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It was always rather clear that Paul Ryan took a liking to Rand for her ideals of ethics and politics, as opposed to her thoughts on religion and epistemology (he wears his Christianity on his sleeves).

Him pointing out he doesn't follow her epistemological philosophy doesn't address people's real concern: a want to significantly decrease the presence of government in our lives, at the cost of a great many public services and projects. How far would he be willing to go with that, if given the power to do so? The Randian extreme would include an end of antitrust laws, no more minimum wage, and so on, taking us right back the late 1800s.

Actually, a Randian extreme would be worse than what we had way back then.  At least then, the government was still building railroads and canals if Congress so chose.  I would presume Rand would be against any and all such government funded infrastructure projects, and Ryan doesn't seem like a fan himself.