Speaking of the Gilded Age, It’s Paul Ryan’s Budget!
Here is Paul Ryan’s path to a balanced budget in three sentences: He cuts deep into spending on health care for the poor and some combination of education, infrastructure, research, public-safety, and low-income programs. The Affordable Care Act’s Medicare cuts remain, but the military is spared, as is Social Security. There’s a vague individual tax reform plan that leaves only two tax brackets — 10 percent and 25 percent — and will require either huge, deficit-busting tax cuts or increasing taxes on poor and middle-class households, as well as a vague corporate tax reform plan that lowers the rate from 35 percent to 25 percent.
But the real point of Ryan’s budget is its ambitious reforms, not its savings. It turns Medicare into a voucher program, turns Medicaid, food stamps, and a host of other programs for the poor into block grants managed by the states, shrinks the federal role on priorities like infrastructure and education to a tiny fraction of its current level, and envisions an entirely new tax code that will do much less to encourage home buying and health insurance.
Ryan’s budget is intended to do nothing less than fundamentally transform the relationship between Americans and their government. That, and not deficit reduction, is its real point, as it has been Ryan’s real point throughout his career.
But the real focus of Ryan’s new budget proposal, like his previous one, is to dramatically reduce spending. The effort starts with a plan to transform Medicare into a voucher scheme. Ryan and his supporters don’t like the word “voucher” because it implies that Ryan’s Medicare reforms would undermine the guarantee of comprehensive health benefits that Medicare has traditionally provided to America’s seniors. But the implication is correct. As of 2024, people who reach retirement age would no longer get government insurance. Instead, they would get a voucher, which they would then use to buy insurance. Year after year, the voucher’s value would rise at a pre-determined pace. And if the voucher weren’t big enough to pay for decent benefits? The last Ryan budget never explained how such a scheme would protect seniors in those cases. The new Ryan budget doesn’t either. Most likely, some if not most America’s seniors would end up having to make up the difference on their own dime.
Ryan’s proposed changes to Medicaid get far less attention. But those changes would be even more profound. Today, Medicaid guarantees a set of benefits to everybody who meets the program’s eligibility requirements, and the federal government promises to pick up the majority of the funding, no matter the cost. Ryan’s budget would end those guarantees. The federal government would write states a check, based on a pre-determined formula, and give states more flexibility over how to spend the money. Problem is, Ryan would also dramatically reduce the programs’ funding. A 2012 analysis of Ryan’s previous proposal, produced by the Kaiser Family Foundation and conducted by researchers at the Urban Institute, concluded that between 14 and 20 million people would lose health insurance as a result.
But, of course, accuse Ryan of trying to end Medicare and you’ll get eleven trillion Pinocchios on fire.
The budget will be balanced, if Ryan gets his way, through a campaign of thoroughgoing class warfare aimed at Americans in the bottom half of the income distribution in order to protect the interests of a small, high-income minority.
Either I’m getting old or I’m just not paying attention. When I saw your links I assumed Joe Klein and Richard Cohen and I wondered “Why the hell are you linking to those guys?”
And then I did follow the links and I was pleasantly surprised. I just wonder how much of this kind of analysis will make it into the wider media environment.
When the budget was release, Joe and Richard were busy having cocktails at the Stonewall Jackson Inn and Spa in Alexandria and were unavailable for comment.
That happens to me all the time.
The corporate media has a big pile of shit to sell in this budget.
Either the government will shut down(and I would be surprised if the Republicans didn’t do that at least once under Obama’s tenure), or best case scenario, two more years of continuing resolutions until we can get a better Congress.
The Republicans are pretty desperate though. So many of them are itching to push the doomsday button rather than live in a country not dominated by old conservative white guys.
I hope Obama has a contingency plan ready that isn’t signing the shit resolution the House passed a week ago.
You seriously think this budget will pass? Why? The last several Ryan budgets have not.
No this budget won’t pass, but the Republicans already passed a piece of shit CR a week ago that basically makes the same calculus of military GOOD! other spending BAD!
I wonder if the PolitiFact people are finally embarrassed by their choice. It always seemed obvious they picked it to burnish their “both-sides-do-it” credentials, but now that Ryan has made it as clear as he possibly could, short of cackling Wicked-Witch-style on national TV, that gutting the welfare state is his chief goal, I bet they’re wishing they made a different choice of example in their pandering.
Love your naive optimism – don’t ever change.
