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Veterans' vouchers: Mitt Romney Flip-Flops on Veterans' Vouchers -

US Republican Paul Ryan’s budget plan revives voucher system for Medicare

By Kate Randall 4 April 2014

US Representative Paul Ryan, Republican of Wisconsin, released a “Path to Prosperity” budget plan on Tuesday that would slash spending by $5.1 trillion over 10 years. Central to this blueprint is the institution of a voucher plan in Medicare, the government health insurance program for seniors and the disabled. The Republicans have dubbed this threat to privatize Medicare “premium support.”

Paul Ryan’s proposals in relation to Medicare are the most open threat by the ruling elite to privatize the social insurance program enacted in 1965. As always, it is being set as a new milestone as part of an ever further shift of the entire political establishment to the right.

In predictable fashion, Ryan’s proposal was swiftly denounced by Barack Obama. Exiting the well-known Zingerman’s deli in Ann Arbor, Michigan on Wednesday, following his University of Michigan appearance to promote a small raise in the minimum wage, the president likened Ryan’s plan to a “Stinkburger” or a “Meanwich.”

The president’s comments continue the phony sparring between the White House and Congressional Republicans over the budget. This cynical dance is aimed at concealing the policies of both big business parties as they conspire to make the working class pay for the continuing economic slump triggered by the 2008 Wall Street crash. Central to this is the slashing of government spending on vital social programs, including Medicare, Medicaid and food stamps.

Ryan’s budget plan follows the release of a budget last month by the White House. Neither proposal will have any real impact on spending during the fiscal year that begins October 1, 2014, as the overall spending for fiscal years 2015 and 2016 was set in a bipartisan agreement last December. Instead, the dueling plans set the tone for the two parties in the upcoming mid-term Congressional elections.

On Wednesday, the Democratic Congressional Campaign Committee launched a new ad campaign called “Battleground: Middle Class,” attacking Republican proposals to revamp Medicare, replace the Medicaid program for the poor with state block grants, and make other cuts to domestic social spending.

The White House is falsely promoting the Affordable Care Act (ACA), its signature domestic initiative, as a progressive reform that will expand the availability and quality of health care for millions of American workers and their families. The ACA is held up as the opposite of Republican proposals, including the plan to privatize Medicare. In fact, the legislation commonly known as Obamacare, which went into effect January 1, 2014, serves as a model for Ryan’s reactionary proposals.

Under Ryan’s plan, Americans who turn 65 on or after January 1, 2024 would be provided “premium support” by the government, essentially a voucher, to purchase either private insurance or a traditional Medicare plan. According to analysis by the Congressional Budget Office (CBO), those choosing Medicare would find fewer doctor choices and narrower provider networks, and less medical costs would be covered. Beginning in 2024, the age of eligibility for Medicare would also begin to rise, while the fee-for-service structure (aimed at slashing reimbursements to hospitals) would be “modernized.”

While Ryan’s budget calls for the repeal of ACA, it conveniently incorporates the roughly $700 billion in cuts to Medicare over a decade planned through Obamacare, as well as $1 trillion in revenues projected to be generated by the legislation. These massive cuts to Medicare, which the White House has cynically claimed will result in better health care for seniors, are embraced in the Ryan’s “Path to Prosperity” budget.

Ryan was brought forward by Democrats and Republicans during budget negotiations last year. The Republican congressman worked with Democratic Party negotiators to pass a deal that makes permanent over a trillion dollars in “sequester” budget cuts, while attacking pensions for federal workers and implementing other right-wing measures. Obama praised the deal and the bipartisan character of the negotiations.

Despite the claims of the Tea Party and other right-wing opponents of Obamacare, the legislation has nothing in common with socialized medicine. The key provision of the ACA, the “individual mandate,” requires individuals and families who are not insured through their employer or a government program such as Medicare or Medicaid to purchase insurance from private insurance companies or pay a penalty. Businesses, on the other hand, have been granted waiver upon waiver to the toothless “employer mandate” under the law.

Uninsured individuals shopping for coverage on the insurance exchanges, or “marketplaces,” set up under the ACA, have been shocked to find that the majority of cheaper “bronze” policies for sale come with deductibles in excess of $5,000, as well as other high out-of-pocket costs. Choices of doctors and hospitals are also restricted. The legislation that Obama pledged would provide “near universal” health care is in reality a scheme to funnel millions of new cash-paying customers to the private insurers.

From the start, the aim of the US health care overhaul has been to create an even more heavily class-based system than that which already exists. Both the White House and Congressional Republicans are in general agreement on this agenda, differing only on the methods and pace for carrying it out.

In particular, both parties are eyeing Social Security, Medicare and Medicaid—programs won through mass social struggles of the working class—for not only sweeping funding cuts, but ultimately for destruction through privatization and other means.

