Medicare...the political hot potato and a compromise brewing

There are political hot potatoes of varying degrees, but one of the hottest is how to keep Medicare viable in the future.

We have come to a polarized legislative standstill full of poison pills fed by one partisan-dominated house of Congress to the other. A third way is sorely needed and boiling up underneath the partisan rhetoric may be a possible compromise.

The decision time is now, since the cost of Medicare in the future is part of the current budget debate before Congress. Those under 55 should keep their eyes wide open as they make plans for their retirement.

I recall attending some political events four or five years ago when angry senior citizens with hand printed signs waived “Don't let government take my Medicare away.” My takeaway was that seniors feel passionately about Medicare, which presents tough political challenges for those seeking to make sure Medicare is available for the next generations.

So far proposed solutions are either unrealistic or politically too hard for constituents to swallow. Those solutions cover the map: to do nothing but to raise taxes or to reduce benefits to all or some, to increase eligibility age, to increase co pays and contributions, or to get it out of government budgets by privatizing it with government subsidized vouchers (aka premium support) that are not enough to keep up with future costs.

The “do nothing” option is no option at all. There is a bulge in numbers of baby boomers tapping into Medicare that is just beginning and costs of medical care have skyrocketed with increasing availability of life extending treatments and equipment. Obamacare helps some, changing reimbursement methods, providing greater access to preventative care, and efficiencies, but that still is not enough to stop costs from increasing until there is nothing left in the non-military budgets to fund infrastructure, education, and social safety nets .

What both political parties have done is what holders of hot potatoes do … toss it to someone else. In this case, they promise no changes will affect those 55 and older. Grandfathers and grandmothers have been grandfathered in.

Republicans have the most motivation to find a third way. For Republicans it is a particularly sensitive topic since seniors exempted by age from proposed changes in Medicare were the only demographic they carried in 2012, other than non-minority men. Their plan to issue inadequate vouchers and move future seniors into the private sector is not popular with voters in general, nor is reducing the debt, the GOP argument for doing it. The voucher concept polled badly in 2012 per Kaiser Health Tracking, and giving seniors the choice between government or private insurance changed little. Debt reduction is a top concern for a mere 5 percent of voters per a recent CBS News/New York Times poll, finishing far behind jobs and the economy and “other.” If they are not careful, the GOP could lose recently retired seniors in future elections.

A potential way out is emerging quietly from the White House and some Republicans seeking an alternative to vouchers. Traditional government-provided Medicare would continue, except the deductibles for doctors visits would increase and the ones for hospital care would be reduced. The theory is that the costs of doctors visits are not increasing nearly as much as the costs of hospital care. The advantage is that seniors would no longer have to pay high prices for supplementals to cover the cost of hospital care. The price the White House may demand for the compromise is to increase some revenue, but it may be the only way the GOP budget hawks can get their way without ticking off a demographic that means so much to them.

My column in the Sky Hi Daily News today

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Romney insults even his supporters

The real Romney revealed himself  with   comments  at a private  fundraiser in Florida in May. I was not surprised.   I have heard  similar  opinions expressed  since  the 1950's, but  in 2012 it is an insult to many, and it  once again dramatized Romney’s disconnect with the reality of the  lives today of  most Americans.

His comments:“There are 47 percent of the people who will vote for the president no matter what. All right, there are 47 percent who are with him, who are dependent upon government, who believe that they are victims, who believe the government has a responsibility to care for them, who believe that they are entitled to health care, to food, to housing, to you-name-it. That that’s an entitlement. And the government should give it to them. And they will vote for this president no matter what…These are people who pay no income tax... my job is not to worry about those people. I’ll never convince them they should take personal responsibility and care for their lives…”(Text source: the Washington Post fact checker blog)

A question to everyone  on Medicare and social security, or whose parents can find health and nursing home care because of  Medicaid when they outlived their assets :  Did you take personal responsibility and care for your lives? Since most of the recipients of Medicaid and food stamps are kids and elderly, are they even able to  take responsibility for their care?  Did you participate or benefit from these programs  because you felt you were a victim? Or did you participate because your income and savings would not sustain you or your family?

Romney deceptively limited  his figures to income taxes.  According to the Congressional Budget Office  all but 10% pay federal taxes in some form, including  payroll taxes and contributions toward   Medicare and Social Security.

So who do not pay income taxes?  Per senior fellows in the Brookings and Urban Institutes writing in the Washington Post: “About half of these households don’t pay federal income tax simply because their incomes are low. More than one-fifth are retirees who benefit from tax breaks for seniors, including an exemption for most Social Security benefits. And another one-seventh are working families with children whose income tax liability is eliminated because of the child tax credit… or the child and dependent care credit. Together, these three groups of taxpayers account for almost 90 percent of the households that pay no federal income tax.”

With these comments Romney brought additional  attention to  his disconnect with the real life of most Americans. His perspective  is stuck in a 1950’s  mind set  when   we could cover  medical bills in chickens  or even pay out of pocket; the medicine practiced then was unencumbered by expensive life extending   modern technology..  Dad could earn enough money for mom to stay home and take care of their aging parents and provide child care.  The poor stayed poor, they  could not go to college, and they were stuck in an underclass until in the 60’s they exploded when they could not take it anymore. .

 To backpeddle, Romney changed his tune.  Now he says he cares about the 100’%, but his and Paul Ryan’s    plans are not where his mouth is: They propose to cut Medicaid by 30%, Pell grants, Head Start,and  food stamps. Catholic Bishops have called these  plans to cut the poor’s safety net immoral. The plan to “save”  Medicare would,  privatize  part  and   eliminate the  guarantee the federal contribution will cover future costs..

To reduce the deficit is indeed an  important goal, but the Romney and Ryan plans are not the only way to do it.  Plans similar to the Simpson Bowles recommendations would inflict less pain on safety net programs and  maintain Medicare as we know it. Many alternatives are discussed at http://www.aarp.org/health/.

 The above is a version that appeared in today's Sky Hi Daily News