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Paul Ryan And Equality Of Opportunity

One of the major differences between people with right of center views on economic policy who know what they’re talking about and those who don’t know what they’re talking about, is that those who don’t know what they’re talking about tend to prattle a lot about equality of opportunity. Not coincidentally, today’s Paul Ryan speech at the Heritage Foundation is all about equality of opportunity. Indeed, Ryan claims to believe that a dispute over this idea is at the core of modern-day partisan politics:

These actions starkly highlight the difference between the two parties that lies at the heart of the matter: Whether we are a nation that still believes in equality of opportunity, or whether we are moving away from that, and towards an insistence on equality of outcome.

This naturally raises the question of what it is that Ryan is doing to level the playing field between kids with rich parents and kids with poor parents. Is he a proponent of boosting Section 8 housing vouchers and other federal programs that might make it easier for poor parents to move their kids into high-quality school districts? Has he done anything to boost child nutrition or children’s health programs? Does Ryan think we should make it more difficult for wealthy parents to directly transfer financial resources to their children? Does Ryan support making Pell Grants more generous? Equalizing funding across school districts? Well, no, he doesn’t support any of those things. We all remember Paul Ryan’s big picture budget plan. Its key planks were:

— Lower taxes on high income individuals.
— Generous retirement benefits for people born in 1956 or older.
— Deep immediate reductions in anti-poverty spending.
— Major reductions in retirement benefits for people born after 1956.

What items on that agenda would increase equality of opportunity? The answer, of course, is that none of them would. As all intelligent proponents of low taxes and stingy welfare programs acknowledge, securing equal opportunities is in fact an incredibly ambitious progressive agenda.

Economy

Bush Had Generated More Regulations At This Point In His Presidency Than Obama

Republican lawmakers have been raking President Obama over the coals due to what they call a “tsunami” of new government regulations. “Business owners are reluctant to create jobs today if they’re going to need to pay more tomorrow to comply with onerous new regulations,” said Sen. Susan Collins (R-ME). Obama’s “excessive regulations that unnecessarily increase costs” just “make it harder for our economy to create jobs,” said House Speaker John Boehner (R-OH).

As with most GOP talking points, the facts tell a different story. A Bloomberg analysis of regulations reveals that Obama has approved fewer regulations than President George W. Bush “at this same point in their tenures, and the estimated costs of those rules haven’t reached the annual peak set in fiscal 1992 under Bush’s father.” Indeed, the record for the most expensive regulations still belongs to the GOP:

Obama’s White House approved 613 federal rules during the first 33 months of his term, 4.7 percent fewer than the 643 cleared by President George W. Bush’s administration in the same time frame, according to an Office of Management and Budget statistical database reviewed by Bloomberg. [...]

In the last 12 months through the end of September, the cost range of new regulations is estimated to be $8 billion to $9 billion, a decrease from 2010, according to non-partisan Government Accountability Office reports analyzed by Bloomberg…The record [cost of regulations] came in 1992 under George H.W. Bush when that total hit $20.9 billion in current dollars. In the last year of Ronald Reagan’s term it was $16 billion in today’s dollars.

We certainly don’t remember Republicans crying about the “excessive” Bush regulations.

More of Obama’s regulations may cost more than $100 million as compared to previous administrations. But many of them help prevent outcomes that would cost exponentially more. For instance, the Department of Interior’s new controls on deep-water oil drilling may cost the industry $180 million, but one oil spill like that caused by Deepwater Horizon could cost the industry $16.3 billion. Some of the administration’s rules, like those governing coal ash, will actually help create thousands of jobs.

The impact of these regulations on small businesses is incredibly minimal. In fact, of the 10,361 mass layoffs last year, only 61 were attributed to regulations. When McClatchy asked small business owners why they have been hesitant to hire, “none of the business owners complained about regulation in their particular industries, and most seemed to welcome it.”

Kentucky Republican Likens Abortions For Rape And Incest Victims To Murdering Mother’s Hypothetical Killer

David Williams

States across the country have passed restrictive abortion laws that don’t include exceptions for rape or incest, and in an effort to solidify themselves with social conservatives, Republican candidates are being more vocal about their extreme opposition to abortion in virtually every circumstance.

In Kentucky, where a restrictive abortion bill failed this year, state Senate President and Republican gubernatorial nominee David Williams used an odd analogy to make it clear that he opposed abortions even in cases of rape or incest. In an interview with the Louisville Courier-Journal’s editorial board this week, Williams likened such abortions to his hypothetical desire to seek vengeance if someone had shot his mother:

Williams said he opposes abortion even for cases of rape and incest, and he likens it to murder: “If somebody shot my mother, I would want to kill them, but I don’t think that is the appropriate thing to do. We have laws against murder.”

