The Tea Party Republicans’ Biggest Mistake

Source: Robert Reich’s Blog, via RSN

Author: By Robert Reich

Representative Mo Brooks, Republican of Alabama and a fierce critic of the Affordable Care Act, has just changed his tune. He now says: “My primary focus is on minimizing risk of insolvency and bankruptcy. There are many paths you can take to get there. Socialized medicine is just one of the component parts of our debt and deficits that put us at financial risk.”

Translated: House Republicans are under intense pressure. A new Gallup poll shows the Republican Party now viewed favorably by only 28% of Americans, down from 38% in September. That’s the lowest favorable rating measured for either party since Gallup began asking this question in 1992. The Democratic Party is viewed favorably by 43%, down four percentage points from last month.

So Republicans are desperately looking for a way of getting out of the hole they’ve dug for themselves – and the President has given them one. He told them that if they agree to temporarily fund the government and raise the debt ceiling without holding as ransom the Affordable Care Act or anything else, negotiations can begin on reducing the overall budget deficit.

What’s the lesson here? The radicals who tried to hijack America didn’t understand one very basic thing. While most Americans don’t like big government, Americans revere our system of government. That’s why even though a majority disapprove of the Affordable Care Act, a majority also disapprove of Republican tactics for repealing or delaying it.

Government itself has never been popular in America except during palpable crises such as war or deep depression. The nation was founded in a revolution against an abusive government – that was what the original Tea Party was all about – and that distrust is in our genes. The Constitution reflects it. Which is why it’s hard for government to do anything very easily. (I’ve never been as frustrated as when I was secretary of labor – continuously running into the realities of separation of power, checks and balances, and the endless complications of federal, state, and local levels of authority. But frustration goes with the job.)

No one likes big government. If you’re on the left, you worry about the military-industrial-congressional complex that’s spending zillions of dollars creating new weapons of mass destruction, spying on Americans, and killing innocents abroad. And you don’t like government interfering in your sex life, telling you how and when you can have an abortion, whom you can marry. If you’re on the right, you worry about taxes and regulations stifling innovation, out-of-control bureaucrats infringing on your freedom, and government deficits as far as the eye can see.

So when Tea Party Republicans, bankrolled by a handful of billionaires, began calling the Affordable Care Act a “wholesale takeover of American health care,” many Americans were inclined to believe them. Health care is such a huge and complicated system, affecting us and our families so intimately, that our inherent distrust of government makes us instinctively wary. It’s no accident we’re still the only advanced nation not to have universal health care. FDR decided against adding it to his plan for Social Security because he didn’t want to jeopardize the rest of the program; subsequent presidents never got close, at least until Obama.

The best argument for the Affordable Care Act is that our current healthcare system is so dysfunctional – the most expensive in the world with the least healthy outcomes (highest infant mortality, shortest life spans, worst rates of chronic disease) of any advanced nation – that we had no choice but to try to fix it. Even so, it’s a typical American fix: It’s still based on private health providers and private insurers. All government does is subsidize the poor, require insurers to take in people with pre-existing health problems, and pay for it by requiring everyone to be insured.

The Tea Party Republicans’ mistake was to assume that Americans’ distrust of big government, and, by extension, the Affordable Care Act, would allow them to ride roughshod over the process we have for making laws.

Their double-barreled threat to shut down the government and cause the United States to default on its obligations if the Affordable Care Act isn’t repealed or at least delayed is a direct assault on our system of government: If even unpopular laws can be gutted by a majority in one house of Congress holding the rest of government hostage, there’s no end to it. No law on the books will be safe. (Their retort that Congress holds the “purse strings” and can therefore decide to de-fund what it dislikes is bunk; appropriation bills have to be agreed to by both houses and signed into law by the president, like any other legislation.)

While most of us distrust government, we’re indelibly proud of our system of government. We like to think it’s just about the best system in the world. We don’t much like politicians but we canonize the Founding Fathers, the Framers of the Constitution. And we revere the fading parchment on which the Constitution is written. When we pledge allegiance to the United States we bind ourselves to that system of government. Anyone who seeks to overthrow or undermine that system is deemed a traitor.

And that’s exactly what some Tea Partiers have begun sounding like – traitors to the system, radicals for whom the end they seek justifies whatever means they think necessary to achieve it. As such, they began losing support even among Americans who had bought their view of the Affordable Care Act.

So they’ve had to back down, and soon, hopefully, we can move to the next stage – negotiating over the size of government. That should be stronger ground for the Tea Partiers. But the President, Democrats, and any moderate Republican who dares show his face can still gain ground by framing the question properly: The size of government isn’t the real issue. It’s who government is for. The best way to reduce future budget deficits is to ensure it’s for all of us and not just a privileged few.

That means revenues should be raised from the wealthy, who have never been wealthier – limiting their deductions and tax credits, closing loopholes like “carried interest,” and taxing financial transactions. Spending should be cut by ending corporate welfare – terminating tax subsidies to oil and gas, ballooning payments to agribusiness, sweetheart deals for military contractors, and the “too big to fail” subsidy for Wall Street’s biggest banks. Future health-care costs should be contained by using the government’s bargaining leverage over providers (through Medicare, Medicaid, and the Affordable Care Act) to force a shift from fee-for-service to payments-for-healthy-outcomes. And we should spend more on high-quality education and infrastructure for everyone.

Americans distrust big government, and always will. There’s ample reason – especially given the huge sums now bankrolling politicians, coming from a relative handful of billionaires, big corporations, and Wall Street. But we love our system of government. That’s what must be strengthened.

By using tactics perceived to violate that system, the Tea Partiers have overplayed their hand. If they don’t stop their recklessness, they’ll be out of the game.


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.

Emphasis Mine

see:http://readersupportednews.org/opinion2/277-75/19833-focus-the-tea-party-republicans-biggest-mistake

 

The morning after

From:The New Republic

By: Johathan Cohn

“The pundits are unanimous. Mitt Romney had more energy, offered more specifics, and may even have come across as more empathetic. I agree and polls suggest voters saw it the same way.

The debate may not change the dynamics of the election. But if I knew nothing about the candidates and this was my first exposure to the campaign, I’d think this Romney fellow has a detailed tax plan, wants to defend the middle class and poor, and will take care of people who can’t find health insurance.

Problem is, this isn’t my first exposure to the campaign. I happen to know a lot about the candidates. And I know that those three things aren’t true. Romney has made promises about taxes that are mathematically incompatible with one another. He’s outlined a spending plan that would devastate the middle class and (particularly) the poor. And his health care plan would leave people with pre-existing conditions pretty much in the same perilous situation they were before the Affordable Care Act became law.

