Viewpoints: Ryan's 'tired ideas;' House GOP 'reboots' on budget; Bloomberg's soda campaign 'ill-conceived'

Mar 14 2013

The New York Times: The Worst Of The Ryan Budgets
All the tired ideas from 2011 and 2012 are back: eliminating Medicare's guarantee to retirees by turning it into a voucher plan; dispensing with Medicaid and food stamps by turning them into block grants for states to cut freely; repealing most of the reforms to health care and Wall Street; shrinking beyond recognition the federal role in education, job training, transportation and scientific and medical research. The public opinion of these callous proposals was made clear in the fall election, but Mr. Ryan is too ideologically fervid to have learned that lesson (3/12). 

The Wall Street Journal: A Ryan Reboot
Mr. Ryan retains the current Congressional Budget Office baseline that says revenue will average 18.8% of GDP between 2014 and 2023, nearly a percentage point above the post-1980 average of 17.9%. That may be achievable, or not, though the numbers depend on CBO growth projections that assume little or no economic benefit from better policy. What really matters for spending over the long term is health care and the vast and growing entitlements. Here Mr. Ryan doesn't shrink from his ambition to convert Medicare into a market-driven program with more competition and choices for seniors. ... The idea is to revamp Medicare's benefits and premium structure so these relics from 1965 work like normal insurance and give seniors the incentive to take a larger role in their own care (3/12).

The New York Times: The Ryan Budget's Step Backward
There were two obvious ways that the Ryan Budget 3.0., which rolled out today, could have further improved on its predecessors. The new budget could have beefed up its Medicare proposals by phasing in reform sooner, instead of continuing to set a ten-year gap between passage and implementation and exempting everyone over 55 from the new regime. Alternatively, it could have addressed the various problems and implausibilities in the non-Medicare portions of the budget roadmap -; by making fewer not-gonna-happen promises on discretionary spending cuts, by offering a real alternative to/replacement for the Obama health care bill, or by making the sketch of revenue-neutral tax reform more plausible by setting the proposed new tax rates higher than 10 percent and 25 percent. The first option would have made for trickier politics but better policy; the latter options would have made for better policy and politics alike (Ross Douthat, 3/12).

Los Angeles Times: Sadder But Wiser Pols
There's been gradual movement toward the center on the substance of the budget as well as the politics. Republicans still oppose tax increases, but some senators have acknowledged that they'll have to accept revenue increases to make a deal. And Obama has been more explicit than before about his willingness to cut future spending on Medicare and Social Security, bitter pills for liberals. The more often the president repeats that message to Democrats, the more skeptical Republicans believe he might mean it. Finally, leaders on both sides know how to get to an agreement -; or, more precisely, how not to get there -; because they've tried so many routes before (Doyle McManus, 3/13). 

Los Angeles Times: Paul Ryan Drinks Deeply From Pool Of Social Security Lies
I'd like to offer my thanks to House Budget Committee Chairman Paul D. Ryan (R-Wis.) for doing so much to validate my list of the five biggest lies about "entitlement" programs published on Sunday. … The ones from my list are: He uses the thoroughly discredited "infinite horizon" projection to claim that Social Security and Medicare are "tens of trillions" of dollars in the hole; he suggests that retirees aren't paying their fair share for their benefits; he suggests that the programs are hammered by benefits going to the wealthy; and he treats Medicare and Social Security as though they're similar programs with similar issues (Michael Hiltzik, 3/12). 

The Washington Post: Paul Ryan's Budget: The Good, The Bad And The Unrealistic
Once again, Mr. Ryan proposes to convert Medicare into a premium-support program, under which seniors would receive a subsidy to shop for insurance on a regulated but competitive market. Unlike some reflexive critics of "vouchers," we think the concept is worth discussing, in that it promises to achieve cost-control through market mechanisms. Alas, even if premium support is workable, Mr. Ryan wouldn't start it for a decade, which makes it all the more disappointing that his budget only calls for a modest $129 billion trim to Medicare in the meantime. That's less than the Obama administration has advocated (3/12). 

