He hopes you and his constituents won't notice.
Not a chance. Not on this site.
I guess Paul Ryan's take on Medicare is best described as two-faced. How he views the program depends upon who resides in the White House, what must be done to ensure a Republican win in the General Election and what Medicare program we're talking about; or another way to look at it is which political party originated the idea. Getting the most possible health care to Americans utilizing the least amount of resources is not what Ryan is about. He's all for the greed based health care system; and if you can't afford it? Drop Dead. Ryan's NO votes against adding more children to SCHIP and regulating tobacco as a drug are predictable, as are most of his Medicare votes.
What's driving Ryan's health care policy votes? In a word, money. Over $440,000 came from health professionals and insurance companies and over $175,000 from Pharmaceutical companies, hospitals and HMO's takes the total to over $600,000 for the 2010 election cycle alone. Follow the money and you see why Paul Ryan wants to dismantle Medicare. In his 21 year political career, Paul Ryan raised a total of $12,655,216, about $5.5 million of it since 2008. Nearly $7 millions since 2006. Who owns Paul Ryan? We sure as heck don't. He's received similar amounts from "retired", which may explain his decision to attempt to divide and conquer us on Medicare, but if you dig through Ryan's voting record....
According to OnTheIssues.org Ryan said or voted:
* Said: Open-ended healthcare entitlement moves US toward bankruptcy. (Jan 2011)
* Said: Medicare is a $38 trillion unfunded liability--add vouchers. (Jan 2010)
* Replace Medicare with $9500/year private insurance payment. (Jul 2009)
* Voted YES on overriding veto on expansion of Medicare. (Jul 2008)
* Voted NO on requiring negotiated Rx prices for Medicare part D. (Jan 2007)
* Voted YES on denying non-emergency treatment for lack of Medicare co-pay. (Feb 2006)
* Voted YES on limited prescription drug benefit for Medicare recipients. (Nov 2003)
* Voted YES on allowing reimportation of prescription drugs. (Jul 2003)
* Voted YES on subsidizing private insurance for Medicare Rx drug coverage. (Jun 2000)
* Rated 11% by APHA, indicating a anti-public health voting record. (Dec 2003)
* Repeal the Job-Killing Health Care Law. (Jan 2011)
Yes, that's a (IMO) psychotic Medicare voting record. Yes, on Medicare food stamp like vouchers and "Yes" for an unfunded prescription drug program. Ryan voted Yes" on rationing care to only those Medicare recipients who can pay their co-insurance but is "ok" with subsidizing private insurers for Medicare Rx drug coverage. The only surprise is that Ryan supports reimporting drugs from Canada (he's probably changed his mind on that by now) but he didn't support negotiating prices on those drugs within our borders then, last year during the fight for ACA or now. He wants to replace Medicare Parts A, B, C & D with an unrealistic (and consequently underfunded) "Medicare Stamps" (also known as a voucher program), but then Ryan turns around and goes bonkers over Obama's plan to expand the authority of the IPAB (Independent Payment Advisory Board) to reduce Medicare growth without cutting needed care.
Here's what Ryan had to say about Obama's plan (via the Wonkroom & CNBC)
- REP. PAUL RYAN (R-WI): “He [Obama] wants to delegate more power to this IPAB, it’s like 12 people who can’t be controlled by Congress who can just unilaterally ration and price control health care through Medicare. [CNBC, 4/13/2011]
Paul Ryan decries "rationing care" at the same time he advocates a system that will effectively deny all care to all seniors because there will be no way they can buy an affordable healthcare policy over and above what the voucher doesn't cover - private insurance companies will price the policies beyond reach (you can bet on that).
BTW, Ryan it's 15 people, not 12 and Congress will have a chance to do their own thing as this commission is:
tasked with offering Congress a comprehensive proposal for reducing excess growth in Medicare (without rationing care or raising premiums or cost sharing) if costs exceed GDP per capita plus 1 percent. Congress must consider the proposal — essentially changes in payment rates — in full and cannot offer an amend with different reduction goals unless it is agreed to by both chambers of Congress (and 60 Senators.) If Congress fails to adopt a substitute provision, the Department of Health and Human Services must implement the board’s proposal.
emphasis added
Apparently, Paul Ryan is more interested in scoring points spewing rhetoric than in presenting a cohesive, competent plan. His position isn't unique and he isn't the only bought and paid for Congress Critter. He follows the Republican KoolAid sipping herd. His plan is a new spin on old, failed ideas, but Teahadists lap it up nodding agreement like bobbleheads. He's offering a killer plan that we can't live with. It's one we can certainly die with, but he keeps saying that it's workable and will "protect" us for generations to come. He's not mentioning that it's really a plan to protect corporate financial health.
Maybe Ryan thinks he's entitled to his own facts. Facts like his voting record for Medicare Part D. Paul Ryan may hate Medicare, but he sure did support and vote for an unfunded Medicare Part D program in 2003. He liked subsidizing private insurers for the unfunded drug program, but didn't like the idea of negotiating for the best prices possible for those drugs that would make the unfunded program, let's just say, less underfunded.
There's no way to put the genie back in the bottle. Medicare Part D is here to stay, but it's original concept was poorly crafted. How underfunded is Medicare Part D? Quite a bit. Here's a snip from the 2010 Medicare Trustee's report, which reported on 2009 figures (emphasis added).