My standard for candor in politics is whether candidates have offered the voters an accurate portrait of what they’ve done and what they are proposing. Tonight, Romney did precisely the opposite. And that really ought to be the story everybody is writing, although I doubt it will be.

Some details:

1. Taxes. President Obama repeatedly described Romney’s tax plan as a $5 trillion tax plan. Romney repeatedly took exception. The figure is correct. Romney has not given many details about his tax plan, but it’s possible to extrapolate from his promises and the Tax Policy Center, a project of the Brookings Institution and Urban Institute, did just that. Crunching the numbers, they determined that his proposed rate cut would cost… $5 trillion.

Romney has said he would offset those cuts by closing loopholes. The Tax Policy Centerhas analyzed that promise and found that it is mathematically impossible, unless Romney raises taxes on the middle class or lets his tax plan increase the deficit—neither of which Romney has said he’s willing to do. Romney has challenged the Tax Policy Center conclusion and did so again tonight, referring mysteriously to “six studies” that supposedly prove he’s right. He’s also been cryptic about what deductions he’d cut and, tonight, even suggested maybe he’d back away from some of the cuts if the numbers didn’t add up—although, as always, he was so vague that the statements could mean absolutely nothing.

I wish Obama had pressed him on this inconsistency even more directly than he did: “OK, governor, you say you can offset the $5 trillion cost of your tax plan. Tell us how, with real numbers. Are you getting rid of the home mortgage deduction? The exclusion for health insurance? Be straight with the American people about what you are proposing.” Obama didn’t do that, but it’s a question Romney has never been willing to answer.

2. The deficit and spending cuts. Asked by moderator Jim Lehrer how he’d cut the deficit, Romney outlined his plan for cutting spending. It included three main provisions.

First, Romney said, he’d repeal the Affordable Care Act. He’s serious about that, I presume. The problem is that, according to the Congressional Budget Office, the health care law reduces the deficit. Repeal it and the deficit goes up. Then Romney said he’d review programs and cut all that are non-essential, singling out PBS. Well, fine. That’s pennies on the budget. It wouldn’t be nearly enough to make a meaningful dent in the deficit.

After that, Romney mentioned “turning programs over to the states.” Here there is real money, particularly if Romney includes Medicaid, which will soon eclipse Medicare as the government’s most expensive health insurance program. But Romney suggested this would work because the states are more efficient. This is what he usually says. The implication is that the states can spend a lot less on the programs without dramatically reducing services.

That’s nonsense. Medicaid already pays less than every other insurance program, private and public. Cutting more from the program would inevitably force states to reduce whom or what the program covers. A year ago, when the House Republicans proposed a similar scheme, a Kaiser Family Foundation report by Urban Institute researchers crunched the numbers and determined that the Medicaid cut would mean between 14 and 27 million people would lose health insurance.

By the way, the researchers assumed states would deal with declining Medicaid money exclusively by cutting eligibility for the able-bodied and non-elderly. In fact, most of the program’s money goes to the disabled and elderly. Most likely, they’d feel at least some of the pain.

3. Medicare: Over and over again, Romney attacked Obama because the Affordable Care Act reduces Medicare spending by $716 billion. As you probably know by now, Paul Ryan’s budget made the exact same cut. And less than a year ago, Romney was praising this budget to the hilt.

But there’s another problem here: Romney’s own budget numbers don’t add up. Remember, he’s promised to cap non-defense spending at 16 percent of GDP. And he’s said he won’t touch Social Security. If he walls off Medicare, too, that would mean even sharper cuts across the board. How sharp? The Center on Budget and Policy Prioritiesran the numbers. If Medicare is getting that $716 billion back, he’d have to cut other programs by an average of a third by 2016 and in half by 2022. Non-discretionary defense spending, which “has averaged 3.9 percent of GDP and never fallen below 3.2 percent,” would fall to 1.7 percent.

That’s simply not realistic. I have no problem believing Romney would cut domestic program deeply; his willingness to endorse the kinds of cuts he has specified, to Medicaid and food stamps, tell you everything you need to know about his priorities. But these figures are the stuff of fantasy. Either Romney can’t restore the Medicare dollars as he says or he’s not living up to his promises on deficit reduction.

The real shame of the exchange was that Romney’s own plan got so little attention. Again, I wish Obama could have pressed Romney harder, or explained more clearly, why the voucher scheme he proposes would likely end the guarantee Medicare now makes to seniors—and why current retirees, as well as future ones, would feel the impact.

4. Health care and pre-existing conditions. Yeah, this was the part when I jumped out of my chair. Obama said that Romney’s alternative to Obamacare wouldn’t protect people with pre-existing conditions. Romney said it would. Sorry, but Romney is just plain wrong here. I’ve written about this before, so I’m just going to quote something I wrote previously:

Romney, like most Republicans, has long favored “continuous” coverage protection. But, for complicated reasons … this protection is relatively weak unless it includes the sort of substantial regulation and subsidies that Romney, like most Republicans, has opposed. As a result, such protection would do very little for many of the people who need it most. Among other things, as Sarah Kliff points out … “There are tens of millions of Americans who lack continuous coverage.” (A typical example would be somebody who lost a job, couldn’t keep making premium payments, and let coverage lapse.)

For people in this situation, Romney and the Republicans have traditionally said they favor coverage through “high-risk pools.” But high-risk pools are basically substandard policies: Although they cover catastrophic expenses, they leave people exposed to huge out-of-pocket costs. They also tend to be underfunded, because they cost a lot of money but serve only a small number of people. …

So what would this mean in practice? Imagine for a second that you have cancer, diabetes, or Parkinson’s. With the coverage you’re likely to get form a high-risk pool, chances are that you’ll continue to struggle with medical bills. You’ll end up going into financial distress, just to cover your health are costs, unless you decide to start skipping treatment. And that’s obviously not a very good idea. These policies are better than nothing, for sure. But what you really need is comprehensive insurance and way to pay for it—in other words, the kind of protection that the Affordable Care Act will provide, starting in 2014, unless Romney and the Republicans repeal it.

I don’t want to pretend Obama was always as forthright as he could have been, any more than I want to suggest he was the more adept debater tonight. At one point, Obama talked about letting tax rates on higher incomes return to Clinton-era levels as essential to reducing the deficit. That’s true. But a truly serious approach to deficit reduction would let all taxes, even those on more modest incomes, return to Clinton-era levels (albeit after the economy is on sounder footing). Obama decried Romney’s plan to leave seniors “at the mercy of the private insurance system” but those are strong words from a guy whose own health care plan relies heavily on insurance plans, albeit with a lot more regulation than most conservatives like.

