U.S. Congressman Paul Ryan Serving Wisconsin's 1st District

U.S. Congressman Paul Ryan Serving Wisconsin's 1st District

U.S. House of Representatives

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Paul Ryan: Poverty Programs Should Be Measured By Outcomes

May 7, 2012

Rep. Paul Ryan (R-Wis.) says taxpayer money being spent on poverty programs are not being measured correctly. Ryan says poverty programs should be measured by outcomes:

REP. PAUL RYAN: You know, I think around here we spend too much of our time in our intellectual effort measuring compassion for those in need by measuring inputs. How much money are we spending? How much money are we increasing spending? How many programs are we creating, but we're not measuring outcomes.

Are these programs working? Are people getting out of poverty? And we need to focus on that, because if we simply measure inputs, Medicaid's phenomenally successful. A 50% increase in the past ten years and a forthcoming 125% increase in the next ten years, or if this passes into law, 123% increase over the next ten years, but surveys are telling us [that] doctors aren't even taking Medicaid patients.

One recent survey said that approximately half of all our doctors aren't going to take any additional Medicaid patients because they lose money every time a Medicaid patient walks into their office.

OMB told us that last year Medicaid made $22 billion in improper payments. That means fraud, waste, $22 billion. That's more than my state's budget in wasteful spending. So the program is not working.

One of the reasons why the program is not working, according to state legislators and governors, people in charge of putting the program in place is, all the strings they get from Washington. They want flexibility. They want to be able to customize this program so that it works in their states for their populations so that they can get at the waste, the fraud. So that they can make sure that their doctors will accept these patients.

It's been called stability requirement. That to me just means strings from Washington. What we're doing with this policy is giving more flexibility to states so that they can fix these problems because they're closer to the people who are in need.

We don't have all the answers in Washington. If we did, this wouldn't be such a problem, but it is a huge problem.


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