Both Sides Would 'End Medicare As We Know It'

It's a classic example of political rhetoric intended to cloud reality.  Explaining why the most recent Medicare trustee report shows the system going bankrupt in thirteen years (five years earlier than predicted last year), Barack Obama's Treasury Secretary Tim Geithner explained the alarming update was the result of, "technical changes in the economic assumptions underlying the projections."  That's the delicate way for a politician to say, "We were counting on our economic policies actually working, but as you all know, they haven't."

And while that provides yet another indictment of Obamanomics for conservatives to present in the courtroom of public opinion, the most concerning part remains the fragility of a healthcare system that is being relied upon by millions of elderly Americans -- and is being counted on by millions more who are nearing the Medicare eligibility age.  That is why now more than ever it is incumbent upon our leadership to have an honest debate about the future of the system.

No American should naively assume that there is one easy, pragmatic answer to solving the Medicare crisis.  Additionally, no American should naively assume that putting the issue off until one such answer emerges is a prudent approach.  The biggest danger to our seniors is not Paul Ryan and the Republicans who are proposing changes to save the system.  Nor is it Democrats who might do the same.

Right now, the gravest threat Medicare faces is the self-serving politician who champions complacency towards the issue with shameless demagoguery condemning any reform proposals as too big, too dramatic, too risky, and endangering the stability of the system.  Take Democratic National Committee Chairwoman Debbie Wasserman Schultz, who has been in re-runs in virtually every television interview she's given on the subject. 

Two weeks ago, Schultz was asked by Harry Smith on CBS's Meet the Nation, "But the trustees said...that this thing could be insolvent in the next decade.  Doesn't something really dramatic have to happen, and as the Congressman suggested, the Republicans have a plan.  Do the Democrats have a plan?"  She refused to answer that question, choosing instead to read from her poll-tested cue cards: "Like I said, the Republicans have a plan to end Medicare as we know it."

Yes, they do.  Anyone who seriously values and wants to save the Medicare system -- or at least who wants to preserve it for those currently relying on it -- knows that if we don't come up with a plan to do so, Medicare as we know it will end itself when it goes belly-up in the next ten to thirteen years.  Wasserman Schultz may pretend otherwise, but if you pay close attention to what even her allies are saying, it's demonstrably true.

Consider New York Times columnist Paul Krugman, whose recent blog post boasted a title, "Yes, Medicare is Sustainable in its Current Form," which surely made Ms. Schultz proud.  But look at what Krugman actually wrote: "Medicare American-style is very open-ended, reluctant to say no to paying for medically dubious procedures, and also fails to make use of its pricing power over drugs and other items.  So Medicare will have to start saying no; it will have to provide incentives to move away from fee for service, and so on and so forth."

Uh, wait a second.  Isn't Krugman suggesting changes to Medicare?  How can you credibly say it is "sustainable in its current form" if you then clarify yourself by citing ways it must be changed to remain sustainable?  Krugman excuses his revealing double-speak by arguing that, "such changes would not mean a fundamental change in the way Medicare works."

Oh really?  Proposing that Medicare stop paying for "dubious medical procedures" may sound simple enough.  But the question any serious thinker would pose to Mr. Krugman is what constitutes dubious?  And perhaps more importantly, who gets to decide that question? 

Ask Jane Sturm.  She was the woman whose 99-year-old mother received a life-saving pacemaker, something Mr. Obama openly questioned in a White House town hall meeting as potentially dubious.  Sorry Mr. Krugman, but empowering boards of bureaucrats to deny surgeries and procedures requested and needed by seniors (ones that they are currently able to access) is the very definition of a "fundamental change" to the system.

Both sides, then, if they are serious about saving Medicare, are proposing to "end Medicare as we know it."  While Paul Ryan and the Republicans are offering solutions to give the individual more control over their healthcare, Krugman and the Democrats are suggesting changes to give the government more control.

What Americans need -- what American seniors deserve -- is for both parties to recognize the system must be changed, and the longer we wait to do it, the more potent and difficult the adjustments will be.  If politics is the art of compromise, then it's time to stop the demagoguery, put all proposals on the table, and fight this out at the ballot box.

If one side refuses to do that, it should tell you all you need to know about their motives and the strength of their ideas.

Peter is a public high school government teacher and radio talk show host in central Indiana.  Email, visit, or like him on Facebook.

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