Thomas Jefferson wrote, "To preserve independence ... we must not let our rulers load us with perpetual debt. We must make our election between economy and Liberty or profusion and servitude." Rep. Paul Ryan's Prosperity Project Budget means that Americans will get the chance to make that "election" between two competing visions of our future.
It's exciting to think of having a real choice. Americans recently have watched in despair as both major parties, when in power, engaged in reckless deficit spending for their own political gain. The only difference seemed to be one of degree.
Now Ryan, a Republican Congressman from Wisconsin, has given us some place to turn. He proposes to spend $6 trillion less than would be spent under President Barack Obama's plan and add $4.7 trillion less to the national debt. Federal borrowing under his plan would fall to 2 percent of GDP, down from the unsustainable 10 percent level we have currently. Spending overall would fall from 25 to 20 percent of GDP, which is the modern average.
To achieve such savings, Ryan has to go where all politicians hate to go, even though the whole world knows it has to be done. He cuts entitlement spending. His reforms are realistic and sensible. Medicaid would become a block grant to the states, just like the successful welfare reform of the 1990s. Medicare would be changed from an open-ended entitlement to a "premium support" model, with each senior given a fixed amount to spend on the health insurance of their choice.
Social Security changes are less defined. But many reforms have already been proposed, including personal savings accounts, raising the retirement age and reducing cost-of-living increases for affluent retirees, all of which are relatively painless and effective at bringing costs under control.
Ryan's plan can be legitimately criticized for not going far enough. It doesn't actually reduce outlays, it just reduces the growth of government spending 40 percent over the next decade. It adds almost a trillion dollars a year to the debt for the next decade and doesn't balance the budget until 2040. It's a dramatic improvement over any other plan on the table, but in negotiating terms, it looks more like a compromised solution than an opening bid.
Surely the Left wouldn't demagogue a proposal so necessary and moderate, would they? We all know the answer to that one. Nancy Pelosi accused Ryan of creating "a path to poverty for American seniors." The plan is "radical," "irresponsible" and "extreme" according to columnist E.J. Dionne. The always-hysterical Paul Krugman asserted the "savings will come entirely from ... denying medical care" to those who aren't wealthy enough.
They are correct that some seniors will pay more for health care under Ryan's plan. The status quo may be great except that it's unaffordable and must be reformed so that something is left for retirees of the future. Ryan's plan relies partially on the savings that would come from making seniors smart consumers of medical care - after all, they're famous for knowing how to get the most out of a buck.
Obama's notion is to save through "efficiencies" like electronic record keeping and payment cuts, which don't save much money but will make health care harder to obtain. His overall solution (for everything) is to tax "the rich." But in spite of the mortal blow it would deal to economic growth, even confiscating all income over $250,000 wouldn't come close to defusing the massive debt bomb we have hanging over us.
Ryan and his colleagues are well aware of their political vulnerability. They hope, with some reason, that enough Americans sense how irresponsibly we are acting toward future generations, that the previously unthinkable can now be considered. Obama and the Left hope that enough Americans are government-dependent and just want their benefits to last as long as possible. If that is so, they can punish Republicans at the polls.
This is very possibly the battle of our lifetime. We the people are the deciders. The outcome won't be determined by the politicians or the lobbyists, unions, businesses or even the media. We still have the time to pass on to future generations a better America than the one we inherited. It's all in the "elections" we make.
• East Valley resident Tom Patterson (pattersontomc@cox.net) is a retired physician and former state senator.
samkat posted at 9:43 pm on Fri, Apr 15, 2011.
Tom: For a physician, you seem to lack common sense. We have corporations paying no taxes whatsoever and you zero tax guys seem to think that is the way to stimulate the economy. If the government has no revenue, who pays the bills? A fair and balanced tax structure is necessary. I am sure that before you made a killing in the medical field and retired, your objective was to generate revenue. What is the difference with governments?
Ricardo Cabeza posted at 10:23 pm on Fri, Apr 15, 2011.
DC has a spending problem not a revenue problem.
Dale Whiting posted at 6:56 am on Sat, Apr 16, 2011.
You know Tom,
Then the debate over healthcare reform heated up a couple of years ago, several of my friends reported to me misgivings from their physicians over reforms they thought would ruin their practices. When I pointed out that the AMA supported reforms, that many of the reforms would replace the antiquated system of billing for services rendered under the medicaid/medicare system which rewarded over-treatment, unnecessary diagnostic proceedures and down right fraud, some of my friends began to question their physicians.
Reading your piece causes me to question your objectivity. Ryan's plan might not effect those of my friends who already are in the system. But surely it will effect their children when their time comes.
Why is it that our US system of administering medical care is the most wasteful in the world? Why are our physicians the most highly paid in the whole world? Why are you, a physician who has doubtlessly benefitted from this system, advocating trashing it for a system which destroys the ability to serve as many as it does now and not advocating to reform that system to bring it into line with the more successful and efficient systems most every other civilized nation has pioneered?
Conservatives are redicent to jump into change. That is why we are called Conservatives. But we do not shun making change when change is necessary and when a path to better systems has been blazzed. We Conservatives do not sell our very souls to the devils of the sort of less efficient but more lucrative operations your special interest cronies advocate.
Shame on you Doctor Tom!
sockratties posted at 11:04 am on Sat, Apr 16, 2011.
Tom, you need to get up there with your friend Pearce. Greed and bias based on the fictional character you perceive of those who didn’t get their bite of the big pie. You obviously categorize seniors as a group (“after all, they're famous for knowing how to get the most out of a buck”) apart from yourself. You’ve got yours, now let them get their own. Explain the ”famous” comment… Sounds prejudice to me.
