It's good that the GOP has admitted to lying about the fiscal crisis. However, the question remains: Will Obama now back off his plan to cut Social Security and Medicare?

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MONDAY, MARCH 18, 2013 05:15 AM MST

GOP: We’ve been lying all along

Boehner's admission that we don't really have a debt crisis reveals his party's ulterior, program-cutting motives

BY DAVID SIROTA

John Boehner (Credit: AP/Susan Walsh)

I never thought I’d write these words, but here goes: Thank you, John Boehner. Thank you, Mr. Speaker, for finally admitting on national television that all the fiscal cliffs, sequestrations and budget battles you’ve created are, indeed, artificially fabricated by ideologues and self-interested politicians and not the result of some imminent crisis that’s out of our control.

America owes this debt of gratitude to Boehner after he finally came clean on yesterday’s edition of ABC’s “This Week” and admitted that “we do not have an immediate debt crisis.” (His admission was followed up by Budget Committee Chairman Paul Ryan, who quickly echoed much the same sentiment on CBS’ “Face the Nation”).

In offering up such a stunningly honest admission, the GOP leader has put himself on record as agreeing with President Obama, who has previously acknowledged that demonstrable reality. But the big news here isn’t just about the politics of a Republican House speaker tacitly admitting they agree with a Democratic president. It is also about a bigger admission revealing the fact that the GOP’s fiscal alarmism is not merely some natural reaction to reality, but a calculated means to other ideological ends.

Before considering those ends, first remember that Boehner (like Obama) is correct on the facts.

As Nobel-winning economist Paul Krugman has pointed out, “Even if we do run deficits, federal debt as a share of GDP will be substantially less than it was at the end of World War II” and “it will also be substantially less than, say, debt in several European countries in the mid- to late 1990s.” It is also lower than the 80 percent of GDP level that many economists say starts to put countries in a precarious position. Additionally, citing Congressional Budget Office data, the Center for American Progress notes that the long-term debt outlook is only dire because the projections simply assume without question that “future Congresses will enact huge new deficit-increasing tax cuts and spending hikes.”

“The debt outlook is bad (but) we’re not looking at something inconceivable, impossible to deal with,” writes Krugman. “We’re looking at debt levels that a number of advanced countries, the US included, have had in the past, and dealt with.”

So yes, we should start dealing with the long-term debt in a pragmatic and sober way, but we shouldn’t pretend it is some sort of imminent crisis worthy of draconian austerity measures.

If we could somehow do that, then there would be plenty of gradual steps that could be taken right now — steps that deal with the debt in measured ways that do the least harm to the overall economy. Those include starting to phase out the Bush tax cuts, which show no correlation with job growth and yet are the single largest driver of annual deficits; starting to reduce defense and war spending, which, job-creation-wise, is one of the least effective ways for the government to spend money; starting to move the United States toward the least costly, more efficient, and more effective single-payer healthcare system that most industrialized countries have, and that lowers overhead for employers; and starting to spend more money on social programs that fight economic inequality, with the understanding that driving down such inequality tends to boost macroeconomic growth and consequently boost public revenues (this is the Reagan-esque idea of growing one’s way out of debt).

But, of course, we aren’t having a sober and measured discussion about such pragmatic solutions. Instead, the national conversation about the budget is dominated by debt demagogues with ulterior motives. Taking a page out of the shock doctrine playbook that says every crisis is an opportunity, these alarmists have sought to create the perception of an immediate crisis in order to quickly manufacture opportunities to legislate their otherwise politically impossible agenda items.

In practice, that means Wall Streeters and conservative ideologues citing the supposedly imminent crisis to successfully nudge the political establishment to endorse cuts to Social Security, even though the program has almost nothing to do with the debt crisis. It also means a GOP budget that targets most of its cuts at the social programs that the poor and middle-class most rely on (this, at the same time most of these same alleged budget hawks supported an extension of most of the deficit-expanding Bush tax cuts; decry any cuts to the defense budget; and either outright oppose a single-payer system or support the Obama healthcare law that while certainly expanding coverage, nonetheless buttresses the private health insurance industry and, thus, arguably makes such a single-payer system more out of reach).

