A Closer Look at Paul Ryan’s Closer Look

The following is a guest blog by Kelly K. Gallaher:

Congressman Paul Ryan has been very busy talking about the health care crisis and touting his plan called “The Patients’ Choice Act”. My local newspaper invited him to write a series of articles to examine the “facts” of current legislation. After reading his article on July 27th, I realized they offered it with no rebuttal or factual verification. A day later, I received a mailing from Ryan criticizing current health care reform proposals while stressing the benefits of his plan. Ryan’s plan sounds great, while U.S. House of Representatives Bill H.R. 3200 sounds scary. This time I sat down and read very closely every idea and derision posed in Ryan’s mailing. With a small amount of research I was able to refute every statement of criticism contained in the mailing. All of them. I was also able to dismantle the benefits Congressman Ryan claims his “Patients’ Choice Act” contains and discovered a pattern of distorted language designed to misrepresent and confuse constituents about health care. I will illustrate a few of the worst:

Regarding his proposed tax refund of $5,700 for every family or $2,300 for individuals, Ryan says:

“My plan, The Patients’ Choice Act, ensures universal affordable health care for all Americans.” and “Allows everyone to use this tax credit to select from a group of comprehensive health insurance plans that fit their specific needs-just like Members of Congress and federal employees do now.”

  • Last year family coverage in the private market averaged $13,000 and exceeded $16,000 per year in some states and is predicted to keep rising nationally. A figure far more than double the tax credit would allocate.
  • Republican Senator Richard Burr admitted that Ryan’s credit is not sufficient to cover American families. Burr says “that probably won’t meet the equivalent of an FEHBP (Federal Employees Health Benefit Program) plan.” Even Ryan’s friend in Congress says this isn’t equivalent to the coverage they have.
  • Under Ryan’s plan, families with employer paid insurance would be taxed on the entire amount the employer contributes just as if it were wages.
  • Replacing the current employer tax exclusion with an individual tax credit would significantly weaken employer-based coverage because individuals receive the credit and employers no longer have an incentive to contribute.
  • Unlike health reform proposals that the House and Senate committees are developing, Ryan’s plan does not set meaningful minimum standards on what benefits insurers must cover. It doesn’t limit deductibles or out-of-pocket costs leaving private insurers to determine those themselves state by state.

On current proposals being debated in the House and Senate, Ryan says the following:

“Total costs would exceed $1 trillion.” and “Creates an entitlement that will cost another trillion over the next ten years, on top of the trillions the government is already scheduled to spend on health care.”

  • The initial report by the CBO (Congressional Budget Office) in early July calculating estimated costs has been used by Ryan and his colleagues frequently and unfairly. The CBO did not calculate savings that health care reform will produce. On July 20th the CBO recalculated that the H.R. 3200 reform bill would not only be budget neutral, it will produce a surplus of $6 billion over time.
  • The real threat to government spending is the system we have now. According to the Kaiser Foundation: by 2018 health care costs are expected to top $4.4 trillion if nothing is done.
  • House and Senate committee reforms would reduce overuse of expensive healthcare technology and cut back on preventable medical error-two of the greatest cost drivers in the entire system. According to the Center for Health Research: comprehensive reform could save as much as $1.4 trillion over ten years.

Perhaps the worst lie Congressman Ryan is telling:

“A recent study predicts two out of every three Americans will lose their current employer-provided insurance under the government plan.”

  • The “recent study” he refers to is a study conducted by the Lewin group who is wholly owned by UnitedHealth Group (UHG), one of the nation’s largest insurers. The Lewin Group is part of Ingenix, a subsidiary of UHG that was accused by the New York attorney general and the AMA for helping insurers shift medical expenses to consumers by distributing skewed data. In January, UnitedHealth paid a $400 million dollar settlement covering conduct going back to 1994.
  • According to Center on Budget and Policy Priorities it is Congressman Ryan’s “Patients’ Choice Act” that “would significantly erode employer-based coverage” while it “fails to create a viable alternative for people losing employer coverage.”

Lastly, Congressman Ryan decries government interference in health care. However, he completely avoids discussing that his plan for the uninsurable constitutes a huge government system itself. Nearly 100 million chronically ill Americans (representing up to 75% of health care spending) who cannot afford coverage except at colossal premium costs would be funneled into a state/government run health insurance exchange with prices and language determined by private carriers in each individual state. Ryan’s plan is devoid of the competition a public option offers and entrusts insurance companies to police themselves.