Positions like Williams’ are clearly unconstitutional and create the absurd situation where a woman who has already been a victim of a crime would have no choice or control over her own body. Unfortunately, though, they’re becoming more and more common among conservatives, from state legislatures where Republicans claim women will fake rapes to qualify for abortions to the party’s presidential race, where candidates have advocated sending doctors who perform abortions for rape and incest victims to prison.

Instead Of Unnecessary Cuts To Benefits, Democrats On Super Committee Should Modernize The System

Our guest blogger is Topher Spiro, the Managing Director for Health Policy at the Center for American Progress.

News reports out today suggest that Democrats on the Super Committee are proposing $400 billion in cuts to Medicare—$200 billion in cuts to benefits, and $200 billion in cuts to providers. It’s unclear what this means, and whether it’s true, but one thing is certain: there is a better way.

Today the Center for American Progress is releasing a package of reforms to modernize the payment and delivery system. These reforms are a win-win: they will reduce costs and at the same time improve the quality of care and the efficiency of the health care system. Here’s what we propose:

– Immediately expand a Medicare program that bundles payments together for certain procedures nationwide. Then, completely replace fee-for-service with bundled payments for all procedures and primary care by 2016.

– Immediately implement competitive bidding for durable medical equipment, prosthetics, orthotics, and supplies nationwide, and expand the program to include laboratory tests.

– Require electronic eligibility, claims processing, and payment, as well as centralized physician credentialing.

Do not pay extra for technologies that are more expensive but no more effective than other available technologies.

More detail on these reforms is available here. Together, they have the potential to reduce the federal deficit by $100 billion or more in a decade, as scored by CBO. Many experts believe that the actual savings to the federal government would be orders of magnitude greater. And of course, the total savings to the health care system would be even greater.

Such reforms are vastly superior to misguided policies that do not actually reduce health care costs, but merely shift them. Unnecessary cuts to benefits and indiscriminate, across-the-board cuts to providers—as the Super Committee is reportedly considering—are blunt methods of reducing the federal deficit. Instead, the Super Committee should seize the opportunity to modernize the health care system—and reduce total health care costs while improving the quality of care.

NEWS FLASH

Supreme Court Could Agree To Hear Affordable Care Act Case As Soon As Nov. 10 | The nine justices are scheduled to have their first discussion of whether or not to hear one or more of the challenges to the Affordable Care Act on Thursday, Nov. 10. This means that the Court could announce that it is hearing the case as soon as that date — although the announcement could potentially come later. Although the Court could conceivably turn down the case entirely, that is unlikely because the Court typically hears cases where a federal law has been struck down by one or more courts of appeal and where the courts of appeal disagree on a question of law.

NEWS FLASH

Report: Democrats Offer $400 Billion In Medicare Savings | Democrats have proposed $2.5 trillion to $3 trillion in measures to reduce the budget deficit in the super committee, Reuters reports, noting that “around $400 billion” would come from Medicare savings. Half of that $400 billion is in the form of “benefit cuts and the other half in cuts to healthcare providers.” No further details were available, but the $400 billion mark is more than the $320 billion in health care savings included in President Obama’s deficit plan and more skewed towards benefit cuts. (Obama’s benefit cuts made up less than 7 percent of the reductions.)

Republican Rep Is ‘Gleeful’ Over Demise Of Long-Term Care Insurance Program

Baby boomers continue to express concerns about financing long-term care needs at the end of life, and federal spending on care through Medicaid is quickly spiraling out of control. But Rep. Phil Gingrey (R-GA) said he was “gleeful” about the demise of the Affordable Care Act’s CLASS program during an Energy and Commerce hearing this morning. Watch it:

Advocates had hoped that CLASS would serve as a long-term care option for people who need special assistance eating, bathing, or getting dressed, but HHS canceled the program after determining that it did not have the authority to ensure is sustainability. Still, advocates believe that an insurance program that individuals pay into is a much more efficient way of financing long-term care than dumping the problem on the already-strained Medicaid system and continue to urge the Secretary to use her discretion to explore ways of rebuilding the CLASS program. But Gingrey, a self-professed small government conservative, disagrees.