Ryan’s program, shamefully passed by the House along party lines, attacks the spending side of economics but leaves the revenue side relatively unscathed. The incorrect perception that “entitlements” (which is a way of classifying necessary social programs so they make minions such as yourself think they are giveaways) is designed to gut the safety nets of working class people.
Few retired doctors, such as yourself, will need Medicare, Medicaid or social security, but I bet you won’t refuse the checks. Neither will the money grubbing lawyers, politicians, corporation CEOs, or those who earn over $250K and want Ryan to protect them from paying their fair share.
Regeanomics, the failed experiment of Milton Friedman’s trickle down economic theory, was manipulated into our system in the 1980s and finally crashed in this decade. Now the likes of Ryan would like to fleece whatever is left from the once middle class who have now become the working class.
Rich posted at 4:18 pm on Sat, Apr 16, 2011.
I always love 'fair share' Take the governmental budget, divide it by the population and you have a 'fair' share. Everybody wants more than they give and in the U.S. 80% get it. Anybody who says 'fair share' isn't paying theirs and wants somebody else to pony up for them, that's about all the term means. It's sort of like a tilted playing field that way, anybody who uses the term is the one one doing the tilting.
Accuracy posted at 6:41 pm on Sat, Apr 16, 2011.
"Rep. Paul Ryan’s budget path gives us a sensible place to turn"
Tom Patterson wrote: "Now Ryan, a Republican Congressman from Wisconsin, has given us some place to turn. He proposes to spend $6 trillion less than would be spent under President Barack Obama's plan and add $4.7 trillion less to the national debt."
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Yes, and the House of Representatives has passed the GOP proposal to cut $6 trillion from the federal budget. The nonbinding plan lays out a fiscal vision cutting $6.2 trillion over 10 years from the budget submitted by President Barack Obama. A budget path for the U.S. Senate.
President Barack Obama and House Budget Chairman Paul Ryan, R-Wis., are offering dramatically different visions for 2012.
President Obama's deficit reduction plan would cut $4 trillion over 12 years, targeting $3 trillion in spending and $1 trillion by raising taxes.
Rep. Paul Ryan's plan would cut $4.3 trillion over 10 years through major Medicare reform and keeping tax cuts for high income earners.
samkat posted at 9:19 pm on Sat, Apr 16, 2011.
Dale: I would consider finding more reputable physicians if I was you. My physicians are open and I have discussed most of the government regulations they are subjected to. I had one family physician who simply closed his practice due to the increased regulations and reporting requirements. He started a weight loss clinic where the regulations were minimal. As to ordering unnecessary tests, I had an ongoing cardiac issue and my Cardiologist finally ordered an angiogram after I keep complaining about fatigue. The outcome was that when I awoke, my wife informed me that I was undergoing heart surgery in two days. I don't know your medical status nor do I really car to find out but I track every Exclamation of Benefits that comes in and you would be surprised as to how much the doctors and other medical providers have their fees reduced. Since I was forced onto Social Security, I was forced to purchase Medicare Gap insurance to cover what Medicare does not cover. The secondary insurance carriers again discount what they pay. I don't know how some doctors stay in business and I can understand why many of them no longer take Medicare and Medicaid patients. Did you know that the Mayo Clinic no longer accepts Medicare. If you want treatment there, you pay up front and then seek payment from Medicare.
sockratties posted at 6:44 am on Sun, Apr 17, 2011.
Fair share is like a flat tax where you pay a % of your net income. The churches worked the method out a long time ago. They call it a tithe. What isn't a fair share is when Joe Grunt has to pay 25% and the Fat Cats pay ziltch.
samkat - another problem is the hospitals "retail vs wholesale" charges. If you get billed directly by the hospital the amount is 4X the amount they would bill an insurance company. Much of that discount is because doctors have to overbill to be sure they get the maximum payment from the system. The current system forces everyone to inflate their charges so if you don't have some kind of insurance you're going to pay through the nose.
Ryan's plan is paying a fixed amount for seniors to spend and trusting the insurance companies. The providers will always charge the max plus, to be sure to get the max. If you don't have a condition that your insurance won't cover and don't get sick, you get by, if not, mortgage your house (if the Ryan plans haven't caused you to lose it by then). Time to line up and get fleeced both by the insurance AND the providers.
I'm sorry some doctor's can no longer stay in business because of Medicare. Guess the financial crisis has taken a bite out of that block of apartments and that shopping mall they invested in and gas costs so much they can't fill up the Hummer.
Can you imagine what the Mayo Clinic will do with the Ryan plans? Do a little research on the difference between current plans "F" and plans "M" of supplemental care for a preview. The F plan screens for existing conditions and the M plan won't pay the higher cost of Mayo. You can be sure Ryan's K-mart and Costco bargain plans aren't going to either.
Rich posted at 9:41 am on Sun, Apr 17, 2011.
It isn't the doctors, it's the insurance. Insurance is 25% off the top, then another 25% goes into checking to see if coverage can be denied and 'group'' discounts. Now look at the rise of a doctor's overhead, the billing that used to be done by a receptionist, in between calls on a pegboard system now requires three full time and a couple part time 'billers' to comply with insurance requirements to get paid, hospitals are worse, billing departments of ten people are now two hundred people. In the end the doctor only gets 20-30% of your dollar for the actual medical care, which is really all that was needed in the first place. The rest of the money is a combination of paper-pushing and fraud (over-billing, denied claims, legal expense etc.). Limit insurance to major medical, outlaw discounting by insurance companies and you'll cut health care about in half.
k33j88 posted at 7:51 am on Mon, Apr 18, 2011.
Why hasn't anyone entertained the idea of competition that crosses state lines? We all know that consumers are the ultimate beneficiaries in such an environment.