My political perspective is different from Paul Ryan‘s.
I will be voting for Obama despite disappointment ObamaCare did not seek to cover ALL Americans for fear that non-documented workers might get health treatment.
Universal coverage critics appear unable to understand that communicable diseases can be stopped at the source saving lots of things–remember the Bubonic plague? Also, read Rat, Lice, and History.
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I am a paraplegic who has been on Medicare for 7 out of the past 18 years I have been a recipient of Social Security Disability Insurance [SSDI]. I have been trying to obtain work–REAL WORK– get off Social Security by the time I am 65, but obstacles to getting off the public dole are considerable.
[I believe the greatest tax imposed on the disabled and elderly poor is requiring us over and over to prove we do not work, obtain outside income, and show (beyond a shadow of a doubt) we are not hiding huge quantities of stock.]
Back to Paul Ryan.
Yes, he gave a dreadful speech at the Republican National Convention.
Perhaps, I might be a bad yardstick, but if I had been able to spend time at the Universe Outside of Time Republican Convention in Tampa, I would have gone stark raving mad–a convention of bored Romney delegates none of whom had bothered to wear t-shirts supporting their candidate.
In the passion of the movement, a young man for the job (remember Teddy Roosevelt?) Ryan freaked out.
Who wouldn’t?
He was chosen to be a vice presidential candidate because of the impressive contribution he has made to the current substantive debate on economic policy. He may be young, but he is the only presidential and vice presidential candidate to have compiled an impressive analysis of the budget problems America faces. AND he has proposed detailed solutions.
I do not agree with the philosophy behind his analysis. Nor, do I agree with his proposals. But, he has the intelligence to realize that trying to understand the current baffling economy in which we are in is worth serious attention. [How many legislators do you know willing to devote time to thinking and learning and trying to solve problems worth solving regardless of their political views?]
Watching Paul Ryan with attention when he appeared last year and early this year on Meet the Pressand other Sunday network television programs, he presents himself as a serious man intent on helping the U.S. economy. He has stated repeatedly that his plan is not the ONLY plan worthy of consideration. He says that he wants to be presented with other plans, hear other people’s ideas regardless of their views.
What is wrong with that?
Ryan has been accorded considerable respect among Wahington-insiders who know him.
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I lived in Washington, D.C. for 17 years.
This is a view of the Capitol focused primarily on the Senate side. For 17 years, I lived six blocks away.
Those living in the beltway know how things really get done in Washington. When I lived in DC, I was:
Senate-confirmed political appointee to the President of the United States serving as special assistant to the deputy secretary of labor
Consultant to Congress’ General Accounting Office and to the Office of Technology Assessment
Consultant to Democratic and Republican Chairmen of the Securities and Exchange Commission
Author of a book on the politics of food [Let me tell you in detail about the Sugar Act of 1948 (as amended)]
Free-lance writer for The New York Times, The New Republic, and Newsday
The two legislators I admired most were: Tom Foley, liberal Democrat from Washington State and Bob Dole, especially in his role as Chair of the Senate Finance Committee.
Former Speaker of the House Thomas A. Foley (D-WA)
Foley became Chair of the House Committee on Agriculture as a result of a revolt by the left-wing of the House who opposed the dictatorial policies of powerful chairmen (yes, men) who refused to allow freshmen members of the Committee to speak at all during hearings).When Foley became Speaker of the House, I was in heaven. At last, a legislator I respect is Speaker of the House. I felt as if I were the Elijah of a New Era where at last serious decisions about serious subjects would be handled by an individual I greatly respect.
Robert Dole (R-KA) former Chairman of the Senate Finance Committee
Bob Dole became a different Bob Dole when he ran as a vice and presidential-candidate coming across as a mean, incoherent, humorless fellow. The reality of Bob Dole as a senate leader is startlingly different. Those of us who lunched with him at the National Press Club were presented with a delightfully funny astonishingly competent senator. Bob Dole was the guy who rescued the farm bill from Senate Chair Jesse Helms’ venomous posturing on non-agriculture related issues.
There are 435 members of the House and 100 members of the Senate. For decades, I have been studying them. In any given Congress, fewer than twenty Senators and Representatives give a damn about solving the country’s problems–not furthering political objectives, but solving problems. Tom Foley and Bob Dole were the exceptions in their time.
Present exceptions include:
The skillful Senate Majority Leader Harry Reid (D-NV)
Senator Max Baucus, Chairman of the Senate Finance Committee, who helped write the original Medicare legislation that President Johnson signed into law.
