Romney-Ryan Plays Healthcare Dodge Ball

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Twisting the Facts About Health Care

OCT. 20, 2012

The outcome of the presidential election will determine which of two opposing paths the nation will follow on health care for all Americans. If voters re-elect President Obama, he will protect the health care reforms that are his signature domestic achievement. If they elect Mitt Romney, they will be choosing a man who has pledged to repeal the reform law and replace it with — who knows what?

The competing visions are often difficult to evaluate because the Republican candidates — Mr. Romney and his running mate, Paul Ryan — have become so artful about obfuscating their plans for Medicare, Medicaid and what they will do to reform the whole system. Almost nothing the Republican candidates say on these or other health care issues can be taken at face value.

Here are some of their bigger evasions:

REPLACING OBAMACARE Although Mr. Romney has said he wants to “repeal and replace” the Affordable Care Act, he has provided few details on what he would replace it with. When challenged to do so at the first presidential debate, Mr. Romney never quite answered and made some egregious misstatements along the way, some of which were repeated by Mr. Ryan in the vice-presidential debate.

Mr. Romney asserted that his plans had already been laid out in “a lengthy description,” implying that anyone could read the whole story by turning to his campaign Web site. As it turns out, the site has a page-and-a-half statement that says he would rely on private markets and state leadership but gives no hint of what it would cost or who would pay. A one-page list of frequently asked questions about his Medicare plan assures us that “Mitt continues to work on refining the details.”

He continues to assert that his plan would cover people with pre-existing conditions when it clearly would not. People who have pre-existing conditions — and are not already covered by insurance — are often refused coverage or charged exorbitant rates by private insurers. Starting in 2014, the reform law will require insurers to accept all applicants and charge them without regard to health status. By contrast, Mr. Romney has simply pledged to protect people who had insurance but then lost it, provided they take out a new policy within a short time. But this protection is already required by law and offers absolutely nothing for millions of people who can’t get or can’t afford private insurance.

He has also implied that the reform law created an unelected board that’s “ultimately” going to tell people what treatments they can have. The advisory board is specifically precluded by the law from recommending cuts in benefits or eligibility; its job is to propose cuts in payments to providers and insurers if necessary to meet budget targets.

A major goal of the law was to cover some 30 million more people by expanding Medicaid and subsidizing coverage for middle-income people. That goal would be lost if the law was repealed. The Republicans, of course, have no plans for covering the uninsured beyond assuming they can use emergency rooms, leaving the problem to the states.

MEDICARE Mr. Romney has misrepresented what would happen to both current beneficiaries and future generations under his proposals. He says his plans would have no effect on people now on Medicare or nearing eligibility. But if he succeeded in repealing the reform law, which has many provisions that hold down costs for Medicare enrollees, most beneficiaries would see their annual premiums and cost-sharing go up. The average beneficiary in traditional Medicare would pay about $5,000 more through 2022, and heavy users of prescription drugs about $18,000 more over the same period, if the act is repealed, according to the Department of Health and Human Services. Department of Health and Human Services.

Mr. Romney also argues that the reform law will weaken Medicare because it cuts some $716 billion from future Medicare spending by slowing the rate of increase over the next decade. Of course, that is essentially the same amount of Medicare cuts in Mr. Ryan’s budget resolutions, approved this year and last year by House Republicans.

The reform law justifiably reduces the excessive subsidies to private plans (known as Medicare Advantage) that enroll many beneficiaries. It also lowers the annual rate of increase in payments to providers, like hospitals, nursing homes and home care agencies, to force them to become more efficient. Mr. Romney wants to keep overpaying the plans and providers simply to pander to elderly voters.

For future generations, the Romney-Ryan ticket would turn Medicare into a premium-support — or voucher — program in which the federal government provides a fixed amount of money to beneficiaries each year and allows it to grow by a small amount annually, which may not keep pace with medical costs. The whole point of turning to vouchers is to reduce federal spending on Medicare, so it seems likely that many beneficiaries would end up worse off than now. (At the vice-presidential debate, Mr. Ryan tried to pretend his premium-support proposal was bipartisan, but the sole Democrat who backed an early version — Senator Ron Wyden of Oregon — has disavowed his plan.)

