By John Brummett
If you try to end something “as we know it,” are you effectively trying to kill that thing?
If the automobile industry switches wholesale next year from cars to motorcycles, will it end the automotive industry as we know it? Will it essentially kill cars? Or will it effectively stay in the motor vehicle business in a way that fashions long-term savings in energy and dollars, if at the expense of highway safety?
That’s just a contrived example of the issue, a metaphor. By presenting issues of wholesale change, savings and safety, the example offers all the relevant elements of the actual case.
That real issue is medical care for old people. It is merely America’s burning political debate of the moment, and maybe for the next several months.
Democrats say Republicans tried earlier this year to kill Medicare by embracing U.S. Rep. Paul Ryan’s now-dormant plan to change it wholesale. Democrats thereby try to scare older folks, who vote heavily. They also take a shot at defining Republicans more broadly as extremist and insensitive to our most vulnerable citizens.
Republicans say this Democratic assertion is a lie and that they actually tried to save Medicare from its bankruptcy course by overhauling it. Some of these Republicans, including U.S. Rep. Tim Griffin in the 2nd District of central Arkansas, have made statements acknowledging trying to end Medicare “as we know it,” if, that is, you refer to bankruptcy-bound as the way we know it.
There are basic facts:
—Medicare is a single-payer government health insurance system into which persons are placed at age 65. It poses an ever-increasing drain, an unsustainable one, on our federal budget.
—Ryan proposed to discontinue Medicare as a single-payer government plan. He wanted to transform it into a system, still called Medicare, by which retirees would be mandated to purchase health insurance privately. A contribution toward that cost would be provided by the federal government.
—The Congressional Budget Office found that Ryan’s plan would shift costs from the government to old people. (Naturally, Republicans say the CBO overstates and that private market forces would bring costs down. They also say the government is going bankrupt and something simply must give.)
So there you have it: End Medicare as we know it? Yes, plainly. Kill Medicare? Alas, that one is classically spinnable, vexingly fair enough either way.
The best thing we can do is tune out these self-serving characterizations and stick to the facts, making of them what we choose after our own suitable and judicious deliberation.
U.S. Sen. Mark Pryor, a Democrat having a newsmaking day at home Monday, went before a senior citizens’ audience and sought to reassure his listeners. He said the country could make Medicare solvent for the long term by tinkering with it through an independent and bipartisan commission that could make something big out of many small cuts.
While it is true by my personal assessment that Republicans acted too drastically with Ryan’s bill, it is equally true by my other assessment that, absent endorsement of specifics, Pryor is serving a tablespoon of mostly Pablum.
A final caveat: Do not be misled when these partisan opposites offer journalistic citations in support of their respective spins.
An independent Democratic group running attack ads against Griffin and Republican Rick Crawford in the 1st District quotes in those ads a news article from April in The Wall Street Journal. The reporter and his editors thought it fair to say in that article that Ryan’s plan would end Medicare.
Right or wrong, that’s a characterization, not a simple fact, and you, if sufficiently committed, could do as well in arriving at your own characterization.
After a quarter-century in this work, I know full well how to get this column quoted, or at least cited in a footnote, in a forthcoming attack ad.
So let me use the remaining space to give both parties a footnote for the 2012 campaign season:
Republicans tried to end Medicare.
Republicans tried to remake Medicare to save it.
Pick what you like. Just spell the name right, with two “m’s and two “t’s.”
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John Brummett is a columnist for the Arkansas News Bureau in Little Rock. His e-mail address is jbrummett@arkansasnews.com; his telephone number is (501) 374-0699.
July 3rd, 2011 at 6:39 am
Remake Medicare to save it? How about remake and diminish Medicare AND Medicaid to pay for tax cuts benefitting the very wealthiest Americans?
Did you look at anything in the Ryan Plan outside of Medicare, maybe to be able to judge it in context?
It lowers the top tax bracket from 35 to 25% and slashes taxes by $4.2 trillion. So we can’t afford to not slash Medicare and Medicaid to save the programs, but we have trillions to throw around in tax cuts?
See how another financial reporting publication spells out the tax provisions:
http://goo.gl/mSPGr
Oh, and here is how our Governor described what the Ryan plan would do to Medicaid, which is an insurer of last resort for the frail elderly, the disabled, and low-income children:
http://goo.gl/cjr3k
I think a fair and objective observer would conclude that Governor Beebe has been working to reform Medicaid to save it. His comments in this letter, signed by several other governors, show his thoughts on what the Ryan Plan would do to Medicaid.
July 3rd, 2011 at 5:00 pm
I wonder if Medicare would have passed had the Congress known the actual cost of the program? I doubt it.
The LBJ adminsitration GROSSLY underestimated (lied) about the costs of the program over the long term, I believe to ensure passage of the prgram. These costs continue to grow almost exponentially with no end in sight . . .
* * * * * * *
But the cost to the government (um, taxpayer) is only half the equation. The other aspect to Medicare is the inflationary impact it has had on the costs of heatlh care.