Still, these are tiny transgressions compared to Romney’s, which also included misleading statements about the origins of the deficit and claims of a jobs plan that is, if anything, even more unspecific than his tax plan. And I worry that nobody will call him on it.

As part of its post-debate analysis, ABC News asked correspondent Jonathan Karl to play the role of fact-checker. He picked out one statement from each side and rated it “mostly false.” But the Obama statement Karl picked was the description of Romney’s tax plan as costing $5 trillion—a figure, again, that comes straight from the Tax Policy Center. That’s not “mostly false.” If anything, it’s “mostly true.” Then Karl talked about Romney’s pre-existing condition promise, which really is “mostly false.” Sigh. ”

Update: Steve Benen and Greg Sargent noticed the same thing, so that’s a start.

follow me on twitter @CitizenCohn

Emphasis Mine

see:http://www.tnr.com/blog/plank/108125/romney-debate-details-tax-medicare-pre-existing-contradictions-deceptions#

Top 5 Fibs In Paul Ryan’s Convention Speech

 

From: TPM

By: Brian Beutler

Vice Presidential nominee Paul Ryan’s headlining speech at the GOP convention in Tampa Wednesday night touched on many of the election’s defining issues. But it was also filled with prevarications — not just recitations of the conventions “you didn’t build that” theme, but on the very policy matters that have endeared him to the political establishment in Washington.

The speech effectively rallied his supporters in the audience. But on the merits it was chock full of misstatements of fact that undermine his reputation for brave, big ideas — which has hastened his rise through the ranks of the GOP.

Here are the top five examples:

Medicare

Ryan forged his reputation in large part by drafting and advancing an unpopular plan to dramatically cut and privatize Medicare. Though he didn’t mention that plan once on Wednesday, he included it in his last two budgets, both of which preserved the Affordable Care Acts cuts to Medicare — taken mostly from overpayments to private insurers and hospitals.

Instead, Ryan once again dubiously accused President Obama of being the true threat to Medicare.

“You see, even with all the hidden taxes to pay for the health care takeover, even with new taxes on nearly a million small businesses, the planners in Washington still didn’t have enough money. They needed more. They needed hundreds of billions more. So, they just took it all away from Medicare. Seven hundred and sixteen billion dollars, funneled out of Medicare by President Obama. An obligation we have to our parents and grandparents is being sacrificed, all to pay for a new entitlement we didn’t even ask for. The greatest threat to Medicare is Obamacare, and we’re going to stop it.”

Obama did use those Medicare savings — in the form of targeted cuts in payments to providers, not in benefits to seniors — to pay for the health care law. Ryan’s budget calls for using them to finance tax cuts for wealthy Americans, and deficit reduction. But by now calling to restore that spending commitment to Medicare, Ryan and Romney are pledging to hasten Medicare’s insolvency by many years.

Ryan said the Obama presidency, “began with a perfect Triple-A credit rating for the United States; it ends with a downgraded America.”

US Credit Rating

Standard & Poors downgraded the country’s sovereign debt rating in 2011 because congressional Republicans, of which Ryan is a key leader, threatened not to increase the country’s borrowing authority — risking a default on the debt — unless Democrats agreed to slash trillions of dollars from domestic social programs and investments. Ryan even briefly toyed with the idea that the country’s creditors would forgive default for “a day or two or three or four” as long as Democrats ultimately agreed to GOP demands.

Janesville GM plant

Ryan criticized Obama for — yes — not using government funds to prop up an auto plant in his district.

“A lot of guys I went to high school with worked at that GM plant. Right there at that plant, candidate Obama said: ‘I believe that if our government is there to support you … this plant will be here for another hundred years,’” Ryan recalled. “That’s what he said in 2008. Well, as it turned out, that plant didn’t last another year. It is locked up and empty to this day.”

Ignoring the inconsistency of a Republican chastising Obama for not bailing out more auto manufacturers, the plant in question closed before Obama’s inauguration in 2009.

Debt Commission 

Ryan chastised Obama: “He created a bipartisan debt commission. They came back with an urgent report. He thanked them, sent them on their way, and then did exactly nothing.”

Ryan sat on that commission. He voted against it. Following his lead, so did the panel’s other House Republicans.

Protecting the poor

Near the end of his speech, Ryan claimed the campaign’s top priority is protecting the poor. “We have responsibilities, one to another — we do not each face the world alone,” he said. “And the greatest of all responsibilities, is that of the strong to protect the weak.”

Just under two thirds of the dramatic spending cuts in Ryan’s budget target programs that benefit low-income people. That plan also calls for large tax cuts for high-income earners.

Emphasis Mine

see: http://tpmdc.talkingpointsmemo.com/2012/08/ryan-risks-reputation-with-misleading-nomination-speech.php

 

The Facts Behind Romney and Ryan’s Medicare Lies

First and foremost, the Ryan plan, in any form, would mark the end of Medicare as we know it—as a guarantee of health coverage for senior citizens

From: workingamerica blog

By: Seth D. Michaels

N.B.: A concise, lucid explanation of what they say, what they mean, and what we need.

“It took approximately five minutes after the announcement of Paul Ryan as the Republican running mate for the spin to begin. Anxious to pre-empt a conversation about Ryan’s plan to end the guarantee of Medicare, the Mitt Romney campaign ison the air with some (strikingly dishonest) Medicare ads of their own. They have plenty of money to advance this message, so it’s worth unpacking what’s really going on.

First and foremost, the Ryan plan, in any form, would mark the end of Medicare as we know it—as a guarantee of health coverage for senior citizens. Instead, it would give older people a voucher to go buy their own private insurance. The Ryan budget would also increase the eligibility age, delaying the time when retirees could get Medicare. That’s the proposal the U.S. House voted on and passed in March and it’s the model Ryan has continued to promote even as he’s suggested possible tweaks.

So let’s move on to the claims the Romney campaign is making. The Affordable Care Act is paid for partly through billions in future savings—about $700 billion over 10 years in reduced payments to health insurance companies and providers. A lot of that money stays in the Medicare system, by paying for free preventative care for seniors and closing the prescription drug “doughnut hole.” The attack leveled by Romney, Ryan and their allies—an attack that’s Jonathan Cohn rightly called “astoundingly cynical”—is that this constitutes a massive cut to Medicare.

But here’s the catch: in the Ryan budget that passed, these future savings are included, even as the rest of the ACA is repealed. So the same reductions that the Romney campaign is complaining about were voted on and approved by Ryan and virtually every House Republican.