Mr. Romney and Mr. Ryan insist that the magic of competition among health insurers — both private plans and a public option like Medicare — will bring down premiums. But if competition fails to do that, beneficiaries would almost certainly get socked with added payments or fewer benefits.

They say that lower-income beneficiaries would get more-generous premium support and wealthier individuals would receive less support. But, of course, they provide no numbers on what those support levels might be.

MEDICAID The Republicans want to repeal the reform law’s expansion of Medicaid to cover millions of low- and middle-income people and instead shrink federal funding by turning Medicaid into a block grant. States would be given a fixed amount of money equal to what they had been getting in federal payments for Medicaid, and that grant would then grow at a rate tied to inflation. If those increases failed to keep up with medical costs, states — faced with the necessity of balancing their budgets every year — would probably have to cut enrollments or benefits or payments to providers. That could include cuts to coverage for long-term and nursing home care that millions depend on.

The block grant proposal in Mr. Ryan’s budget resolution would reduce federal Medicaid payments to the states by more than $800 billion over 10 years and would cut federal funding by a third in 2022, according to the Center on Budget and Policy Priorities. Mr. Romney blithely said that if a state got into trouble “Why, we could step in and see if we could find a way to help them.” Or maybe not. It’s another of those vague promises.

http://www.nytimes.com/2012/10/21/opinion/sunday/the-republican-ticket-twists-the-facts-about-health-care.html?nl=todaysheadlines&emc=edit_th_20121021&pagewanted=all

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Golly Gee! Back to the 50s with Mittisms

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Gosh, Who Talks Like That Now? Romney Does

by Michael Barbaro and Ashley Parker

OCT. 20, 2012

GOFFSTOWN, N.H. — At a campaign stop in Rockford, Ill., not long ago, Mitt Romney sought to convey his feelings for his wife, Ann. “Smitten,” he said.

Not merely in love.

“Yeah, smitten,” he said. “Mitt was smitten.”

It was a classic Mittism, as friends and advisers call the verbal quirks of the Republican presidential candidate. In Romneyspeak, passengers do not get off airplanes, they “disembark.” People do not laugh, they “guffaw.” Criminals do not go to jail, they land in the “big house.” Insults are not hurled, “brickbats” are.

As he seeks the office of commander in chief, Mr. Romney can sometimes seem like an editor in chief, employing a language all his own. It is polite, formal and at times anachronistic, linguistically setting apart a man who frequently struggles to sell himself to the American electorate.

It is most pronounced when he is on the stump and off the cuff, not on the stuffy and rehearsed debate stage. But Mr. Romney offered voters a dose of it during his face-off with President Obama last week, when he coined the infelicitous phrase “binders full of women.”

Mr. Romney’s unique style of speaking has distinguished him throughout his career, influencing the word choices of those who work with and especially for him. Should he reach the White House, friends and advisers concede, the trait could be a defining feature of his public image, as memorable as Lyndon B. Johnson’s foul-mouthed utterances or the first President Bush’s tortured syntax.

Mr. Romney, 65, has spent four decades inside the corridors of high finance and state politics, where indecorous diction and vulgarisms abound. But he has emerged as if in a rhetorical time capsule from a well-mannered era of soda fountains and AMC Ramblers, someone whose idea of swearing is to let loose with the phrase “H-E-double hockey sticks.”

“He actually said that,” recalled Thomas Finneran, the speaker of the Massachusetts House of Representatives when Mr. Romney was governor. “As in, go to ‘H-E-double hockey sticks.’ I would think to myself, ‘Who talks like that?’ ”

Mr. Romney, quite proudly. In fact, he seems puzzled by the fascination with something as instinctive (and immutable) as how he talks, as if somebody were asking how he breathes. “It’s like someone who speaks with an accent,” he said in an interview. “You don’t hear the accent.”

His Mormon faith frowns on salty language, and so does he. A man of relentless self-discipline, he made clear to lawmakers in Boston and colleagues in business that even in matters of vocabulary, he “held himself to a high standard of behavior,” said Geoffrey Rehnert, a former executive at Bain Capital, the firm Mr. Romney started in the 1980s. Mr. Romney’s father, George, whom he idolized, shared the same style of refined and restrained speech.

