Last Sunday, I wrapped up my series of posts on Mitt Romney's positions in the debates. Now it's time to look at Gary Johnson, who initially ran as a Republican but has now secured the nomination for the Libertarian Party. Since Johnson was only in two debates, the first and the sixth, there's simply not as much material as there was for Romney, who was in 19 debates. While Romney got five entries, Johnson only gets this one.
National Security
In the first debate, he said he would withdraw from Afghanistan "tomorrow," was against the war in Iraq from the beginning, and was also opposed to intervention in Libya (Syria was not yet an issue at the time). He is solidly against war, saying in the 6th debate, "The biggest threat to our national security is the fact that we're
bankrupt." As part of his promise to balance the budget, he supports a 43% cut to military spending.
Immigration and Trade
He said in the first debate that there was "very little, if any benefit" to securing the border, and that freer immigration would create "tens of millions of jobs." On trade, he said, "I'm a free market guy... I don't favor tariffs of any
kind, whatsoever." In the two debates, he was only able to address trade with one country, Cuba, which he supports, because he believes that trade encourages friendship.
Taxes and Spending
He supports the Fair Tax, a national sales tax that would replace the corporate and personal income taxes. On spending, he would balance the budget in his first year in office. Since he says current spending outpaces revenue by 43%, that's how much he wants to cut from all federal spending, including 43% each from the military, Medicare and Medicaid. To get it done, he would turn Medicare and Medicaid into block grants, veto any bill where expenditures exceeded revenue, completely eliminate the Department of Education and subject federal programs to cost-benefit analyses, then get rid of the ones that don't measure up.
The Economy
To get the economy growing again, he would restructure the tax code and greatly reduce federal spending as described above. He also sees freer immigration as a way to encourage "tens of millions" of new jobs. He would eliminate the federal minimum wage, and stop extending unemployment benefits.
Social Issues
He declined to describe himself as "pro-life," and said in the first debate that he supports abortion "up until viability." (While viability lacks a precise definition, that would allow abortions at least into the fifth month of pregnancy, and possibly later.) However, he opposes public funds for abortion, and favors parental notification and counseling. On drugs, he admits to having smoked marijuana, and supports legalization along with regulation and taxation of marijuana. While gay marriage didn't come up in the debates, on Twitter he often sells himself as the only candidate supporting "marriage equality" (at least, prior to Obama's recent conversion).
Ron Paul
When directly asked in the sixth debate what made him a better choice for libertarian Republicans than Ron Paul, Johnson said, "I'm not going to presume to make that
assumption." When asked who his running mate would be if it had to be someone at the sixth debate, he said Ron Paul. On Twitter, many of his public tweets are also directed towards Ron Paul. While I haven't seen anything explicitly laying this out, I suspect he looks at Paul's age and wants to be the next Ron Paul once Paul himself leaves public life. It will be very interesting to see how much support Johnson gets from Paulites once Paul eventually quits the race.
Showing posts with label Medicare. Show all posts
Showing posts with label Medicare. Show all posts
Monday, May 21, 2012
Friday, May 11, 2012
Mitt Romney on Health Policy
This is the fourth in a series of entries revisiting Mitt
Romney's policies as stated in the debates. The first covered foreign
policy; the second
covered economic policy. The third covered the social issues
of religion, gay marriage, contraception, abortion, and guns. This entry covers health care, including Obamacare, Romneycare, Medicare, Medicaid and other health reform ideas.
Obamacare vs Romneycare:
Romney often highlighted differences between the Massachusetts health care reform commonly called "Romneycare" and the national Patient Protection and Affordable Care Act, commonly called "Obamacare." While he supported and throughout the debates continued to defend Romneycare, he opposed Obamacare to the extent that he promised to grant waivers to all 50 states on his first day in office and to press Congress for full repeal. Claimed differences include:
Medicare and Medicaid
As mentioned above, Romney often criticized Obamacare for cutting Medicare. In fact, almost every time Romney mentioned Medicare, it was either to criticize Obamacare for cutting it, or defending Romneycare for not cutting it.
Regarding actual reforms to Medicare, he wants a shift to a premium support model like the Ryan plan. He also favors means testing for Medicare, where the rich would receive lower benefits and everyone else would receive higher benefits. Finally, he would not repeal Medicare Part D.
