The Paul Ryan/GOP budget finally made available nearly three years since the GOP started whining about Obama’s stimulus package and the spending it entailed has been touted as a serious piece of legislation. Ryan makes claims about his plan in a WSJ Op-ed, that have been seriously challenged by other objective sources like the impartial Congressional Budget Office (CBO) and both conservative and moderate economist.
David Stockman, Ronald Reagan’s Office of Management and Budget Director says the GOP plan “doesn’t address in any serious or courageous way the issue of the near and medium-term deficit” and further criticizes its ill-fated belief that any deficit problem can be seriously resolved without generating revenue through taxes. The Libertarian economist Tyler Cowen says “the plan doesn’t do anything to control health care costs, and cutting Medicaid is neither good policy, nor urgent. Indeed, he notes, ‘Medicaid should be one of the last parts of the health care budget to cut.’” (Conservative Economists Criticize ‘Off The Deep End’ Republican Budget, by Brian Beutler, TPMDC, 4/11/11)
Ryan and the GOP’s claim to credibility is severely undercut through it’s use of data from the right-wing think tank, the Heritage Foundation. One of the most absurd presumptions by an author of this Heritages analysis, William Beach, was that Ryan’s plan would reduce unemployment to 2.8% before he retracted it later under fire from serious economists.
All of the numbers that Ryan and the Heritage Foundation have proposed in this bill have been aptly challenged and debunked but I’ll leave it to the reader to go over the details here. What I would like someone to seriously answer for me is just one aspect of the budget claim. How is Medicare going to be made better or even remain the same once it is converted to a block grant for the states to choose how best to serve their citizens?
I live in the state of Texas where any federal funding that serves social needs of the states poor, elderly and disabled is frowned on and considered a burden to deal with. Recently conservative legislators have talked about getting out of the Federal/State Medicare program to fight their deficit problems. If Ryan’s plan provides block grant money giving conservative legislators the power to determine how it will be spent, I fear we will see more people hurt than helped. There are already 6 million uninsured people in Texas and the state’s population growth is one of the nation’s highest, meaning that rate is likely to increase proportionately.
The block grant money is to be allocated by the state to individuals so they can purchase insurance from the private sector on their own. If red flags didn’t just go up with you on this information then you are not paying the full health care premium for your policy. This makes you an employed worker whose company has a health insurance benefits or you are still on your parents’ policy.
That leaves the unemployed in this state, including children, the disabled and the elderly to find insurance from an industry that until recently has been able to exclude them from coverage for pre-existing conditions they have (that would be all the disabled people) or whose age puts them in the high risk category (that would be children and the elderly).
However the current health care reform that prohibits insurance companies from denying coverage for pre-existing conditions is being threatened by repeal (a move by the way that would increase the deficit) by those same Republicans and conservatives that want to opt out of the current Medicare program. Does this sound promising to you if you fall into the above mentioned categories? Health insurance rates are high for everyone but for those people who work for a living, making wages near the poverty level, it is virtually unaffordable. In fact, unless you are a family of three making over $18,312 annually, you cannot qualify for state assistance.
Needles to say poor families struggle the most trying to find effective, low-cost health insurance but the sad truth is that most have to forego this expense and are only served by the state when their health deteriorates to a level that will then qualify them. In my case though my age is now a factor that determines whether or not I can buy health care insurance.
My wife is still currently employed as a nurse with a school district looking to cut positions to reduce the state’s $27 billion deficit. It costs an extra $425 a month to insure me but at least I have coverage. But when she retires in a few short years (if she hasn’t been terminated before then) we will only have my Social Security benefits and a meager amount of retirement funds to sustain us. The state’s retirement system my wife is on opted out of social security for them years ago. These resources are insufficient to purchase private health care insurance on our own.
Rep. Ryan says that his plan to fund medicare after 2022 is “not a voucher program but rather a premium-support model. A Medicare premium-support payment would be paid, by Medicare, to the plan chosen by the beneficiary, subsidizing its cost.” And though this model claims to allow people to “choose a plan that works best for them” it must be done “from a list of guaranteed coverage options”. As usual the devil is in the details so I am curious as to whose on this list and what extent the coverage is in these “guaranteed options”.
Ryan claims his plan will ensure that “Medicare will provide increased assistance for lower-income beneficiaries and those with greater health risks.” Knowing how reluctant Republicans are now to spend money on anything except tax breaks for the wealthy, can we be assured that whoever makes such decisions will do so based on needs prescribed by our physician or will they allow the for-profit health insurers to make that call. Currently this is not a problem for Medicare recipients so I worry that people turning 65 in 2022 will have less health security than this current generation of elders.
Also, I have not seen any wording in Ryan’s plan about cost of living adjustments (COLAs) and correcting Medicare benefits as inflation impacts them. Again, I worry about the sincerity of those who think somehow all people are equally capable to provide for their own welfare. Are they willing to take measures to protect the most vulnerable amongst us who physically cannot make it on their own by locking into a system that will address future costs without expecting beneficiaries to somehow find the means beyond their fixed incomes to do so?
My guess is they will only do so when enough people scream loud and long enough and by then it will be too late for some while others must endure for the time it will take these foot-draggers to accommodate those who depend on Medicare’s services.
So, here’s my offer to jump on your band wagon Paul Ryan. Present your bill with iron clad assurances that future recipients of Medicare and Medicaid will not suffer any less quality of services than those who are currently enrolled. Furthermore, assure us that those people who decide who do and don’t qualify are people connected with direct care in the health care field and do not have vested, for-profit interests in undermining the system; large stock holders in CIGNA Health Insurance Corp. for example
If, as you suggest, your plan is arranged to control health care costs and thus current services can be sustained without any tax increases to do so, please describe in detail how this will be achieved. Furthermore, in the event that everyone else is right and you and the Heritage Foundation are way off the mark, a trigger mechanism in the bill should be included that will discontinue it’s legitimacy and we can revert back to the existing system with this caveat – it will be reimplemented with the objectives stated in the President’s health care reform bill to eliminate waste and fraud and curb rising health care costs; the ones you are saying that are not there.
Keeping Medicare and Medicaid Strong? (Center for Medicare Advocacy, Inc.)
Kill Medicaid and Medicare and You Eliminate Social Security(woodgatesview.wordpress.com)