Why Medicare Reform Is So Difficult

There's a lot to agree with in Kevin Drum's take on the political barriers to Medicare reform:

Both parties can talk about reform all they want, but when the campaign rubber hits the electoral road they know that attacking cuts to Medicare is the way to win votes. And if both Democrats and Republicans take turns bashing anyone who has the gall to cut back Medicare spending, then Medicare spending will never get cut back.

On a wonky note, it's worth pointing out just how outrageous this whole "no one over 55" approach is. If you don't want to rein in Medicare growth in the first place, that's fine. But if you do want to rein in Medicare growth, current and near seniors are the #1 group that should be required to share in the pain. Seniors all like to think that they're just getting their due from a system they paid into all their lives, but it ain't true. They paid a pittance compared to what they're taking out. People in my generation, and the one before mine, will end up getting far more in Medicare benefits than we ever paid in.

I wouldn't quite say it's "outrageous" that seniors are exempt from the changes brought on by the reforms in Paul Ryan's plan. Regardless of what they paid in, the federal government sold them on certain expectations about what sorts of benefits would be available, and it's not entirely unreasonable to design a reform plan that phases in changes over a period of time in order to facilitate planning.

But it's certainly true that a reform plan that started immediately would be far more effective, that seniors often seem deluded about the value of the contributions versus their benefits, and that the majority of politicians in both parties have proven stubbornly unwilling to prepare the public for the challenges of reform. President Obama sells ObamaCare on the argument that it strengthens the Medicare trust fund without mentioning that it only does so if you double count the Medicare savings. Romney is running an evasive and sketchy Medicare reform proposal as well as an explicit promise to repeal the Medicare cuts in ObamaCare. This suggests how challenging it would be to introduce a reform plan that, as Drum says, makes current beneficiaries share the pain. And given Medicare's size and place in the budget firmament, it is not an equilibrium that bodes well for the federal government's long term fiscal health. 

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  • Dylan||

    Today's seniors are to Medicare as the Mets are to Bernie Madoff.

  • Archduke PantsFan||

    Just hire the unemployed to take care of the elderly.

  • Hugh Akston||

    Are there really enough shotguns and clubs to go around, though?

  • Beefkins||

    Just hire the unemployed to "take care of" the elderly.

  • Death Rock and Skull||

    I will do it for free. Nobody has to ask or approve of it.

  • ||

    The only way to find out is to give it a shot, Hugh.

  • ||

    You mean bums vs old people fight clubs? I like the way you think, Archduke.

  • Archduke PantsFan||

    PPV fundraiser?

  • ||

    The first rule is don't talk about geezer fight club.

  • R C Dean||

    Exempting everyone over 55 from Medicare reform guarantees there will be no reform For 10 years. That means that Medicare costs will at least double to over a trillion dollars. Yeah, that'll work.

  • Sevo||

    R C Dean| 8.22.12 @ 9:30PM |#
    "Exempting everyone over 55 from Medicare reform guarantees there will be no reform For 10 years. That means that Medicare costs will at least double to over a trillion dollars. Yeah, that'll work."

    Let's assume that actually passed and became law. How long do you think it would take to exempt those over, oh, 45?
    I'm guessing one election cycle when blue pandering SOB says 'it's not fair' and red pandering SOB says 'it's not fair and I up the bet to 35!'

  • Anacreon||

    Pick an age (80? 85? 90?) and make that your endpoint -- in other words, reach that age and you are terminated, a much later-onset Logan's Run if you will. That's about the only way to make Medicare, Social Security, and health care in general solvent for the long-term future. Sound good?

  • Brutus||

    The thing to remember about Medicare is that it really doesn't have a "budget," it just has an assumption about what it's going to cost in any particular year. If the bills are more than the assumption, we just keep on paying them.

    I don't see any constitutional basis for Medicare, but when did that musty old document stop Congress? If we're going to have it, it should be something along the lines of Ryan's plan for supporting private insurance for oldsters, beyond which they foot the bill themselves.

  • ||

    Indeed, medicare is fucking financially insane.

    It's like offering an all-you can eat planet buffet to a black hole.

  • CE||

    The Constitution is really not all that musty. I've seen it, and they keep it dried out, air tight, under glass, in and underground vault. It rises up so they can check it whenever they want to, which is never.

  • PapayaSF||

    Three good comments. +1 to each.

  • Gladstone||

    OT:
    http://www.washingtonpost.com/.....story.html

    Waiting for the antiwar libertarians at Antiwar.com and Lewrockwell.com to defend this and use Gary Johnson and Ron Paul as justification. I mean according to Daniel McAdams the mere act of criticizing a foreign government is "interventionist" and therefore unlibertarian.

  • Hugh Akston||

    That strawman didn't put up much of a fight.

  • Brutus||

    Uh, wut?

  • Gladstone||

  • ant1sthenes||

    You mean, the fact that the duoparty abuses ballot access law (GJ) and party rules (RP) to keep actual opposition out?

    Observing that America has its own problems that should be the larger concern for Americans isn't really a defense of foreign tyranny.