Those around him are so accustomed to his verbal tics that they describe them in shorthand. “Old-timey,” said one aide. “His 1950s language,” explained another. “The Gomer Pyle routine,” said a third.

Asked about his boss’s word preferences, Eric Fehrnstrom, a veteran Romney adviser, responded knowingly: “You mean like ‘gosh, golly, darn’?”

For Democratic strategists, Mr. Romney’s throwback vocabulary feeds into their portrayal of a man ill-equipped for the mores and challenges of the modern age. David Axelrod, a top adviser for an Obama campaign that has adopted “Forward” as its slogan, once quipped that Mr. Romney “must watch ‘Mad Men,’ ” the hit television show set in Manhattan in the 1960s, “and think it’s the evening news.”

His exclamations can sound jarring to the contemporary ear — or charming, depending on whom you ask. Midway into a critique of Mr. Obama’s economic policies a few months ago, Mr. Romney declared: “They’ve scared the dickens out of banks,” he said. “They’ve scared the dickens out of insurance companies.”

He declared, “To heck with it!” while urging reporters to use their fingers to dig into a box of pastries he was passing around on a plane. “Darn good question,” he replied to a voter in Kalamazoo, Mich., who asked how he would work with Congress if elected. (His wife also got the “darn” treatment in Michigan, when he enthused, “Gosh, darn, she is amazing!”) “Thank heavens” is another favorite.

For people used to peppering their speech with four-letter words, time with Mr. Romney can prove an exercise in self-control. A half-dozen people recalled the precise moment when they swore — almost always accidentally — in his presence.

When Robert Travaglini, then the Democratic president of the Massachusetts State Senate, would curse in front of Mr. Romney, the governor would frown and interject, “Well, I wouldn’t choose that diction,” Mr. Travaglini recalled.

Mr. Rehnert, the former Bain executive, was mortified when a potential client he took into Mr. Romney’s office promptly dropped a string of profanities. “Mitt wanted to know what cats and dogs I was dragging in here,” Mr. Rehnert said.

His cussing colleagues said Mr. Romney took pains not to judge them publicly. “He did not impose his language preferences on us,” Mr. Finneran said. “But I wonder if we became a little bit more restrained because we knew this about him.”

Mr. Travaglini recalled lawmakers’ discussing how Mr. Romney “should be more in tune with the vernacular of the day and express himself more passionately.”

“But,” he added, “that’s not who he is.”

Mr. Romney does have his own distinctly G-rated arsenal of angry expressions — “Good grief,” “flippin’,” “good heavens” and even the occasional “crap.”

Perhaps the most intriguing of these is “grunt.” Most people just grunt. Mr. Romney, however, talks about grunting. “Grunt” he says, onomatopoetically, when annoyed with a last-minute change in his campaign schedule.

Many of Mr. Romney’s verbal habits can sound like those of a hyper-literate graduate student who never left school. (In college, he majored in English.) He favors the gentlemanly qualifier “if you will,” which he invoked three times during a recent speech.

On how to reduce the debt: “You have to start accumulating, if you will, reserves.”

On speaking to a group of soldiers: “The cadets were all lined up and sitting at attention, if you will.”

On his business background: “I’ve had the experience of working in the real world, if you will.”

In interviews, voters expressed an equal measure of admiration for and curiosity about his quaint dialect, which many described as a conspicuous break from the normally harsh tone of politicians.

“It’s a wonderful change,” said Irene Sperling, a retiree from Allentown, Pa. “He’s a gentleman.”

Wendy Tonn, 63, a Romney supporter who splits her time between Michigan and Florida, said she found comfort in his vocabulary, comparing it to the simple innocence of “Leave It to Beaver.” “We are of that era, and we’d like to be returned to that kind of era,” she said. [emphasis added]

Even Dennis Miller, the comedian, has weighed in, suggesting that after four years of having a “hipster president” in the White House, Americans craved a “gosh president.”

A few acquaintances have tried to drag him linguistically into the 21st century. Mr. Finneran, an admitted serial curser, said that after years of working closely with Mr. Romney, he began to fantasize about provoking him to utter a particularly crude word.

“It got to the point where I started to think that my greatest achievement of all time would be if I somehow or other got him to say the word,” he said.

