The Republican Case for Medicare Vouchers

Tuesday, April 19, 2011

Welcome to Politics Bites, where every afternoon at It's A Free Country, we bring you the unmissable quotes from the morning's political conversations on WNYC. Today on the Brian Lehrer Show, Congresswoman Nan Hayworth (R-NY 19) discussed the battle in Congress over what to do with Medicare.

Trickle-down responsibility

Democrats have attacked House Republican Paul Ryan's proposal to transform Medicare into a private insurance voucher fund, saying it will shift the country's debt burden on to senior citizens without improving health care or controlling costs.

But Representative Nan Hayworth wouldn't characterize it that way. She says the current system sweeps the cost of medical treatment under the rug: the elderly can expect the government to foot almost any bill, leading to a sort of "why not?" attitude toward accepting care. Hayworth said we need individuals and doctors to pay greater attention to what's really necessary, and how much it really costs, rather than mandating it from Washington.

It has been shown in areas of the country that have programs...with health savings accounts for state employees and Medicaid recipients: when people are aware of what it costs to do certain things, they will make sensible choices. Right now we don't have an incentive that is based appropriately in the consumer world. There are no incentives to bring those costs under control, and yet we are faced with a situation in which those restraints will be forced upon the public through mechanisms like [the Affordable Care Act].

Incentives and efficiencies

The Republican approach is about letting health care decisions fall to states, consumers and providers, and forcing action at the bottom of the policy ladder, rather than from the top. Revamping Medicare and Medicaid is "a broad stroke approach, it's true," said Hayworth, "but smaller strokes really do have to exist within our states and communities."

However, people receiving excessive care aren't the only cause for rising costs, Hayworth said. Federal oversight (and overreach, depending on who you ask) runs counter to private sector mechanisms that would deliver a better product. Getting government out of the way, as the Ryan plan suggests and Hayworth supports, would improve the heath care market.

The universe of choices been limited. One example is that we have a limited selection of insurance options in a state like New York. Insurers have to honor menu of more than 50 mandates and that makes the cost of insurance in New York for those of us not in large purchasing groups nearly prohibitive. It's an expensive proposition and the number of insurers entering that marketplace becomes limited.


Nan Hayworth


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Comments [57]

Cin from NY

I am so sick of this woman. I just saw an ad saying senior citizen should thank Nan Hayworth. You have go to be kidding me. She voted for Paul Ryans plan. Recently I received a flyer saying she received an award. Guess what it is from a right wing group who likes to use prosperity, freedom or the like in their names. Which is far from what they are. Wake up people. Our lives are being changed with lies and more lies.

Nov. 07 2011 11:36 AM

It is painful to listen to her interviews, but I forced myself to do so while driving to visit my mother. I don't believe she will ever support funding NPR. As someone who lives in her district, I had asked her why she supported Army funding of Nascar, but not NPR. Her aide said it was because the public supported NPR; thus NPR did not need government support - the logic eludes me.

Apr. 20 2011 10:07 PM

Brian, I'm starting to give up on you. I love your show dearly but when you allow people like Hayworth to spout her views unchallenged you are doing no one a service. I feel like I may as well be listening to Fox News.

Where is my old Brian?

Apr. 20 2011 08:32 AM
donald Patriss from Manhattan

If Nan Hayworth is an example of the new Republican politicians elected in 2010, God help us.

Apr. 20 2011 01:51 AM
Bill from Beacon

I pity you poor folks who sat through the interview. I heard the one Brian did with Hayworth a few weeks ago and was appalled by how he just let her spout on and on. Complete softball interview. That's why I pulled my WNYC subscription back in the Bush years. A stronger approach is needed!

Apr. 19 2011 06:10 PM

Perhaps its time to compare US physicians' salaries to those in the rest of the developed world. Since we're looking for cost cutting everywhere - how about having American doctors take a salary cut? Or better yet - how about opening up medical practices in the US so that international medical providers could offer some lower cost competition. Plus - we obviously need many many more primary care providers in the US. We need keep up with training them.

Apr. 19 2011 03:49 PM
Kirstyn from St Thomas,

Please do not invite this guest on again. It was painful to listen to her. Umm-ing and uhh-ing her way through her partisan line non-speak. Thought it might be interesting to listen to a Republican physician speak on healthcare issues - it was not.

Apr. 19 2011 01:26 PM
Edward from NJ

Perhaps they should only have members of Congress on in balanced pairs. Nan Hayworth would only appear if accompanied by Anthony Weiner.

