When Paul Ryan produced his Medicare reform plan a little over a year ago, he was just a congressman from Wisconsin, but he had what his fellow-Republicans have had trouble formulating: ideas.
Ryan's Medicare plan could be summed up in one word: privatization. But it created an illusion of big savings and used seductive words like "free markets" and "competition." And when Mitt Romney elevated Ryan to his vice presidential pick, the Ryan Medicare plan, retooled with softer edges, took front and center, especially in a graying battleground state like Florida.
The act is worth reviewing. Should Romney and Ryan win, it'll mean the retooling of our own future health care. Based on Ryan's numbers and assumptions, it won't be for the better.
With very few exceptions, if you age 65 or over, you're on Medicare. You get to see almost any doctor you want, your hospital care is taken care of, so are most of your prescriptions. It's the closest thing we have to universal health insurance. Seniors love it. Had Medicare been expanded to cover everyone, health reform would have been a lot healthier than it is. But that's another story.
Ryan wants to privatize most of Medicare by turning it into a voucher program. He would give seniors a set amount of dollars to buy their own insurance on the open market. Traditional Medicare would still be an option, but it would be more expensive because its pool of participants would shrink and private insurers could compete with it. Supposedly, that would compel seniors to spend less on Medicare, as if seniors were the problem, as opposed to a health care system that charges double and triple the costs charged in other civilized countries.
Remember, Ryan's plan for seniors isn't much different from John McCain's version of health care reform four years ago. McCain would have given families a $5,000 tax credit to buy insurance, though the average cost for families was already above $12,000. Remaining costs would have been your problem. Same story with Ryan's voucher plan, except that seniors' health costs are much higher than younger people's. If the voucher falls short of your costs, that's your problem, not the government's.
Ryan's plan might save money -- but it's not about doing the most and the best for seniors. It's about giving private insurers another huge bite at America's health care pie, at the expense of seniors' budgets and peace of mind. A voucher plan will slouch us back to near where we were before 1965, when poverty among the elderly was one of this nation's most persistent diseases.
Sure Medicare is expensive. It cost the country $551 billion last year. What payroll and other taxes exist aren't nearly enough to cover future rising costs. And with seniors' numbers increasing, so will Medicare's costs increase.
But two simple fixes could bring in the necessary dollars to cover Medicare well past the half-century mark, when the senior bulge will end: raise the Medicare payroll tax by half a percent, split between employer and employee, and end tax-free employee health care, a $250 billion-a-year hand-out that makes zero sense. Those two fixes alone would ensure Medicare's viability for years.
Let's just not claim it's not affordable. We just spent a trillion dollars on a dubious war and are on pace to spend another trillion before the Afghan war is over. We didn't have that money. We spent it anyway, on the assumption that it was a vital matter of national security.
Seniors aren't a vague distant project to pacify. They're a national responsibility, veterans of a different security that they alone built for us to enjoy.
Health care for seniors isn't a useless campaign. It's a moral responsibility. And it's certainly more affordable than snake-oil schemes like do-it-yourself vouchers.