The Price Is Ryan

There's been a lot of scary buzz lately about Washington's newest Gruesome Twosome (House Speaker Paul Ryan and HHS Secretary-Designate Tom Price) publicly drooling over taking the buzz-saw to Medicare.

No matter that even VP-elect Mike Pence vowed as late as this past Sunday that the Trump administration would protect Medicare. No matter that even Ayn Rand fanboy Ryan admitted on 60 Minutes that the privatization of Medicare might have to wait until such time that Republicans - who'd truly love to slash it to bits, yesterday - won't be quite as vulnerable to the wrath of the old people in their respective districts. If Ryan has inside dope that vulnerable voting seniors are dying off more quickly than dopey pols, he didn't say.

Vulnerable Democrats and their veal pen offshoots, meanwhile, are in a frenzy of fund-raising and flailing around the meme that Medicare As We Know It Is Doomed the minute Donald Trump takes the oath of office. As usual, they are placing themselves in a purely defensive crouch. Rather than boldly re-introducing HR 676 or a similar Medicare for All single payer health care bill, they vow to simply fight back and protect what little we already have. It's so much more virtue-signalling fun to shoot diseased fish in a barrel than it is to be therapeutically proactive and progressive.

Medicare actually would have been more vulnerable to attack under a Clinton administration. Hillary ran her winning campaign on, among other things, praising the austerity plan of the Bowles-Simpson Cat Food Commission. Bill Clinton, who would have been "in charge of the economy," had hoped to play Good Cop to Paul Ryan's Bad Cop in the triangulation game. They might even be called the original Gruesome Twosome, as evidenced by an open mic catching them openly plotting Grandma's fate a couple of years ago.

For, as evidenced by the Clintonoid welfare "reform" package of the 90s, it is only through the collusion of both sides of the Right Wing Party that people can be punished. If the Democrats and Republicans can cancel each other out in the Sadism Sweepstakes, voters will never know what really hit them. They won't know who to blame for the sudden loss in their basic standards of living. They will again be forced to hold their noses and vote for the lesser evil. (Democrats really, really tried. Don't let the perfect be the enemy of the good. Don't be a purist.)

As far as Donald Trump is concerned, his selection of Tom Price for Health and Human Services Secretary would seem to be in direct conflict with his vow to protect Medicare and Medicaid and Social Security. A bone-cutter by trade, Dr. Price not only wants to cut social programs to the bone, he wants to perform a radical amputation. So, can the two Republican sadists (Price and Ryan) from the Island of Dr. Moreau succeed in triangulating as ably with Trump as they could have with Clinton? We will have to wait and see. As with everything else in the Trump administration, it's still a mystery.

The New York Times explains that Price's main allegiance is to the greedy and powerful members of the American Medical Association, who have historically made it their business to prevent universal health care coverage for everybody.

Throughout his career, Mr. Price — who has been picked by President-elect Donald J. Trump to be secretary of health and human services — has argued that the government should get out of the way of doctors and give patients more control over their health care.

This position is rooted in Mr. Price’s experience as an orthopedic surgeon for more than 20 years. “As a physician,” he said in the House in 2007, “I know oh so well how the intervention of the state and federal government into the practice of medicine destroys the ability to take care of people. It makes it so you can’t provide quality health care for children and moms and dads.”

What the Times doesn't tell you: orthopedic surgeons have been legally thwarted from the practice of price-gouging, receiving kickbacks or bribes and profiting personally from the sale of orthopedic and other medical devices. Price's specialty is also subject to some of the highest medical malpractice insurance rates in the country. Even with their off-shored accounts and LLCs, they're in the highest income tax bracket. If they can't keep everything they earn and if they can't charge egregious above-Medicare rates, then they might as well destroy Medicare. If it weren't for Medicare, the orthopods could make enough money to pay for a third vacation home and a fifth luxury sports-car. But instead of admitting this, they scapegoat old people.  According to Price and his ilk, Granny is literally shoving little kids with easy and profitable greenstick fractures out of her way in her own selfish quest for a price-controlled hip replacement. The price just isn't right enough to suit Price.

 Price even likes to describe the slave-owning Founders as champions of wealthy orthopedic surgeons. The Times article continues: 

And in 2010, when Congress approved the Affordable Care Act, Mr. Price called it “a dark day for America,” saying that “our founders are weeping” over a bill that was “an affront to federalism, an affront to individual liberty.”

Senate Democrats are sure to challenge many of his positions at his confirmation hearings. Just as they distrust him on health care, he distrusts them.

“The true desire of those on the left,” Mr. Price said on the House floor in 2007, “is to gradually and enticingly move all Americans to Washington-controlled bureaucratic health care.” The bureaucracy, he said, is “not nimble like the private sector.”

The scariest aspect of Price's tenure at HHS is that he is apt to behave as much as a fascistic strongman as his boss. Directors of the agency have always enjoyed the power to act unilaterally, to tweak rules and regulations at their whim. So Price might not even need Ryan as much as Ryan needs him. It's hard out there for a flim-flam man acting out his sadistic fantasies all by his lonesome.

Come on Down! (graphic by Kat Garcia)

For his part, Ryan hopes to effectuate the increased suffering and swifter deaths of seniors via a cheap voucher or coupon system, which he euphemizes as "premium supports." It would change Medicare from the single payer government system it is today into a program more in tune with the Affordable Care Act. Older people, including Alzheimers patients and those suffering from chronic diseases affecting mentation and physical stamina would be forced to spend days or weeks navigating the "marketplace" of private insurance plans in order to get the least horrible coverage for their meager government buck.

Ryan's colleagues once thought he was crazy for wanting to kill Medicare, but he brought many of the squeamish along to his Ayn Randian way of thinking by also advocating for cuts in education, housing, food assistance to poor families, and veterans' programs. The theory is that if you spread the pain around equally, it is more palatable both to yourself and to your victims. 

And forget about polls showing that 80 percent of Americans -- and that includes Trump voters -- don't want their Medicare touched. Paul Ryan doesn't care about polls. "Leaders are elected to lead and are supposed to change the polls because that's what the country wants," he told David Gregory of NBC back in the austerian good times of 2011.

When Ryan was trying to sell his voucher program a couple of years ago, he hysterically complained that it wasn't fair to call it a voucher system. People might actually suspect that he was trying to kill them. 

So to help poor Paulie and his Price-pal in the newly-named Hell and Inhumane Services Lab, here are a few alternative names for them to chew on while they await their main course:

MediPRIC (Paul Ryan's Insurance Cabal).

MediPOP (Profits Over People).

MediCRAP (Conservative Republicans Against Patients).

MediKIL (Kleptocratic Insurance Limited).

MediSCAM (Social Conservatives Against Mankind).
 
MediCHEAT (Conservatives Hiding Eugenics Agenda Totally).

And, when the Democrats inevitably cave and compromise so as not to let the perfect be the enemy of the good, they might offer the following "improvements" to Medicare As We Know It:

MediBUT (Bipartisanship Under Table).

MediPUNT (Pragmatism Until New Term).

MediSTRIP (Surrender to Republicans in Peace).