He would send Medicaid to the states as a block grant and only allow it to grow at either 1-2% per year (in the 8th debate) or inflation-plus-one-percent (in the 10th debate). He never mentioned any other reform to Medicaid, but repeated this block grant plan in several debates.
Other Health Reforms
Individual Mandates: While Romney opposes Obamacare, including its national individual mandate, he often defended the individual mandate itself as a good policy to carry out on the state level. In the 3rd debate, he compared it to states' ability to require children to attend school. He sees individual mandates as ways to provide the uninsured with what he called in the 6th debate "market-based, private" insurance. In the 8th debate, he said about the individual mandate in Massachusetts, "A lot of people were expecting government to pay their way. And we said, you know what? If people have the capacity to care for themselves and pay their own way, they should." Romney disagrees with Obama on what level of government should impose the individual mandate, but he agrees that it's a good policy in the first place.
Health Savings Accounts: In the 5th debate, Romney said health care "isn't working like a market," but rather is "working like a government utility" because consumers are separated from the cost of health care. He advocated health savings accounts to fix this problem, mentioning HSAs in the 5th and 9th debates.
Employer-based Insurance: In the 9th debate, Romney said we should treat individually-purchased insurance the same as employer-purchased insurance in regards to the tax code. He also mentioned this in the 19th debate.
Tort Reform: In the 9th debate, he advocated tort reform as part of the package of reforms he would replace Obamacare with.
Health Issues Covered Elsewhere
Romney's positions on contraception and abortion were covered in the third entry in this series, on social issues. In addition to the section above, Obamacare was also covered in the second entry in the context of regulations and fiscal responsibility.
Obamacare vs Romneycare:
Romney often highlighted differences between the Massachusetts health care reform commonly called "Romneycare" and the national Patient Protection and Affordable Care Act, commonly called "Obamacare." While he supported and throughout the debates continued to defend Romneycare, he opposed Obamacare to the extent that he promised to grant waivers to all 50 states on his first day in office and to press Congress for full repeal. Claimed differences include:
- Obamacare raises taxes; Romneycare didn't
- Obamacare takes money from Medicare; Romneycare didn't
- Obamacare is a national program; Romneycare is a state program
- Similarly, Obamacare is unconstitutional for the national government; Romneycare is constitutional because it's at the state level
- Obamacare includes "a panel that ultimately is going to tell people what kind of care they can have," referring to the Independent Payment Advisory Board; Romneycare does not include such a panel
- Obamacare applies to 100% of the citizenry; Romneycare supposedly only addressed the 8-9% who were uninsured (he said 9% in the 5th debate, 8% in the 6th, 7th and 17th debates)
- Obamacare leads to regulations like the contraception mandate; Romneycare had a provision that people did not have to buy coverage for treatments or medical devices which violated their religious beliefs
- Obamacare was 2,700 pages long; Romneycare was 70 pages long
Medicare and Medicaid
As mentioned above, Romney often criticized Obamacare for cutting Medicare. In fact, almost every time Romney mentioned Medicare, it was either to criticize Obamacare for cutting it, or defending Romneycare for not cutting it.
Regarding actual reforms to Medicare, he wants a shift to a premium support model like the Ryan plan. He also favors means testing for Medicare, where the rich would receive lower benefits and everyone else would receive higher benefits. Finally, he would not repeal Medicare Part D.
He would send Medicaid to the states as a block grant and only allow it to grow at either 1-2% per year (in the 8th debate) or inflation-plus-one-percent (in the 10th debate). He never mentioned any other reform to Medicaid, but repeated this block grant plan in several debates.
Other Health Reforms
Individual Mandates: While Romney opposes Obamacare, including its national individual mandate, he often defended the individual mandate itself as a good policy to carry out on the state level. In the 3rd debate, he compared it to states' ability to require children to attend school. He sees individual mandates as ways to provide the uninsured with what he called in the 6th debate "market-based, private" insurance. In the 8th debate, he said about the individual mandate in Massachusetts, "A lot of people were expecting government to pay their way. And we said, you know what? If people have the capacity to care for themselves and pay their own way, they should." Romney disagrees with Obama on what level of government should impose the individual mandate, but he agrees that it's a good policy in the first place.