Once, Mr. Romney seemed on the cusp of fulfilling that wish during a heated discussion. But he caught himself. “And I thought, ‘Oh, God, my closest moment ever,’ ” Mr. Finneran said. “But it’s not going to happen.”

http://www.nytimes.com/2012/10/21/us/politics/romneys-throwback-language-his-mittisms.html?pagewanted=2&_r=0&nl=todaysheadlines&emc=edit_th_20121021&pagewanted=all

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Romney’s BS on Job Creation

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Snow Job on Jobs

by Paul Krugman

OCT. 18, 2012

Mitt Romney talks a lot about jobs. But does he have a plan to create any?

You can defend President Obama’s jobs record — recovery from a severe financial crisis is always difficult, and especially so when the opposition party does its best to block every policy initiative you propose. And things have definitely improved over the past year. Still, unemployment remains high after all these years, and a candidate with a real plan to make things better could make a strong case for his election.

But Mr. Romney, it turns out, doesn’t have a plan; he’s just faking it. In saying that, I don’t mean that I disagree with his economic philosophy; I do, but that’s a separate point. I mean, instead, that Mr. Romney’s campaign is telling lies: claiming that its numbers add up when they don’t, claiming that independent studies support its position when those studies do no such thing.

Before I get there, however, let me take a minute to talk about Mr. Romney’s claim that he knows how to fix the economy because he’s been a successful businessman. That would be a dubious claim even if he were honestly representing his business career, because the skills needed to run a business and those needed to manage economic policy are very different. In any case, however, his portrait of his own experience is so misleading that it takes your breath away.

For Mr. Romney, who started as a business consultant and then moved into the heady world of private equity, insists on portraying himself as a plucky small businessman.

I am not making this up. In Tuesday’s debate, he declared, “I came through small business. I understand how hard it is to start a small business.” In his speech at the Republican convention, he declared, “When I was 37, I helped start a small company.”

Ahem. It’s true that when Bain Capital started, it had only a handful of employees. But it had $37 million in funds, raised from sources that included wealthy Europeans investing through Panamanian shell companies and Central American oligarchs living in Miami while death squads associated with their families ravaged their home nations. Hey, doesn’t every plucky little start-up have access to that kind of financing?

But back to the Romney jobs plan. As many people have noted, the plan has five points but contains no specifics. Loosely speaking, however, it calls for a return to Bushonomics: tax cuts for the wealthy plus weaker environmental protection. And Mr. Romney says that the plan would create 12 million jobs over the next four years.

Where does that number come from? When pressed, the campaign cited three studies that it claimed supported its assertions. In fact, however, those studies did no such thing.

Just for the record, one study concluded that America might gain two million jobs if China stopped infringing on U.S. patents and other intellectual property; this would be nice, but Mr. Romney hasn’t proposed anything that would bring about that outcome. Another study suggested that growth in the energy sector might add three million jobs in the next few years — but these were predicted gains under current policy, that is, they would happen no matter who wins the election, not as a consequence of the Romney plan.

Finally, a third study examined the effects of the Romney tax plan and argued (implausibly, but that’s another issue) that it would lead to a large increase in the number of Americans who want to work. But how does that help cure a situation in which there are already millions more Americans seeking work than there are jobs available? It’s irrelevant to Mr. Romney’s claims.

So when the campaign says that these three studies support its claims about jobs, it is, to use the technical term, lying — just as it is when it says that six independent studies support its claims about taxes (they don’t).

What do Mr. Romney’s economic advisers actually believe? As best as I can tell, they’re placing their faith in the confidence fairy, in the belief that their candidate’s victory would inspire an employment boom without the need for any real change in policy. In fact, in his infamous Boca Raton “47 percent” remarks, Mr. Romney himself asserted that he would give a big boost to the economy simply by being elected, “without actually doing anything.” And what about the overwhelming evidence that our weak economy isn’t about confidence, it’s about the hangover from a terrible financial crisis? Never mind.