Between 1965 and 2005 expenditures on Health Care as a % of GDP tripled.
This is Progressive economics at work: Hyperinflation and Bankruptcy coupled the requisite Dependency which makes reform impossible.
* * * * * * ** *
Once a political class begins to bestow direct “benefits” on a citizenry there will never be an end to it . . .and such policies will always lead to dependency, corruption, bankruptcy . .and the creation of a totalitarian state.
July 3rd, 2011 at 9:37 pm
RE Captain saying: “I wonder if Medicare would have passed had the Congress known the actual cost of the program?”
Yeah, one would have thunk after the people knew how much it cost that given a Republican Congress and Republican President it would have been repealed. Instead, they added a drug benefit to it that will cost more than $1 trillion per decade.
Actually, the costs of providing care though traditional Medicare has grown at a much slower rate than premiums for private insurance, and Medicare has done a much better job delivering care than private insurers had. The old Lincoln quote on the appropriate role of government applies well here: “The legitimate object of government is to do for the people what needs to be done, but which they can not, by individual effort, do at all, or do so well, for themselves.”
Our government needs to do an even better job holding health costs down than we have. Our government should also do more to ensure the program has sufficient public funding and ask seniors to pay a reasonable amount, that they can afford, toward the cost of their care.
July 3rd, 2011 at 11:33 pm
@Lefy
“Yeah, one would have thunk after the people knew how much it cost that given a Republican Congress and Republican President it would have been repealed. Instead, they added a drug benefit to it that will cost more than $1 trillion per decade”
But see, this is my point. Once the political class starts doling out benefits to the public – there is no stopping it regardless of who we elect.
And people don’t know how much things cost. The average person can readily calculate the “benefits” he receives from government . . .but not 1 in a 100 can tell you what the aggregate costs are.
Eventually we will have a situation in which more people are receiving benefits from the government than are paying into the system. A situation which, as Edwin Gibbons noted, led to the dissolution of the Roman Empire.
July 5th, 2011 at 5:36 am
RE Captain musing: “Eventually we will have a situation in which more people are receiving benefits from the government than are paying into the system.”
I’ll have to concede a point to you there. Expanding the number of people qualifying for Medicare has gotten way out of hand.
In 1972 it was expanded to cover the disabled, with just a two year waiting period after someone became eligible for Social Security disability.
Then in 2001 there was a specific group of said disabled people that got even better treatment. ALS patients, with average life expectancy a little over two years after diagnosis, had the two year waiting period eliminated for them. They now qualify for Medicare about five months after they are deemed to be disabled. These mooches are clearly going to die any way, why should taxpayers help them?
July 5th, 2011 at 7:09 am
http://www.realclearpolitics.com/articles/2011/07/04/unhappy_birthday_110448.html
http://www.nytimes.com/2011/07/05/opinion/05brooks.html?ref=davidbrooks
These are a couple of great columns by Robert Samuelson and David Brooks.
Bottom line: We need statesmen (and women) who are willing to stand up to their respective bases and cut a deal. Which means tax increases and spending cuts.
July 5th, 2011 at 11:36 am
John, fairly good analysis as the facts are on the surface.
More to the point though, this is “A” plan.
Would make things a bit easier, I hope you would agree, if we had other plans to compare this one against.
That is as compared, in the present case, ONLY to the present, unsustainable,status quo.
Being one of those possibly soon medicare recipients, I agree the present situation is a problem, but I am not convinced the Ryan plan is the “BEST” solution.
That is why we elect or reps. (no matter their party), to come up with a counter offer plan…still waiting????
July 5th, 2011 at 9:57 pm
Captain, we’ve been at this debate long enough to reach agreement. I thought the Samuelson column made a fair amount of sense. The Brooks column is absolutely a correct sumation of where things stand.
Unfortunately, most conservatives I know have a considerable dislike of Brooks propensity to tell things from a practical perspective.
July 6th, 2011 at 1:29 am
I like Brooks. He is a Burkean conservative like myself.
The problem with Conservatives today is that they still believe the year is 1981:
#1 They believe in increased defense spending,
#2 Cuts in the top marginal rates,
#3 And continue to look for a candidate resembling The Gipper.
The problem is that this ISN’T 1981. We no longer have a 70% top rate, and we are not facing 50,000 Soviet tanks in Central Europe. Reagan’s playbook made sense then, but times have changed.
That’s the problem when you allow ideology to do your thinking for you.
The same problem afflicts Liberals as well, only over different issues. . .
July 6th, 2011 at 1:42 am
Lefty, one final thing – - if I were a national Republican leader, I’d definitely push for tax hikes in exchange for real spending cuts. This is what the country needs now.
But my fear in raising tax rates is that it will only give the political class another excuse to spend money. . . .and eventually we’ll find ourselves in the same financial predicament – only with higher tax rates.
California is an example of this – - -highest tax rates in the country and STILL bankrupt.