Ultimately, Congressman Ryan’s “Patients’ Choice Act” benefits for-profit, private health insurance companies by retaining and defending their central role in this billion dollar industry. Perhaps then, it is no coincidence that the insurance industry has been Congressman Ryan’s top contributor since 1989. In fact, he has received $1,143,560.00 in campaign contributions from health care industries over the last decade.

As 14,000 Americans lose their health insurance every single day, Paul Ryan offers nothing new; he is obstructing real reform and offering us more of the same. His “Patients’ Choice Act” is a retread of two bills already introduced in 2008 and both were recycled by John McCain in his unsuccessful run for President. In contrast, H.R. 3200 has included 160 Republican amendments, which proved to be smart, constructive and bipartisan, but you won’t hear that from Paul Ryan.

I believe we will have comprehensive health care reform this year and I hope it will be a good plan. It is clear that my U.S. Representative, Paul Ryan, intends to play no role in helping to shape this historic legislation. He said last week on MSNBC, “let’s have an honest debate.” My reply to him is: you first.


Kelly Gallaher is a founding member and coordinator for Community for Change and is currently working with Organizing for America in the 1st Congressional District in Wisconsin. Kelly is a partner in the “Artists Gallery” cooperative art gallery in Racine. She is married and has a nine year old daughter, Tess.

“I wrote this commentary because I truly believe we must work together to construct a plan for health care reform that works for everyone. Seeing and hearing my Representative, Paul Ryan, politicize that facts of current proposals for political clout is disappointing and underscores the perils of special interest influence on our elected officials.”


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13 thoughts on “A Closer Look at Paul Ryan’s Closer Look

  1. Kelly wrote: “Nearly 100 million chronically ill Americans (representing up to 75% of health care spending) who cannot afford coverage except at colossal premium costs would be funneled into a state/government run health insurance exchange with prices and language determined by private carriers in each individual state.”

    With respect, I am skeptical of “100 million chronically ill Americans”. Kindly point to your information source for this. I do not believe that 1 out of 3 Americans are chronically ill.

    If this is not an accurate figure, please know that I may be skeptical of other data you cite.

  2. Thanks for qualifying your skepticism! The figure of 100 million chronically ill comes from a study from the Robert Wood Johnson Foundation & Partnership for Solutions. It represents, elderly, people with preexisting conditions all who are forced to come up with exorbitant premiums and/or deductibles as well as up to one third of the 47 million who the Kaiser Foundation believes are also chronically ill.

  3. The who and what foundatins.One third, now who is using research that is A distortion. This mess will never pass if Obama stays true to his word. It’s impossible to have social health care without raising tax’s on all of us.

  4. Are you sure they said chronically ill? That has a very specific meaning in medical terms.”In medicine, a chronic disease is a disease that is long-lasting or recurrent”

    From the CIA Fact Book

    0-14 years: 20.2% (male 31,639,127/female 30,305,704)
    15-64 years: 67% (male 102,665,043/female 103,129,321)
    65 years and over: 12.8% (male 16,901,232/female 22,571,696) (2009 est)

    It appears false that 100 million Americans are chronically ill by definition. If ALL seniors had chronic conditions that would be 39M, leaving 60M to come from other age groups. Children would be excluded based upon your description of being forced to pay for pre-existing conditions ( they don’t pay). Which leaves 60M to come from the 206M between the ages of 15 and 64, the working people who pay for everyone else. I do not accept that 25% of the working people in the US are chronically ill.

    It appears to me that there is an overlap that has not been dealt with. Do you have an explanation or can you point the way to one?

  5. I might also point out that I am unswayed by how many industry contributions are made to politicians. As Greg Palast has said for years “We have the best democracy money can buy”. Neither you nor I can tell whether a contribution is made to change a person’s vote or to support him in his beliefs.

    And your comment: “Ultimately, Congressman Ryan’s “Patients’ Choice Act” benefits for-profit, private health insurance companies by retaining and defending their central role in this billion dollar industry.” That is precisely what Obama’s plan does, too. Everybody is forced to buy insurance. Obama’s Plan allows the government to sell insurance, too. Don’t you think that both political groups need more diversity in paying for healthcare? Why is insurance the only option for both parties? Tells us something right there.

