Ryan Unsuited to Lead ‘Adult Conversation’ About Poverty

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House Budget Committee Chairman Rep. Paul Ryan (R-WI) takes part in a San Antonio Hispanic Chamber of Commerce event, Thursday, January 23, 2014, in San Antonio. Ryan said House Republicans will tackle immigration reform in pieces rather than the Senate's comprehensive approach. (AP Photo/Eric Gay)

These days, a favorite talking point of Republican Congressman Paul Ryan’s is calling for an “adult conversation” about poverty.

“It’s time for an adult conversation,” he told The Washington Post.

“If we actually have an adult conversation,” he said in remarks at the Brookings Institution, “I think we can make a difference.”

The problem is that a prerequisite for any adult conversation is telling the truth and it is there the congressman falls monumentally short.

In addition to Rep. Ryan’s recent, racially-coded comments about “our inner cities” where “generations of men [are] not even thinking about working,” his rhetoric around policy should raise red flags for anyone — including the media — assessing his credibility.

In addition to Rep. Ryan’s recent, racially-coded comments about “our inner cities” where “generations of men [are] not even thinking about working,” his rhetoric around policy should raise red flags for anyone — including the media — assessing his credibility.

A report from Emily Oshima Lee, policy analyst at the Center for American Progress Action Fund, examines the hatchet job Rep. Ryan did on Medicaid in his 204-page account of antipoverty programs that The Washington Post generously described as a “critique.” Indeed, Ryan’s report — which would have been flagged by my excellent 10th grade English teacher for misrepresenting and cherry-picking data — is a dangerous disservice to a public which has neither the time nor the staff that Ryan has at his disposal to delve into literature assessing antipoverty programs.

Lee notes that Ryan misuses research to imply that Medicaid coverage leads to poorer health — that people enrolled in Medicaid will have worse health than those with private insurance and the uninsured.

“The privately insured comparison is patently unfair because these people tend to be higher income and that comes with a whole host of health privileges,” said Lee.

She notes that Medicaid enrollees tend to struggle a lot more with chronic conditions and illnesses than other populations.

“A large body of literature identifies various social determinants of health, including socioeconomic status and living and work environments, as risk factors for poor health outcomes,” writes Lee, in my opinion admirably resisting the temptation to add, “duh.”

As for the uninsured being healthier — it would be one thing if Ryan were making an “apples to apples” comparison, but he’s not.

“The uninsured is a diverse group and doesn’t only include low-income individuals. It may include people who are high-income and don’t really want insurance but can afford health services, and lower-income people who may not have previously enrolled in insurance for a number of reasons — including cost and not having any real health issues,” Lee says. “But again, to imply that Medicaid is somehow making people worse off is absurd.”

Ryan also argues that Medicaid coverage has little positive effect on enrollees’ health. But as Lee points out, Ryan conveniently overlooks studies showing an association between Medicaid and lower mortality rates; reduced low-weight births and infant and child mortality; and lower mortality for HIV-positive patients, among other heath benefits.

“In general, we need more data to accurately assess the effect of Medicaid coverage on people’s health,” Lee continues. “But several studies do indicate positive health and non-health effects of coverage — such as increased use of preventive care and greater financial security.”

Despite Ryan’s shabby work when it comes to antipoverty policy, the media repeatedly seems willing to overlook it.

Rep. Ryan also plays on fears of low-income people abusing the welfare system when he asserts that Medicaid coverage improperly increases enrollees’ use of health care services, including preventive care and emergency department services. Ryan makes this case too by comparing Medicaid enrollees to uninsured people, who, as Lee writes, “are less likely to use health care services due to significant financial barriers.”

“Presenting data that Medicaid enrollees use more health services than the uninsured affirms that insurance coverage allows people who need care to seek it out,” writes Lee, “and that being uninsured is a major barrier to receiving important medical care.”

Further, one of the two studies Ryan references explicitly states that “neither theory nor existing evidence provides a definitive answer to… whether we should expect increases or decreases in emergency-department use when Medicaid expands.”

Despite Ryan’s shabby work when it comes to antipoverty policy, the media repeatedly seems willing to overlook it. That’s another strike against the prospects of a truly adult conversation about poverty — in addition to honesty, it requires accountability.

