The Big Lie: Medicare is unsustainable and Republicans want to save it.
The Truth: Medicare is the most cost-effective health care system in America. Paul Ryan’s plan to turn it into a fixed benefit voucher program would void the Medicare promise and cost seniors trillions.
Less than two years after his inauguration, a charismatic Democratic president suffers a shellacking in a midterm election. A fiery Republican majority floods into the Capitol, declaring they’re determined to take their country back and attack the scourge of big government. A bold intellectual leader roundly praised by the Washington elite for his “seriousness” steps to the forefront, certain that he has answers for the American people.
His solution to budget woes? End Medicare as we know it.
The year? 1995. The Republican leader? Newt Gingrich.
“Now we don’t get rid of it in round one because we don’t think that that’s politically smart, and we don’t think that’s the right way to go through a transition,” Gingrich said, in a now famous statement replayed thousands of times during the 1996 presidential campaign. “But we believe it’s going to wither on the vine because we think people are voluntarily going to leave it — voluntarily.”
When Medicare was signed into law by Lyndon B. Johnson in 1965, a majority of Republicans voted against the creation of a single-payer health care plan for retirees that, combined with Social Security, promised security and a basic standard of well being for all Americans 65 and older. Generations later. Medicare remains one of the most popular government innovations in American history. A 2011 poll found that 88% of Americans believe that Medicare has been good for the country—making it nearly as popular as the tax rebates, mid-afternoon naps, and apple pie.
And it’s not only liberals who love Medicare. In 2010, in the midst of the Tea Party’s peak furor, a New York Times/CBS poll found that 62 percent of Tea Partiers answered “Yes” when asked, “Are the benefits from government programs such as Social Security and Medicare worth the costs of those programs?” 62 percent! That’s nine points higher than the percentage of Tea Partiers who described themselves as “angry” at the federal government.
Still, the Republicans cherish their fantasy that people would voluntarily want to leave Medicare — even after saving it helped Bill Clinton win an easy reelection in 1996.
Fifteen years after Newt Gingrich revealed his plan to let the original vision of Medicare wither away, another right-wing scion stepped forward to propose an updated version of the same scheme. Call it “Kill Medicare 2.010.” Like the second version of the Terminator, this futuristic destroyer was a shape shifter, determined to succeed where its predecessor had failed.
Paul Ryan—the latest GOP wunderkind to believe that all retired people are missing in life is the joy of wrangling with private insurers—is part of a new House majority that has even less shame than Gingrich’s 1994 “Contract With America” class. For Ryan and the so-called Tea Partiers who took 63 seats in the 2010 elections had actually won their majority by campaigning against cuts to — say it with me — Medicare!
It was a Machiavellian move that would make Machiavelli blush (which is by definition a Karl Rove move). Republicans around the country attacked their opponents for voting $500 million in Medicare cuts that were part of the Affordable Care Act. What they didn’t explain is that those cuts were entirely to a program called Medicare Advantage, a private insurance experiment championed by conservatives that proved to be wasteful and bloated.
No cuts to actual benefits were made. No costs were passed on to seniors. In fact, the ACA closed the so-called Medicare Part D “doughnut” hole, giving many seniors a $250 refund on the prescriptions they purchased. Additionally, for the first time Medicare would cover preventative care for free.
So what did this new majority propose as soon as they were blown into Washington on the wind of their campaign against cuts to Medicare? Trillions and trillions in cuts to Medicare benefits.
It should go down as history’s greatest bait and switch. But in a post-Citizens United America, history belongs to whoever can afford it.
Of course, Paul Ryan and this new class of Republicans had learned one thing from Gingrich’s debacle: they would never be able to get those who enjoy or were about to enjoy Medicare’s benefits to opt out of the program. They knew first hand, seniors would reject any immediate cuts to Medicare the same way they’d rejected the Democrats who voted for the ACA.
So how do you gut Medicare when seniors who always vote won’t let you gut Medicare? You pretend that your plan to voucherize Medicare and to raise retirement age to sixty-seven won’t actually affect seniors. “If you’re fifty-five or over,” Paul Ryan said over and over, “this doesn’t effect you.” You get to keep the program you love. Don’t worry, seniors, Ryan reassured. This won’t affect you. It will only affect your younger siblings, your cousins, your children. They’ll pay for you to keep the Medicare you love.
