Who Cares About Medicare?


Republican Congressman Roy Blunt draws the ire of The Washington Monthly's Steve Benen for suggesting that maybe Medicare wasn't such a good idea after all. Benen writes:

It's a reminder of how the status quo can trip up GOP leaders. The current system already has the government playing a role in making health care available to the elderly, military personnel and veterans, the poor, and low-income children. None of these developments have ushered in the collapse of capitalism or a dystopian bureaucratic nightmare for consumers. It puts Republicans in the position of having to explain why it's fine for the government to play a health care role in some contexts but not others.

I won't dispute that Medicare is popular, or that politicians — even Republicans — don't usually criticize it, but it hasn't exactly been an unqualified success. On the contrary, as the CBO reports, the program's fiscal future looks dire:

For decades, spending on the federal government's major health care programs, Medicare and Medicaid, has been growing faster than the economy (as has health care spending in the private sector). CBO projects that if current laws do not change, federal spending on Medicare and Medicaid combined will grow from almost 5 percent of GDP today to almost 10 percent by calendar year 2035 and to more than 17 percent of GDP by 2080. That projection means that in 2080, if there are no changes in policy, the federal government would be spending almost as much, as a share of the economy, on just its two major health care programs as it has spent on all of its programs and services in recent years.

Medicare might be an old and beloved program, and that might make it politically untouchable most of the time, but the program is far from a runaway success. Indeed, fixing the looming budgetary problems with Medicare is a key reason why many are keen to overhaul the current system. Suggesting that Medicare's potential problems outweigh its benefits — particularly given that the establishment of Medicare and Medicaid have made it exceedingly difficult to implement a true market-driven health-care system — might be politically ill-advised, but it doesn't actually seem all that crazy.

It's probably true that health-care reform geared toward providing universal coverage wouldn't "usher in the collapse of capitalism or a dystopian bureaucratic nightmare" for patients. But one needn't see a Roland Emmerich-style catastrophe on the horizon to worry about the potential for problems with a massive expansion of government involvement in health care, nor does one need to think of Medicare as an unmitigated disaster to think that perhaps it wasn't all that great an idea.

Last month, Shikha Dalmia wrote about problems with Medicare-style insurance; in 2003, Kerry Howley wrote about generational warfare over Medicare deficits; and in 1999, former Reason editor Virginia Postrel warned against expanding the program.

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  1. Nice to see some in the GOP are getting it but of course it will be meaningless if they dont put a stop to Obamacare.

  2. Damn good thing the last Republican administration took proactive steps to reduce the size, complexity and cost of Medicare.

  3. As a health insurance broker that specializes in the self employed and small business owner, a good deal of our clients transition into Medicare. because of all of the pitfalls of the standard Medicare plan,most opt for a Medicare advantage, which are offered through state and national carriers.why?, because HMOs have dominated for the past 15 years and people gravitate to what their familiar and comfortable with.

    1. provided that however through the pitfalls through the common Medicare plan,most go for almost any Medicare advantage, which have been provided as a result of place out and nationwide carriers.why?, provided that HMOs have dominated for the earlier 15 many years and grownup women and men gravitate to what their recognizable and safe with.

  4. None of these developments have ushered in the collapse of capitalism or a dystopian bureaucratic nightmare for consumers.

    My action isn’t going to kill you, and if you die it was your own fault for blocking the knife.

  5. I don’t think anyone doubts that there are serious problems with medicare. USA still spends more per percentage of GDP and per capita on healthcare than any other nation.

    15% of our GDP is spent on healthcare, the greatest percentage of any nation on the planet. There is something wrong with the healthcare system, whether it’s in government inefficiency, social and business attitudes towards healthcare, or even market inefficiency.

    Of course, the healthcare industry has no desire to reform its systems as it has become an extremely profitable sector of the economy. The fact is most Americans are paying for unnecessary treatments and bloating costs.

    The other fact is healthcare relies on doctors to make wise decisions for patients. When decisions are made based on profitability, you will see rising costs like in the USofA.

  6. Isn’t it fair to assume that, despite the government’s best efforts, healthcare will probably be dramatically cheaper in, say, 50 years?

  7. The other fact is healthcare relies on doctors to make wise decisions for patients. When decisions are made based on profitability, you will see rising costs like in the USofA.

    Almost. When you have government footing the bill, with almost no direct cost billed to the consumer, you will see rising costs. If you’re spending someone else’s money, you’ll spend more of it without questioning the bill.

  8. Wow, I have to admit that does raise some pretty interesting points!


  9. That medicare is untouchable proves that there’s no hope for America. I hope my children do the right thing and retaliate by banning health care to anyone over 70.

  10. James Ard,

    I like Eugenics, too. Let’s get together.

  11. Silentz:

    I think other countries deal with this by requiring larger co-pays. Citizens still have to pay for doctor visits, and I think they actually pay more per visit than a typical USA insurance policy.

    Americans would still be spending money to access healthcare under universal care, the only difference is that everyone will be insured.

    Nobody is advocating ‘FREE’ healthcare. Everyone will still have to pay.

  12. Nobody is advocating ‘FREE’ healthcare. Everyone will still have to pay.

    That’s the point. Everybody pays, and services are rationed by fiat; as opposed to market pricing — because the market exploits the underprivileged proles, because accumulation of wealth is equal to violence, because wealth is finite.

  13. I am from vancouver canada and i wanted to say that president Obama is not going to be any different than other presidents when it comes to health care.
    Health care is considered a commodity like everything else under capitalism.It is not done for the good of the people,as far as the gov. is concerned profit comes before people.
    In Cuba health care is a top priority for the people and it is free.Besides that the health care in Cuba is better than it is in canada or the usa.In Cuba there is no shortages of doctors or nurses and the cuban gov.sends lots of doctors to third world countries to help the people there without charge to them.So the cuban system is far in advance of the usa or any other capitalist gov.

    Stan Squires

  14. Medicare will be a big election issue later this year. Here in Ohio, health insurance rates in Ohio are still low but folks on Medicare are wondering about their future.

    Certain Senior plans may be taken away so their vote will be very critical to both Obama and Romney.

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