In the ACA, the cost savings that come out of Medicare go back into the health care system. In the Ryan budget, they’ll be needed to pay for the massive tax cuts proposed in that plan. Cohn notes that not only does this money get pulled out of providing health care entirely, but the attack the Romney campaign is making is a “brazen misrepresentation of reality.” Or, to say it in fewer and shorter words, “a lie.”

The Ryan plan doesn’t replace the guarantee with the vouchers for 10 years, so that major change doesn’t immediately affect today’s retirees. But the repeal of the ACA’s provisions on prescription drugs and preventative care absolutely will. If those provisions are gone, seniors who are on Medicare now will be paying hundreds of dollars more out of pocket. Ryan’s cuts to Medicaid, which many seniors depend on for nursing home care, would also have a big impact—his proposed cuts to Medicaid and the repeal of the ACA Medicaid expansion are a big and under-covered change in his budget. Some 6 million of today’s retirees depend on Medicaid and could lose out under Ryan’s plan. This is what was in the Ryan budget the House passed, and he hasn’t backed off of this at all.

What’s more, if Ryan’s plan kicks in ten years from now, today’s Medicare beneficiaries will getan unpleasant wake-up call as the voucher plan starts to erode the program:

In 2022, when the limited-subsidy program would be introduced, seniors who qualified for traditional Medicare would be allowed to switch to the new program. If healthier or younger beneficiaries make the change to lower their out-of-pocket costs, those still participating in Medicare would be part of an insurance pool that is less healthy and more expensive. To cover those higher per-person costs, Medicare might well be forced to either raise premiums or limit reimbursements to health care providers—which could prompt many to stop taking Medicare patients.

Romney has suggested he may back off of the Medicare savings that Ryan included in his original budget. But in that case, the Ryan budget math gets even more implausible. And by the standards Romney has laid out for how he wants his budget to work, Medicare would have to be slashed either way. That these cuts to programs for vulnerable people would be required in order to pass his huge tax cuts for the rich adds insult to injury. As Derek Thompson notes, Romney’s proposals “have clear and inevitable conclusions: Tax cuts for the richest and spending cuts for the poorest.”

It’s hard to overstate how hypocritical and dishonest the new Romney-Ryan attacks over Medicare are, coming from two people who have pledged changes so radical that they’d leave it unrecognizable.

Emphasis Mine

see::http://blog.workingamerica.org/2012/08/15/the-facts-behind-romney-and-ryan%E2%80%99s-medicare-lies/

12 Things You Should Know About Vice Presidential Candidate Paul Ryan

From: Think Progress

By:Igor Volsky

Mitt Romney has picked as his running mate 42 year-old Republican Congressman Paul Ryan (R-WI), the architect of the GOP budget, which the New York Times has described as “the most extreme budget plan passed by a house of Congress in modern times.” Below are 12 things you should know about Ryan and his policies:

1. Ryan embraces the extreme philosophy of Ayn Rand. Ryan heaped praise on Ayn Rand, a 20th-century libertarian novelist best known for her philosophy that centered on the idea that selfishness is “virtue.” Rand described altruism as “evil,” condemned Christianity for advocating compassion for the poor, viewed the feminist movement as “phony,” and called Arabs “almost totally primitive savages. Though he publicly rejected “her philosophy” in 2012, Ryan had professed himself a strong devotee. “The reason I got involved in public service, by and large, if I had to credit one thinker, one person, it would be Ayn Rand,” he said at a D.C. gathering honoring the author of “Atlas Shrugged” and “The Fountainhead.” “I give out ‘Atlas Shrugged’ as Christmas presents, and I make all my interns read it. Well… I try to make my interns read it.”

2. Ryan wants to raises taxes on the middle class, cuts them for millionaires. Paul Ryan’s infamous budget — which Romney embraced — replaces “the current tax structure with two brackets — 25 percent and 10 percent — and cut the top rate from 35 percent.” Federal tax collections would fall “by about $4.5 trillion over the next decade” as a result and to avoid increasing the national debt, the budget proposes massive cuts in social programs and “special-interest loopholes and tax shelters that litter the code.” But 62 percent of the savings would come from programs that benefit the lower- and middle-classes, who would also experience a tax increase. That’s because while Ryan “would extend the Bush tax cuts, which are due to expire at the end of this year, he would not extend President Obama’s tax cuts for those with the lowest incomes, which will expire at the same time.” Households “earning more than $1 million a year, meanwhile, could see a net tax cut of about $300,000 annually.”

Audiences have booed Ryan for the unfair distribution!

3. Ryan wants to end Medicare, replace it with a voucher system. Ryan’s latest budget transforms the existing version of Medicare, in which government provides seniors with a guaranteed benefit, into a “premium support” system. All future retirees would receive a government contribution to purchase insurance from an exchange of private plans or traditional fee-for-service Medicare. But since the premium support voucher does not keep up with increasing health care costs, the Congressional Budget Offices estimates that new beneficiaries could pay up to $1,200 more by 2030 and more than $5,900 more by 2050. A recent study also found that had the plan been implemented in 2009, 24 million beneficiares enrolled in the program would have paid higher premiums to maintain their choice of plan and doctors. Ryan would also raise Medicare’s age of eligibility to 67.

4. Ryan thinks Social Security is a “ponzi scheme.” In September of 2011, Ryan agreed with Rick Perry’s characterization of Social Security as a “Ponzi scheme” andsince 2005 has advocated for privatizing the retirement benefit and investing it in stocks and bonds. Conservatives claim that this would “outperform the current formula based on wages earned and overall wage appreciation,” but the economic crisis of 2008 should serve as a wake-up call for policymakers who seek to hinge Americans’ retirement on the stock market. In fact, “a person with a private Social Security account similar to what President George W. Bush proposed in 2005″ would have lost much of their retirement savings.

5. Ryan’s budget would result in 4.1 million lost jobs in 2 years. Ryan’s budget calls for massive reductions in government spending. He has proposed cutting discretionary programs by about $120 billion over the next two years and mandatory programs by $284 billion, which, the Economic Policy Institute estimates, would suck demand out of the economy and “reduce employment by 1.3 million jobs in fiscal 2013 and 2.8 million jobs in fiscal 2014, relative to current budget policies.”

6. Ryan wants to eliminate Pell Grants for more more than 1 million students.Ryan’s budget claims both that rising financial aid is driving college tuition costs upward, and that Pell Grants, which help cover tuition costs for low-income Americans, don’t go to the “truly needy.” So he cuts the Pell Grant program by $200 billion, which could “ultimately knock more than one million students off” the program over the next 10 years.

