reform, Ideologues, Ideology, Journalists, Media, Medicare, Middle Class, Politics, President Obama, Press, Public, Pundits, Rep Paul Ryan, Republicans, Right Wing, Tea Party, Uninsured | , , , , , , , , , , | Leave a comment

Seniors, Are You Paying Attention To Paul Ryan’s Medicare Plan?

Tea Party members who railed against health care reform because of the spin they were sold about how “Obamacare” would affect Medicare played a big role in returning the House of Representatives to Republican control.

I’m betting that many of them, if they’re paying attention to what Rep. Paul Ryan (R-Wisconsin), wants to do to the Medicare program, are having some serious buyer’s remorse. If Democrats are wise, they’re already drafting a strategy to remind Medicare beneficiaries, including card-carrying Tea Party members, just how fooled they were into thinking that Republicans were the protectors of the government-run program they hold so dear.

As a speaker at an especially contentious town hall meeting during the summer of 2009, I saw firsthand just how many senior citizens were snookered about how reform legislation would alter Medicare. Shortly after I testified before Congress about how the insurance industry was conducting a behind-the-scenes campaign to influence public opinion about reform, Rep. Bill Pascrell (D-New Jersey) invited me to share my perspective as a former insurance industry insider at his September 3, 2009, town hall meeting at Montclair State University.

More than 1,000 people had crammed into the school’s auditorium, not so much to hear the speakers as to express their opinions. Reform opponents were on one side of the auditorium, and reform advocates were on the other side. I had to shout just to be heard above the insults the groups were hurling at each other. Many of the reform opponents were carrying signs that read, “Hands Off My Medicare!” They clearly had bought the lie that the Democrats planned to dismantle the program.

There was no doubt in my mind that the insurance industry was the original source of that lie. While insurers liked the part of reform that would require all Americans not eligible for Medicare or Medicaid to buy coverage from them, they did not like the provision that would eliminate the overpayments the federal government has been paying private insurers for years to participate in the Medicare Advantage program, which was created when Republicans controlled both chambers of Congress in the late 1990s.

A little history: A provision of the Balanced Budget Act of 1997, written primarily by the insurance industry and backed by House Speaker Newt Gingrich and Senate Majority Leader Trent Lott, gave Medicare beneficiaries the option of getting their benefits through private insurers. Republicans envisioned this as the first step toward the total privatization of Medicare.

The Insurance Industry’s Government Favor

The problem was that insurers were reluctant to jump in unless they could be assured of a substantial profit. To get them to market Medicare Advantage plans, the government agreed to give them a big bonus. As a result, we the taxpayers now pay private insurers 14 percent more than the per-patient cost of the traditional Medicare program. These overpayments have contributed significantly to the record profits insurance companies have been posting in recent years, even though only 22 percent of people eligible for Medicare have bought what they’re selling.

The insurers were not able to keep the Democrat-controlled Congress of 2010 from eliminating those bonuses when they passed the Affordable Care Act. The law will indeed reduce future Medicare spending — not benefits — by an estimated $500 million over the next 10 years in a variety of ways, one of which is to stop overpaying insurers. This means that they will not get an extra $136 billion that they — and their shareholders — had been counting on, and they’re really bummed about that.

Knowing they fare much better when the GOP is running things on Capitol Hill, they devoted millions of the premium dollars we paid them to help elect more Republicans to Congress.

An Insurer-Funded Misinformation Campaign

The insurers funneled millions of dollars to their business allies and front groups in an effort to convince the American public that the Democrats wanted to cut Medicare benefits. Not only is that not true, but the new law actually adds an important new benefit and greatly improves another. For the first time, Medicare now pays for preventive care. And the law closes the hated “doughnut hole” in the Medicare prescription drug program.

But thanks to the success of the insurer-funded misinformation campaign, many seniors went to the polls last November convinced that the Democrats not only had created death panels in the Medicare program, they had also slashed their benefits.

The insurance industry funneled $86 million to the U.S. Chamber of Commerce to pay for TV ads that charged that the new law would “cut Medicare.” Also joining in on the campaign of lies was the 60 Plus Association, a group that, according to the Washington Post, AARP and other sources, has received the lion’s share of its funding over the years from the pharmaceutical industry and other special interests.

The 60 Plus Association ran TV ads in numerous congressional districts last fall against Democrats who had voted for the reform law. The ads were amazingly effective. Most of the Democrats they targeted lost.

The irony, of course, is that the GOP had no intention of preserving Medicare as seniors have known it since it was created more than 45 years ago. Ryan’s plan to reduce the deficit — which was approved by the House last week — would complete the privatization of Medicare that insurers and their Republican allies have been plotting for years.

