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Saving Medicare Without Destroying It

| June 4, 2011

saving medicare without destroying it.

At least he has Acme insurance.

FlaglerLive Editor Pierre Tristam’s weekly commentaries are broadcast on WNZF on Fridays just after 9 a.m. Here’s this week’s.

If welfare is defined as a government handout, the country’s two biggest welfare programs have virtually nothing to do with the poor. They’re middle and upper class bonanzas. One of them is the mortgage interest deduction. At a cost of $80 billion a year to taxpayers, homeowners get to deduct their interest on loans of up to $1 million. The more expensive the home, the fatter the deduction. It’s the opposite of a progressive tax. It’s a regressive handout.

The other hand-out is the tax exemption on employee-provided health care. That subsidy costs up to $150 billion a year. It encourages people to buy more coverage than they need. It encourages insurers to jack up premiums. And like the mortgage deduction, it benefits wealthier people. When he was running for president, John McCain had half a good idea. He proposed to eliminate that subsidy and use the money to pay for his version of health care reform. Unfortunately, that version was so divorced from the reality of everyday medical costs as to be the sort of proposal that could come only from a man who’d lost count of the number of houses he owns. McCain wanted working-age adults to buy their own private insurance in exchange for a “tax credit” of $2,500 to individuals and $5,000 to families. That would have covered less than half the cost of premiums for either. And it wasn’t going to be adjusted for inflation.

McCain wasn’t elected president. But Paul Ryan seems to think he was. That’s the Wisconsin congressman whose recent plan to balance the federal budget sent reactionaries in a swoon until details of the plan began to emerge, and Democrats began to capitalize at the polls.

The Live Column

Ryan wants to privatize Medicare. It would no longer be the fairest, single-payer insurance system we have, at least for the elderly. The government’s role would be eliminated. Ryan would crib the worst part of the McCain health plan—that $5,000 subsidy—with the worst part of America’s health care system: its slavery to the private insurance industry. The program would be phased in, grandfathering current beneficiaries. But anyone 55 and younger today would then have to shop for his or her own retirement health care plan, with that $5,000 hand-out from the government, and with this catch: that subsidy won’t be indexed to health care inflation, but to general inflation, which typically grows two or three times slower. Over time that subsidy would lose value, burdening the elderly to make up the costs.

Give Ryan this much. At least he’s trying. That’s more than you can say about Barack Obama or the Democrats, who have no serious deficit-reduction plan. Obama’s idea stops at taxing the rich by restoring the Clinton-era tax rates, but only for those making $250,000 and above. That’s just 2 percent of the country’s households. It’s neither realistic nor fair. If we’re going to pay down the deficit, no one should be exempt, whether through regressive deduction schemes or the marginal tax rate.

And simply saying that Republicans have a terrible plan isn’t enough, particularly when it comes to Medicare. But Medicare doesn’t need to be destroyed to be saved. As an insurance system, it works better than anything in the private sector, with lower overhead, better coverage and more freedom for patients to choose any doctor they please. That’s what Ryan and his fans don’t like about it. It’s a single-payer system that leaves out private insurance. Their aim isn’t to provide quality care to the elderly. It’s not even to balance the budget. It’s to re-open the massive market of elderly consumers to predatory private insurers. Let’s not.

As always with the budget, there’s an easy fix if we get off the notion that we shouldn’t have to pay for what works. Handouts like the mortgage interest deduction could be capped at $100,000. The tax-free ride on employee-provided health care could be ended. The Medicare tax could be increased by half a percent, providing not only enough money to insure Medicare long into the future, but to expand it to the 55 and over bracket. Of course private insurers would have a conniption and reactionaries would trot out the usual yaps about socialized medicine. But not many of the 50 million Medicare beneficiaries will complain.  If we give a whit about our elderly’s care and dignity–if there is such a thing as society’s moral responsibility for its elderly generation–that’s who comes first. Not your selfishly too-low taxes. The rest is noise.

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12 Responses for “Saving Medicare Without Destroying It”

  1. Dorothea says:

    Pierre, Obama does have a plan already in place. It’s called the Affordable Care Act. I would have much preferred an extension of Medicare to all Americans along with modest increases in costs to the beneficiaries. But the Affordable Care Act is still far superior to the Republican’s plan to destroy Medicare in totality.

  2. Layla says:

    It’s going to be interesting when those “affordable” premiums reach the $400 a month mark and people don’t have the money to pay them.

    Blindly we march off the cliff.

  3. rickg says:

    We are the only industrialized nation without a health care plan for all of its citizens. Its time to look around us and realize that health care should not be a profit making industry. It is a right along with the right thing to do. The benefits go beyond keeping one healthy.

  4. Liz McLaughlin says:

    “Let’s not” – perfect.

  5. noelarroyo says:

    Healthcare is not subject to normal market forces! Anything that you have to buy at any random moment in order not to die is not something to which a rational supply/demand calculus can apply. Check out “Penny Health Insurance” articles on how to reduce the cost of insurance.