7. Ryan supports $40 billion in subsides for big oil. In 2011, Ryan joined all House Republicans and 13 Democrats in his vote to keep Big Oil tax loopholes as part of the FY 2011 spending bill. His budget would retain a decade’s worth of oil tax breaks worth $40 billion, while cutting “billions of dollars from investments to develop alternative fuels and clean energy technologies that would serve as substitutes for oil.” For instance, it “calls for a $3 billion cut in energy programs in FY 2013 alone” and would spend only $150 million over five years — or 20 percent of what was invested in 2012 — on energy programs.

8. Ryan has ownership stakes in companies that benefit from oil subsidies . Ryan “and his wife, Janna, own stakes in four family companies that lease land in Texas and Oklahoma to the very energy companies that benefit from the tax subsidies in Ryan’s budget plan,” the Daily Beast reported in June of 2011. “Ryan’s father-in-law, Daniel Little, who runs the companies, told Newsweek and The Daily Beast that the family companies are currently leasing the land for mining and drilling to energy giants such as Chesapeake Energy, Devon, and XTO Energy, a recently acquired subsidiary of ExxonMobil.”

9. Ryan claimed Romneycare has led to “rationing and benefit cuts.” “I’m not a fan of [Romney’s health care reform] system,” Ryan told C-SPAN in 2010. He argued that government is rationing care in the state and claimed that people are “seeing the system bursting by the seams, they’re seeing premium increases, rationing and benefit cuts.” He called the system “a fatal conceit” and “unsustainable.”

10. Ryan believes that Romneycare is “not that dissimilar to Obamacare.” Though Romney has gone to great lengths to distinguish his Massachusetts health care law from Obamacare, Ryan doesn’t see the difference. “It’s not that dissimilar to Obamacare, and you probably know I’m not a big fan of Obamacare,” Ryan said at a breakfast meeting sponsored by the American Spectator in March of 2011. “I just don’t think the mandates work … all the regulation they’ve put on it…I think it’s beginning to death spiral. They’re beginning to have to look at rationing decisions.”

11. Ryan accused generals of lying about their support for Obama’s military budget. In March, Ryan couldn’t believe that Joint Chiefs of Staff chairman Gen. Martin Dempsey supports Obama’s Pentagon budget, which incorporates $487 billion in cuts over 10 years. “We don’t think the generals are giving us their true advice,” Ryan said at a policy summit hosted by the National Journal. “We don’t think the generals believe that their budget is really the right budget.” He later apologized for the implication.

12. Ryan co-sponsored a “personhood” amendment, an extreme anti-abortion measure. Ryan joined 62 other Republicans in co-sponsoring the Sanctity of Human Life Act, which declares that a fertilized egg “shall have all the legal and constitutional attributes and privileges of personhood.” This would outlaw abortion, some forms of contraception and invitro fertilization.

Emphasis Mine.

see: http://thinkprogress.org/politics/2012/08/11/677171/12-things-you-should-know-about-vice-presidential-candidate-paul-ryan/

Happy Birthday Medicare!

Medicare

What is Medicare?

Medicare is a national social insurance program, (like Social Security) administered by the U.S. federal government since 1965, that guarantees access to health insurance for Americans ages 65 and older and younger people with disabilities as well as people with end stage renal disease. As a social insurance program, Medicare spreads the financial risk associated with illness across society to protect everyone, and thus has a somewhat different social role from private insurers, which must manage their risk portfolio to guarantee their own profit – if not solvency.

A brief history.

In 1965, Congress created Medicare under Title XVIII of the Social Security Act to provide health insurance to people age 65 and older, regardless of income or medical history. Before Medicare’s creation, only half of older adults had health insurance, with coverage often unavailable or unaffordable to the other half. Older adults had half as much income as younger people and paid nearly three times as much for health insurance. (Medicare also spurred the integration of thousands of waiting rooms, hospital floors, and physician practices by making payments to health care providers conditional on desegregation.)

Success

While the USA does not have good results (compared to other industrialized nations) in measures such as average life expectancy and infant mortality, we rank well in the measure of those who reach 65 living until 85.

Medicare administrative overhead costs (2%) are well below the overhead of large companies that are self-insured (5-10%), health insurers offering coverage to small employers (25-27%), and individual insurance (40%). Insurers offering coverage in “Medicare Advantage” plans spend up to 16.7% on profit and overhead.

Who is eligible?

As above, Americans ages 65 and older (who have been legal residents of the United States for at least 5 years ) and younger people with disabilities as well as people with end stage renal disease.

What is covered?

There are four parts to Medicare: types A, B, C, and D.

Part A (hospital insurance) covers inpatient hospital stays (at least overnight), including semiprivate room, food, and tests, and brief stays for convalescence in a skilled nursing facility if certain criteria are met.

Part B (medical insurance) helps pay for some services and products not covered by Part A, generally on an outpatient basis, e.g. doctor visits.

Part C With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the original Medicare plan (Parts A and B). As Part C cost the government about 14% more than traditional Medicare, it is being phased out, as per the ACA.

Part D (prescription drug plans)went into effect on January 1, 2006. Anyone with Part A or B is eligible for Part D. Part D is not ‘human friendly’ because it covers prescriptions up to a cost point, then no long covers them until another cost point is reached (the coverage gap or ‘donut hole’). Part D did not allow for negotiation of prescription prices, but this and the coverage gap are addressed in the ACA.

Who benefits from Medicare?

Those eligible above, and their children and/or other family members, as the latter do not have to bear the cost for the care!

How is it funded?

Medicare has several sources of financing. Part A largely is funded by revenue from a 2.9 percent [payroll tax] levied on employers and workers (each pay 1.45 percent). Until December 31, 1993, the law provided a maximum amount of compensation on which the Medicare tax could be imposed each year. Beginning January 1, 1994, the compensation limit was removed. Part B is funded in part by premiums paid by the recipient (about $100/month).

Changes under the ACA.

The Patient Protection and Affordable Care Act (“ACA”) of 2010 made a number of changes to the Medicare program. Several provisions of the law were designed to reduce the cost of Medicare. Congress reduced payments to privately managed Medicare Advantage plans to align more closely with rates paid for comparable care under traditional Medicare. Congress also slightly reduced annual increases in payments to physicians and to hospitals that serve a disproportionate share of low-income patients. Along with other minor adjustments, these changes reduced Medicare’s projected cost over the next decade by $455 billion.

Due to the passage of the ACA Medicare’s unfunded obligation over the next 75 years declined from $13.4 trillion to $3 trillion.

