The I’m-Rubber-You’re-Glue Approach to Medicare Discourse

April 02, 2014
5:00 pm

Mere hours after Representative Paul Ryan (R-WI), the chairman of the House Budget Committee, released his budget proposal containing a Medicare reform concept that would give beneficiaries a choice of staying in conventional fee-for-service Medicare or choosing from a number of competing private health plans, I received an e-mail from one of the several organizations in D.C. purporting to represent the interests of seniors (no, not the big one with the four letter acronym starting with “A”).

I told myself that the e-mailed statement would be a thoughtful analysis of the Ryan proposal, laying out pros and cons and encouraging a dialogue on how to build a sustainable Medicare program for future generations.

But I was just playing an April Fool’s joke on myself.

Of course, the message was full of the usual, tired rhetoric – “ending Medicare as we know it,” “allow it to wither on the vine,” “forces seniors and people with disabilities to pay more for less” – that bubbles back up every time it is suggested that Medicare may need structural change in order to avoid fiscal calamity.   It’s a little like the movie Groundhog Day, except it’s not at all funny because the Medicare trustees have told us that the program only has solvency until 2026.

This post isn’t an endorsement of the Ryan plan, but it is an endorsement of responsible, reasonable discussion about Medicare’s future.  It’s irresponsible to engage in name-calling and rhetorical mud throwing instead of substantive debate about how to place the program on sounder financial footing while providing beneficiaries with access to quality care.  It’s also a crime against accuracy to say that a premium support approach will make seniors pay more for their healthcare when the Congressional Budget Office has said that it’s possible to structure an approach that would cost both beneficiaries and taxpayers less money.

To be fair, my organization has spoken with members of both parties in the House and Senate who do, in fact, want to have this thoughtful, productive discussion.  I’m optimistic that it will happen and that we will one day see a bipartisan plan that leads to a stronger, more sustainable Medicare.  That day might come sooner if some of the opportunists in Washington start throwing ideas instead of insults.

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