  6. concerned says:

    Here’s a handy interactive map, put out by the energy/commerce commission, showing exactly how the GOP Plan will affect you, your community, your friends, family and neighbors.

  7. Dorothea says:

    Concerned, thanks for posting the link. These are the immediate effects of the Republican health”care” bill for current Medicare recipients in this Congressional district. They happen immediately, not ten years from now.

    • Increase prescription drug costs for 9,600 Medicare beneficiaries in the district who enter the Part D donut hole, forcing them to pay an extra $95 million for drugs over the next decade.
    • Eliminate new preventive care benefits for 151,000 Medicare beneficiaries in the district.

  8. concerned says:

    Dorothea – you’re most welcom. Your comment re the Affordable Healthcare Act was appreciated, as well. However, IMO there was no way then or now that the GOP would/will allow single payer for all type coverage. The GOP’s into making more folks poor & confiscating their assets than it is in assisting the masses out of the abyss our elected officials are making of our country. Rick Scott being a rather telling example…

  9. kevin says:

    Pierre’s paragraph…”Give Ryan this much. At least he’s trying. That’s more than you can say about Barack Obama or the Democrats, who have no serious deficit-reduction plan.” is absolutely correct. There are other plans out there as well but they come from sources, which you wouldn’t read only because of their implied beliefs regardless of the intelligent and factual information they provide and are defintely ignored by most media sources because they bode favorably for the republicans.

    …”Republican’s plan to destroy Medicare in totality.” Another completely unsubstantiable, overblown, innaccurate comment. The facts, which I would bet a huge amount of money on that you have no detailed understanding of, because the details of enacting these plans and their real time outcomes are tremendously complex where even experts who spend their days analyzing everything, have difficulty; you a part-time democrat average person (based on the sum of your previous comments and logic) knowing more than they—I doubt it Dorothea.

    One observable, irrefutable fact is Obama’s ideas are not working and that he, Pelosi, and Reed, The Evil Triumpherant, have nothing but tax and spend as their only generalized, unorganized, plan . More and more he is showing to be a day late and a dollar short, continuing to use failed policies that don’t work, lacking the courage and leadership skills that would make him flexible and willing to admit to error, change positions, and create impoved upon ideas then those we have seen to date. Hell, Obama is even getting lambasted by other G8 leaders for his adhearence to continuing with what he is doing, even losing critical members of his team because they see him as not knowing what he is doing and not wanting to go down with the ship. At least he has Timmy Geithner to continue to help the country with the wisdom he has being Timmy is the single most intelligent, best qualified human in the world for the position as Obama once communicated but not in those specific terms (but darn close to it).

  10. Jack says:

    Regurgitating conservative talking points, blah blah blah. But I do have to ask and I’ve asked this once before, what is the deal with the Republicans and “lower” spending? Reeeeally? Are the Republicans known for balancing the budget? Are Republicans known for “shrinking” government? Really? I ask this, not just sarcastically, but also honestly. Empirically speaking, Republicans have done NONE of this on the state and federal levels.

  11. Dorothea says:

    Jack, I appreciate your relevant comment and question. I have tried many times to respond to Kevin,s distortions and untruths and have grown weary of the effort. You can’t get through to him. Now he’s relegated me to a “part-time democrat average person,” whatever that is. In his own mind he believes himself a full-time genius pharmacy student, stockbroker, teacher, and numerous other fields where he claims expertise. In truth, just, as you state, he regurgitates Republican talking points, while slamming the credentials and character of the person with whom he is arguing. Jack, don’t expect a cogent answer. What you will get from Kevin is more Republican talking points and eventually character assasination because you don’t agree with him.

  12. William says:


    We’ve just passed the 10 year anniversary of the first of shrub’s tax cuts, and the proof, as they say, is in the pudding. THEY HAVE NOT CREATED JOBS! The country is far worse off now than a decade ago. Millions of jobless. Forclosures at crisis levels. An economy in tatters as a direct result of the republican mantra of deregulation (see Glass-Steagall). Income inequality at levels not seen since just before the onset of the great depression where, at present, the top 20% own 93% of the nations wealth, and the remaining 80% share a mere 7%. All this while general taxation levels are the lowest since the Truman administration.

    According to the Bureau of Labor Statistics, job growth under Chimpy McCokespoon was 0.5% over 8 years, the worst since record keeping began. The position of second worst is occupied by boosh the slightly smarter with 0.6% job growth over 4 years.

    As you should be aware by now, I am not a great fan of Obama, but if we’re going to examine failed policies we could start with raygun, who tripled the national debt, and dumbya, who doubled it again.

    I’m deeply offended by the fact that we are being asked to sacrifice in areas of social services, education, health care, ect. in order to pay for tax cuts which benefit the wealthiest families in America, and to pay for our endless wars.

    Doesn’t fit very well with christian values as I understand them.

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