The ACA also made some changes to Medicare enrollee’s’ benefits. By 2020, it will close the so-called “donut hole” between Part D plans’ coverage limits and the catastrophic cap on out-of-pocket spending, reducing a Part D enrollee’s’ exposure to the cost of prescription drugs by an average of $2,000 a year.  Limits were also placed on out-of-pocket costs for in-network care for Medicare Advantage enrollees.  Meanwhile, Medicare Part B and D premiums were restructured in ways that reduced costs for most people while raising contributions from the wealthiest people with Medicare. The law also expanded coverage of preventive services.

What does Medicare Cost us as a nation?

As a share of GDP, Medicare cost is expected to increase from 3.6 percent in 2010 to 5.6 percent in 2035 and to 6.2 percent by 2080. That is, a mere 4% – 6 % to provide health care for our old and disabled citizens.

Why is Medicare Under attack?

This is not an easy point to address from a non-partisian standpoint! If one has as a dogma that no government program can be successful, then counter examples of very successful programs such as Medicare and Social Security are a threat. If one believes that Medicare is a major drain on our finances (it isn’t), then one might view it as an opportunity to cut spending. It revisits the failed privatize Social Security efforts of the last decade. The major causes of our current debut are the reduced tax rates on high incomes, and two wars.

From Politifact:

Barack Obama has slashed Medicare by $500 billion. Mitt Romney and House Republicans want to end Medicare. And a new board is going to ration care so Washington can waste more money. 

Believe any of that? You shouldn’t.” (Politifact)

Information from many sources, including:http://en.wikipedia.org/wiki/Medicare_(United_States)

Kathleen Sebelius: The Affordable Care Act has made the U.S. health-care system stronger

From:Washington  Post

By:Kathleen Sebelius

“The Supreme Court decision upholding the Affordable Care Act was a turning point in the health-care debate, a chance to stop refighting old political battles and move forward with implementing and improving a law that is already lowering health-care costs and providing more security for millions of American families. Instead, congressional Republicans will spend Wednesday staging yet another repeal vote.

Fortunately for those Americans whose health and finances depend on protections in the law, the vote is only symbolic. But it’s worth setting the record straight about some false claims that have recently resurfaced.

One claim is that the Affordable Care Act is driving up Americans’ health-care costs. The facts tell a different story.

In the decade before the law was passed, national health expenditures increased about 7 percent a year. But in the past two years, those increases have dropped to less than 4 percent per year, saving Americans more than $220 billion. And that trend is expected to continue, with health-care costs projected to stay level as a share of gross domestic product from 2009 all the way through 2013.

You can see the same trend with premiums. Between 2000 and 2009, the average family premium more than doubled, from $6,438 to $13,375, an annual increase of 8.1 percent. From 2009 to 2011, family premiums still rose — but at a rate 25 percent lower. That generated savings of more than $1,200 per family, a trend of lower premium increases that independent experts such as Mercer, the human resources consultant, and the nonprofit National Business Group on Health project will continue. And the law will provide even more relief in the years to come, including a tax cut averaging $4,000 for 18 million middle-class Americans — a tax break that repeal would eliminate.

Another falsehood repeated by opponents of the law is that it is putting a greater burden on small businesses. Again, the facts show that the opposite is true.

Small-business owners were struggling in the health insurance market long before the law passed, spending an average of 18 percent more than their large competitors annually for health coverage and often seeing their insurance bills skyrocket if a single employee got sick. The result was that the number of small businesses in the United States offering coverage to employees was falling rapidly — from nearly 70 percent in 2000 to less than 60 percent of employers by 2009 — leaving millions of working families without coverage.

Since the law passed, the share of small businesses offering employee coverage has held steady at 59 percent, the Kaiser Family Foundation has found, in part because new tax credits in the law are saving hundreds of thousands of small companies thousands of dollars each on their insurance costs. And independent experts such as Rand Corp. predict the number of employers offering coverage will rise in 2014 — just as it did in Massachusetts after health reform was passed — when small-business owners have the choice of shopping for health coverage in new competitive marketplaces.

A third false attack recycled in recent weeks is that the Affordable Care Act cuts Medicare benefits. In truth, Medicare is stronger than ever.

Thanks to the law, seniors have new benefits such as free preventive care as well as discounts on brand-name medications in the “doughnut hole” coverage gap that have already saved more than 5 million people with Medicare about $600 each. Medicare Advantage premiums have fallen two years running. New crackdowns on fraud and abuse returned a record $5.4 billion to Medicare in 2010 and 2011. And the health-care law has strengthened Medicare’s long-term outlook, adding eight additional years to the projected solvency of the Medicare trust fund.

Those calling for repeal have yet to propose credible ideas for lowering health-care costs. In fact, the same House Republicans who are voting Wednesday to repeal these Medicare savings voted to keep them in their budget in March.

People are entitled to their opinions, but not to their own facts. And the facts in this case are clear: Since the Affordable Care Act was passed, national health spending is rising at a slower rate, health insurance premiums are rising at a slower rate, small-business coverage is holding steady and Medicare is on a stronger financial footing.

Now that the Supreme Court has issued a decision, the American people would be better served if Congress joined the president in working to build on that progress, not undo it.

Emphasis Mine

see:http://www.washingtonpost.com/opinions/kathleen-sebelius-the-affordable-care-act-has-made-the-us-health-care-system-stronger/2012/07/09/gJQA1BOOZW_story.html?wpisrc=nl_opinions

Healthcare Jujitsu

But with a bit of political jujitsu, the President could turn any such defeat into a victory for a single-payer healthcare system – Medicare for all. compared to private insurance, Medicare is a great deal. Its administrative costs are only around 3 percent, while the administrative costs of private insurers eat up 30 to 40 percent of premiums. Medicare’s costs are even below the 5 percent to 10 percent administrative costs borne by large companies that self-insure, and under the 11 percent costs of private plans under Medicare Advantage, the current private-insurance option under Medicare.

From: Robert Reich’s blog

By: Robert Reich

“Not surprisingly, today’s debut Supreme Court argument over the so-called “individual mandate” requiring everyone to buy health insurance revolved around epistemological niceties such as the meaning of a “tax,” and the question of whether the issue is ripe for review.

Behind this judicial foreplay is the brute political fact that if the Court decides the individual mandate is an unconstitutional extension of federal authority, the entire law starts unraveling.

But with a bit of political jujitsu, the President could turn any such defeat into a victory for a single-payer healthcare systemMedicare for all.

Here’s how.

The dilemma at the heart of the new law is that it continues to depend on private health insurers, who have to make a profit or at least pay all their costs including marketing and advertising.