Other people I’m not expecting they wished they made a different choice:
- ‘serious people’ who thought the Iraq War was a good idea
- the key Democrats that killed filibuster reform
- the financial community that almost killed the global economy and then decided they were the only people that deserved life support measures
- etc.
These people are too busy looking for new issues to fuck over the general public with to spend even a nanosecond wishing that they hadn’t fucked over the public on some bogus issue in the past when we all know it’s not the issues that matter but the fucking over of the general public that’s the point. After all, fucking over the public over WMDs, fiscal policy, or socialized costs to support privatized profits are just the incidental details that are simply excuses to have the public take the fucking over everyone understands is necessary to maintain good order and keep the populace in a constant state of masochistic fear of their betters. The instruments may get more sophisticated but we’re never more than two steps away from a complete restoration of the feudal state where a conscience and an honest assessment of past behaviors and their intended/unintended consequences is simply an unnecessary burden.
I know a bunch of the PoltiFact people. Short answer is, some are indeed embarrassed and have been since that happened. Others toe the company line to this day. Still others are the people in the position to actually make decisions, and those folks barely even remember it.
Given that at least some of them benefit from the tax cuts and do not see themselves as getting hurt by the cuts (which is likely not accurate), the answer is that they will never change.
Republicans do change, when the consequences of their policies become personal. There’s nothing like having a lifetime medical insurance cap exceeded to motivate republican to reassess his position.
You, like the OP, give Paul Ryan too much credit. Paul Ryan is a pimp for Charles and David H. Koch. No more, no less.
To think that this country was a paltry 2,487,723 votes (that’s about the size of Houston) from this being the President’s budget. Scary shit.
but the military is spared
Guns or butter?
Guns before butter
https://www.youtube.com/watch?v=B_eF9hPCW_U
Talk to me like I’m stupid here.
The government loans you however much you need to go to law school, which allows law schools to raise their prices year after year without pricing anyone out of the market. If the loan was for an amount that only rose with inflation, this might help curb tuition rises, right?
The medicare voucher plan would not be my choice of solution, by any means. But, is there a possibility that it could slow the rate of rising healthcare costs? My guess is no, but why is it different?
I imagine if you consider the market for people consuming the product of law schools, and the market for people consuming healthcare you’d find they’re different: pretty much everyone consuming law school products requires a govt loan of some kind, so pressure on the amount of loan would put pressure on prices for law school.
But the majority of healthcare consumers aren’t on Medicare, so capping the amount of money Medicare pays won’t affect the majority of the market.
Medicare et al already have lower rates of cost increase than the private sector, but they do nothing – or almost nothing – to restrain private sector cost increases, because they’re not a large enough market.
But the majority of healthcare consumers aren’t on Medicare, so capping the amount of money Medicare pays won’t affect the majority of the market.
Medicare et al already have lower rates of cost increase than the private sector, but they do nothing – or almost nothing – to restrain private sector cost increases, because they’re not a large enough market.
Aren’t Medicare costs lower precisely because its such a large market and thus has substantial power to negotiate discounts?
But, is there a possibility that it could slow the rate of rising healthcare costs? My guess is no, but why is it different?
Medicare = single buyer, with power to set prices.
Vouchercare = millions of atomized buyers.
Why would vouchercare possibly be better than medicare at controlling costs, unless by “controlling costs” you mean “let poor people die early”?
Well, but once they kill off all the sick poor people, the market price for health care will collapse from lack of demand, leaving us wth a balanced budget!
And soylent green will be cheap and plentiful!
Long pig: the other other white meat. Also available in dark.
Soylent Verde Gorditas at Taco Bell: “Have you had your fill of illegal immigrants?”
“controlling costs” in Ryan’s context means “controlling the govt’s costs, we don’t give a stuff about the wider market” -> “market failure? I can’t hear you!” -> “using the power of govt to solve problems is unconstitutional because Reagan”
In a negotiation between you and a law school, the power all belongs to the law school. In a negotiation between Medicare and a health care provider, the power belongs to Medicare. A voucher program would accelerate the increase in prices, because it would shift the power back to the seller — the government would no longer be negotiating rates.
Yes. This. I used to emphasize the importance of power relationships in economic transactions when I used to teach intro macro and intro micro as an adjunct, and my students seemed to grasp that in a way that they never really grasped many other economic concepts. Looking back on it, this may or may not be related to why they stopped offering me classes last year …
Indeed we see the same thing in Part D. Instead of having Medicare negotiate drug prices we allow private insurers to do it and we end up with way higher prices than we would otherwise.