This is how you save Medicare, Ryan claimed.
Why would Ryan claim that he was “saving” Medicare as he was proposing to dismantle it and replace it with a system that closely resembled to the Affordable Care Act he and the GOP allegedly despise? Simply because he knew nearly no one wants to buy what he’s selling.
When Ryan released his plan, polls showed that 65 percent of Americans oppose turning Medicare into Ryan’s voucher system, about the same percentage who opposed Gingrich’s Medicare ideas in the 90s.
Why do they reject Ryan’s Vouchercare? Mostly because Medicare works. Not only are the costs of Medicare rising much more slowly than private insurance — despite serving an elderly population — the program is much more popular than the private insurance programs into which the GOP wants to funnel hapless Americans.
A 2012 Commonwealth Fund study states the case plainly: “Medicare beneficiaries age 65 and older are more satisfied with their health insurance, have better access to care, and are less likely to have problems paying medical bills than working-age adults who get insurance through employers or purchase coverage on their own.”
In every way that matters to Americans, Medicare is more cost-effective and popular than private insurance. Gingrich and Ryan both know this fact. So how do they make the case to end this program that has saved so many lives and alleviated so much heartache?
Scream, “Medicare is going broke!”
The idea that Medicare is going broke is almost as old as the program itself. The GOP knows that no one trusts their assessment of the solvency of a program they clearly want to kill. That would be like trusting the Big Bad Wolf to babysit Little Red Riding Hood. So to properly scare Americans, opponents of Medicare constantly turn to the good old Medicare Trustee’s Report.
In the Trustee’s report, the GOP always finds the Mediscare they’re seeking. In 1970, the Report said Medicare would go bankrupt in 1972. In 1981, it predicted Medicare would be out of cash by 1994. In 1990, the expiration date was 2003. In 2010, the predicted year of insolvency was 2029.
The Affordable Care Act elimination of private insurer waste and addition of smarter care has added years to the life of the Medicare program. And this is before the ACA even begins to take full effect, potentially improving the health of the millions of Americans who become eligible for health care every year and saving us untold billions.
Despite looking at 19 years of solvency — the most optimistic prediction for Medicare since the days of the Clinton surplus — Republicans decided that their huge victory in 2010, won by “defending Medicare,” was a mandate to tear the program apart while they had the chance.
Paul Ryan loves to say that the United States is facing the most predictable debt crisis in history. He says the only solution is to reduce our debt now by cutting spending and asking seniors to pay more for Medicare — roughly twice as much for the same care current beneficiaries receive now.
If we are truly headed for a crisis, wouldn’t any “serious” leader point out that taxes on the American people haven’t been lower in more than thirty years? When mega-millionaires like Mitt Romney are paying 14 percent tax rates, certainly there are solutions other than passing enormous costs on to seniors and cutting essential services.
But now we come to the darkest lies in Paul Ryan’s rhetoric. While asking future seniors to pay $6,500 more a year for Medicare, he would be cutting taxes on millionaires by an average of $265,000 a year. Is this what you do when you’re facing a debt crisis?
The Ryan Plan was obviously written in the Twilight Zone. It isn’t a plan to save Medicare. It’s a plan to roast the middle class.
How can we actually save Medicare? Keep the efficiencies written into the Affordable Care Act. Don’t invite private insurers and Wall Street into the system to vacuum trillions of dollars from senior citizens. Legislate basic reforms that in the past have been supported on both sides of the aisle.
For instance, many commentators have asked why everyone who accepts Medicare isn’t required to sign a living will stating how they’d like to be treated in their last days, the period when a remarkably high percentage of our Medicare budget is actually spent. This sort of reform has been scare-mongered by Ryan’s allies as a nefarious government plan to get between you and your doctor when it does just the opposite.
You can also make the argument that the best way to save Medicare is to expand it to all citizens, as Canada has done with a system they ingeniously call “Medicare.” Every developed country in the world has universal health care and they all pay less for their care than we do. The fact that the Affordable Care Act provides near universal coverage will also lead to a more healthy population of Medicare beneficiaries in the years to come.
But, of course, the best way to save Medicare is to keep Newt Gingrich, Paul Ryan and the Republicans who want to “save” it as far from the program as you possibly can.
Photo Credit: AP/Mary Altaffer