Can Ryan Succeed as Speaker?
If he seeks innovative solutions, he might forge some grand compromises.
Paul Ryan
Paul Ryan has a shot at working some grand compromises, if he can succeed in parking some of the extreme positions taken by the presidential candidates of both parties.
For instance leaders from both parties have talked about lowering the top 35% corporate income tax, a good ten points higher than the average of other industrialized countries. It makes the American economy uncompetitive and drives corporate headquarters to tax friendly countries. That has to stop. A 25% top rate, endorsed in campaigns by President Obama, would get the job done.
There would be some lost tax revenue, but that eliminating corporate tax loopholes and creating an alternative minimum tax for companies could offset revenue loss. There is no logic or fairness to a system that lets GE and other big tax evaders pay next to no taxes in the United States.
He could also seek cross-aisle consensus on the drag of subsidies on the U.S. economy by getting innovative. Social Security, Medicare and Medicaid deficits, present and future, need to brought under control, and everyone knows it. Within that subsidy hemorrhage, the biggest bleeder is out-of-control health costs.
At the heart of the company plans that are operating at 50% less cost than public sector plans are consumer-driven principles that offset high deductibles and co-insurance with Health Savings Accounts (HSA), a Republican invention, and free primary care, which Democrats ought to love.
Proactive primary care keeps people out of hospitals, and HSAs could buttress Social Security payments. There are already 20 million HSAs in the country, and they are growing at a fast clip. The HSA blessings to taxpayers could mitigate the need to increase Social Security payments in the years ahead.
Big national studies have shown that consumer driven plans save 20% to 30% on health costs per year, because consumers are spending their own money.
Three of ten large companies now have on-site primary care for their workers. Why? Because it works to improve workforce health and to lower costs. No surprise there. Better health equals lower costs.
Ryan should be able to convince a majority in Congress to latch onto these popular tools, apply them to recipients of Medicare and Medicaid, lower their cost trend lines.
A broader application of these health cost management methods to the Armed Services could free up major dollars for weapons and troops.
In short, medical cost inflation is crowding out many national priorities, for both parties’ favorite agendas. Ryan, the policy wonk, could craft an elegant national solution.
For a variety of reasons – serving the country, political ambition, the limelight – Ryan rose above reasons not to take the Speaker job. He will succeed to the extent that he breaks way from political ideologies and runs toward innovative solutions to the nation’s biggest problems.
John Torinus is the chairman of Serigraph Inc. and a former Milwaukee Sentinel business editor who blogs regularly at johntorinus.com.
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John, As usual you have written a fantastic article on Paul Ryan. Now lets see if he can deliver.
Tom. I am puzzled by your comment. There is almost nothing about Ryan in this piece. It is mostly Torinus’ opinions on healthcare, and his hope that Ryan might pursue these policy choices. With more detail, it might be a good article.
Paul Ryan is no centrist when it comes to his political ideology. Ryan is tea-party, so he will get along well with the Freedom Caucus. Ryan signed Grover Norquist’s Pledge…no tax increases, ever, with a goal to cut taxes in half. Scott Walker, and probably all the Republicans in the Assembly and Senate, signed Norquist’s pledge. Ryan will be your man to privatize Medicare, Medicaid and Social Security. To a degree, Medicare is already privatized…it is called Medicare Advantage Plan. For now, it is elective, and it is subsidized by taxpayers. That makes it possible for insurance companies to offer Advantage Plans with lower premiums, deductibles & co-pays to help reel-in seniors. Seniors in those Plans think it’s great to pay less until the plan changes or costs more, or goes out of business. MAPs are run by insurance companies for profit. For profit Medicaid/Medicare companies will raise prices or exclude services to retain profitability. Iowa Governor, Terry Branstad, Republican, recently privatized the Medicaid program. He selected 4 private health care businesses to run the program. The trouble is he neglected to make this process open to the public, and, also, for making highly questionable claims on the amount of savings over government run Medicaid. It appears that government run Medicaid is as, or more cost efficient. Also, some of the companies were found to have paid millions of dollars in fines due to illegal manipulations. So why change it? Must have something to do with making money off the sick and poor.
How well has Medicare Plan D worked for seniors? It is a gift that keeps on giving…to the pharmaceutical/insurance companies who are free to charge whatever amount they choose. All thanks to GWB. The Doctor prescribes medications; the insurance clerk may deny doctored ordered medicine. Patient and Doctor appeal the ruling. More documentation required. Doctor has only so much time to work on appeals, so if it doesn’t go through the first time…Doctor drops out. Doctor hands prescription to ill, elderly or disabled person who must now pay the high cost of a drug out of pocket. From year to year drugs move from tier to tier…with the patient paying more and more. What is covered in tier one this year may be in tier two next year. You may need to enroll in a new plan if your drug situation changes or even if it doesn’t. When you sign up for your new plan during open enrollment, checking to make sure your drugs are somewhat covered, plus paying a hefty monthly premium and an increasingly large deductible, you may discover in January that they have changed the formulary and the medicine you need is in a higher tier or it may have disappeared off the formulary. Now you feel deceived, but you can change the plan in a year. Pity the poor seniors who have no adult children or grandchildren nearby to help them through this maze. Or call your insurance agent for guidance…(s)he has your best interest at heart. Pharmaceutical and Insurance companies are making record profits. This, IMO, is how privatizing Medicaid and all of Medicare will go. Private companies will deny doctored ordered services (unless you are in a platinum plan) telling patients they may pay out of pocket if they want that medical service. Those that have the money will pay out of pocket for the service even though they are paying a fortune for the policy. There will be an arbitration clause in all insurance policies requiring health consumers to agree to the decision of the company selected arbitrator.
What I would like to see is single payer health care. Everyone is in the same plan. No more platinum, gold, silver, brass, or tin foil plans to select from based on your wealth or lack thereof. No tiers for medications. If your doctor says you must have it..you get it.
Way to rock the facts Barb!