[31 March 2014]

The US budget deal and the political conspiracy against the working class

. The US budget deal and the political conspiracy against the working class

13 December 2013

The bipartisan budget agreement reached between congressional Democrats and Republicans, with the support of the Obama administration, is the latest act in a political conspiracy against the working class, aimed at slashing social programs and effecting a further redistribution of wealth to the corporate and financial elite.

The agreement, adopted Thursday by the House of Representatives by an overwhelming margin of 332-94, makes permanent over a trillion dollars in “sequester” budget cuts, increases federal employee pension contributions, establishes new consumption fees, and makes nearly $30 billion in additional cuts in Medicare reimbursements. President Obama has already said he will sign the measure. The regressive, anti-social character of the budget deal is most clearly expressed in the fact that it allows for the expiration of federal unemployment benefits, ending cash assistance for the long-term unemployed after Christmas.

A total of 1.3 million people are scheduled to lose their unemployment benefits on December 28, and an additional 3.6 million people will be cut off from income support next year. By the White House’s own estimate, two additional family members are supported by each recipient of extended jobless aid, bringing to nearly 15 million the number of people potentially affected by the expiration of federal jobless benefits—nearly five percent of the population.

The class character of the entire political system is starkly revealed by this cruel act. It is being carried out even as the Federal Reserve continues to funnel $85 billion a month— more than three times the cost of extending benefits for an entire year—to fuel a record stock market boom and soaring corporate profits. The budget deal restores military spending approximately equal to the cost of the unemployment benefits, further feeding a military and intelligence machine that consumes close to $1 trillion every year.

How many people will be made homeless, or forced to choose between medical care and putting food on the table, as a result of the unemployment benefit cuts? How many will be thrown into poverty? These cuts are being implemented, despite the talk by the Obama administration and the media of “economic recovery,” as requests for food assistance are rising and the country remains plagued by mass unemployment.

The two big business parties posture as bitter opponents, but in reality they are united on all fundamental aspects of policy. The basic unity of the two parties was summed up by Democratic Senate Budget Committee Chair Patty Murray in announcing the deal on Tuesday. She and her Republican counterpart, Paul Ryan, “cheer for a different football team,” Murray said. “We catch different fish. We have some differences on policy, but we agree that our country needs some certainty and we need to show that we can work together.”

Ryan, the House Budget Committee chairman and Republican vice presidential candidate in 2012, has put forward budgets that would dismantle Social Security and Medicare. He is now presented by the media as the “moderate” face of the Republican Party.

The outcome of the budget talks was predictable. Against those who promoted the official narrative of the October government shutdown—peddled by both the mainstream press and various fake “left” organizations—that the main characteristic of US politics is the vast ideological chasm between the Democratic and Republican parties, the World Socialist Web Site wrote: “Behind the façade of partisan ‘gridlock,’ there has never been greater consensus between the two parties on substantive matters of social policy. They completely agree on making the broad mass of the population pay for the crisis of American and world capitalism.”

As the WSWS predicted, the government shutdown was the prelude to a further shift to the right by the Obama administration and the Democratic Party. The aftermath of the government shutdown has brought a renewed drive to impoverish the population.

In November, food stamp benefits were slashed nationwide for the first time in US history, eliminating the equivalent of two days of food every month for 47.7 million people. Congress is scheduled to vote on a farm bill in the coming days that will slash billions more from the food stamp program.

Earlier this month, a federal judge approved the Detroit bankruptcy, with the support of the White House, setting the stage for massive cuts in Detroit city worker pensions and similar attacks on public employee pensions across the country. >br>
This is only the latest stage in a series of measures, each aimed at furthering the transfer of wealth to the corporate and financial elite. While both parties initially claimed they favored doing away with the automatic sequester cuts, these claims were entirely for public consumption.

The bipartisan agreement keeps the sequester cuts in place to serve as a mechanism for slashing spending by a hundred billion dollars per year, year after year, and bring domestic spending down to the levels that existed in the 1950s. Since 2011, US domestic social spending has been slashed by 8.9 percent, a fact of which Obama speaks with pride.

For many years, and particularly since the financial collapse of 2008, the ruling class has been engaged in a restructuring of class relations. On the one hand, bank bailouts and “quantitative easing,” on the other, cuts in social programs and the utilization of mass unemployment to drive down wages and reduce living standards. Each of the manufactured budget crises since 2010 has shifted the political establishment further to the right.

More is to come. As Obama himself put it, the budget agreement is a “first step.” With the deal set, the ruling class turns its greedy eyes to the substantial funds contained in the Medicare and Social Security programs. A persistent theme in media and political commentary is that the budget deal creates the bipartisan framework to take on entitlement programs such as Social Security and Medicare in the face of overwhelming popular opposition to any cuts.