Apr. 19 2011 12:31 PM

You'd never guess, listening to this woman, that our competitors in the industrialized world provide healthcare to their every citizen, and with better outcomes than ours, for 1/3rd to 1/2 the price, and that they don't do it with so-called free market solutions.

But this is America. Free enterprise or death. And usually the latter.

Apr. 19 2011 12:27 PM

WNYC really needs to explain to its listeners ("supporters") exactly how it's serving the public interest by programming unchallenged corporate propaganda -- whether it comes from the industry directly, or through its paid spokespersons, Republican or Democrat.

No fact checks, no debunking of circular arguments, no pointing out of obvious absurdities.

But rejoice! We're going to turn health care into a division of financial services! You'll get to invest in your healthcare just like a casino! Assess what you need and don't need, take out some options and futures, and make a killing (that is, if your choices don't kill you first)!

Is being polite to yet another bought and paid for politician of a higher interest than basic fairness -- much less truth?

Apr. 19 2011 12:15 PM
R. Thornhill from NYC

Is Hayworth truly that uninformed and naive?! As Congresswoman Hayworth would have it: When you're older, when you need medical care on a more regular basis, when the odds of a serious illness increase, when medical testing is integral to diagnosing a serious illness and can save your life - Hayworth backs a mandate that will 'enable' seniors on a fixed income who can least afford to purchase high cost 'better' medical insurance, the right to have a 'bargain basement' health care plan that will not cover the costs of diagnostic testing - testing that can and does save lives. Hayworth paints a picture of frivolous seniors in an amusement park of diagnostic tests and treatments enjoying their barium laden cotton candy and sipping their jumbo big gulp contrast while waiting on line for the MRI Tunnel of love ride!! That scenario is as ridiculous as Hayworth's assessment stating that seniors should be more aware of the costs of these tests! People - young or old - have medical testing done to help in diagnosing or treating an illness. Should preventative measures also be considered frivolous? Should innovative treatments not be accessible to those who don't have the funds to pay for them? Again, we are talking about lives - lives that matter. So, if as a senior, I do not have the enormous amount of funds necessary to pay for a private insurance plan that offers life saving treatments and testing, then I will have the dubious honor to choose a 'bargain basement' plan that will not allow me the right to access these life-saving treatments. Pity the older masses that will be at the mercy of health insurance companies without Medicare to assist them. Hayworth is a dangerous voice that will be very effective in 'culling' our population - re-emphasizing the devaluation of our older citizens. Disgraceful and so short sighted! Perhaps Hayworth is independently wealthy or is it possible she was hatched and never had parents or grandparents! Is It possible that Hayworth has found the ‘fountain of youth’ and will never grow old or suffer illness?

Apr. 19 2011 12:07 PM

Hayworth talked in circles and Brian held her hand.
How will the cost of health care be reduced? NOT ONE WORD on that.
She advocated flooding the NY insurance market with unregulated "new products." Imagine if CAR MANUFACTURERS had no regulation?
We would be flooded with over priced death traps.
Do you know how quickly a savings account can be drained if you pay out of pocket? THOUSANDS FOR AN MRI, etc. What happens when our seniors' medical savings accounts run out of money? (by then, I will be the senior citizen this affects). This woman should be stripped of he medical degree...

Apr. 19 2011 12:00 PM
Edward from NJ

I don't know why any doctor would want to make the costs of medical care more apparent to consumers. Right now everyone hates their insurance companies and loves their doctors. If patients had to really think about what they're paying their doctors, doctors would end up with public opinion numbers similar to lawyers.

Apr. 19 2011 11:49 AM
Mike from West End Avenue

Add me to the list of listeners who found Nan Hayworth incoherent and unworthy of being interviewed on the show. She could not complete a single cohesive sentence. Her ramblings never addressed the original questions. What was worse was that Brian never intervened. I know fair and civil discourse is the hallmark of the show, but there must be a polite way to say, "OK, it's clear you have little to add here. Good-bye, thanks for coming."

Apr. 19 2011 11:46 AM
Otto Cosmopolis from Cold Spring

I'm tired of hearing this nonsense about "empowering consumers" about , "making smart choices about healthcare". I am not a doctor, I do not have the slightest amount of training that would "empower me" to make a "smart decision" on this matter. When you are sick, when you are in pain, comparative shopping is not an option. We have no choice except to leave our decisions to those who have the training. Healthcare is fundamentally incompatible with all of this free market hoo-haa.

