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Editorial: Unhealthy Acts

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Posted: Wednesday, June 1, 2011 9:59 am

United States Rep. Paul Ryan (R-Minn.), whose proposal for Medicare could have a major adverse effect on seniors, is both a Catholic adherent of Christian teachings and a devotee of the polemicist Ayn Rand, whose literature preached self over self-sacrifice. One might not immediately see a conflict between these two trains of thought, but the sparks have flown in the aftermath of Ryan's bill.

A major chasm is developing between those on the religious and economic right, questioning whether Ryan's calculus can coexist with a society rooted in Judeo-Christian principles. The debate has raged for months, and strong viewpoints have emerged. Many economic and political conservatives have hailed Ryan, whose Medicare proposal was touted as a break from conventional thinking.

On the other hand, some ardent religious conservatives, have questioned the lack of humanity in Ryan's budget proposals. Notable is Chuck Colson, a mainstay of the Nixon Administration implicated in the Watergate scandal, who has dedicated much of his subsequent life to prison ministry.

"Rand could say that the world was ‘perishing from an orgy of self-sacrifice,'" Colson said recently. "Not because it was true but because, for Rand, any regard for your neighbor was an offense against the only god who mattered: the self. How such a toxic idea can inspire "public service" is beyond me."

Nowhere is this commentary on Ryan and Rand more apt than in dissecting the congressman's Medicare plan. Branded as an effort to control costs while continuing to deliver effective health care to seniors, the proposal's internal logic withers on both fronts when subjected to even mild scrutiny.

The Ryan plan would, beginning in 2022, extend a concept similar to the current Medicare Advantage, which relies on private insurers, to the entirety of Medicare coverage (see www.politifact.com) on a good discussion of how much more "private" the Ryan plan is than current Medicare). It would, based on figures prepared by the nonpartisan Congressional Budget Office, reduce payments to a typical beneficiary by 20 percent, while increasing costs far more than under present legislation, as much as 40 percent (there's a good analysis of this at www.bloomberg.com ). The reasons are the higher administrative costs in private plans, and not as much negotiating power with providers.

The overall effect of Ryan's scheme is to provide substantially less to seniors than they have been receiving while losing out on buying power and relatively decent administrative costs. Ryan has characterized the plan otherwise. We would still disagree with the plan if he were forthcoming, but instead, he's couching the proposal as one that is a responsible budgetary step, rather than one based upon his Randian leanings.

And while it may not have been a bellwether, the recent special federal congressional election victory by Rep. Kathy Hochul (D-NY) over Jane Corwin seemed to indicate voters are reluctant to take apart Medicare at its seams. You can call this selfish voting by seniors and their advocates if you want, but it's nothing different than what Rand would herself predict--those who are afforded a benefit are fighting like hell to keep it.

And it's also the right thing, of course. Yes, we need serious budget criticism, and lots of thought put into it, and we are appreciative to Ryan for engaging the debate on a so-called "third rail" issue even though we materially disagree with his damaging solution.

As Jews, we help each other, and we do so through various forms of tzedakah. We fairly discuss whether and how to build safety nets, both within and outside our Jewish community. Most support a combination of private benevolence and public subsidy, with the balance teetering one way or the other based on personal philosophy and politics.

That's just fine, and we begrudge no one his or her right to advocate with respect to how that balance ought be struck. But what is not alright in Ryan's plan is an alarming lack of empathy and respect for seniors, as a group one of the most vulnerable in our society, and who may collectively have the least potential for reentering the job market to help themselves.

Paul Ryan may be able to reconcile his Christian beliefs with the utterly cold and detached views of his admired Ayn Rand, and it's not our role to question his intentions. As to his actions, though, in the form of a proposal that would strip seniors of much-needed support and dignity, we have every right to object. And we do, quite strongly.

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