June 19, 2012 update on Marilyn Tavenner’s confirmation (don’t hold your breath) hearings:
“So what did Sen. Max Baucus (D-Mont.) say when HHS Secretary Kathleen Sebelius asked him to hold a confirmation hearing for Marilyn Tavenner, acting administrator of CMS?
“’It’s going to be difficult to proceed with the Republican opposition,’ said Baucus, chairman of the powerful Finance Committee, when I asked him about the conversation.'”
You call the enthusiastic endorsement of Tavenner by Rep.Eric Cantor, House Republican Majority Leader, “Republican opposition.” Give me a break Senator Baucus.
Senator Max Baucus, Chairman of the Senate Finance Committee, who helped write the original Medicare legislation that President Johnson signed into law.
Here is what I told Katrina vanden Heuvel , the editor and publisher of the Nation Magazine [who appeared this Sunday as a refreshingly articulate advocate for abandoning the current foolish policy of austerity above all else on This Week with George Stephanopoulos ] when she asked me to give my younger daughter a gift subscription as a college graduation present:
“Katrina:
“I am shocked by The Nation’s failure to report on the deterioration of the current Medicare system which as a recipient and a left-of-center Democrat, I can report on what is actually going on (despite the Nation’s unexamined rhetoric). Indeed, I have suggested that I write about it for you to no avail. Hence, no subscription for my daughter Amelia: https://joelsolkoff.com/blueroof-reality/countdown-to-amelias-graduation/”
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In response to the report from the Wall Street Journal below: 11:52 pm May 21, 2012 Joel Solkoff wrote :
The failure of Max Baucus and the 12 Democratic members of the Senate Finance Committee, many of whom are liberals whose rhetoric on saving Medicare is voluminous, to hold hearings on Marilyn Tavenner to be head of Medicare and Medicaid is a disgrace. As a paraplegic who has experienced the deterioration of Medicare as it currently exists under President Obama, the fact that his Administration has not had a confirmed Administrator reveals the sharp disparity between a President who lauds Medicare while cutting its budget by half a trillion dollars as part of the cynical price paid to ensure passage of Obamacare. Eric Cantor’s support of Tavenner would have forced Senate Republicans to think twice about voting against her. As one who enthusiastically supported the President four years ago, my unenthusiastic vote for his re-election is indicative of the lukewarm support that could cost him the election. The Nation, The Progressive, and other presumed defenders of Medicare have failed to be critical of the President’s penny-wise, pound foolish administration of a program which he is currently destroying while speaking eloquently about preserving its future. A genuine confirmation hearing for an Administrator whose budget is larger than the Pentagon’s is long overdue. Failure to hold hearings undermines the Democratic pretense that Medicare is worth saving and makes me ashamed to admit that I am a Democrat. What happened to the party of Adlai Stevenson and Eleanor Roosevelt? The best way for Obama to prove his credibility is to push for the support of his nominee and to indicate his commitment to what used to be Democratic values.
Presidential Nominations
112th Congress (2011 – 2012)
PN1165-112
Nomination: PN1165-112
Date Received: December 01, 2011 (112th Congress)
Nominee: Marilyn B. Tavenner, of Virginia, to be Administrator of the Centers for Medicare and Medicaid Services, vice Donald M. Berwick, resigned.
Referred to: Senate Finance
Legislative Actions
Floor Action: December 01, 2011 – Received in the Senate and referred to the Committee on Finance.
Organization: Department of Health and Human Services
Now for some background information. In December, I published the following article in HME News, the publication for the home medical equipment industry which may help you understand the circumstances behind the nomination of Marilyn Tavenner to head the half trillion-dollar agency which significantly affects the life and health of all Medicare and Medicaid recipients.
Who is in charge of Medicare?
The wide-ranging debate over Medicare, a major factor in the presidential election next year, primarily focuses on whether future generations will benefit in the same way that the current 46 million recipients like me benefit. Politicians, critics and would-be-recipients express the illusion that the health care I receive from Medicare represents the ideal. I believe that the only way to save Medicare is to dramatically improve the way it is run today so that it remains a program worth saving.
The primary audience for this commentary is the men and women who provide DME other equipment necessary to sustain and maintain the quality of life. Recently, 87-year-old Lilian Hutchinson, who gets around on an unstable walker, fell and broke her elbow in an independent living facility for 90 elderly and disabled residents where I live in State College, Pa. I believe that if Lillian had access to a scooter or a power chair in her apartment, she would not have fallen. The tales of needless suffering you could tell resulting from a Medicare bureaucracy that increasingly limits access to mobility equipment and medical oxygen seem beside the point.