From Boehner to Ryan to the Bowles-Simpson tandem to an unending parade of television pundits, the last year has been marked by the most prominent political voices ignoring the more prudent way forward, and instead claiming that these shock doctrine prescriptions — i.e., Social Security/Medicare cuts, social program cuts, etc. — are all required. And not just required, but required immediately, because of the supposed urgency of the debt crisis.

Using that supposed urgency as a rationale to create fiscal cliffs, sequestration battles and debt ceiling crises, their talking points have lately assumed a similar tenor to that of the old Thatcherites’ “There Is No Alternative” mantra, the idea being that because the emergency is supposedly so imminent, there is simply no other way forward than the conservative neoliberal path of profligacy for the rich (tax cuts, continued corporate subsidies, etc.) and austerity for everyone else.

But suddenly, thanks to yesterday’s declarations by Boehner and Ryan, the charade’s most sacred lie has been exposed. In acknowledging that “we do not have an immediate debt crisis,” GOP leaders are admitting that there is, in fact, an alternative. They are also admitting that their longtime claims to the contrary were ends-justify-the-means tactics to manufacture an unnecessary panic — one that they hoped would scare America into abruptly accepting the kind of draconian policies polls show the public opposes.

Now that the truth is out, maybe a more reasoned debate can begin and more pragmatic policies can finally take center stage.

 

David Sirota is a nationally syndicated newspaper columnist, magazine journalist and the best-selling author of the books "Hostile Takeover," "The Uprising" and "Back to Our Future." E-mail him at ds@davidsirota.com, follow him on Twitter @davidsirota or visit his website at www.davidsirota.com.  

MORE DAVID SIROTA. 
 

The Vice Presidential Debate: Joe Biden Was Right to Laugh

POSTED: October 12, 10:45 AM ET

Original here

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Joe Biden at the vice presidential debate in Danville, Kentucky.
Alex Wong/Getty Images

I've never thought much of Joe Biden. But man, did he get it right in last night's debate, and not just because he walloped sniveling little Paul Ryan on the facts. What he got absolutely right, despite what you might read this morning (many outlets are criticizing Biden's dramatic excesses), was his tone. Biden did absolutely roll his eyes, snort, laugh derisively and throw his hands up in the air whenever Ryan trotted out his little beady-eyed BS-isms.

But he should have! He was absolutely right to be doing it. We all should be doing it. That includes all of us in the media, and not just paid obnoxious-opinion-merchants like me, but so-called "objective" news reporters as well. We should all be rolling our eyes, and scoffing and saying, "Come back when you're serious."

The load of balls that both Romney and Ryan have been pushing out there for this whole election season is simply not intellectually serious. Most of their platform isn't even a real platform, it's a fourth-rate parlor trick designed to paper over the real agenda – cutting taxes even more for super-rich dickheads like Mitt Romney, and getting everyone else to pay the bill.

The essence of the whole campaign for me was crystalized in the debate exchange over Romney's 20 percent tax-cut plan. ABC's Martha Raddatz turned the questioning to Ryan:

MS. RADDATZ: Well, let's talk about this 20 percent.

VICE PRESIDENT BIDEN: Well – (chuckles) –

MS. RADDATZ: You have refused yet again to offer specifics on how you pay for that 20 percent across-the-board tax cut. Do you actually have the specifics, or are you still working on it, and that's why you won't tell voters?

Here Ryan is presented with a simple yes-or-no answer. Since he doesn't have the answer, he immediately starts slithering and equivocating:

REP. RYAN: Different than this administration, we actually want to have big bipartisan agreements. You see, I understand the –

"We want to have bipartisan agreements?" This coming from a Republican congressman? These guys would stall a bill to name a post office after Shirley Temple. Biden, absolutely properly, chuckled and said, "That'd be a first for a Republican congress." Then Raddatz did exactly what any self-respecting journalist should do in that situation: she objected to being lied to, and yanked on the leash, forcing Ryan back to the question.