Health Savings Accounts: In the 5th debate, Romney said health care "isn't working like a market," but rather is "working like a government utility" because consumers are separated from the cost of health care. He advocated health savings accounts to fix this problem, mentioning HSAs in the 5th and 9th debates.
Employer-based Insurance: In the 9th debate, Romney said we should treat individually-purchased insurance the same as employer-purchased insurance in regards to the tax code. He also mentioned this in the 19th debate.
Tort Reform: In the 9th debate, he advocated tort reform as part of the package of reforms he would replace Obamacare with.
Health Issues Covered Elsewhere
Romney's positions on contraception and abortion were covered in the third entry in this series, on social issues. In addition to the section above, Obamacare was also covered in the second entry in the context of regulations and fiscal responsibility.
Monday, November 7, 2011
The Cain-Gingrich Debate
Herman Cain and Newt Gingrich held their own two-person debate on Saturday. Cain and Gingrich are now the two strongest non-Romney candidates according to RCP's poll of polls, with Cain and Romney vying for the #1 position. Ron Paul and Rick Perry are pretty close to Gingrich, but while Gingrich is trending upwards, Perry is still trending downwards, and Paul just isn't going anywhere.
Before this debate, I had said it had the potential to finally rally the anti-Romney vote around either Cain or Gingrich, provided it got enough eyeballs. Unfortunately, I don't think that was the case. It was carried by C-SPAN rather than any of the major networks. Not only was it scheduled on a Saturday night, but it went head-to-head with the LSU-Alabama game. The full video is here, but be warned, it's plagued by jumpiness, a shaky camera and bad sound, and the actual debate doesn't start until about 15 minutes in.
This debate had three main sections, one each for Medicare, Medicaid and Social Security. Defense spending, which is about the same as Social Security at 20% of federal expenditures, was not addressed.
Medicare
Newt doesn't want to force people into a particular system, but rather provide different options and allow people to choose. He says the government is losing $70-120 billion per year to Medicare fraud (which is 13-23% of the Medicare budget).
Cain says, "I'm supposed to have a minute to disagree about something he [Newt] said, but I don't." He says when it was established in 1965, Medicare was projected to grow to $12 billion per year by 1990. The actual Medicare budget in 1990, he says, was $109 billion (in 2010 it was $520 billion [PDF]). To reform it, he supports HR 3000 (which is apparently the same as HR 3400 from the previous Congress). The important parts of that bill, he says, are health savings accounts, allowing association health plans and loser-pay laws.
Newt criticizes the third-party-payer system by comparing health care to getting a burger at McDonald's. He says we don't have Congressional hearings on McDonald's fraud because there's a direct relationship between the provider and the consumer, and we need to restore that relationship to health care. Newt also wants to eliminate the CBO, which is a very dangerous proposition. Certainly the CBO has it's problems, but is less Congressional accountability really the answer?
Asked about means testing, Cain talks more about health savings accounts, which doesn't directly answer the question but are still, I think, the most important part of Medicare reform. On the same question, Newt says we wouldn't need means testing if we simply dealt with the massive amount of Medicare fraud he mentioned earlier.
Both Cain and Gingrich are opposed to defined-benefit Medicare. Gingrich doesn't like defined benefits because that means you need bureaucrats to define those benefits in ever-increasing detail. As an example he cites the recent ruling on the prostate cancer test. Cain prefers defined contributions because it allows individuals to put their name on the account and to truly own the money, which he says will result in the money being spent more wisely.
Social Security
Asked about the three reform options of raising the retirement age, cutting benefits or raising taxes, Cain says, "None of the above." He says 30 countries follow the Chilean model of personal retirement accounts, and it's worked for them. He wants to institute optional personal retirement accounts, so that those close to retirement, or who simply prefer the current system, can continue to pay into the current system and receive their promised benefits, while those who want to exit the system and get personal retirement accounts can do so. He says that for people who choose the retirement accounts, half of their payroll taxes would go into that personal account, while the other half would pay for the benefits of those who choose to remain on the old system.
