Wednesday, May 18, 2011

Who is Paul Ryan?

[Yes, there is the intentional hint of Ayn Rand in the headline, for those who are wondering. Because why not evoke John Galt when talking of Paul Ryan?] 

But it's a fair question to ask - this "who is Paul Ryan" question, since he seems to have seized control of the GOP's platform of late.

He's so out in front of the curve that Newt Gingrich, a man who aspires to be the GOP nominee for president, slammed Ryan's Medicare reform plan, which has been adopted by the GOP-dominated House. Referring to the Ryan plan, Gingrich said he was "against a conservative imposing radical change." [Why do I believe that Newt's campaign is not long for this world?]


A Product of America's Dairyland
What we know about Ryan: that he comes from Wisconsin - a Midwestern state with an economy that wears its cheesehead proudly. Yes, there's a mix of agricultural, industrial and dairy in its economy, but Wisconsin brands itself as "America's Dairyland" right there on its license plates. Its largest city, Milwaukee, is bordered less by suburbs and more by farmland, a strong contrast to the miles upon miles of suburia that ring Chicago.

I live not far from the Wisconsin border - and whenever I cross over into Wisconsin for a visit, I always marvel at the roads. To this Illinoisan, Wisconsin seems to take care of its infrastructure. At least on the surface. Their public pension plan, deemed by Pew Research as one of the most fiscally responsible in the nation,  is still underfunded and has come under strong attack by Scott Walker, the state's Republican governor.

Ryan sits in the congressional seat once occupied by Democrat Les Aspin. He hails from the state that once gave us Senator Joe McCarthy and today is presided over by Walker, who is actively shaping state government into a very conservative mold.

Wisconsin is Midwestern, proud of its heritage as a dairy producer and relatively ignored by national media. [Until recently - when was the last time you saw tweets about any state's Supreme Court elections?! Way to grab the national focus, Cheeseheads!].

And obviously there are great passions that run through some of its political leaders, Ryan included.


Just a Janesville boy
According to Ryan's official biography, he is a practicing Catholic and a "fifth-generation Wisconsin native." He's raising his family in the same town he was raised in, Janesville, which is also home to the Ryans' family-owned business, Ryan Incorporated Central, a company with both public and private customers.

His father died when Ryan was 16; according to US News and World Report, Paul Ryan used Social Security survivors' benefits to pay for college.

He received a bachelor's degree in economics and political science from Miami of Ohio. He was under 30 when first elected to the US House of Representatives.


The Devil is in the Details
These details are important; they tell the story of a man who grew up in the Midwest - outside the influence of Wall Street and Washington, D.C. It's likely he does not believe (as so many who focus exclusively on the Wall Street/Washington beltway believe) that the Ivy League is the only place for a college education. And he was a young man when he first assumed power and headed over to the nation's capital.

His is a story of a man with deep roots in middle America, a man who experienced early loss, a man who is publicly committed to faith, family and country.

He's a man who did not hesitate to take advantage of a government welfare program when he needed it to fund his own pursuit of higher education.

He's a man that seems unaware that our nation has endured the worst financial crisis in decades - otherwise he could not possibly define the extreme measures taken by the government to prop up and sustain the economy as "the spending spree of the last two years" (as he calls it in his Path to Prosperity plan.) And he fails to note that a good chunk of the "spending spree" was done to rescue our "free market" financial sector from its precipitous fall off the cliff (using funds granted through programs he voted for.)

What he doesn't mention in Path to Prosperity is that bankers got bonuses through the Ryan-endorsed TARP. And the rest of us got to see the economy outside of Wall Street tank. We got to see highest unemployment in decades. We got to see the value of our homes decline precipitously. And as we saw and experienced a major economic catastrophe, Ryan saw a government "spending spree."

He does call for an end to "corporate welfare" - but in this age of "systemically risky" financial institutions, such a sentiment needs to be backed up with a plan. I am not sure how his budget will free banks from the umbilical cord that attaches them to the Federal Reserve - but I'd like to hear what Ryan has to say about this.

He is also a man who's likely never had to purchase health insurance on his own. Otherwise, he would never, ever in a million years be able to say with any honesty:
"Our plan is to give seniors the power to deny business to inefficient health care providers."
I read that sentence in the Trib and thought it would LOL funny if it were not uttered by a man intent on reshaping the delivery of health care to seniors - it's that delusional and that ignorant about health care in America.

We have Medicare today because seniors had no power in the market back in the 1960s. They have no power in the market today. They are cost drains on the system, not powerful purveyors of commerce.

The power in the health care market belongs to insurance companies. They can and do deny coverage to anyone who needs health care. They can and do dump covered patients onto public plans when they can get away with it. They can and do deny individual claims and make it very very difficult for physicians to get paid.

In which the "invisible hand" is inflicted with paralysis
The problem with health care as a "market" is simple: the for-profit insurance company's goal of minimizing "medical loss ratios" (payouts for health care) is diametrically opposed to the customer's goal of getting health care when needed. The payor and  the customer want completely different things. That's a far cry from Adam Smith's "mutually beneficial" economy. And it's a model that can only offer up ongoing conflict, not an efficient resolution of the problem.

As someone who is self-insured, I will tell you what I've learned. The high-quality doctors do not waste time on low-paying patients. They gear their practices toward those who can pay the private-sector rates. If you're on an HMO or other restricted pay type of program, the physicians you want to see most likely won't honor your plan.

Ryan wants to hand seniors an $11,000 voucher, with increases tied to the cost of living, not to the much higher increases in health care costs. Certainly, this plan will cut costs, because seniors will rapidly run out of money, and thus, the ability to purchase health care of any kind at all. And apparently, Ryan's convinced that insurance companies will actually offer premium-based coverage to seniors, which will only happen with a government-enforced, government-written mandate. That's a big injection of "government" into a market Ryan wants to free up.

Those so eager to let the markets decide (like Paul Ryan) seem always to forget that, throughout the centuries, the markets have decided that those lacking money also lack power, Ryan's tactics are completely at odds with his stated goal of giving "patients more power to reward providers."

And what happens when the health care problems cost more than the voucher? In a free market, consumers without money are outta luck. No more health care for those so sick they eat up their voucher! Costs are cut. Done! Health care? We don't need no stinking health care. Especially for all those who will follow the Boomers into retirement.

So who is Paul Ryan? 
What we discover if we match Ryan's words with reality is that he is a modern day Don Quixote. With his goal to hand patients less money in an attempt to give them "more power to reward providers who deliver high-quality, low-cost care (and deny business to those who fail to provide quality, affordable care)," he's a man eager to slay giants by tilting at windmills.

Only in the Paul Ryan version of the tale, some of our most vulnerable citizens will end up taking the hit. And we won't need "death panels" to decide any outcomes because the issue of health care for seniors will be decided - and rationed - by "the market."


More links to Ryan-related stories:

Wisconsin Magazine feature on Ryan

Ryan's Path to Prosperity

A look at "unconscionable math" that is used in health care

Paul Krugman on "what's in a name"




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