The Washington Post's The Plum Line: Budget War Showcases Sharp Contrast In Values And Priorities
According to the source, the plan -; which is being presented by Senate Budget Committee Chairperson Patty Murray to the Dem caucus today -; replaces the whole sequester and includes a total of $1.85 trillion in deficit reduction, derived from a 50-50 split of cuts and revenues derived from closing tax loopholes. The spending cuts include $275 billion in cuts to health care spending (but no Medicare benefits cuts; the source says cuts would be focused on the provider side), another $200 billion in non-defense spending cuts, $240 billion in defense cuts, and $242 billion in reduced interest rates (Greg Sargent, 3/12). 

The Washington Post: Paul Ryan's Magical Budget
Paul Ryan's budget is an amazing and wondrous document. Not only does it balance the budget in 10 years while reducing tax rates, it also does so without any pain or suffering -; or even breaking a sweat. It achieves not just the longtime goals of policymakers -; "a safety net strengthened . . . retirement secured . . . a nation protected" -; but also brings about changes in human nature that have bedeviled civilization from the beginning of time. "This budget ends cronyism; eliminates waste, fraud and abuse," Ryan's plan promises (Dana Milbank, 3/12). 

Bloomberg: Ryan Budget Replays Republican Hits As Time Marches On
Still, it's hard to view this latest budget as anything more than a holding pattern for a political party caught between its past and its future. Like the fiscal outlook, the nation's politics have shifted. Ryan's budget pockets the savings from Obama's health-care plan while calling again for its repeal. As Jim Nussle, a former Republican congressman and budget director under George W. Bush, said to CNBC: "I think we fought that battle." Pretending otherwise is silly (3/12).

And on other issues --

WBUR: A Not-So-Rosy View Of Mass. Health Reform
Hundreds of healthcare journalists will be attending the Association of Health Care Journalists' (AHCJ) conference in Boston this week to hear from many speakers with rose-colored ideas about both our Romneycare law and a brand new state cost-control law. Yet all is not well in the Commonwealth. State officials now predict "extreme premium increases" for many small businesses under Obamacare. In a letter to federal regulators the day after Christmas 2012, a perfect day to bury news, Massachusetts officials floated the idea of obtaining a waiver from the Affordable Care Act (ACA) out of fear of the premium spikes. Yet, recently finalized federal regulations slammed the door on that flexibility. Many small companies justifiably feel sick over the decision (Josh Archambault, 3/12). 

Fox News: How ObamaCare Is Dividing The U.S.
As the experiment for transforming the American health care system ensues, consumers face the potential for a disastrous outcome on October 1, when the marketplaces are supposed to be up and running. As of a few weeks ago, the states were evenly split as to whether they will establish their own marketplace, or whether they will defer to the federal government to set it up. For the most part, states led by Democrats have opted to set up their own marketplaces, while most Republican states have declined (Dr. Sreedhar Potarazu, 3/13).

San Jose Mercury News: Feinstein Fighting Outrageous Health Insurance Rate Hikes
Thirty three states have laws regulating insurance rates. Private insurers have had ample opportunity to get behind fair regulation in California to allow reasonable rate increases and profits, but they have fought it at every turn. Instead, for years they have been pounding customers with double-digit rate increases far beyond the rise in medical costs and raking in record profits. Sen. Dianne Feinstein has the solution for the 17 states lacking the authority to block or modify egregious rate increases. She is proposing to give the secretary of Health and Human Services power to examine health insurance premiums and deny unjustified or excessive rate hikes. Congress should pass Feinstein's bill, and if it doesn't, Californians should protect their own interests with a ballot proposition planned in 2014 (3/12). 

The New York Times: Mayor Bloomberg's Anti-Obesity Campaign
The mayor and his health officials are right to assert that sugary drinks contribute to obesity, a leading cause of diabetes, heart disease and other chronic health problems. And they've done a good job of advertising the dangers of these drinks: a particularly powerful ad shows a young man eating 16 packets of sugar, which is the amount in 20 ounces of soda -; while others watch in disbelief. But the big-drinks ban was ill conceived and poorly constructed from the start (3/12).

Los Angeles Times: When CPR Isn't The Right Medicine
The 911 call last month that led to an emergency dispatcher begging workers at a Bakersfield senior living facility to perform CPR on a woman captured the attention of the public. A staff worker told the dispatcher it was against the facility's policy to intervene. The woman, Lorraine Bayless, died. It is difficult to understand how liability concerns could dissuade anyone from helping a person in distress. However, this stark event should awaken us to another question: Should we be performing CPR on 87-year-olds in a community setting such as a senior home (Kevin M. Dirksen and Neil S. Wenger, 3/13)?