Newt brings up the Galveston plan, and says that you can put in half as much to the system and get twice as much back under the Galveston plan. He talks about how economic growth affects Social Security solvency and bashes Obama for scaring seniors over the summer, but ultimately reaches the same conclusion as Cain. Newt supports optional personal retirement accounts, just as Cain does, but unlike Cain, he doesn't address the transition period, which is possibly the most important question with these accounts.
Since they agree on personal retirement accounts, they spend the rest of the Social Security segment talking about where those accounts go and where you "park" the money. Newt says that keeping it in Treasury bills like the current Social Security trust fund is fine, as long as that money is kept separate from the general budget, but that some of it would also be put into the private sector. Cain focuses on the money in the private sector, and says workers would be able to choose the level of risk they're willing to take on, and that would determine the kind of investments the money is put into.
Medicaid
Cain supports block grants to the states while ending federal mandates. He says this would allow us to bring down the costs gradually over time, but doesn't really explain why. I think block granting might be good, but my main concern is that it turns one unsustainable system into fifty unsustainable systems. That one unsustainable system could be reformed by a single act of the federal government. Some of those fifty unsustainable systems would also be successfully reformed, but many of them wouldn't be. God help you if you live in a blue state.
Newt supports block grants, but he also wants to tie personal behavior to benefits. He cites a program in Florida where people with certain long-term illnesses who took care of themselves and avoided emergency room visits were given Christmas bonuses. It was a win-win because the people were healthier and got extra money, while the state saved money since the Christmas bonus cost less than the emergency room visits would. I'm not sure whether Newt wants to do something similar nationally, or just wants every state to do what Florida did.
Cain would support a health care voucher system, provided the vouchers did not cover the entire cost of the care. He says people need "some skin in the game." Newt doesn't come out specifically for or against vouchers, but rather goes back to the block grant idea, and says if individual states want to try vouchers, that's fine for them.
How would they stop Medicaid fraud? Cain says he wants to block grant both the money and the responsibility, and that if states had the responsibility of managing the money without federal strings attached, they would be able to stop the fraud. He has a lot more faith in state governments than I do. Newt pins Medicare fraud on the CMS, which he says is an outdated agency still using paper when they should be digital. He says a crook with an iPad working late in the evening is always going to beat a bureaucrat using paper who went at 5pm.
Conclusion
Since this was just a two-person debate, I'm not going to score it the same way I do the usual circuses. I will say that I really enjoyed this format, and I would absolutely love to see the rest of the debates converted into a format like this, with just two or three candidates getting to sit down and really explain their views in depth. Neither candidate really "won" this debate, I thought. Newt was obviously more comfortable with this format than Cain was, but Newt also had more statements that I disagreed with. Both showcased some really good ideas, but ultimately they agreed on so much of the policy that they really did seem like a President & VP ticket rather than two men competing for the same job (which is something mentioned by Cain himself).
Before this debate, I had said it had the potential to finally rally the anti-Romney vote around either Cain or Gingrich, provided it got enough eyeballs. Unfortunately, I don't think that was the case. It was carried by C-SPAN rather than any of the major networks. Not only was it scheduled on a Saturday night, but it went head-to-head with the LSU-Alabama game. The full video is here, but be warned, it's plagued by jumpiness, a shaky camera and bad sound, and the actual debate doesn't start until about 15 minutes in.
This debate had three main sections, one each for Medicare, Medicaid and Social Security. Defense spending, which is about the same as Social Security at 20% of federal expenditures, was not addressed.
Medicare
Newt doesn't want to force people into a particular system, but rather provide different options and allow people to choose. He says the government is losing $70-120 billion per year to Medicare fraud (which is 13-23% of the Medicare budget).
Cain says, "I'm supposed to have a minute to disagree about something he [Newt] said, but I don't." He says when it was established in 1965, Medicare was projected to grow to $12 billion per year by 1990. The actual Medicare budget in 1990, he says, was $109 billion (in 2010 it was $520 billion [PDF]). To reform it, he supports HR 3000 (which is apparently the same as HR 3400 from the previous Congress). The important parts of that bill, he says, are health savings accounts, allowing association health plans and loser-pay laws.
Newt criticizes the third-party-payer system by comparing health care to getting a burger at McDonald's. He says we don't have Congressional hearings on McDonald's fraud because there's a direct relationship between the provider and the consumer, and we need to restore that relationship to health care. Newt also wants to eliminate the CBO, which is a very dangerous proposition. Certainly the CBO has it's problems, but is less Congressional accountability really the answer?