I'm convinced Raddatz wouldn't have pounced on Ryan if he hadn't trotted out this preposterous line about bipartisanism. Where does Ryan think we've all been living, Mars? It's one thing to pull that on some crowd of unsuspecting voters that hasn't followed politics that much and doesn't know the history. But any professional political journalist knows enough to know the abject comedy of that line. Still, Ryan was banking on the moderator not getting in the way and just letting him dump his trash on audiences. Instead, she aggressively grabbed Ryan by his puppy-scruff and pushed him back into the mess of his own proposal:

MS. RADDATZ: Do you have the specifics? Do you have the math? Do you know exactly what you're doing?

So now the ball is in Ryan's court. The answer he gives is astounding:

REP. RYAN: Look – look at what Mitt – look at what Ronald Reagan and Tip O'Neill did. They worked together out of a framework to lower tax rates and broaden the base, and they worked together to fix that. What we're saying is here's our framework: Lower tax rates 20 percent – we raise about $1.2 trillion through income taxes. We forgo about 1.1 trillion [dollars] in loopholes and deductions. And so what we're saying is deny those loopholes and deductions to higher-income taxpayers so that more of their income is taxed, which has a broader base of taxation –

Three things about this answer:

1) Ryan again here refuses to answer Raddatz's yes-or-no question about specifics. So now we know the answer: there are no specifics.

2) In lieu of those nonexistent specifics, what Ryan basically says is that he and Romney will set the framework – "Lower taxes by 20 percent" – and then they'll work out the specifics of how to get there with the Democrats in bipartisan fashion.

3) So essentially, Ryan has just admitted on national television that the Romney tax plan will be worked out after the election with the same Democrats from whom they are now, before the election, hiding any and all details.

So then, after that, there's this exchange.

VICE PRESIDENT BIDEN: Can I translate?

REP. RYAN: – so we can lower tax rates across the board. Now, here's why I'm saying this. What we're saying is here's a framework –

VICE PRESIDENT BIDEN: I hope I'm going to get time to respond to this.

REP. RYAN: We want to work with Congress –

MS. RADDATZ: I – you'll get time.

REP. RYAN: We want to work with Congress on how best to achieve this. That means successful – look –

MS. RADDATZ: No specifics, yeah.

Raddatz did exactly the right thing. She asked a yes-or-no question, had a politician try to run the lamest kind of game on her – and when he was done, she called him on it, coming right back to the question and translating for viewers: "No specifics."

Think about what that means. Mitt Romney is running for president – for president! – promising an across-the-board 20 percent tax cut without offering any details about how that's going to be paid for. Forget being battered by the press, he and his little sidekick Ryan should both be tossed off the playing field for even trying something like that. This race for the White House, this isn't some frat prank. This is serious. This is for grownups, for God's sake.

If you're going to offer an across-the-board 20 percent tax cut without explaining how it's getting paid for, hell, why stop there? Why not just offer everyone over 18 a 1965 Mustang? Why not promise every child a Zagnut and an Xbox, or compatible mates for every lonely single person?

Sometimes in journalism I think we take the objectivity thing too far. We think being fair means giving equal weight to both sides of every argument. But sometimes in the zeal to be objective, reporters get confused. You can't report the Obama tax plan and the Romney tax plan in the same way, because only one of them is really a plan, while the other is actually not a plan at all, but an electoral gambit.

The Romney/Ryan ticket decided, with incredible cynicism, that that they were going to promise this massive tax break, not explain how to pay for it, and then just hang on until election day, knowing that most of the political press would let it skate, or at least not take a dump all over it when explaining it to the public. Unchallenged, and treated in print and on the air as though it were the same thing as a real plan, a 20 percent tax cut sounds pretty good to most Americans. Hell, it sounds good to me.

The proper way to report such a tactic is to bring to your coverage exactly the feeling that Biden brought to the debate last night: contempt and amazement. We in the press should be offended by what Romney and Ryan are doing – we should take professional offense that any politician would try to whisk such a gigantic lie past us to our audiences, and we should take patriotic offense that anyone is trying to seize the White House using such transparently childish and dishonest tactics.