Yet the only way private insurers can afford to cover everyone with pre-existing health problems, as the new law requires, is to have every American buy health insurance – including young and healthier people who are unlikely to rack up large healthcare costs.

This dilemma is the product of political compromise. You’ll remember the Administration couldn’t get the votes for a single-payer system such as Medicare for all. It hardly tried. Not a single Republican would even agree to a bill giving Americans the option of buying into it.

But don’t expect the Supreme Court to address this dilemma. It lies buried under an avalanche of constitutional argument.

Those who are defending the law in Court say the federal government has authority to compel Americans to buy health insurance under the Commerce Clause of the Constitution, which gives Washington the power to regulate interstate commerce. They argue our sprawling health insurance system surely extends beyond an individual state.

Those who are opposing the law say a requirement that individuals contract with private insurance companies isn’t regulation of interstate commerce. It’s coercion of individuals.

Unhappily for Obama and the Democrats, most Americans don’t seem to like the individual mandate very much anyway. Many on the political right believe it a threat to individual liberty. Many on the left object to being required to buy something from a private company.

The President and the Democrats could have avoided this dilemma in the first place if they’d insisted on Medicare for all, or at least a public option.

After all, Social Security and Medicare require every working American to “buy” them. The purchase happens automatically in the form of a deduction from everyone’s paychecks. But because Social Security and Medicare are government programs financed by payroll taxes they don’t feel like mandatory purchases.

Americans don’t mind mandates in the form of payroll taxes for Social Security or Medicare. In fact, both programs are so popular even conservative Republicans were heard to shout “don’t take away my Medicare!” at rallies opposed to the new health care law.

There’s no question payroll taxes are constitutional, because there’s no doubt that the federal government can tax people in order to finance particular public benefits. But requiring citizens to buy something from a private company is different because private companies aren’t directly accountable to the public. They’re accountable to their owners and their purpose is to maximize profits. What if they monopolize the market and charge humongous premiums? (Some already seem to be doing this.)

Even if private health insurers are organized as not-for-profits, there’s still a problem of public accountability. What’s to prevent top executives from being paid small fortunes? (In more than a few cases this is already happening.)

Moreover, compared to private insurance, Medicare is a great deal. Its administrative costs are only around 3 percent, while the administrative costs of private insurers eat up 30 to 40 percent of premiums. Medicare’s costs are even below the 5 percent to 10 percent administrative costs borne by large companies that self-insure, and under the 11 percent costs of private plans under Medicare Advantage, the current private-insurance option under Medicare.

So why not Medicare for all?

Because Republicans have mastered the art of political jujitsu. Their strategy has been to demonize government and seek to privatize everything that might otherwise be a public program financed by tax dollars (see Paul Ryan’s plan for turning Medicare into vouchers). Then they go to court and argue that any mandatory purchase is unconstitutional because it exceeds the government’s authority.

Obama and the Democrats should do the reverse. If the Supreme Court strikes down the individual mandate in the new health law, private insurers will swarm Capitol Hill demanding that the law be amended to remove the requirement that they cover people with pre-existing conditions.

When this happens, Obama and the Democrats should say they’re willing to remove that requirement – but only if Medicare is available to all, financed by payroll taxes.

If they did this the public will be behind them – as will the Supreme Court.”


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 latest book, “AFTERSHOCK: The Next Economy and America’s Future.” His ‘Marketplace’ commentaries can be found on publicradio.com and iTunes.

Emphasis Mine

see: http://readersupportednews.org/opinion2/272-39/10655-healthcare-jujitsu

Romney Tells The GOP He Is The Hero Who Will Destroy Social Security

Willard, like nearly all conservatives, also parrots the fallacy that Social Security is adding to the nation’s debt, but in accordance with the Trust’s rules, Social Security is forbidden from taking one penny from the government for administrative costs or benefit payments. It is a self-sufficient program that not only works well, but is extremely popular.

From: Politicususa

By:

“Human beings are fortunate that one function of memory is to forget the enormous amount of data a person absorbs throughout their lifetime. Important events are often difficult to forget and they either become valuable life lessons or unhealthy obsessions that if left unresolved become a grudge that gives a vindictive person a reason to hold something against someone. Conservatives have held a grudge against Progressives and FDR over the New Deal and especially the creation of the Social Security Trust, and they are obsessed with destroying the most successful and popular program in the nation’s history.

In 2010, George W. Bush said his greatest failure was not privatizing Social Security even though doing so in 2005 would have left tens-of-millions of retired Americans without security in their old age after the stock market crashed in 2008. Bush’s regret at not destroying Social Security when he had the opportunity informs the level of contempt conservatives have for the American people and it seemed that Republicans learned their lesson, but their obsession with the New Deal prevents them from learning. Perhaps Republicans are competing with each other to be the conservative hero that gets even with Progressives for creating Social Security, and if presidential hopeful Willard “Mitt” Romney wins the nomination and presidency, he promises to be the hero that destroys Social Security.

Romney resorts to every conservative hero’s tactic of lying to promote an agenda that harms millions of Americans. At the recent Conservative Political Action Conference (CPAC), Romney resorted to lying to promote privatizing Social Security. Willard said, “We’re going to have to recognize that Social Security and Medicare are unsustainable and we can’t afford to avoid these entitlement challenges any longer.” It is a typical Republican lie that Bush used in 2005, and the truth is that without any adjustments, Social Security will remain solvent for the next thirty years or more. Romney also lied when he said current retirees would not see a change in their benefits under his plan. During the same speech, Romney promised to  increase defense spending, give the wealthiest 1% approximately $6.7 trillion in tax cuts,  and slash “entitlement” spending that surely includes Medicare and Social Security as part of his balanced budget farce.

Then there is this recurring “Social Security is an entitlement” meme that Republicans use to portray the program as welfare. Every working American pays 6.2% of every dollar they earn into the Social Security Trust. The rate decreased by 1% as part of President Obama’s payroll tax holiday except for wealthy Americans like Romney who pays on only the first .5% of his income because his earnings exceed the current $110,100 cap. If Romney is concerned that Social Security is in jeopardy of running out of funds, his Republican pals can eliminate the cap on payroll tax contributions and keep the Trust bloated with cash forever. Every other American pays Social Security tax on 100% of their income and with the median income at $49,909, over 90% of Americans would never reach the cap limit.