Right, gotcha, cos it dilutes the purchasing power of the Medicare consituancy between all the different insurance companies they’re buying from.
Second question: If the states get block grants, can they use them to employ doctors and run UK-NHS type hospitals which are free at point of use?
What the others above have said, and in addition, if you find your voucher isn’t enough to cover tuition and using your own money isn’t worth it, you can just decide to not go to law school.
if you find your voucher isn’t enough to cover tuition and using your own money isn’t worth it, you can just decide to not go to law school.
This is rather the important point, and perhaps the most crucial reason that markets in health care don’t work.
Yep.
Medicine is “disease care” not healthcare.
Because there are infinite alternatives to law school. When you are sick, there are no alternatives, you pay or you die.
No more government health insurance for seniors? They’ll have to get insurance on their own and try to find a way to pay for it? I’m just boggled by this . . . what insurance company would insure your typical 70-year-old with the usual assortment of chronic (and expensive) conditions?
Which, of course, would be why Medicare was passed in the first place.
They already do in Medicare. It’s just that the government has to pay them much more than they would if they just had them in regular Medicare.
My 81 year-old Mother had to have (somewhat emergency) hernia surgery last week.
Damn that Medicare!
It didn’t allow me the pleasure of haggling with doctors and hospitals over the best price!
I just took her to her Primary Doctor, who then recommended a specialist, and my Mom had the operation in a few days.
And all of than, with no vouchers to redeem!
So I missed-out on the sheer joy of calling dozens and dozens of doctors and surgeons, and the 4 hospitals in our area, and figuring out the best deal for her.
Woe is me…
Can’t we just send Paul Ryan to North Korea, and just leave him there?
Or, are the people there too “socialized” and well-fed for him?
I agree, we shouldn’t call it a “voucher”. It’s a coupon for $8K off a health insurance policy that no for-profit company would ever write.
Here’s a fine example of what states like mine would do if our tattered federal safety net became a block grant.
Going back to yesterday’s anarchist debate, its kind of telling that the Far Right and Far Left favor the more initimate communities as the most important political communities rather than the less intimate ones. When people have to rely on the more intimate communities for their welfare than those intimate commmunities get more power. That power is more often that not used to enforce a particular set of norms on people whether they like it or not. With larger and less personal political communities, enforcing social norms effectively is harder. It gives people more ability to act as they want. Its why I’m a left-liberal rather than an anarchist.
And quite frankly I don’t care what social norms are being enforced by the initimate community, whether they are evil or good. Its still the coercive enforcement of ideas on people whether they like it or not.
“So many of them are itching to push the doomsday button rather than live in a country not dominated by old conservative white guys.”
You’re just saying that because you don’t already think the world is coming to an end. They do. Whether it’s religious fundies who think they’ll see the rapture in their lifetime, business fundies who think the class war is coming for their BMWs, or the outright racists (of varying intensity) who see brown and black people where they didn’t used to be, they all think the doomsday button has already been pushed.
The Ryan “budget”? For them it isn’t a new relationship between government and people (or whatever), it’s a brilliant plan to forestall the apocalypse that is already upon us.
Whoops, that was supposed to be a reply to wengler upthread. Second time I’ve done that in a week. Did I change a browser setting or something?
Ezra got played on Social Security
If you go behind the Roapmap PR to the bill language and read Sec 704 on SS Policy
http://budget.house.gov/uploadedfiles/2014_budget_resolution.pdf (90 page PDF)
You will see that Ryan sets up a rigged process that gives veto powers to the two Public Trustees of SS. Of whom the Dem Robert Reischauer is a Peter G Peterson affiliate and so committed to a cuts only SS ‘reform’ while the Repub Chuck Blahous was Bush’s point man on privatization. It is certain as anything can be that any package forwarded by the Trustees for “expedited” action by Congress that has to be pre-cleared by Reichshauer and Blahous is going to be ugly indeed. Though without Ryan’s fingerprints openly on it.
“See!! It was the Public Trustees!! And Bi-Partisanship!!!” and oh no, not rigged in advance, not at all.
It’s pretty transparent when his budget says “unelected bureaucrats deciding what happens to Medicare=bad…unelected bureaucrats deciding what happens to SS=good”
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