Greg Kaufmann is a senior fellow with the Center for American Progress, the former poverty correspondent for The Nation and a former contributor to BillMoyers.com. The opinions expressed here are his own. You can follow him on Twitter @GregKaufmann.
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  • Pam Barone

    Where is the data or supporting documentation for the assertions to the contrary? I agree that Ryan represents the most cynical of all political professionals. I believe expanding Medicaid would help poor people get practical treatment for common illnesses such as asthma, diabetes, and heart disease at a reasonable cost to society and to those individuals who might be able to get work if their uncontrolled chronic illness was treated. But, citing the opposing viewpoint with nothing more than “a large body of literature” without giving the footnotes is frustrating the dialogue. And is it necessary to be snarky?

  • Anonymous

    Ryan is a shill for his wealthy financial backers. He is trying to take us down the path of every demagogue. Gain power by blaming an innocent and powerless group of people. First you blame, then demonize, then dehumanize and finally persecute.

    You can expect to see more of his ilk if we don’t reverse the downward economic spiral of our society caused by increasing inequality — less and less for workers and more and more for executives and stockholders.

  • Anonymous

    If you have time enough to comment you have time enough to click on some of the highlighted terms in the article. There you will find what you’re looking for, as have I. And ‘snarky’? Define please.

  • Edward98

    The most difficult is try and understand why a man will deliberately lie to hurt people and that man is Paul Ryan. He needs to pay a price for this and I mean a real price.

  • Charles Shaver

    As one of those who voted for Gramm-Leach-Bliley (ex post facto) in 1999, Ryan helped create a lot of today’s poverty. And, it is still so little known that the U.S. FDA may have created today’s healthcare crisis with multiple epidemics of chronic and degenerative diseases with their 1980 approval of the expanded use of added MSG (monosodium glutamate), knowing full well at the time ‘a few people’ would be harmed. Forget about ‘adult conversation,’ how about prosecuting a few hundred public officials ‘as adults’ for much of the unnecessary disease and poverty we have today?

  • Marjorie Picard

    It just so happens I wrote an article on this subject. It’s a few years old but still is valid, I think. https;//suite101.com/a/medicaid-works-a-new-study-reveals-how-and-why-a379137

  • Carol Long McCulloch

    For starters, one of the big reasons that people are on Medicaid is that they have serious illnesses that preclude them from working, and their consequent poverty entitles them to Medicaid. Tautology.
    Another reason that Ryan is unfit to have an adult conversation is that he somehow thinks that Ayn Rand is compatible with Roman Catholic theology. If he cannot understand something that basic and obvious, he won’t be able to understand much of anything else.

  • http://thepodunkblog.blogspot.com/ Alan L. Maki

    Democrats are no better than Republicans.

  • Anonymous

    Carol Long McCulloch makes the point I was going to – people
    with serious illnesses are more likely not to work, therefore are poor and in need of
    Medicaid.

    Also it stands to reason, those raised without adequate medical care as infants
    and children, and are unfortunate to suffer from health conditions – childhood
    diabetes, inadequate nutrition, lack of vaccinations, broken bones healed
    improperly, no dental care, and so on, are more in need of health care as
    adults, no matter their income level when they reach adulthood. Add in
    poor education, learning disabilities, unstable family life, dangerous living
    conditions, and so on… how can anyone “blame” people for their own
    poverty when they’ve been born burdened with two strikes and two outs, bottom of
    the ninth. Just to use another baseball metaphor (as the opposite from born on
    third but thinks he’s hit a triple).

  • BBunsen

    So Ryan has a staff do this review, and they manage to come up with “People with access to health care use more health care than people without access to health care.” Thank you, Paul, I’m glad we’ve got you in Congress to come up with brilliant findings such as that. I no longer fear for the Republic, since it’s in good hands.

  • Anonymous

    Somewhere in his youth, Ryan fell in love with Ayn Rand’s bull$h!t philosophy and he doesn’t have the integrity (or perhaps the intelligence) to admit his error.

  • Anonymous

    30 years past time for single payer. Let’s do it. Single payer now.