In all of this, the state emerges clearly not as a neutral arbiter, but as a ruthless instrument of class rule. The fight back by the working class requires a political and revolutionary mobilization, aimed at taking political power and instituting a program based on the interests of the vast majority of the population.

The defense of the social rights of working people is impossible within the framework of the capitalist system. In opposition to the two big business parties, the working class must build a mass political movement armed with a socialist program to reorganize society on the basis of social need, not private profit.

Andre Damon

Vouchers for Veterans

Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America

Cost of Treating Veterans Will Rise Long Past WarsJULY 27, 2011

Times Topic: Veterans Val S November 14, 2011 Healthcare will never flow efficiently in this country with a bottleneck of private insurance companies blocking the way.

American health care is remarkably diverse. In terms of how care is paid for and delivered, many of us effectively live in Canada, some live in Switzerland, some live in Britain, and some live in the unregulated market of conservative dreams. One result of this diversity is that we have plenty of home-grown evidence about what works and what doesn’t.

Naturally, then, politicians — Republicans in particular — are determined to scrap what works and promote what doesn’t. And that brings me to Mitt Romney’s latest really bad idea, unveiled on Veterans Day: to partially privatize the Veterans Health Administration (V.H.A.).

What Mr. Romney and everyone else should know is that the V.H.A. is a huge policy success story, which offers important lessons for future health reform.

Many people still have an image of veterans’ health care based on the terrible state of the system two decades ago. Under the Clinton administration, however, the V.H.A. was overhauled, and achieved a remarkable combination of rising quality and successful cost control. Multiple surveys have found the V.H.A. providing better care than most Americans receive, even as the agency has held cost increases well below those facing Medicare and private insurers. Furthermore, the V.H.A. has led the way in cost-saving innovation, especially the use of electronic medical records.

Paul Krugman Credit Fred R. Conrad/The New York Times

What’s behind this success? Crucially, the V.H.A. is an integrated system, which provides health care as well as paying for it. So it’s free from the perverse incentives created when doctors and hospitals profit from expensive tests and procedures, whether or not those procedures actually make medical sense. And because V.H.A. patients are in it for the long term, the agency has a stronger incentive to invest in prevention than private insurers, many of whose customers move on after a few years.

And yes, this is “socialized medicine” — although some private systems, like Kaiser Permanente, share many of the V.H.A.’s virtues. But it works — and suggests what it will take to solve the troubles of U.S. health care more broadly.

Yet Mr. Romney believes that giving veterans vouchers to spend on private insurance would somehow yield better results. Why?

Well, Republicans have a thing about vouchers. Earlier this year Representative Paul Ryan famously introduced a plan to convert Medicare into a voucher system; Mr. Romney’s Medicare proposal follows similar lines. The claim, always, is the one Mr. Romney made last week, that “private sector competition” would lower costs.

But we have a lot of evidence about how private-sector competition in health insurance works, and it’s not favorable. The individual insurance market, which comes closest to the conservative ideal of free competition, has huge administrative costs and has no demonstrated ability to reduce other costs. Medicare Advantage, which allows Medicare beneficiaries to buy private insurance instead of having Medicare pay bills directly, has consistently had higher costs than the traditional program.

And the international evidence accords with U.S. experience. The most efficient health care systems are integrated systems like the V.H.A.; next best are single-payer systems like Medicare; the more privatized the system, the worse it performs.

To be fair to Mr. Romney, he takes a somewhat softer line than others in his party, suggesting that the existing V.H.A. system would remain available and that traditional Medicare would remain an option. In practice, however, partial privatization would almost surely undermine the public side of these programs. For example, one problem with the V.H.A. is that its hospitals are spread too thinly across the nation; this problem would become worse if a substantial number of veterans were encouraged to opt out of the system.

So what lies behind the Republican obsession with privatization and voucherization? Ideology, of course. It’s literally a fundamental article of faith in the G.O.P. that the private sector is always better than the government, and no amount of evidence can shake that credo.

In fact, it’s hard to avoid the sense that Republicans are especially eager to dismantle government programs that act as living demonstrations that their ideology is wrong. Bloated military budgets don’t bother them much — Mr. Romney has pledged to reverse President Obama’s defense cuts, despite the fact that no such cuts have actually taken place. But successful programs like veterans’ health, Social Security and Medicare are in the crosshairs.

Which brings me to a final thought: maybe all this amounts to a case for Rick Perry. Any Republican would, if elected president, set out to undermine precisely those government programs that work best. But Mr. Perry might not remember which programs he was supposed to destroy.