The Republican Effort to Kill Medicare: a Losing Proposition

Ryan wants to give Medicare beneficiaries a voucher they can use to get coverage from a private insurance company. Initially, the vouchers would enable beneficiaries to get coverage comparable to what they have today. But the value of the vouchers would diminish over time. The Congressional Budget Office predicts that 65-year-olds would be paying 68 percent of their Medicare coverage costs by 2030, compared with 25 percent today.

What this means is that almost all Medicare beneficiaries would eventually be woefully underinsured, just as an estimated 25 million younger Americans already are and just as most of the nation’s elderly — the ones who could afford coverage at all — were before Medicare was enacted in 1965. (Most senior citizens had no health coverage before Medicare because insurance companies refused to sell it to them. That’s why it was so urgently needed.)

Ryan’s plan is a losing proposition for just about every American who lives long enough to qualify for Medicare benefits, but it is the business model that insurance firms have been dreaming of for years. It would enable them to reap profits that would make their earnings today pale by comparison.

If Democrats have any hope of keeping control of the Senate and regaining the House, they better be able to explain what’s really going on in ways that even the Tea Party seniors will understand. If I were a Democratic strategist, I would be ordering enough “Hands Off My Medicare” signs to blanket the country.

By: Wendell Potter, Center for Media and Democracy, April 18, 2011

April 18, 2011 Posted by | Affordable Care Act, Budget, Congress, Conservatives, Deficits, Democrats, Economy, Elections, GOP, Government, Health Care, Health Care Costs, Health Reform, Insurance Companies, Medicaid, Medicare, Pharmaceutical Companies, Politics, Public Opinion, Rep Paul Ryan, Republicans, Seniors, Tea Party, U.S. Chamber of Commerce | , , , , , , , | Leave a comment

A Vision Of Optimism And Equal Opportunity: What It Means To Be A Democrat

I’m glad I waited for President Obama’s heralded budget speech Wednesday before criticizing it (such a novel idea); there was much to praise in it and little to challenge. The best news: Obama laid out the kind of sweeping “story” of American democracy, and the bold vision of how we grow together, that I thought was too much to ask for even yesterday. He even talked about the scariest fact of American inequality: The dangerous hold the top 1 percent of Americans has on wealth, income and (he didn’t say this) politics. He pushed back on the cruel GOP deficit plan, made his toughest case yet for tax hikes on the richest, and stayed away from the worst ideas floated by his own deficit commission. The devil will be in the deficit-cutting details, and frankly, there weren’t a whole lot of them in the speech. But the president came out fighting with firmness, and with a rhetoric of social justice and equality, that I haven’t seen enough of these last two years.

Obama acknowledged our American history as “rugged individualists, a self-reliant people with a healthy skepticism of too much government.” But he quickly identified “another thread running throughout our history”:

A belief that we are all connected; and that there are some things we can only do together, as a nation. We believe, in the words of our first Republican president, Abraham Lincoln, that through government, we should do together what we cannot do as well for ourselves. And so we’ve built a strong military to keep us secure, and public schools and universities to educate our citizens. We’ve laid down railroads and highways to facilitate travel and commerce. We’ve supported the work of scientists and researchers whose discoveries have saved lives, unleashed repeated technological revolutions, and led to countless new jobs and entire industries. Each of us has benefited from these investments, and we are a more prosperous country as a result.

Part of this American belief that we are all connected also expresses itself in a conviction that each one of us deserves some basic measure of security. We recognize that no matter how responsibly we live our lives, hard times or bad luck, a crippling illness or a layoff, may strike any one of us. “There but for the grace of God go I,” we say to ourselves, and so we contribute to programs like Medicare and Social Security, which guarantee us health care and a measure of basic income after a lifetime of hard work; unemployment insurance, which protects us against unexpected job loss; and Medicaid, which provides care for millions of seniors in nursing homes, poor children, and those with disabilities. We are a better country because of these commitments. I’ll go further – we would not be a great country without those commitments.

So far, so good. It got even better when Obama took direct aim at Paul Ryan’s cruel and ludicrous budget plan. He laid out its many cuts, and concluded:

These are the kind of cuts that tell us we can’t afford the America we believe in. And they paint a vision of our future that’s deeply pessimistic. It’s a vision that says if our roads crumble and our bridges collapse, we can’t afford to fix them. If there are bright young Americans who have the drive and the will but not the money to go to college, we can’t afford to send them. Go to China and you’ll see businesses opening research labs and solar facilities. South Korean children are outpacing our kids in math and science. Brazil is investing billions in new infrastructure and can run half their cars not on high-priced gasoline, but biofuels. And yet, we are presented with a vision that says the United States of America – the greatest nation on Earth – can’t afford any of this.

