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Ryan points past vote to alternatives on health-care reform

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FRANK J. SCHULTZ
January 19, 2011

First District Rep. Paul Ryan said there's more to come after the House votes on repeal of the health care reform law this week.


Ryan spoke to the Gazette in a telephone interview Tuesday. He acknowledged that he and fellow Republicans won't be able to overcome the Democrats' majority in the Senate or the veto power of the president in this instance.


Ryan, a Janesville resident who was elected to his seventh two-year term in November, also discussed the recent attack on a fellow House member in Arizona.


Here are some of Ryan's responses, edited for length and clarity:


Q: Isn't it a foregone conclusion that the Senate or the president will block the House Republicans' repeal of the health care law?


A: "This is something we pledged to do in the campaign, and I think it's very, very important that if you make a commitment in the campaign that you do it. …


"I also think it's important for us to begin to articulate how we would replace this law. … What you'll see in subsequent weeks and months is how we believe there is a better way to fix what's broken in health care without breaking what's working in health care."


Q: The major argument for repeal seems to be that the law would cost so much, but Democrats disagree.


A: "This law adds about $2.6 trillion in new spending over a 10-year period when it's fully implemented, and it is paid for with big Medicare cuts and big tax increases."


(Note: Critics say the Republicans' analysis includes costs that aren't part of the health care law and would be costs no matter what happens. For example, the Republicans include increases in Medicare payments to better cover doctors' costs, estimated at $208 billion over the next 10 years.)


Q: The Congressional Budget Office says that repealing health care reform would actually increase the deficit by $240 billion.


A: Lawmakers have manipulated the assumptions and used accounting tricks to get the response from the nonpartisan CBO that they want, Ryan said. When those things are removed, the law adds to the federal deficit by about $700 billion, he said, "and that's using CBO numbers as well."


Q: Could it also be that the assumptions you provide to the CBO lead to inaccurate conclusions?


A: "That's why I requested from the CBO, in a letter, whether or not this money is being double-counted, whether or not certain monies were not being counted, and they confirmed that that was the fact. And that if you used these sorts of budget gimmicks that it would result in about a $700 billion deficit."


Ryan went on to say that he doesn't agree with a CBO assumption about how many employers will stop providing health insurance, sending their employees into the government exchange, set up for the non-insured.


"I've talked to so many different employers who have told me to my face that once this law gets kicked in, they're going to dump their employees into the exchange (because employers will have to provide health insurance at a higher cost or pay a $2,000 per-employee fine.)


"And what employers are telling me is that their employers are already deciding to do this. … When one employer in a sector starts dumping their employees for cost savings … other competitors will do the same so they don't lose a competitive advantage."


(Note: Critics say employers have the choice of passing added health costs to their workers.)


"A lot of private-sector actuaries are telling us that as much as two-thirds of America's employers will dump their employees into the government-run exchange when this law is fully implemented, and that scares me. And if that actually materializes, the costs will explode within this law."


Q: Why explode?


A: "Because the government will be on the hook for tens of millions of more people's health care than what is currently estimated. … This is the largest open-ended entitlement that's ever been created, and it will explode in costs, I believe, because all open-ended entitlements that have ever been created have come in far, far above their original cost estimates, and I don't see how this is going to be any different."


(Note: Ryan also subscribes to the Republican charge that the law would destroy jobs. Some independent analyses, however, say it would create jobs. )


Q: Is there another way to alter health-care reform because repeal is highly unlikely?


A: Ryan noted a federal judge already has ruled that the mandate that all Americans obtain health insurance is unconstitutional. The Supreme Court is likely to take up the question. Ryan said the high court could strike down the entire law. At that point, "I do believe we can have universal access to affordable health care, even for everybody with pre-existing conditions without having the government take it over. …


"There's a better way to do this. Many of us have proposed those alternatives. We approached the president over a year ago to work with us to put these alternatives in place. Unfortunately, he chose not to go that way and do a one-party rule."


Ryan said he will propose a market-driven approach in which providers compete, thus reducing costs.


Q: Many on the other side will provide equally convincing arguments. How do we know whom to believe?


A: "I look at the evidence of government-run systems, and they mean more price controls, less consumer choice, lower quality. That's the inevitable outcome."


Ryan pointed to the costs of Lasik eye surgery, which is elective and therefore subject to market forces. The prices have dropped by more than 100 percent in 10 years while quality has increased, he said.


"We basically have health care monopolies that are price-increasing and reducing choices, and consumers … really can't shop around based on price and quality because you don't have that information. You're often told who and where you have to go to because you're forced in an HMO. And so I think the status-quo system, this third-party system, is one of the root causes of high health care costs. … And the answer is not to have the government take it over. … The answer is make people—patients, the consumer—more powerful in the marketplace so we can use the power of choice, of competition, of accountability, of transparency, to solve this problem in health care like it has solved so many other problems in other aspects of our economy."


Q: How have the Arizona shootings affected how you do business?


A: Ryan said he was at home in Janesville when he got the news.


"Our hearts just sunk. Our family, we just said a prayer at that moment. Gabby Giffords (the Democratic House member who was wounded) is a delightful human being. I'm really excited about the prognosis. Every day we seem to be getting better news about her prognosis, and we just pray and look forward to her joining us back in the House chamber where she belongs."


Q: Does the attack change how you interact with constituents here in the district?


A: "No. I do not want to have any new barrier between myself and my employers. I'm still going to hold my town hall meetings, my mobile office tours, my office hours, like I've always done.


"There might be more of a mild police presence. We've had that in the past, and we'll probably have that in the future, but it's not going to seem much different from what constituents have experienced in the past."


Q: Does it give you pause about your career choice?


A: "No, it doesn't. We've all had these kinds of threats before. We've all run into individuals like this before in these jobs. It's something I think that every elected official can relate to. It just makes you think a little bit more about how you proceed with respect to security. And I just want to do it in a way that allows me to do my job."


Q: So you intend to run for re-election in 2012?


A: Oh, gosh, I'm not even thinking about 2012. I'm focused on 2011 right now. What I'm really focused on is my new responsibility as chairman of the budget committee. So I'm spending a lot of my time trying to work on the budget and the economy."


(Note: Ryan's campaign website states at the top: "2011/Re-elect Ryan.")


Dems point fingers in overhaul debate

Even if this week's House vote on health-care reform is an empty gesture, it certainly has stirred the political pot.


The Democratic Congressional Campaign Committee challenged Rep. Paul Ryan in a news release Tuesday, saying in part:


"Rep. Paul Ryan has a choice to make—stand with big health insurance companies that have profited off discrimination and denying health care or stand with middle class families."


The release goes on to say that repeal would mean insurance companies could deny coverage to children with pre-existing conditions, higher prescription-drug costs for senior citizens and small businesses losing tax breaks.


"Voters deserve to know why Representative Paul Ryan would vote for the health insurance industry, its lobbyists and the corporate special interests," the release states.



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