Apr. 19 2011 11:39 AM

I got a call last week to join a "telephone town hall" by Nan Hayworth. It was in progress when I joined and what I heard was a love fest of those who went right down Republican talking points about "Obama care", cutting the deficit, putting environmental regulations in the hands of local officials, and keeping Indian Point open because the Nuclear Regulatory Commission says its safe.

After listen to all of this I have a question for my representative. What about me? What about my opinions? What about my concerns? I am a constituent and I vote and am entitled to representation. It is clear that there is no place for me in Nan Hayworth's world. So sad.

Apr. 19 2011 11:37 AM
Edward from NJ

I'm guessing Nan Hayworth won't allow callers or online questions as a condition of her appearance. She certainly wouldn't be the only politician who does that.

Apr. 19 2011 11:35 AM

Why don't you ask Ms. Hayworth why she believes that giving further tax reductions to the wealth will result in job creation?

It didn't happen under Ronald Reagan, it didn't happen under George H.W. Bush and it certainly didn't happen under George W. Bush.

In fact, whenever Republican economic policies have been put into effect, they have caused a recession.

The main reason Republicans use to justify tax cuts for the wealth is a fallacy.

Apr. 19 2011 11:29 AM

Sorry Brian. Another namby-pamby interview--great job dude!

Apr. 19 2011 11:29 AM
RLewis from the Bowery

So many great online questions, so little attention to them from the BL show. Commenting here is just a total waste of our time. Why do we even bother?

Apr. 19 2011 11:28 AM

No one knows what medical procedures cost. How much is a mammogram or a colonoscopy? Who knows??? - different prices in different places and for different providers. How do we compare? We know how much a car or TV or home cost and can compare. Not so for medicine.

Can every American expect treatments of over a million if they need it? How could we possibly afford that?

Since we do not now and most likely will never have enough jobs with health care benefits - why do we make health care dependent on having a job? and why do we burden employers with supplying health care?

Apr. 19 2011 11:28 AM

We need to honor our commitments. We've seen where IRA's and 401ks have left us in the wake of a housing disaster.

Exactly. Republicans in this country are the only group in the entire industrialized first world who think this type of healthcare funding is a good idea. Just because they're unique in this way does NOT mean they're correct. Sometimes you have to look to other countries for guidance.

Apr. 19 2011 11:27 AM

I was hoping Brian would ask her about jobs...she seems to thing they'll trickle out of the wealthy getting wealthier?

Did he actually ask her about jobs? Did she actually answer?

I feel like I've been walking through heavy word fog....

Apr. 19 2011 11:27 AM

She is the voice of pure evil.

Apr. 19 2011 11:25 AM

Downturns affecting the health of millions must be viewed in the broader view, which, I think means hard times will get harder for the non-wealthy and the wealthy will be able to pick up bargains for pennies on the dollar. Especially when those not wealthy will find they need to just Hurry Up and Die. Or lose their homes.

But, as the population dies off, some will get more jobs.

"Be incentiivzed to have efficiencies." Heh. Just Hurry Up and Die, weaklings, that is more efficient!

Apr. 19 2011 11:25 AM

if the ryan plan will improve medicare, why not institute it now instead of 15 years from now? political cowardice perhaps?

Apr. 19 2011 11:25 AM
Sophia from Yonkers, NY

Why not make medicare the safety net it was intended to be. Why should I pay the medical bills of millionaires when you are dissolving the medicare I was supposed to receive?

Apr. 19 2011 11:24 AM
jgarbuz from Queens

Germany, Italy, Japan and soon China will have proportionately even more seniors than we do. So what are they doing? They seem to have fairly high life-expectancy rates. How are our economic competitors doing in this regard?`

Apr. 19 2011 11:23 AM
Henry from Katonah

As one of the congresswoman's constituents, I am not hearing any policies that will actually work.
Aren't the policies she is advocating the ones that caused the economic crisis in 2008 to 2009? Thanks to her predecessor, John Hall, for voting for the stimulus package that averted a full blown depression.
I am glad I have 2 senators in Congress to represent my views.
Excuse my negativity, but we need greater perspective here.

Apr. 19 2011 11:22 AM
Maria Schafer from Westchester district 19

How does Nan Hayworth square "sensible cost" of Medicare and healtcare generally through embracing the Ryan plan when the administrative costs for Medicare are so much lower than those of the private sector. The reality is that Nan Hayworth is for all the coverage that an individual can pay for, with the insurance companies as coconspirators and funders for her and her husband's very lucrative and rapidly growing medical empire.

