Twelve Things you Should Know about Paul Ryan

By now most people know that Mitt Romney has chosen Paul Ryan a Republican Congressman from Wisconsin as his vice-presidential running mate. A recent article byIgor Volsky in Truthout continues the parade of negative volleys fired by those opposed to the Republican slate. Nevertheless some of the factoids listed are interesting. First Ryan supposedly embraces extreme individualism and has heaped praise on Ayn Rand. I have always been puzzled that politicians would dare to become associated with the views of Rand. It must be due to choosing very selectively from her ideas.

No doubt her praise of free market capitalism and of the individual that attracts some. While as Volsky points out she does praise selfishness as a virtue and criticizes altruism as evil, she also condemned Christianity and faith in general. It seems simply weird that someone such as Ryan who is said to be a devout Roman Catholic would praise her. Rand was also pro-choice rather than pro-life as Ryan is. Not surprisingly in 2012 Ryan has now rejected her views! They might be a political liability

Ryan's GOP budget would raise taxes for the middle class and cut them for millionaires.. There would be just two brackets 10 per cent and 25 per cent. This would involve cutting the top rate from 35 per cent. Revenue collected would decline by about $4.5 trillion over the next decade. However to cover that loss there would be massive cuts to social programs although he also wants to close tax loopholes and shelters which would be a good move if it actually came about. But most of the savings would come for programs that benefit the middle and working classes. Ryan would extend the Bush tax cuts but not those of Obama targeting those with lowest incomes. Ryan's plan would see those households earning over a million a year get a tax cut of almost $300,000 a year.

Number three of the twelve things you should know involves increased costs to seniors for Medicare. Ryan would introduce a premium support system rather than a guaranteed benefit. Future retirees would receive a government contribution from which the pensioners could purchase private insurance from an exchange of private plans or traditional fee-for-service Medicare. However the voucher would not keep up with increasing health care costs so over time pensioners would pay more. Ryan would also raise the age of eligibility to 67. Ryan's plan manages to ensure that private ensurers would profit from the system since the vouchers would be used to buy private insurance. This article is already getting long. The other nine remaining things you should know can be found at this link. . .

Dental Service Management companies involved in dental abuse

There is a long article at Bloomberg News detailing abuses by Dental Management Service companies. These companies are often owned by private equity firms. In this report I will just deal with one example of questionable dental work.

Last October 4 year old Isaac Gagnon got off the school bus sobbing and showed his mother where it hurt. He had steel crowns on his back teeth. There was a dental statement in his backpack that showed he had two polpotomies or baby root canals, together with crowns and ten X rays. This happened all while he was at school. He didn't need the work.

Gagnon's mother said:“I was absolutely horrified,” “I never gave them permission to drill into my son’s mouth. They did it for profit.” This case and similar cases are being looked at by federal lawmakers. The companies follow a popular business model backed by Wall Street money and taking advantage of government programs.

ReachOut Healthcare is the dental service management company that sent the dentist to Isaac's school. The company is in the portfolio of Morgan Stanley Private Equity. The company has wide reach operating in 22 different states and dealing with 1.5 million patients. These management companies are the object of a Senate inquiry. There are reports of unnecessary procedures as in Isaac's case, poor quality treatment, and even unlicensed practice of dentistry. For much more see the entire article.

AMA spokesperson: US Medicare needs treatment.

This is from the Hill Blog. Unlike most advanced capitalist countries the US does not have a universal health care system. Even what system is has is underfunded one of the opportunity costs of wars such as in Iraq.

Medicare is Flawed and Needs Treatment
March 16th, 2007
The release earlier this month of MedPAC’s report to Congress on the Medicare physician payment morass once again highlighted the inherently flawed Medicare physician payment update formula – the sustainable growth rate (SGR).

Next year, Medicare will cut payments to physicians 10 percent, as the cost of caring for Medicare patients continues to increase. In fact, current Medicare payments are about what they were in 2001. As seniors live longer, healthier lives, they rely on Medicare to pay for the doctor’s care they need to maintain active lifestyles. But as Medicare slashes payments, doctors are put in the unenviable position of making practice changes in order to keep the doors open.

An AMA survey of physicians found that nearly half would be forced to limit the number of new Medicare patients they treat if a 5 percent cut occurred – that’s half of next year’s cut. We are deeply concerned about the impact on a 10 percent cut on seniors’ ability to quickly get in and see the doctor of their choice.


Earlier this month, I had an opportunity to testify to the Senate Finance committee on the need for Congressional action to stop next year’s cut and provide a positive payment update in line with practice cost increases. MedPAC has recommended Congress provide a 1.7 percent payment increase for 2008. I also encouraged Congress to begin taking the necessary steps to replace the SGR with a system that pays doctors based on practice costs. This would put physician payment on the same footing as other Medicare providers and enable Congress to make good on its promise that Medicare will provide seniors with access to health care.

Part of the discussion at the hearing focused on the cost of replacing the formula. We know the costs are high, and we know that Congress must make difficult decisions every year about which programs to fund. But frankly, the costs of doing nothing are even greater, in both social and economic terms. Every year that Congress waits to act, the price tag rises. But, the Administration can help significantly lower the price by taking immediate action to retroactively remove the cost of physician-administered drugs from the Medicare payment formula.

The flawed payment formula also undermines the vision of having physicians use health information technology and quality initiatives to deliver the highest quality care. Doctors are committed to always improving health care for patients, but the threat of steep Medicare pay cuts makes it impossible for physician practices, most of which are small businesses, to make the substantial financial investments needed for health information technology and quality improvement programs.

As the baby boomers age into Medicare in just three short years, we need to make sure there are doctors available to treat this huge influx of American’s into the Medicare program. Congressional action is the key to making sure that happens.




Posted by American Medical Association Board Chair Cecil B. Wilson, M.D.