  6. Thank you for your thoughtful debate, we could argue the details forever. The point is that Ryan’s plan dumps people (whether it’s 50 or 100 million) who cannot afford insurance in to a state by state pool, each state has their own rules and language. That’s quite a potential governmental mess in my opinion for someone who says we need to keep the government out of health care.

    Nate Silver has done his statistical magic with the correlation between health care campaign contributions and likeliness to vote in favor.

    Finally, this mailer of Paul Ryan’s was sent out using taxpayer funds and is rife with misrepresentations. I’m just a regular person going on record. He could be doing a much better job.

    1. I apologize if I have offended you. That was not my intent. Your skills with internet search engines and the patience to shift thru complex organizational ownership structures is formidable.

      Most blogs have data enwrapped by the author’s opinion. When the data is not defendable, one wonders if the wrong conclusions have been made.

      I agree with your comments that Ryan’s plan retains the State’s control over insurance companies and their plans. In fact, that is part of the problem. Each State dictates what shall be included in each insurance plan. This reduces the choices that we consumers have. One cannot buy healthcare insurance just for cancer or heart attack or some specific malady. One must have accident as well as disease insurance. The Obama/Kennedy plan does not appear to improve that part of the process.

      I support a nationwide health insurance program and only reluctantly support a Federal program. Medical insurance programs will always have some government scrutiny because of their nature. I am not clear if those programs are best constructed by government alone, by industry alone, or by joint panels of government and industry. Nor am I clear if they should be federal or state programs. There are some things that only the Federal government can do. Healthcare may be one of them and I would like to hear more about why insurance companies cannot have more diverse programs that can cross state lines.

      I also want to know why insurance is the solution du jour for both political parties. This forced approach takes 48 M uncovered Americans and gives them one option. It takes millions of others and changes their insurance options when they change jobs.

      I want portability, health savings accounts, catastrophic coverage,chronic coverage and insurance that changes with age. I want the term pre-existing conditions to be eliminated for anyone that has had contiguous coverage for 10 years or more regardless of the insurance provider.I want choices more than gold, silver, and bronze plans that “fit” the economic conditions of the owners.

      I am hoping that the Senate can diversify the House plan enough to meet my concerns but if it cannot, I will still support it. Right now there are no other options on the table.

  7. Partially Blue: You make really good points. Thank you for taking the time to add them to the discussion.

  8. There are a number of separate issues, that can be best addressed on their own rather than changing everything. Philosophically, I am against federal government running/managing healthcare as broadly as Congress & the President want. But more importantly, logically the idea that the people in Washington are at all capable of implementing such a large program in an effective way is nothing short of laughable. Can some one name me a program of comparable size that has been even remotely efficient and effective?

    The biggest problems with healthcare in this country right now are:

    rapidly rising costs and along with it, premiums.
    some number of people (not nearly 42 million though that’s a separate topic) are without healthcare insurance.
    portability/flexibility/choice – mainly healthcare tied to employement, but pre-existing condition disqualifications is part of this.

    I’m sure there’s more, but off the top of my head, these are the biggies. Individually, these issues and their related/contributing factors are something our federal government can deal with realtively effectively. But overhauling the whole system will lose too many of the good things about our healthcare without actually resolving all that many of the problems.

    1. Three things the government runs really well: Department of Defense
      Social Security
      Veterans Administration

      Three things that are pretty good:


  9. My feeling on the health care system and possible reform is this: the system’s very obviously broken, so why aren’t lawmakers on both sides trying to work to find solutions? It seems the only solution being offered by Republicans involves market-based solutions, without taking into account that the market thus far hasn’t brought down costs or ensured all citizens have coverage.

  10. Can Congressman Ryan or other men answer a question about State & Federal Legislation meddling with women’s rights.
    Specifically regarding abortion legislation, including the (proposed) Health Care Reform Act –
    Please answer these questions –
    Men –

    Do you feel men should only comment if they are Pro-Choice?
    Yea – Nay

    Can you put yourself in the same mental and physical place as
    women with an unwanted pregnancy?
    Yea – Nay

    Questions for women –

    Do you feel men should only comment if they are Pro-Choice?
    Yea – Nay

    Do you agree with this statement –
    Most ‘Pro-Life’ women feel that a women’s right to control her
    reproductive abilities, and life choices, should not be denied?
    Yea – Nay

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