Democrat Attacks Administration For Abandoning Long-Term Care, Says HHS Has Adopted Republican Thinking

Rep. Frank Pallone (D-NJ) slammed the Department of Health and Human Services (HHS) for abandoning CLASS, the Affordable Care Act’s long-term care insurance program, and accused the administration of playing into the “same negative theme” of Republicans on the hill during a Joint Oversight and Invesitations and Health Subcommittee hearing this morning. “I would ask the department go back to the drawing board, be optimistic, and come back with a plan that implements the CLASS Act,” he said in his opening statement. Watch it:

Pallone’s push may be the very first public sign of growing frustration among some Democratic lawmakers and long-term care advocates who believe the administration has not done all it could to implement the program, given the difficulty Americans face in obtaining necessary coverage. Since Medicare does not provide long-term benefits, Americans spend more than $200 billion a year on services in nursing homes, at home, or in assisted living facilities. But families often can’t afford to purchase private coverage, and as a result spend down to “$2,000 in financial assets” to qualify for long-term care under Medicaid. The program is now the largest single provider of long-term care and by mid-century will likely swallow 16 percent of anticipated federal revenues to fund care for the baby-boom generation.

“I think we can do things. We can have affordable health care, we can have a plan on log term care and I think we understand that the American people expect us to do something,” Pallone said, warning the department that abandoning the program would sentence millions of citizens into “unnecessary poverty.” Pallone suggested that HHS can improve the sustainability of CLASS by adopting changes like phased enrollment, a temporary exclusion for coverage, and convening the program’s advisory panel to discuss additional options for improving it.

Perry Touts Reductions To Safety Net Health Programs, But Says He’s ‘Not Ready’ To Cut Defense

Rick Perry’s new economic plan calls for significant changes to the country’s health care programs, a la Paul Ryan, including raising the Medicare eligibility age and potentially pushing seniors out of the government health care program and into the private health insurance market. The Texas governor also reiterates his proposal to transform the current federal matching rate states receive for Medicaid into a pre-established block grant that does not keep up with actual health care costs.

Perry touted his “spending reduction” during an appearance on Fox News Business last night, stressing that while he’s willing to significantly cut the nation’s safety net programs, he won’t limit military spending:

PERRY: We know that one of the places that Mr. [Ron] Paul is going to talk about cutting and that’s in defense. And I will tell you, I’m not ready to put our national defense on the line for that kind of a meat cleaver. So there is obviously places we can cut…you look at what Paul Ryan is doing on Medicare. There are some great members of the Congress that have plans that can help us reduce spending and let me tell you, that’s what we need to have.

Watch it:

But Perry has it backwards: cuts to the military would likely have almost zero impact on national security — as they would target the many wasteful, costly weapons programs, many of which are barely even used. Reductions to Medicare and Medicaid, on the other hand, would significantly increase costs for beneficiaries and the nation and undermine care for lower-income Americans who need it most.

Opinion surveys show that the public shares these priorities and routinely ranks cutting defense spending ahead of Medicare and Medicaid cuts.

Morning CheckUp: October 26, 2011

White House endorses GOP health bill: “In a Statement of Administration Policy, the White House said it supports passage of the measure that would change the definition of modified adjusted gross income in the Affordable Care Act to include both taxable and nontaxable Social Security benefits.” [Modern Healthcare]

Medical school enrollment is on the rise: “The number of students enrolling in medical schools has reached its highest level in more than a decade. More than 19,200 people entered their first year of medical school this year, a 3 percent increase over 2010, according to new data from the nonprofit Assn. of American Medical Colleges.” [LA Times]

Missouri and Kansas launch medical homes: The test model, part of the Affordable Care Act, “means providers — ranging from primary-care doctors to counselors — will be able to share the same data on each patient and provide better coordinated care.” [Kaiser Health News]

Judge blocks North Carolina ultrasound requirement: “A federal judge has blocked a portion of North Carolina’s new abortion restrictions that would make new requirements of medical providers who perform ultrasounds on pregnant women.” [The Republic]

Republicans say HHS should be more aggressive: “Republicans on the Senate Finance Committee charged that HHS isn’t using a new tool to prevent Medicare fraud. The healthcare reform law allows the Centers for Medicare and Medicaid Services (CMS) to issue a temporary moratorium on new suppliers when there’s a high risk of waste, fraud or abuse. But HHS hasn’t used that power, Sens. Orrin Hatch (R-UT) and Chuck Grassley (R-IA) said.” [The Hill]

Cost of long term care increases: “U.S. long-term health-care costs rose as much as 5.6 percent this year, led by assisted-living expenses, and are climbing at a steeper rate during a weak economy, MetLife Inc. said.” [Bloomberg]

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