Asked about means testing, Cain talks more about health savings accounts, which doesn't directly answer the question but are still, I think, the most important part of Medicare reform. On the same question, Newt says we wouldn't need means testing if we simply dealt with the massive amount of Medicare fraud he mentioned earlier.
Both Cain and Gingrich are opposed to defined-benefit Medicare. Gingrich doesn't like defined benefits because that means you need bureaucrats to define those benefits in ever-increasing detail. As an example he cites the recent ruling on the prostate cancer test. Cain prefers defined contributions because it allows individuals to put their name on the account and to truly own the money, which he says will result in the money being spent more wisely.
Social Security
Asked about the three reform options of raising the retirement age, cutting benefits or raising taxes, Cain says, "None of the above." He says 30 countries follow the Chilean model of personal retirement accounts, and it's worked for them. He wants to institute optional personal retirement accounts, so that those close to retirement, or who simply prefer the current system, can continue to pay into the current system and receive their promised benefits, while those who want to exit the system and get personal retirement accounts can do so. He says that for people who choose the retirement accounts, half of their payroll taxes would go into that personal account, while the other half would pay for the benefits of those who choose to remain on the old system.
Newt brings up the Galveston plan, and says that you can put in half as much to the system and get twice as much back under the Galveston plan. He talks about how economic growth affects Social Security solvency and bashes Obama for scaring seniors over the summer, but ultimately reaches the same conclusion as Cain. Newt supports optional personal retirement accounts, just as Cain does, but unlike Cain, he doesn't address the transition period, which is possibly the most important question with these accounts.
Since they agree on personal retirement accounts, they spend the rest of the Social Security segment talking about where those accounts go and where you "park" the money. Newt says that keeping it in Treasury bills like the current Social Security trust fund is fine, as long as that money is kept separate from the general budget, but that some of it would also be put into the private sector. Cain focuses on the money in the private sector, and says workers would be able to choose the level of risk they're willing to take on, and that would determine the kind of investments the money is put into.
Medicaid
Cain supports block grants to the states while ending federal mandates. He says this would allow us to bring down the costs gradually over time, but doesn't really explain why. I think block granting might be good, but my main concern is that it turns one unsustainable system into fifty unsustainable systems. That one unsustainable system could be reformed by a single act of the federal government. Some of those fifty unsustainable systems would also be successfully reformed, but many of them wouldn't be. God help you if you live in a blue state.
Newt supports block grants, but he also wants to tie personal behavior to benefits. He cites a program in Florida where people with certain long-term illnesses who took care of themselves and avoided emergency room visits were given Christmas bonuses. It was a win-win because the people were healthier and got extra money, while the state saved money since the Christmas bonus cost less than the emergency room visits would. I'm not sure whether Newt wants to do something similar nationally, or just wants every state to do what Florida did.
Cain would support a health care voucher system, provided the vouchers did not cover the entire cost of the care. He says people need "some skin in the game." Newt doesn't come out specifically for or against vouchers, but rather goes back to the block grant idea, and says if individual states want to try vouchers, that's fine for them.
How would they stop Medicaid fraud? Cain says he wants to block grant both the money and the responsibility, and that if states had the responsibility of managing the money without federal strings attached, they would be able to stop the fraud. He has a lot more faith in state governments than I do. Newt pins Medicare fraud on the CMS, which he says is an outdated agency still using paper when they should be digital. He says a crook with an iPad working late in the evening is always going to beat a bureaucrat using paper who went at 5pm.
Conclusion
Since this was just a two-person debate, I'm not going to score it the same way I do the usual circuses. I will say that I really enjoyed this format, and I would absolutely love to see the rest of the debates converted into a format like this, with just two or three candidates getting to sit down and really explain their views in depth. Neither candidate really "won" this debate, I thought. Newt was obviously more comfortable with this format than Cain was, but Newt also had more statements that I disagreed with. Both showcased some really good ideas, but ultimately they agreed on so much of the policy that they really did seem like a President & VP ticket rather than two men competing for the same job (which is something mentioned by Cain himself).
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