I've never been a Joe Biden fan. After four years, I'm not the biggest Barack Obama fan, either (and I'll get into why on that score later). But they're at least credible as big-league politicians. So much of the Romney/Ryan plan is so absurdly junior league, it's so far off-Broadway, it's practically in New Jersey.

Paul Ryan, a leader in the most aggressively and mindlessly partisan Congress in history, preaching bipartisanship? A private-equity parasite, Mitt Romney, who wants to enact a massive tax cut and pay for it without touching his own personal fortune-guaranteeing deduction, the carried-interest tax break – which keeps his own taxes below 15 percent despite incomes above $20 million?

The Romney/Ryan platform makes sense, and is not laughable, in only one context: if you're a multi-millionaire and you recognize that this is the only way to sell your agenda to mass audiences. But if you're not one of those rooting gazillionaires, you should laugh, you should roll your eyes, and it doesn't matter if you're the Vice President or an ABC reporter or a toll operator. You should laugh, because this stuff is a joke, and we shouldn't take it seriously.

 

Related

• Joe Biden Vs. Paul Ryan: The 15 Best Tweets About the Vice Presidential Debate
• The First Debate: Mitt Romney's Five Biggest Lies
• Mitt Romney's Tax Dodge
• How the Hype Became Bigger than the Presidential Election

Matt Taibbi is a contributing editor for Rolling Stone. He’s the author of five books, most recently The Great Derangement and Griftopia, and a winner of the National Magazine Award for commentary.

Read more: http://www.rollingstone.com/politics/blogs/taibblog/the-vice-presidential-debate-joe-biden-was-right-to-laugh-20121012#ixzz29CVQmDDY

Republican Deficit Hawk Hypocrites

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http://youtu.be/KYPvaC831xY

FROM ROBERT REICH'S BLOG

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http://youtu.be/cO1F7EcGFAc                                                                                    Original here


Monday, August 20, 2012

The Five Reasons Why the Ryan-Romney Economic Plan Would Be A Disaster for America

Mitt Romney hasn’t provided details so  we should be grateful he’s selected as vice president a man with a detailed plan Romney says is “marvelous,” “bold and exciting,” “excellent,” “much needed,” and “consistent with” what he’s put out.

So let’s look at the five basic features of this “marvelous” Ryan plan.

FIRST: It  would boost unemployment because it slashes public spending next year and the year after, when the economy is still likely to need a boost, not a fiscal drag. It would be the same austerity trap now throwing Europe into recession. According to the Economic Policy Institute, Ryan’s plan would mean 1.3 million fewer jobs next year than otherwise, and 2.8 million fewer the year after.

SECOND: Ryan would take from lower-income Americans and give to the rich – who already have the biggest share of America’s total income and wealth in almost a century. His plan would raise taxes on families earning between 30 and 40 thousand dollars by almost $500 a year, and slash programs like Medicare, food stamps, and children’s health What would Ryan do with these savings? Reduce taxes on millionaires by an average of almost $500,000 a year.

THIRD: Ryan wants to turn Medicare into vouchers that won’t keep up with the rising costs of health care – thereby shifting the burden onto seniors. By contrast, Obama’s Affordable Care Act saves money on Medicare by reducing payments to medical providers like hospitals and drug companies.

FOURTH: He wants to add money to defense while cutting spending on education, infrastructure, and basic research and development. America already spends more on defense than the next five biggest military spenders put together. Our future productivity depends on the public investments Ryan wants to cut.

FIFTH AND Finally, Ryan’s budget doesn’t even reduce the federal budget deficit – not for decades. Remember: He’s adding to military spending, giving huge additional tax cuts to the very rich, and stifling economic growth by cutting spending too early.  The Center for Budget and Policy Priorities estimates Ryan’s Roadmap would push public debt to over 175 percent of GDP by 2050.

So there you have it. The Ryan – Ryan-ROMNEY – economic plan.

And the five reasons why it would be a disaster for America.

(Please watch the video — and share.)

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ROBERT B. REICH, Chancellor’s Professor of Public Policy at the University of California at Berkeley, was Secretary of Labor in the Clinton administration. Time Magazine named him one of the ten most effective cabinet secretaries of the last century. He has written thirteen books, including the best sellers “Aftershock" and “The Work of Nations." His latest is an e-book, “Beyond Outrage.” He is also a founding editor of the American Prospect magazine and chairman of Common Cause.