Romney just wants to transfer approximately $2.7 trillion in surplus assets in the Social Security Trust Fund to Wall Street to enrich himself and other high-income investors. A typical conservative ploy to convince Americans Social Security does not work is to label it a failure and a fraud and Romney said, “To put it in a nutshell, the American people have been effectively defrauded out of their Social Security,” and that there is a “looming bankruptcy of Social Security.” Willard just doesn’t get that Social Security is popular with nearly every American (especially older tea party-supporting white voters) because it works and that is one reason why he is losing popularity by the second. Willard, like nearly all conservatives, also parrots the fallacy that Social Security is adding to the nation’s debt, but in accordance with the Trust’s rules, Social Security is forbidden from taking one penny from the government for administrative costs or benefit payments. It is a self-sufficient program that not only works well, but is extremely popular.

Republicans are so consumed with hatred for the New Deal that produced Social Security, that 76 years after its creation they are still attempting to dismantle the only retirement income for millions of Americans as well as the largest insurance program for children. The program has never failed to pay out benefits on schedule, and the surplus is invested in U.S. Treasury securities that are considered the safest investment in the world. More than anything, Social Security provides a measure of security that Wall Street can never match, but that doesn’t stop conservatives from lying about the system to garner support for eliminating it. Romney is not the first conservative to promote privatizing or eliminating Social Security and he will not be the last.

Romney is out-of-touch with America and out of touch with reality if he thinks he will ever convince Americans to allow him to take their hard-earned retirement savings and offer it up to his god Wall Street. It is a mystery why Republicans cannot recognize that despite their lies, misinformation, and scare tactics, Americans do not want Social Security privatized. It is telling that Bush laments not privatizing Social Security even though doing so would have left millions of Americans without income in their golden years, and it is a testament to the man’s vile contempt for Americans. Romney is worse than Bush. He is also stupider because his desire to be the conservative hero that dismantles the New Deal is taking the same path that began Bush’s popularity slide.

If Romney wants to raid programs to enrich Wall Street and his investor cohorts, he can return to Bain Capital and destroy struggling businesses because Americans will never allow him near the White House. As one pundit said, “There is a reason you are having serious trouble in primaries and caucuses in states where older white voters reside in disproportionately large numbers, such as Missouri, Maine (almost losing to Ron Paul?) and Minnesota.”  Romney will continue having trouble with Americans and it is a good lesson that holding a grudge is about as good of an idea as trying to be a hero for a losing cause; especially when the cause is dismantling the New Deal.””

Emphasis Mine

see:http://www.politicususa.com/en/social-security-romney

American health care is remarkably diverse.

In fact, it’s hard to avoid the sense that Republicans are especially eager to dismantle government programs that act as living demonstrations that their ideology is wrong. Bloated military budgets don’t bother them much —

From: NY Times, via Truthout

N.B.: Republicans continue to lie, while people continue to die, and before I die, I hope the word ‘socialism’ is no longer pejorative, along with ‘atheism’, and ‘humanism’, in our country.

By: Dr. Paul Krugman

“In terms of how care is paid for and delivered, many of us effectively live in Canada, some live in Switzerland, some live in Britain, and some live in the unregulated market of conservative dreams. One result of this diversity is that we have plenty of home-grown evidence about what works and what doesn’t.  

Naturally, then, politicians — Republicans in particular — are determined to scrap what works and promote what doesn’t. And that brings me to Mitt Romney’s latest really bad idea, unveiled on Veterans Day: to partially privatize the Veterans Health Administration (V.H.A.).

What Mr. Romney and everyone else should know is that the V.H.A. is a huge policy success story, which offers important lessons for future health reform.

Many people still have an image of veterans’ health care based on the terrible state of the system two decades ago. Under the Clinton administration, however, the V.H.A. was overhauled, and achieved a remarkable combination of rising quality and successful cost control. Multiple surveys have found the V.H.A. providing better care than most Americans receive, even as the agency has held cost increases well below those facing Medicare and private insurers. Furthermore, the V.H.A. has led the way in cost-saving innovation, especially the use of electronic medical records.

What’s behind this success? Crucially, the V.H.A. is an integrated system, which provides health care as well as paying for it. So it’s free from the perverse incentives created when doctors and hospitals profit from expensive tests and procedures, whether or not those procedures actually make medical sense. And because V.H.A. patients are in it for the long term, the agency has a stronger incentive to invest in prevention than private insurers, many of whose customers move on after a few years.

And yes, this is “socialized medicine” — although some private systems, like Kaiser Permanente, share many of the V.H.A.’s virtues. But it works — and suggests what it will take to solve the troubles of U.S. health care more broadly.

Yet Mr. Romney believes that giving veterans vouchers to spend on private insurance would somehow yield better results. Why?

Well, Republicans have a thing about vouchers. Earlier this year Representative Paul Ryan famously introduced a plan to convert Medicare into a voucher system; Mr. Romney’s Medicare proposal follows similar lines. The claim, always, is the one Mr. Romney made last week, that “private sector competition” would lower costs.

But we have a lot of evidence about how private-sector competition in health insurance works, and it’s not favorable. The individual insurance market, which comes closest to the conservative ideal of free competition, has huge administrative costs and has no demonstrated ability to reduce other costs. Medicare Advantage, which allows Medicare beneficiaries to buy private insurance instead of having Medicare pay bills directly, has consistently had higher costs than the traditional program.

And the international evidence accords with U.S. experience. The most efficient health care systems are integrated systems like the V.H.A.; next best are single-payer systems like Medicare; the more privatized the system, the worse it performs.

To be fair to Mr. Romney, he takes a somewhat softer line than others in his party, suggesting that the existing V.H.A. system would remain available and that traditional Medicare would remain an option. In practice, however, partial privatization would almost surely undermine the public side of these programs. For example, one problem with the V.H.A. is that its hospitals are spread too thinly across the nation; this problem would become worse if a substantial number of veterans were encouraged to opt out of the system.

So what lies behind the Republican obsession with privatization and voucherization? Ideology, of course. It’s literally a fundamental article of faith in the G.O.P. that the private sector is always better than the government, and no amount of evidence can shake that credo.

In fact, it’s hard to avoid the sense that Republicans are especially eager to dismantle government programs that act as living demonstrations that their ideology is wrong. Bloated military budgets don’t bother them much — Mr. Romney has pledged to reverse President Obama’s defense cuts, despite the fact that no such cuts have actually taken place. But successful programs like veterans’ health, Social Security and Medicare are in the crosshairs.

Which brings me to a final thought: maybe all this amounts to a case for Rick Perry. Any Republican would, if elected president, set out to undermine precisely those government programs that work best. But Mr. Perry might not remember which programs he was supposed to destroy.

Emphasis Mine

see:http://www.nytimes.com/2011/11/14/opinion/krugman-vouchers-for-veterans-and-other-bad-ideas.html?_r=2