  • Anonymous

    I am for it, while we are at it let’s prosecute the CEOs and Boards of Directors of Exon Mobile, Monsanto, General Electric, Duke Energy, all the members of Big Pharma and on and on. If corporations are people then they need to be subject to criminal prosecution for the death and destruction reaped by their activities.

  • Owen Johnson

    Well, that would be up to the voters in his district. He still has to be re-elected every two years by his constituents, and the rest of us are stuck with him, with no choice.

  • Anonymous

    When a Republican says “adult conversation” he or she means more cuts to the social safety net and more tax cuts for the rich…..it is that simple…..

  • Anonymous

    My Uncle Caleb just got red Ford Focus ST
    by working off of a computer. try this C­a­s­h­D­u­t­i­e­s­.­ℂ­o­m

  • William Smith

    inner city males who don’t even think about working huh I am not an inner city male but I am a 48 year old who recently became employed with a profitable company starting pay is 11.50 an hour with a chance for 12.00 in three months o k not bad you say gas has raised .40 cents a gallon since I started so that is 1.00 an hour gone just to get to work then $100 a week in taxes another $2.50 an hour so now I am working for $8.50 an hour then I received my benefits package health coverage is $129 and change a week another $3.24 an hour now im down to $5.26 an hour to live on do I pay rent or buy groceries with my $210 a week mr ryan I do not have cable or internet I drive a 20 year old car and I don’t drink but I believe a person working for a profitable company should be able to support themselves without skipping meals I can afford to eat one meal a day if I am lucky wonder why inner city males don’t want to work???

  • MsC

    Or he means, “Stop being uppity and let the white Christian men do what they want.”

  • Charles Shaver

    You seem to have a good grasp of the situation. I tend to focus on elected officials because they swear oaths of office and should be reminded they are doubly to triply criminal, incompetent and/or treasonous when they fail to police themselves and properly serve the majority, accordingly.

  • Joe Clam

    Hell, now I don’t want to work…

  • Byard Pidgeon

    Paul Ryan, like many Libertarians, was exposed to the philosophy of Ayn Rand during a vulnerable adolescence, and was swept into an adolescent crush. Unfortunately, like most others, he never got over it and remains a true believer, willing to do anything to gain the admiration and love of, if not his very dead object of affection, his fellow worshipers.
    The Ryans of this world see no problems with lying to advance their belief system; they are zealots, and so rationalize any cruelties they feel necessary in order to prevail.
    They also are able to overlook the contradictions and hypocrisy of Rand.

  • Dolly

    As rightwingers so often do, they only look at a few variables (or in worst cases, harp on only one variable) that suit their argument, and then they ignore the remaining variables that DESTROY their argument.

  • Brian

    Rather than complain about who leads the conversation, why not just start to have it?

    He seems like he’s a willing participant and it’s pathetic that you claim yourself as judge on who gets it going.

  • Sue Em

    Just by looking at his evil arrogant smirk you cell tell how much he enjoys targeting the poor.

  • Anonymous

    Over the past couple of years I have come to discount Mr. Ryan’s political
    antics, and wonder how he is still allowed to represent the Republican Party.

  • Invasive Evasion

    Belief in the ramblings of Ayn Rand should be used as a test of fitness for public office. It demonstrates a deficiency of critical thinking skills, and a total lack of basic morality. Putting a Randian in public office is like putting a serial killer in charge of the police department. That of course brings up the more general point that at least half of congress consists of members who are ideologically opposed to the existence of government (with the exception of the military), and who are committed to its failure. It’s no surprise that government doesn’t work. A board of directors composed of communists would probably not result in a profitable corporation either.

    The things Ryan says are deliberately dishonest and nonsensical. Political rhetoric (his, or any other politician’s) has nothing to do with factual accuracy or logical validity. It is the intellectual equivalent of baby food (pablum) designed to appeal to the infantile world view of the right wing base. Analyzing his words as if they were serious justifications of public policy is missing the whole point of why he says any of the things he does. WE know it’s meaningless, and HE knows it’s meaningless. How it is perceived by the followers of Ailes’ FOX political organization and the listeners of conservative talk radio is what is relevant. We need to figure out how to get some facts to penetrate into that bubble, instead of preaching to ourselves the things we already know.