This idea of empowering the consumer does not account for the fact that if we continue to push the bulk of the cost for health care onto middle class and underprivileged America, we will end up with an increasingly impoverished, unwell, uncompetitive and unfit population.

Medicare was started to keep seniors out of poverty and a burden on society at large. Nan Hayworth and her ilk will put us right back there.

We can reform Medicare/Medicaid without destroying it. We need to honor our commitments. We've seen where IRA's and 401ks have left us in the wake of a housing disaster. Do we now want to have "consumer-driven" health care (meaning less and less actual CARE for people) going the same route. There is no way a private individual can afford even the most basic kind of health care services for a broken arm or leg, much less for serious illness, if what we're counting on is Nan Hayworth's oft-touted Health Savings Accounts (which are only available to people with JOBS). She never deals with how we should handle those of us who are a paycheck away from being without a job, or the long-term unemployed or disabled.

Americans may need to confront in a serious way the changes that need to take place for Medicare/Medicaid, but Nan Hayworth's approach is NOT the solution.

Apr. 19 2011 11:22 AM
Mark from Bedford, NY

‎Rep. Hayworth said [to the American Medical Group Association (AMGA) on Saturday ] the price Obama pays for getting the GOP-led House to agree to raising the federal debt ceiling might be the repeal of major parts of the Affordable Care Act.

Note: Her husband, also a doctor, is chairman of the AMGA, a physician lobby group. And CEO of the Mt. Kisco Medical Group.

Isn't this a conflict of interest?


Apr. 19 2011 11:22 AM
john from nyc

Can you please stop playing softball with Congress Member Hayworth. She should not be allowed to frame the debate with lies about our ability to continue and improve social programs. We do have the money for it.

Apr. 19 2011 11:21 AM

How does a 65 year old with a pre-existing condition (which most 65 year old have) get insurance? Why would a for profit insurance company offer insurance to a old person, who by definition get sick and die?

Even with "vouchers" there will never be enough money to pay for bypass surgery, cancer treatment, hip replacements.

People should simply be prepared to die earlier, if they are not wealthy.

I have had individual insurance for most of my adult life.

I am in my early 50s, with no pre-existing conditions, pay $9,000/year in premiums for a $5,000 deductible. The plans has many conditions excluded, and high co-payments after the deductible is met.

The Paul Ryan plan will result in early deaths; senior suicides, and many sick seniors without insurance.


Apr. 19 2011 11:21 AM
jeff from brooklyn

So this is "rationalizing" healthcare...but not
"rationing". Make "sensible" choices based
on your government ration health coupon based on insurance
co. profit schedules? Cant wait for the
Ed McScam equivalent selling seniors crappy
insurance schemes on TV.

Apr. 19 2011 11:21 AM
Chris from Putnam county

Please confront her jibberish. Count the number of times she's said "so to speak", etc. Please Brian.

Apr. 19 2011 11:21 AM

Please ask Nan Hayworth's view of NPR funding, pressing her on whether she'd support funding cuts in light of the fact that she regularly appears on your NPR-sponsored program! Ask her! Get her to commit, one way or the other!!!!

Apr. 19 2011 11:21 AM
Lloyd Trufelman from KAtonah, NY

Shouldn't she disclose that her husband owns the multi million dollar Mt. kisco Medical Group and could profit greatly from Medicare vouchers?

Apr. 19 2011 11:20 AM

I think she indeed is saying that people must make choices for health care based on how much they personally can afford, so, logically, the poorer among us need to Hurry Up and Die.

For the good of the society, of course.

Their choice will be to spend and if they cannot spend then they must die if their bodies need care they cannot afford.

Apr. 19 2011 11:20 AM
jeff from brooklyn

So this is "rationalizing" healthcare...but not
"rationing". Make "sensible" choices based
on your government ration health coupon based on insurance
co. profit schedules? Cant wait for the
Ed McScam equivalent selling seniors crappy
insurance schemes on TV.

Apr. 19 2011 11:20 AM

Brian, maybe you get someone on the show better informed. Or maybe this is the point.....

Apr. 19 2011 11:19 AM
Martin Chuzzlewit from Manhattan

Go Nan !!!!! We have enough Chuckie Schumer-Anthony Weiner-Nadler-Maloney knee-jerk "never say no" clones representing New York. It takes courage to say "Stop!"....and you get all of the opprobrium.

Go for it!

As the song goes....."Let's give them something to talk about."

Apr. 19 2011 11:18 AM
Eleanor from Carmel

Dismantling Medicare is just plan stupid. As a senior, it's a non-starter in my book. I voted for Hayworth, but didn't realize she would turn on us.