THE BUSH TAX CUTS (ABOUT TO BE MADE PERMANENT BY THE SOCIAL DARWINISTS) "SAVED THE RICHEST 1 PERCENT OF THE TAXPAYERS MORE MONEY ON THEIR TAXES LAST YEAR THAN THE REST OF AMERICA'S 141 MILLION TAXPAYERS RECEIVED IN TOTAL INCOME!"

The Republican’s Social-Darwinist Budget Plan

TUESDAY, MARCH 20, 2012

In announcing the Republicans’ new budget and tax plan Tuesday, House Budget Committee Chairman Paul Ryan said “We are sharpening the contrast between the path that we’re proposing and the path of debt and decline the president has placed us upon.”

Ryan is right about sharpening the contrast. But the plan doesn’t do much to reduce the debt. Even by its own estimate the deficit would drop to $166 billion in 2018 and then begin growing again.

The real contrast is over what the plan does for the rich and what it does to everyone else. It reduces the top individual and corporate tax rates to 25 percent. This would give the wealthiest Americans an average tax cut of at least $150,000 a year.

The money would come out of programs for the elderly, lower-middle families, and the poor.

Seniors would get subsidies to buy private health insurance or Medicare – but the subsidies would be capped. So as medical costs increased, seniors would fall further and further behind.

Other cuts would come out of food stamps, Pell grants to offset the college tuition of kids from poor families, and scores of other programs that now help middle-income and the poor.

The plan also calls for repealing Obama’s health-care overhaul, thereby eliminating healthcare for 30 million Americans and allowing insurers to discriminate against (and drop from coverage) people with pre-existing conditions.

The plan would carve an additional $19 billion out of next year’s “discretionary” spending over and above what Democrats agreed to last year. Needless to say, discretionary spending includes most of programs for lower-income families.

Not surprisingly, the Pentagon would be spared.

So what’s the guiding principle here? Pure social Darwinism. Reward the rich and cut off the help to anyone who needs it.

Ryan says too many Americans rely on government benefits. “We don’t want to turn the safety net into a hammock that lulls able-bodied people into lives of dependency.”

Well, I have news for Paul Ryan. Almost 23 million able-bodied people still can’t find work. They’re not being lulled into dependency. They and their families could use some help. Even if the economy continues to generate new jobs at the rate it’s been going the last three months, we wouldn’t see normal rates of unemployment until 2017.

And most Americans who do have jobs continue to lose ground. New research by professors EmmanualSaez and Thomas Pikkety show that the average adjusted gross income of the bottom 90 percent was $29,840 in 2010 — down $127 from 2009 and down $4,842 from 2000 — and just slightly higher than it was forty-six years ago in 1966 (all figures adjusted for inflation).

They could use better schools, access to higher education, lower-cost health care, improved public transportation, and lots of other things Ryan and his colleagues are intent on removing.

Meanwhile, America’s rich continue to grow richer — and many of them (and their heirs) are being lulled into lives whose hardest task is summoning the help.

Anyone who thought the Great Recession might reduce America’s wild lurch toward wild inequality should think again. The most recent data show that just 15,600 super-rich households – the top 1 tenth of 1 percent – pocketed 37 percent of all the economic gains in 2010. The rest of the gains went to others in the top 10 percent.

Republican Social Darwinists are determined that the Bush tax cuts of 2001 and 2003 be made permanent. Those cuts saved the richest 1 percent of taxpayers (roughly 1.4 million people) more money on their taxes last year than the rest of America’s 141 million taxpayers received in total income.

Thank you,House Republicans, for “sharpening the contrast” between your radical Social Darwinism and those of us who still cling to the belief that the most fortunate have a responsibility to the rest.

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Robert Reich is Chancellor's Professor of Public Policy at the University of California at Berkeley. He has served in three national administrations, most recently as secretary of labor under President Bill Clinton. He has written thirteen books, including The Work of Nations, Locked in the Cabinet, Supercapitalism, and his most recent book, Aftershock. His "Marketplace" commentaries can be found on publicradio.com and iTunes. He is also Common Cause's board chairman.