Then he attacked the Gilded Age social inequality and tax cuts that have helped create our troubles:

Think about it. In the last decade, the average income of the bottom 90% of all working Americans actually declined. The top 1% saw their income rise by an average of more than a quarter of a million dollars each. And that’s who needs to pay less taxes? They want to give people like me a two hundred thousand dollar tax cut that’s paid for by asking thirty three seniors to each pay six thousand dollars more in health costs? That’s not right, and it’s not going to happen as long as I’m President.

Indulge me here, because this is how Democrats should be talking, and rarely do:

The America I know is generous and compassionate; a land of opportunity and optimism. We take responsibility for ourselves and each other; for the country we want and the future we share. We are the nation that built a railroad across a continent and brought light to communities shrouded in darkness. We sent a generation to college on the GI bill and saved millions of seniors from poverty with Social Security and Medicare. We have led the world in scientific research and technological breakthroughs that have transformed millions of lives.

This is who we are. This is the America I know. We don’t have to choose between a future of spiraling debt and one where we forfeit investments in our people and our country. To meet our fiscal challenge, we will need to make reforms. We will all need to make sacrifices. But we do not have to sacrifice the America we believe in. And as long as I’m President, we won’t.

That’s the president I voted for.

On the meat of the president’s plan to cut the deficit: He deserves credit for rejecting Medicare vouchers, for turning aside specific talk about Social Security (even though it has nothing to do with the federal deficit, the privatizers and Obama’s friends on his deficit commission wanted it thrown on the table in a grand bargain that can only be bad news for Democrats and working people; Obama seemed not to be willing to do that); for promising that reforms and innovations already part of the Affordable Care Act will bring down the costs of Medicare and Medicaid; and for saying we need bigger defense cuts than so far proposed.

(Small point: I liked the way Obama trashed Ryan without mentioning him — you don’t fight down — but I wish he’d been a tiny bit more confrontational on exactly what Ryan’s “Medicare vouchers” would do; if seniors could afford insurance at all, which is debatable, they’d certainly be at the mercy of privatized “death panels” refusing care over its costs. I say that because I’m sure some GOP prevaricator will bring back the “death panel” lie now that Obama has committed to curbing costs in Medicare. I hope I’m wrong.)

My quibbles? I’m still concerned that Obama has agreed to freeze the 12 percent of the budget that goes to “discretionary spending.” And I’m assuming that freeze includes the cuts made this week. I don’t like his promise of $3 in spending cuts for every dollar raised in revenue via tax hikes. In a statement, AFL-CIO president Richard Trumka praised the speech but added: “President Obama does not yet have the balance right between spending cuts and new revenue.” I also never like it when Obama undermines himself by saying things like:

I don’t expect the details in any final agreement to look exactly like the approach I laid out today. I’m eager to hear other ideas from all ends of the political spectrum.

I know, I know, he thinks it makes him sound reasonable to independents; I worry he sounds weak to Republicans. If Obama thinks the plan he laid out is as far to the left as Ryan’s plan is to the right, and that the answer is to meet in the glorious middle, we’re all in trouble.

But for today, I’ll take him at his word. After the speech, pundits called it the opening salvo of the Obama 2012 reelection campaign, as though there was something wrong with that. If these are the founding principles of the president’s 2012 campaign, Democrats and the country will be better off than we’ve been in a while. 

By: Joan Walsh, Editor at Large, Salon, April 13, 2011

April 14, 2011 Posted by | Class Warfare, Congress, Conservatives, Democracy, Democrats, Economic Recovery, Economy, Elections, Federal Budget, GOP, Government, Ideologues, Ideology, Income Gap, Independents, Jobs, Medicaid, Medicare, Middle Class, Politics, President Obama, Republicans, Social Security, Voters, Wealthy | , , , , , , , | Leave a comment

Budget Compromise Shows Conservative Big Government Hypocrisy

They hate big government, those conservative Republicans—especially a big federal government, trying to meddle in Americans’ lives on everything from healthcare to light bulbs.

Except, of course, when it comes to the District of Columbia, which the GOP-controlled House seems to view as its own little political petri dish. As part of its pending agreement to cut $38 billion from the federal budget, negotiators decided to cave in to the GOP’s demand to bar the District from using its own money to subsidize abortions for poor women.

A lot of people don’t like abortion, think it should be illegal, and don’t think government should pay for it. That’s a simple equation: if you don’t like abortion, don’t have one. If you think it should be illegal, take it up with the courts, or push for a constitutional amendment banning it. Barring government money from being spent on a legal women’s health service—however controversial—is not defensible. We all have to pay for activities we don’t want, through our taxes or health insurance premiums. Some taxpayers would prefer that their contributions to the federal treasury not be used to pay for wars; some who pay health insurance premiums don’t want the pool of money to be used to pay for someone’s Viagra. But group funds don’t allow for individual micro-management.