Apr. 19 2011 11:18 AM
RJ from prospect hts

I'm 53 years old and have waded through the Oxford book to try and understand what I have. My 80+ year old parents, both lucid and independent, are completely baffled. The notion that ill seniors should have to make sense of these appalling, profit-focused industrial manuals is ludicrous.

Apr. 19 2011 11:18 AM
Estela from White Plains

She is very unsure about the whole topic, that her voice is not firm and clear. So that means, not even she believes her points.

Her ideas are so mix-up, and taking a lot time to put her anwsers (Iies) together.

Apr. 19 2011 11:18 AM

I am tired of hearing that she is a doctor. I would prefer "non-practicing" doctor, or formerly a doctor or a doctor-without-patients,

Apr. 19 2011 11:17 AM
SickInPhilipstown from Philipstown

What the H.... is she talking about?
I am not sure she even knows!

Apr. 19 2011 11:17 AM
Suzi from Millwood, NY

She speaks, and yet she says nothing.

Apr. 19 2011 11:17 AM

My goodness, is it more obvious what is wrong with politics? She has no clue what she is talking about. She can't speak a complete sentence on one subject. This is painful.

Apr. 19 2011 11:16 AM
Ken from Brooklyn

Get real Congresswoman.

Paul Ryan's plan is a path to more prosperity for those that are all ready prosperous.

A 10% tax decrease for the wealthiest Americans?

This is class warfare.

Stop the soapbox Brian.

Apr. 19 2011 11:15 AM
Marsha Waldman from Mahopac, NY

Nan Hayworth will attempt to dismantle Affordable Health Care because her personal wealth is based on exploiting the medical system. Her husband founded the Mount Kisco Medical Group, which is taking over health care in Westchester and Putnam County. The wealth from that business funded her campaign. You refer to her as a doctor, but she was an ophthalmologist and has not worked as a doctor in a long time. Her perspective is based on her family's personal wealth.

Apr. 19 2011 11:15 AM
RLewis from the bowery

Brian, please stop being filibustered. You have just got to pin this person down on an answer to where she stands on block grants to state and individual vouchers for medicare/aid. Is there a limit to how much should be paid to heal a sick person? And what does that person do after that money is used up?

Apr. 19 2011 11:13 AM

@Lisa from Philipstown, NY

she didn't come out because she really doesn't have anything to say about it...perhaps she benefits from major tax loopholes herself.

Apr. 19 2011 11:08 AM
Bernice from Philipstown

When asked for her position on our current tax system at her office yesterday, Hayworth's spokesperson told the group (actually about 100) that (1) she thought everyone should pay their taxes (profound, huh?) and (2) she thought the tax system should be "simple". Study after study has shown that so-called simple taxes, such as flat tax or Fair Tax, raise taxes for the middle class and lower taxes for the wealthy (once again). Where is Nan Hayworth when it comes to serving the working people (and out of work people) in her district? Her concerns are 24/7 with preserving her own already considerable wealth and the wealth of her friends in banking, medicine, insurance and fossil fuel energy.

Apr. 19 2011 11:06 AM
NeedAJobJane from Garrison, NY

Jobs, Jobs, Jobs, Jobs - that is what we want to hear from Nan H. - What is she doing about getting jobs to the 19th. Congressdional District? Voting about more cuts doesn't get jobs here to the 19th.

Apr. 19 2011 11:02 AM
Lisa from Philipstown, NY

Where was Nan Hayworth when she refused to talk to the over 50 people who came to her office in Fishkill, NY to discuss the fact that many major corporations are not paying their Federal Income Taxes - yesterday? She refused to come out of her office and talk to us about anything! But she has time to do a radio talk show!

Apr. 19 2011 10:50 AM
Randy from Warwick

Over and over again, residents of Congresswoman Hayworth's district say they need her to focus on : 1) bringing jobs back to our district, 2) improving our educational system so that we can retrain our workforce and improve our childrens' ability to compete in the 21st century job market, and 3) improving our crumbling infrastructure.

These are the issues people of Congresswoman Hayworth's district care about yet she seems not to hear us. Instead she continuously focuses on cutting and cutting and cutting. Why?

Here's a good article in today's LoHud about this:

Apr. 19 2011 10:37 AM

Crap! Nan Hayworth again? Wasn't she here a few weeks ago and had ABSOULTELY NOTHING to say of any relevance? Brian, I hope you don't engage in another namby-pamby interview with her again.

Apr. 19 2011 10:12 AM

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