Actuarial Analysis (289 pg pdf)
Table III.C17—Statement of Operations of the Part D Account in the SMI Trust Fund during Calendar Year 2009
[In thousands]
Total assets of the Part D account in the trust fund,
beginning of period ............................................................ $911,374
Revenue:
Premiums from enrollees:
Premiums deducted from Social Security benefit checks .... $2,478,857
Premiums paid directly to plans1 ................................... 3,805,105
Total premiums .......................................................... 6,283,961
Government contributions:
Prescription drug benefits ....................................... 46,732,377
Prescription drug administrative expenses ................. 324,866
Total government contributions ............................... 47,057,243
Payments from States ................................................ 7,571,857
Interest on investments ............................................. 11,896
Total revenue .......................................................... $60,924,958
Expenditures:
Part D benefit payments1 ........................................ $60,453,149
Part D administrative expenses .................................... 324,866
Total expenditures .................................................... $60,778,015
Net addition to the trust fund ..................................... 146,943
Total assets of the Part D account in the trust fund,
end of period ................................................................... $1,058,317
1Premiums paid directly to plans are not displayed on Treasury statements and are estimated. These premiums have been added to the benefit payments reported on the Treasury statement to obtain an estimate of total Part D benefits. Direct data on such benefit amounts are not yet available. Note: Totals do not necessarily equal the sums of rounded components. (1) Revenues
The major sources of revenue for the Part D account are (i) contributions of the Federal Government that are authorized to be appropriated and transferred from the general fund of the Treasury; (ii) premiums paid by eligible persons who voluntarily enroll; and (iii) contributions from the States.
Of the total Part D revenue, $2.5 billion represented premium amounts withheld from Social Security benefit checks or other Federal benefit payments. Total premium payments, including those paid directly to the Part D plans, are estimated to be $6.3 billion or 10.3 percent of total revenue.
In calendar year 2009, contributions received from the general fund of the Treasury amounted to $47.1 billion, which accounted for 77.2 percent of total revenue.
With the availability of Part D drug coverage and low-income subsidies beginning in 2006, Medicaid is no longer the primary payer of drug costs for full-benefit dual eligibles. States are subject to a contribution requirement and must pay the Part D account in the SMI trust fund a portion of their estimated forgone drug costs for this
page 136
The most important take away from this report is that Medicare is not broke. The Medicare Part D program is not broke either.
The Medicare Part D "trust fund" increased from $911 million to $1.06 billion in 1 year - 2009. That's all to the good. Ryan's bitch is that the only reason there's a Medicare Part D "trust fund" is because the feds kick in about $47 billion per year from the U.S. General Fund - not payroll taxes. Didn't Ryan understand that Part D was a departure from how the entire Medicare system is funded when he cast this vote in 2003? The Medicare Part D program is the most honest of all the Medicare programs as the fed contributions comes entirely out of the General Fund - there's no payroll tax surplus to steal. He's now saying he didn't know that was how it is? Then why did he vote for it in 2003? We're looking at a decision tree here. Either Ryan did know the program was an underfunded giveaway and voted for it anyway to keep a Republican majority in 2004 or he didn't know and he was/is the village idiot. Ryan isn't an idiot, but he's hoping his constituents are dumb enough to not see or ignore his double dealing.
However true it may be that the Medicare Part D program should have been funded with an offsetting hike in the Medicare payroll tax or other tax hike of some sort, there was NO WAY the Republicans were going to do anything that fiscally responsible when they created Medicare Part D in 2003. This battle cry of cutting entitlement programs is bogus. Where were they in 2003 when they screwed up? Oh, yeah, I momentarily forgot, Medicare Part D was created in 2003 so the Republicans could keep a majority in 2004 and help defeat Kerry. Political expedience trumps sound public health policy every time. Ryan doesn't care about Medicare recipents, he just wants to play to the Teahadist crowd. At least he does this year, this month, this week. Who knows what he's going to say if the Republican winds shift in the coming months ahead. One thing you can be sure of it will be right wing failed policy du jour and it will not have anything to do with sound public health policy principles.
The Medicare Part D drug benefit program no doubt saves lives by regularly sucking out nearly $50 billion a year from the General Fund while it saves those lives. The drug benefits' growth projections change regularly as no one can get a handle on it. We can't get a handle on it because we aren't bartering, negotiating or asking for better pricing from drug manufacturers. Medicare Part D is going up and up and the likes of Paul Ryan and the rest of his Republican gang don't have the balls to demand a volume discount from PhRMA.
The Summary of the 2010 trustee report states:
Part B of Supplementary Medical Insurance (SMI), which pays for doctors’ bills and other outpatient expenses, and Part D, which pays for access to prescription drug coverage, are both projected to remain adequately financed into the indefinite future because current law automatically provides financing each year to meet the next year’s expected costs. However, the aging population will result in SMI costs growing rapidly from 1.9 percent of GDP in 2009 to 3.5 percent of GDP in 2040; about three-quarters of these costs will be financed from general revenues and about one-quarter from premiums paid by beneficiaries. Relatively small amounts of SMI financing are received from special payments by States and from fees on manufacturers and importers of brand-name prescription drugs.
The only reason Part D is adequately funded is because more funds are allocated to it every year. Instead of coming up with a plan that deals with the realities of the U.S. health care system's greed; out comes this ridiculous budget plan of Ryan's and it actually passed through the House! I think Ryan has his head ... Well, maybe I should just say that Ryan plans to do a heckuva job on Medicare.