Durable medical equipment represents only a small fraction of the Medicare budget. The whole system for providing medical care for the elderly, disabled and poor is not working efficiently in large part because of the absence of leadership at CMS, an agency of the U.S. Department of Health and Human Services. My intention here is to answer the question: Who runs Medicare? In theory, Dr. Donald Berwick, a distinguished Harvard physician with an outstanding reputation as an advocate for efficient health care, runs CMS.
Last year, President Obama named Dr. Berwick to be administrator of CMS, a position one senator described as the nation’s health czar since the job also includes putting in place much of the legislation passed last year, which, by one estimate, will extend health care to 32 million Americans who do not have coverage.
Sadly, the president had failed to appoint an administrator early on in his administration, when Senate confirmation would not have been a problem and when an adviser with the expertise and gravitas Dr. Berwick has in the medical community would have proven useful. The major flaw in the president’s landmark legislation was how he intended to pay for it. He decided against raising taxes, which might have doomed passage.
Instead, half the estimated trillion dollars required to extend healthcare coverage was targeted to come from savings to the Medicare budget as a result of achieving cost savings, reducing fraud and abuse, and increasing efficiency. Anyone who has ever made a New Year’s resolution to save money can tell you it is imprudent to spend it before the money is actually saved.
By the time Dr. Berwick arrived at Medicare, he was in the impossible situation of being required to save $500 billion, a requirement for which he had not been consulted and in a situation where the president had given him neither the time nor the authority to implement.
The political comedian Mark Russell observed, in a similar context, that exercising leadership without the necessary authority is equivalent to sending a eunuch to an orgy. Fearful of Republican reaction to Dr. Berwick’s appointment and unsure of the allegiance of Democrats on the Senate Finance Committee, the president refused to fight for Berwick’s confirmation or to find a replacement who would achieve bipartisan support.
Using the recess appointment mechanism, which allows a president to appoint an official on a temporary basis while Congress is not in session, Berwick currently serves as acting administrator and will be replaced next year by his deputy Marilyn Tavenner. Tavenner, while respected for her organizational skill, her background as a nurse and a hospital and state health care administer, does not have the stature required to lead what is in effect a cabinet level position.
Although CMS has a larger annual budget than the Pentagon, as I write this, there has not been a confirmed head of Medicare since 2006. For the purposes of comparison, if the Defense Department did not have a confirmed secretary for five years, there would be a national outcry.
–Joel Solkoff was a political appointee in the Carter Administration, serving as special assistant to the Under Secretary of Labor. He believes a bipartisan solution to the problems of Medicare is achievable.
On February 3, I sent the following letter to Senator Max Baucus (D Montana), chairman of the Senate Finance Committee which has oversight over Medicare and has the power to conduct confirmation hearings on President Obama’s nominee to run Meadicare:
The Honorable Max Baucus
Chairman
Committee on Finance
United States Senate
219 Dirksen Senate Office Building
Washington, D.C. 20510
Dear Senator Baucus
I am writing to request an invitation to testify at the confirmation hearing of Marilyn Tavenner to be Administrator of the Centers for Medicare and Medicaid Services.
I am a paraplegic who is a Medicare recipient. While I am generally supportive of Acting Administrator Tavenner’s appointment, especially since it has been so long that CMS has had a confirmed Administrator; I have considerable concerns about durable medical equipment. As a user of mobility devices and as one who has researched other equipment in the durable category, especially medical oxygen, I think it important that my concerns be discussed.
Specifically, I am concerned about the cumbersome procedures involved in obtaining medical equipment. The current competitive bidding program, the absence of assurances that award winners will provide batteries, other necessary equipment, and maintenance are among the issues on which I would like assurance—both from Acting Administrator Tavenner and from the Senate Finance Committee with its oversight responsibilities.
I realize that no hearings have been scheduled as of this writing. However, given the importance of Medicare and Medicaid I would appreciate my voice being heard, especially on the subject of indigent disabled individuals who have suffered most from current and proposed CMS practices.
I write frequently on disability issues for Voices of Central Pennsylvania, HME News, the monthly publication of the home medical care industry, and for a variety of other publications. I am the author of three books including Learning to Live Again My Triumph over Cancer. My disability writing can be accessed easily by keyboarding my name into Google.
Thank you.
Sincerely,
Joel Solkoff
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Of course I cannot testify unless there are hearings.
For a number of reasons, it seems likely that Marilyn Tavenner is not a controversial nominee and the committee and the Senate would vote to confirm her.
It is hard to run something when you do not have the necessary authority.
Politicians are using this election season to talk about the important of Medicare and Medicaid. If they really believe what they say they would hold confirmation hearings.
There has not been a confirmed had of Medicare since the Bush Administration.