Reagan Budget Director Slams Paul Ryan Plan, Says 'Absolutely' Raise Taxes Instead

As Washington considers ways to rein in the deficit, Republicans have obstinately demanded that any tax revenue increases be taken off the table, claiming that raising taxes during a down economy would doom the recovery. As evidence, they often point to the presidency of Ronald Reagan, claiming his massive 1981 tax cuts caused that decade’s economic boom. But this anti-tax position makes it almost impossible to do anything serious about the deficit, since — despite GOP talking points — the country has a revenue problem, not a spending problem. On ABC’s This Week today, Reagan’s own budget director, David Stockman, exposed the GOP tax cut “theology” for the ahistorical sham it is. Asked by Reuter’s Chrystia Freeland if the economy could “sustain” a tax increase, Stockman said “absolutely,” noting that the economy only recovered under Reagan once he raised taxes in 1982 after “cut[ting] taxes too much” the year before:

FREELAND: You worked for Ronald Reagan. Do you think the American economy — so you’re, like, a red-blooded capitalist — could it sustain higher taxes than it has now?

STOCKMAN: Absolutely. In 1982, we were looking at the jaws of the worst recession since the 1930s. We overdid it in 1981, cut taxes too much. We came back with a big deficit reduction plan in 1982. Unemployment’s at 10 percent, the economy is in dire shape, and we raise taxes by 1.2 percent of GDP, which would be $150 billion a year right now — not 10 years down the road — but right now.

Watch it:

Stockman also attacked Rep. Paul Ryan’s (R-WI) budget plan, noting it “does not cut one dime from the debt” in the next three years. Indeed, in addition to being draconian and regressive, Ryan’s budget fails to acomplish the only thing it sets out to do — solve the deficit — despite claims from Washington journalists that his plan is “serious.”

By Alex Seitz-Wald | Sourced from 1304
Posted at May 1, 2011, 10:05 am

SOME QUESTIONS FOR CONGRESSMAN PAUL RYAN THAT EVEN AGING REPUBLICANS WOULD WANT TO KNOW THE ANSWERS TO: REAL DEATH PANELS?

Congressman Ryan, I Don’t Want To Be A Lab Rat

Apr. 22 2011 - 3:38 pm

Posted by Mark Sunshine

An open and a sent letter to Rep. Paul Ryan (R-Wisc.)

Congressman Paul Ryan

1233 Longworth HOB

Washington, D.C. 20515

Dear Congressman Ryan,

Please explain your Medicare plan to me and my wife. We are in our early fifties and are concerned about how your changes to Medicare will affect us. We know that Washington can seem disconnected from the real world but, for people of our age, your plan to do away with Medicare is very real.

Getting rid of Medicare feels like a free markets experiment to us and neither of us wants to be a “lab rat” for a social and economic experiment gone awry. Lab rats are usually expendable and we don’t want to be part of a discarded generation.

By way of background, both of us believe in free markets, personal responsibility and individual choice. We agree that the nation’s future demands fiscal responsibility. We are educated (we have graduate degrees), are employed, are savers and have put aside money for retirement.

We were surprised by the fast track House acceptance of your plan to eliminate Medicare benefits and change Medicaid. Because of the lack of meaningful debate or hearings we don’t know anything about the details of your plan and want to understand how it will change our lives.

Please do not take offense by any of the questions. They are intended to be non-partisan but these are questions that need to be addressed. We believe that elder care benefits will determine when we die and whether or not we end with dignity. We just want to know what the future holds under your voucher program.

As we understand your plan, when we reach our golden years, we, like every other senior in our age group, will be given a voucher to purchase private health insurance. We will need to personally chose which health care plan to purchase from what is hoped to be an array of choices. To the extent that insurance or non-covered health care costs exceed the amount of our voucher, we will pay the extra amount out of our savings.

