Sunday, August 19, 2012

A Healthcare Plan To Run Like The Congress?


One of the smartest things that Paul Ryan does on the campaign trail these days is point out how dysfunctional governance has become in America, especially at the federal level where the nerve center of politics is located – the District of Columbia, to be precise. And this is the place where Ryan has lived and worked for twelve years; the place inside of which exists the most important institution of all, the Congress of the United States of America. And this is the institution that has rendered itself infamous by becoming the most dysfunctional of all; the one that enjoys no more than ten percent of the public's confidence and respect.

And yet, you see and hear Paul Ryan repeatedly attack the provision in the Affordable Healthcare for America Act which shields the system from the kind of dysfunction that is plaguing the Congress of infamy. It is a provision that is not unique to the Act but one that exists at all levels of democratic institutions by virtue of which professional technocrats are employed to write the regulations and oversee their implementation in practice. This is the work that these people do without passing judgment on anything or anyone; they do it in good faith and do it in accordance with the intent of the legislators.

What is odd about the Ryan stand is that while attacking the dysfunction of the Congress as if the institution were made of clowns, he praises the work force of America for making the country what he calls the best in the world in all of history. Well, this labor force is made of 150 million non-elected technocrats whereas the Congress is made of 535 elected clowns. If he believes that a work force of technocrats made America the greatest thing while a Congress of clowns made it one of the worst, why on Earth does he attack the technocrats for not being elected? Does he want all of America to become as dysfunctional as the Congress of useless clowns?

What he is complaining about are 15 professional technocrats who will have no axe to grind, no one to pander to, and nothing to guide them but their conscience and the sense of pride in doing what they do while maintaining the highest level of professionalism. This is what will get lost if Ryan has it his way in asking these people to run for office. Sooner or later, they will be compelled to prostitute themselves sucking up to this one group and then that one, trying to win some votes in here and then win some more in there. And like it happens all the time, they will learn to say absolutely anything that will help them raise as much money as they can.

Does Ryan want to see these individuals run to the gun lobby and proclaim that it is acceptable to shoot people if this will safeguard their right to shoot rabbits? Does he want to see these individuals run to the Jewish lobby and proclaim that it is acceptable to kill unarmed Palestinians if this will safeguard the Jewishness of the stolen Palestinian lands? Does he want to see American citizens placed on a blacklist and barred from receiving any kind of healthcare because they said something that did not sound kosher enough to the despots of AIPAC or the Anti Defamation League? Would Paul Ryan commit the care of his mom – whom he dearly loves as he made abundantly clear – into the hands of a Sheldon Adelson rather than the hands of 15 medical professionals? Does he want to see the administration of the Affordable Healthcare for America Act become as paralyzed and as useless as the Congress of the United States?

Ryan is campaigning and saying those things, having been chosen to run as vice president alongside the presumptive presidential nominee, Mitt Romney who represents the Republican ticket. Romney has had a plan for nearly a year now which he prepared in case he gets elected. It is contained in a publication he put out, in which he claims that he can fix all of America's problems, and get the country back on track where it belongs. He has a letter at the beginning of the publication in which he says this: “I have formulated a ... plan that focuses [among other things] on ... labor, human capital, and fiscal policy.”

Inside the publication, there is a subtitle that reads as follows: “Enact Entitlement Reform.” In it, Romney promises that: “with respect to Medicare, the plan put forward by Congressman Paul Ryan makes important strides in the right direction ... As president, Romney’s own plan will differ, but it will share [Ryan's] objectives.” And talking about Medicaid, as he does later in the letter, he says this: “As president, Romney will push for the conversion of Medicaid to a block grant … This approach could save … over $200 billion each year.”

This brings to the fore a few points. For one thing, it shows that the Romney plan for healthcare will end up being substantially that of Paul Ryan, especially in the areas where Ryan conforms to the philosophy of Romney. Also, like Romney has stated on numerous occasions, he prides himself on achieving efficiency by cutting cost where he sees fit. In fact, he promises to do so in healthcare where he wants to cut $200 billion from Medicaid alone. Now imagine how much he would cut from the entire Healthcare Act. And this, in case he does not scrap the whole Act altogether as he promised he would do on a few occasions -- and so did Paul Ryan on many occasions.

But there is more to the Romney-Ryan approach than meets the eye. What is obvious is that even the Republican hopefuls see there is much fat in the healthcare system that can be cut without reducing its quality. They see the waste, the fraud and the abuse that everyone else sees. Yes, this was to be expected in a project of that size, especially when considering the amounts of money which are involved. But what came as a surprise was the fact that Ryan -- and now Romney -- lambaste President Obama for trying to save $716 billion from Medicare by ending all that waste, all that fraud and all that abuse.

What Obamacare (as it has come to be called) will do is save money in Medicare, and use it to make the Affordable Healthcare for America Act run better. Yet, Romney and Ryan say that this move would be like robbing Peter to pay Paul. If this is their view, it is one that conveys the notion they intend to rob the States of their Medicaid money -- to the tune of at least $200 billion -- to pay the federal government.

Is this what they wish to communicate? Or was it a Freudian slip? Please explain or retract.