  • Gladstone||

    But isn't saying that support for Pussy Riot is intervenionist and how the media is lying about Russia and Belarus a bit different.

  • Killazontherun||

    This would make for the basis of a killer Eastern European national anthem:

    http://www.youtube.com/watch?v.....ellist=UL

  • Sevo||

    "Why Medicare Reform Is So Difficult"

    Lemme guess: It's because people think they're getting money for nothing and checks for free?

  • ||

    Medicare reform is hard, because old people don't give a fuck what happens after they die.

  • Gladstone||

    How many people give a fuck what happens after they die? Isn't that a major critique of democracy?

  • Sevo||

    HazelMeade| 8.22.12 @ 11:19PM |#
    "Medicare reform is hard, because old people don't give a fuck what happens after they die."

    Not sure that sentiment is limited to 'old people' regardless of claims of 'sustainability' or equal hogwash.

  • Homple||

    Another thread that reads like a discarded Beavis and Butthead script.

  • ||

    Seriously?

  • Archimedes||

    FYI: Rachel Maddow is tearing you Rethuglicans to pieces on Letterman.

  • Killazontherun||

    Her teeth like 27 X-acto blades tearing into carpet, her tongue pushing forward in a polishing motion, go get 'em Maddow!

  • PapayaSF||

    You've got it mixed up: it's her tongue that goes into the carpet. *Rimshot*

  • ||

    You mean one liberal hack is tossing a fellow liberal hack softball questions on an unfunny talk show?

  • Killazontherun||

    Yup, and she is licking those rethugs like Anne Coulter who were too afraid to debate her own Letterman. Why else would they not be there?

  • Gladstone||

    The only thing he needed more was Bill Maher so the Unfunny Liberal Smugness Singularity could form.

  • Archimedes||

    Last night Rethuglican Actor Kelsey Grammer steered clear of politics.

  • Killazontherun||

    That 24 hours between his appearance and Maddow's must have made him hesitant and weary to revel publicly in his manifest evil less he be stricken. As he should be. She that possess a fiery tongue of righteousness is not only a lightbringer, but a timebender as Korzybski so prophesied.

  • ||

    unfunny talk show

    I think you're confusing Letterman with Leno and O'Brian.

  • OldMexican||

    Re: Archimedes,

    FYI: Rachel Maddow is tearing you Rethuglicans to pieces on Letterman.


    I am sure the Rethuglicans you allude to are crying all the way to bed.

    Instead, nobody needs to tear you to pieces - you are pretty much a self-teared man.

  • CE||

    Wrong website. Not many Rethuglicans here.

  • Archimedes||

    So you take no issue that Mittens' tax plan will actually raise tax on the middle class?

  • PapayaSF||

    Tiresome troll is tiresome.

  • ||

    I don't think calling him "Mittens" is going to make people like him less.

  • Red Rocks Rockin||

    Why wouldn't it? Paying for poor welfare sucks is expensive.

  • VG Zaytsev||

    FYI: Rachel Maddow is tearing you Rethuglicans to pieces on Letterman.

    Yes, she and awesome strawman assassin.

    Too bad she turns into a whiny little bitch every time she has to debate a real human being, instead of the voices in her head.

  • ||

    You're such a fucking retard you make shrike, Tony, and Derider look Mensa level intelligent.

  • Enjoy Every Sandwich||

    Tearing Republicans to pieces is not a very impressive feat. They're not the sharpest tools in the shed.

    It also doesn't prove that the Democrats are one bit better. It's masturbation: fun but not productive.

  • OldMexican||

    Why Medicare Reform Is So Difficult


    Because seniors have time in their hands to unionize while we young'uns have to work all day to pay for their Medicare. That's why.

  • CE||

    Medicare (and Social Security) are difficult to reform because old people vote, and tend to live in Florida, a battleground state.

    Ditch the Electoral College, or better yet, the Presidency and the Congress, and things would be a lot better.

  • PapayaSF||

    Ditching the electoral college means that millions of nonexistent Democratic voters in Chicago and Philadelphia would decide every Presidential election.

  • Archimedes||

    What this country needs is a president who will give us a good halftime speech.

  • PapayaSF||

    OT, but a great photo of Obama this week: http://news.yahoo.com/photos/t.....48405.html

    (P.S.: Why does "Preview" STILL NOT WORK??)

  • Carly EngageAmerica||

    Medicare “as we know it” cannot continue. Now that Congress did allow current law to be enacted as written, ratcheting down provider payment rates cannot be done without consequences for patients. The actuary states, ‘In practice, providers could not sustain continuing negative margins and, absent legislative changes, would have to withdraw from providing services to Medicare beneficiaries, merge with other provider groups, or shift substantial portions of Medicare costs to their non-Medicare, non-Medicaid payers,’ (http://bit.ly/KhlvrI)
    There is another option. Moving Medicare to a premium support model, paired with other reforms, could solve the problems facing the program in a way that is affordable for taxpayers and preserves access to quality coverage for America’s seniors.

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