To summarize, then, the true Romney plan is to create an economic boom through the sheer power of Mr. Romney’s personal awesomeness. But the campaign doesn’t dare say that, for fear that voters would (rightly) consider it ridiculous. So what we’re getting instead is an attempt to brazen it out with nakedly false claims. There’s no jobs plan; just a plan for a snow job on the American people.

http://www.nytimes.com/2012/10/19/opinion/krugman-snow-job-on-jobs.html?src=me&ref=general

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Romney-Ryan’s Death by Ideology

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Death By Ideology

 By Paul Krugman – OCT. 14, 2012

Mitt Romney doesn’t see dead people. But that’s only because he doesn’t want to see them; if he did, he’d have to acknowledge the ugly reality of what will happen if he and Paul Ryan get their way on health care.

Last week, speaking to The Columbus Dispatch, Mr. Romney declared that nobody in America dies because he or she is uninsured: “We don’t have people that become ill, who die in their apartment because they don’t have insurance.” This followed on an earlier remark by Mr. Romney — echoing an infamous statement by none other than George W. Bush — in which he insisted that emergency rooms provide essential health care to the uninsured.

These are remarkable statements. They clearly demonstrate that Mr. Romney has no idea what life (and death) are like for those less fortunate than himself.

Even the idea that everyone gets urgent care when needed from emergency rooms is false. Yes, hospitals are required by law to treat people in dire need, whether or not they can pay. But that care isn’t free — on the contrary, if you go to an emergency room you will be billed, and the size of that bill can be shockingly high. Some people can’t or won’t pay, but fear of huge bills can deter the uninsured from visiting the emergency room even when they should. And sometimes they die as a result.

More important, going to the emergency room when you’re very sick is no substitute for regular care, especially if you have chronic health problems. When such problems are left untreated — as they often are among uninsured Americans — a trip to the emergency room can all too easily come too late to save a life.

So the reality, to which Mr. Romney is somehow blind, is that many people in America really do die every year because they don’t have health insurance.

How many deaths are we talking about? That’s not an easy question to answer, and conservatives love to cite the handful of studies that fail to find clear evidence that insurance saves lives. The overwhelming evidence, however, is that insurance is indeed a lifesaver, and lack of insurance a killer. For example, states that expand their Medicaid coverage, and hence provide health insurance to more people, consistently show a significant drop in mortality compared with neighboring states that don’t expand coverage.

And surely the fact that the United States is the only major advanced nation without some form of universal health care is at least part of the reason life expectancy is much lower in America than in Canada or Western Europe.

So there’s no real question that lack of insurance is responsible for thousands, and probably tens of thousands, of excess deaths of Americans each year. But that’s not a fact Mr. Romney wants to admit, because he and his running mate want to repeal Obamacare and slash funding for Medicaid — actions that would take insurance away from some 45 million nonelderly Americans, causing thousands of people to suffer premature death. And their longer-term plans to convert Medicare into Vouchercare would deprive many seniors of adequate coverage, too, leading to still more unnecessary mortality.

Oh, about the voucher thing: In his debate with Vice President Biden, Mr. Ryan was actually the first one to mention vouchers, attempting to rule the term out of bounds. Indeed, it’s apparently the party line on the right that anyone using the word “voucher” to describe a health policy in which you’re given a fixed sum to apply to health insurance is a liar, not to mention a big meanie.

Among the lying liars, then, is the guy who, in 2009, described the Ryan plan as a matter of “converting Medicare into a defined contribution sort of voucher system.” Oh, wait — that was Paul Ryan himself.

And what if the vouchers — for that’s what they are — turned out not to be large enough to pay for adequate insurance? Then those who couldn’t afford to top up the vouchers sufficiently — a group that would include many, and probably most, older Americans — would be left with inadequate insurance, insurance that exposed them to severe financial hardship if they got sick, sometimes left them unable to afford crucial care, and yes, sometimes led to their early death.

So let’s be brutally honest here. The Romney-Ryan position on health care is that many millions of Americans must be denied health insurance, and millions more deprived of the security Medicare now provides, in order to save money. At the same time, of course, Mr. Romney and Mr. Ryan are proposing trillions of dollars in tax cuts for the wealthy. So a literal description of their plan is that they want to expose many Americans to financial insecurity, and let some of them die, so that a handful of already wealthy people can have a higher after-tax income.

It’s not a pretty picture — and you can see why Mr. Romney chooses not to see it.

http://www.nytimes.com/2012/10/15/opinion/krugman-death-by-ideology.html?nl=todaysheadlines&emc=edit_th_20121015

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