Since we will be elderly, after we get sick we won’t have a “second chance” to go back to work, earn new money or financially recover. If our savings run out before we die that’s it — there won’t be any more money coming our way — so we think that it’s really important for your plan to get it right, and the first time. There won’t be any second chances for us.

Since you are known as a “serious and responsible” thinker, before proposing the dismantling of Medicare as we have known it, we assume you figured out what will replace it and verified that the private insurance market can fairly and adequately service the needs of seniors. We just want to know what you were thinking before introducing legislation on the floor of the House that was passed in a matter of hours from introduction.

We assume that you looked at the current Medicare Advantage program as a starting point for your plan. Medicare Advantage is also known as Medicare Part C and gives seniors the option to enter an HMO or PPO rather than receive traditional Medicare benefits.

We hope insurance experts told you that Medicare Part C is a bad reference point for what you want to do because it is a reversible option. Seniors that don’t like or aren’t adequately covered by Medicare Part C can opt back out into a traditional Medicare program. So the insured pool of seniors in the Medicare Advantage program isn’t random or representative of what will happen if your program is adopted. The Medicare Advantage program provides false comfort that private insurance can be expanded to all seniors without serious bad effect.

Below are some of our questions about your program. We will probably have other questions after we understand some of the basics of your plan.

1. How is your plan going to deal with pre-existing conditions and pricing?

If we need to change insurance companies will we be rejected by replacement companies because of pre-existing conditions?

Since your plan calls for a repeal of the President’s health care bill it seems that protections for pre-existing conditions will be repealed . Is that correct or do you expect to keep some parts of the President’s healthcare reform law?

Also, what insurance company in their right mind is going to voluntarily insure me and a group of old people? We will be a bad risk because every one of us will either be sick and dying or about to be sick and dying. For the insurance company to make a profit on a group of old people they will have to charge a really high premium. Will there be a cap on premiums and if so how is this a “free market solution”?

2. How does your program protect us if we have diminished mental capacity?

It is a fact that as some people age they have diminished mental capacity and I am expecting that neither my wife nor I will be an exception. I am worried that we won’t be able to make an informed decision as to which insurance plan to purchase. The contracts are complicated and full of small print. They are drafted by Wall Street lawyers and designed to protect the insurance company. If we can’t understand our insurance options and make an intelligent choice how will we purchase the right plan?

3. What happens when we have less than diminished capacity and can’t effectively make any decisions on our own?

I know from firsthand experience that in some states elderly are still deemed to have “legal capacity” even though they are dramatically diminished and can’t make their own decisions or take care of themselves. Are you proposing some new form of Federal definition of “capacity” that supersedes state law so that very impaired elderly people have someone that helps them purchase insurance?

As an example, my wife’s grandfather is 90+ years old and has had several strokes. He can’t read, talk, write, drive, feed or otherwise take care of himself without full time assistance. He lives in Maryland and despite his mental and physical disabilities, in the state of Maryland he is legally competent and was only recently denied his driver’s license renewal (we took away his car keys more than 8 years before Maryland took away his legal right to drive).

Even before my wife’s grandfather had his major stroke, when he was in his early 80s, he didn’t have the mental capacity to understand and purchase MediGap insurance. When he got sick we discovered that he had messed up the application and thought that he was covered even though he hadn’t paid premiums for years.

If that happens to me or my wife, who will help us when we are still deemed competent by the state, but clearly unable to live independently or make adult decisions?

And, what happens if we are deemed incompetent?

Who will take care of us and purchase insurance if we are truly incapacitated?

Also, what happens to us if our guardian makes a bad insurance purchasing decision and we neither have money, insurance nor capacity to help ourselves?

4. If an insurance company decides to incorrectly deny benefits who will protect and defend us?

When we are old and sick who will protect us from an insurance company refusing payment on legitimate claims?

Even worse, how will anyone even know if an insurance company refuses payment on necessary care and I (or my wife) am harmed as a result?

Will the insurance company have any liability for refusing to pay for care or for dictating what care we receive? Can we sue? If we are old and permanently harmed, will it even matter if we can sue?

Who at the insurance company will be making coverage and payment decisions? What standard of care will they need to use? Do they have a fiduciary responsibility to me as the insured or will their shareholders obligations be more important?