The attack on the District of Columbia adds even more insult to the unforgivable injury Washingtonians already endure as the nation’s only legally disenfranchised voters. It’s bad enough that U.S. citizens in Washington—people who pay local and federal taxes, volunteer, serve in wars and on jury duty—don’t have a full voting representative in the House and have no U.S. senators. It’s the height of arrogance for members of the U.S. Congress from other parts of the country to presume to tell the District how to spend tax dollars it collected from its own citizens. Aside from the abortion restrictions, the pending budget agreement also reinstates and expands a private school voucher program for the District.

D.C. Mayor Vincent C. Gray, who was arrested at the Capitol this week in protest over the meddling, sounded just like a genuine political conservative as he described his objections: “I’m tired of being a pawn in a political game. All we want is to be able to spend our own money.”

How unfortunate that congressional Republicans, who demanded the control over the District—and Democrats, who caved into their bullying—can’t see their way to apply true conservative principles when it comes to the city where they work. Other jurisdictions have imposed a “commuter tax” on people who live in one state and work in another. Members of Congress pay taxes in their home districts and states, but not here. If they want a say in how District funds are used, maybe it’s time they started to pay up.

By: Susan Milligan, U.S. News and World Report, April 12, 2011

April 12, 2011 Posted by | Abortion, Big Government, Congress, Conservatives, Democracy, Democrats, Federal Budget, GOP, Health Care, Human Rights, Ideologues, Middle East, Politics, Republicans, Women, Women's Health, Womens Rights | , , , , , , , , | 1 Comment

Gut Punch To Seniors: Republicans Are Done Pretending

“Should Congress have cut Medicare half a trillion dollars to pay for ObamaCare?” asked a 2010 ad for Republican newcomer Renee Ellmers in North Carolina’s 2nd congressional district. 

That theme — “Obama’s coming for your Medicare!” — helped Ellmers and GOP candidates across the nation consolidate the senior vote, winning that crucial voting bloc by a 59-38 margin. In 2008, Democrats won seniors by 49-48. The dramatic shift was a massive component of the GOP wave.

It was a dishonest attack, of course. The Democratic healthcare law cut $126 billion from Medicare Advantage over 10 years, not half a trillion. And Medicare Advantage, which allowed seniors to get healthcare via private insurers, was an inefficient and wasteful experiment to see whether private companies could deliver health services more efficiently than the government. It failed. In fact, Medicare Advantage cost 11 percent more to run than standard Medicare for identical services.

Yet “fiscally responsible” Republicans successfully demagogued the issue all the way to a majority, winning precious senior support with promises to “protect Medicare.” Those promises are now officially history. Republicans are now rewarding seniors for their vote by punching them in the gut.

GOP Rep. Paul Ryan (Wis.) has fired the first shot in a new war to destroy the benefit structure that seniors paid for throughout their working lives. Under his plan, seniors will no longer enroll in Medicare, but rather receive vouchers to try and secure care through private insurers. Ryan’s plan delays implementation for 10 years to ward off the wrath of current seniors, but the end result is the same — the elimination of a program Republicans pretended to protect.

After all, if the plan is so great for seniors, why wait until 2021 to implement it? 

Ryan’s plan would cap the growth of vouchers to a hair over the rate of inflation. However, the cost of medical services has far outpaced inflation. So what happens when the vouchers aren’t enough to cover the cost of expensive life-saving medical procedures? If Republicans won’t bargain with drug companies or limit reimbursements to doctors (and they won’t), the only thing left would be real-world death panels.

In other words, seniors would die, needlessly and prematurely.

It is no coincidence that Republicans are using this moment to try and discredit the AARP, which will undoubtedly push back against this irresponsible plan. The House Ways and Means Committee has launched an investigation into the organization’s finances, arguing that its support for last year’s healthcare reform measure should invalidate its tax-exempt status. “Republicans are desperate to try to break the trust that America’s seniors have in AARP,” said Rep. Pete Stark (D-Calif.) during the committee hearings. “They need to do so before they announce their budget that will devastate Medicare, Social Security and Medicaid.”

If Republicans were serious about containing healthcare costs, they would take a fresh look at a public option, allowing Americans to choose government-run insurance that would compete against private insurers. But Republicans don’t really care about providing quality care at reasonable prices — they care about enriching their insurance lobbyist friends. 

Seniors allowed themselves to be taken in by the GOP in 2010. But their choice now is obvious. Republicans are done pretending.

By: Markos Moulitsas, The Hill, April 5, 2011

April 12, 2011 Posted by | Affordable Care Act, Congress, Conservatives, Corporations, Democrats, Elections, GOP, Health Care, Health Reform, Insurance Companies, Lobbyists, Medicaid, Medicare, Pharmaceutical Companies, Politics, Public Option, Republicans, Right Wing, Social Security, Voters | , , , , , , , , | Leave a comment

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