Will the insurance company be allowed to earn more money if they deny care to seniors?

It’s my impression that seniors and their doctors know the Medicare rules and as long as they stay within the rules, reimbursement is predictable and timely. No one from the government has a financial incentive to deny payment or mess around with patient care.

Private insurance is different. There is a big incentive to go cheap on care and not pay out benefits. I am worried that panels of insurance executives will end up effectively deciding who lives and who dies in an effort to maximize profits while fulfilling fiduciary responsibilities to their shareholders. These will be real Death Panels and the prospect terrifies me. It’s bad enough when insurance companies take advantage of young people. How will old people who killed off by insurance companies defend themselves?

5. What will protect us from bait and switch advertising and tactics?

For seniors, it’s too late to figure out that an insurance company has pulled a bait and switch after care is denied.

I think that the recent national experience of having banks bait and switch virtually every individual and institutional customer should be enough to be concerned about conflicts of interest between customer needs and shareholder profits. Regulators couldn’t control the banks, why do you think they will be able to control insurance companies any better?

Seniors need more protection than bank customers. The elderly can’t risk regulators being late to the game. There aren’t any do overs when it comes to seniors. Small mistakes are fatal.

How do you propose to protect me and my wife from bait and switch tactics?

6. Medicare is a national program but insurance is regulated on a state by state basis. Are you proposing an expansion of Federal authority over insurance companies or will the options, protections and risks be different depending upon what state I live in?

When I am a senior, will I have to decide where to live based upon insurance regulation of my state? My parents didn’t have to make those choices or decisions, nor did their parents, nor did anyone before me since Medicare was enacted.

Will my wife and I have to move from our home if our state has crummy insurance and consumer protection laws?

Or, are you proposing new Federal regulation over insurers that provides consistent national coverage for seniors that isn’t dependent upon state residence status?

And, if you are proposing new Federal insurance regulations how do governors, state insurance officials and state’s rights advocates feel about the Federal government expanding onto their turf? Also, where in your budget is the funding for this new agency?

7. What happens if I outlive my financial resources? Will Medicaid cover me so that I can die with dignity? Or will I just die?

With the cost of nursing home care in some places exceeding $75,000 per year per person, it isn’t hard to imagine that my wife and I may outlive our financial resources. You are proposing large scale cuts to Medicaid. What happens if we run out of money before we die because we are placed in a nursing home?

Will someone take care of us and help us when we literally can’t go to the bathroom by ourselves but also have no money to pay for help?

Or will we have to choose between food, clothing or housing and medical care (and that assumes we have the mental or physical capacity to make choices)? Will your plan make us homeless and indigent like many of the elderly of the 1920’s and 1930’s?

8. What other large industrialized countries have adopted a plan for senior care similar to what you propose and how has it worked?

I am hoping that sometime since the beginning of the industrial revolution another country has tried your plan and it worked.

Can you point to any country, anywhere in the world, where your plan has been tested and it worked? I would feel a lot better if that were the case.

Congressman Ryan, please feel free to provide as much detail as possible on how, as a practical matter, your plan will be implemented. I understand that your objective is to save money — I just wonder if there isn’t a less radical approach that would work.

For example what’s wrong with modifying the current Medicare system to include means testing on co-payments and deductibles, increasing the eligibility age by a few years, restricting payment of certain elective procedures and working to reduce hospital and provider administrative costs. Tort reform relating to end of life care couldn’t hurt either. These changes would be easy to implement, fair to all and still provide protection for the elderly.

When I was a child I read stories about how animals that that get old walk into the forest to die. They are never heard from again and as a result aren’t a burden on their herd. The remaining animals have better survival odds because they are not forced to waste precious resources on old animals that are going to die anyway.

For better or worse, a long time ago we decided that we were different than animals and that old people shouldn’t be asked to “take one” for the team.

Congressman Ryan, I am worried that your plan basically is telling me and my wife to get ready for that long walk into the forest. Please tell me it isn’t true and that I am over reacting.

Sincerely,

Mark Sunshine

PS. Even though I don’t live in your district it would be nice if you answer this letter.