JONATHAN COHN APRIL 4, 2011
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Based on what we know so far, the Republican plan for Medicare would appear to be one part hypocrisy and one part con.
Republicans have spent much of the last two years attacking President Obama and the Democrats for cutting Medicare spending, as part of the Affordable Care Act. Now those same Republicans appear to be proposing cruder, deeper cuts that would, for all intents and purposes, destroy the program.
That's the hypocrisy. And the con? That would be the ability of Republicans to hold the allegiance of senior citizens. As Paul Krugman writes today, it looks like seniors who thought voting Republican would preserve Medicare got played for "suckers."
But did they really?
The Republicans may be calling for the end of Medicare as we know it. But the end wouldn't come for another ten years. From the sounds of things, everybody who is in Medicare now and everybody who would become eligible for it before 2021 could still enroll in the traditional, government-run program with the full guarantee of benefits. And they'd get to stay on the plan for the rest of their lives. Only people who are now less than 55 years old would be part of the less secure, privatized system.
And why would Republicans do that? Matt Yglesias has one theory:
part of the plan here is that Ryan is going to promise currently elderly people that they’ll get all their currently promised benefits plus that he’ll undue the Medicare cuts that were part of the Affordable Care Act. The idea here is that today’s old people--a very white group that’s also hostile to gay rights, and thus sort of predisposed to like conservative politicians--will also get to benefit from an extremely generous single-payer health care system. But younger people--a less white group that’s friendly to gay rights and thus predisposed to skepticism about conservative politicians--will get to pay the high taxes to finance old people’s generous single-payer health care system, but then we won’t get to benefit from it. This is in part in order to clear headroom in the budget so as to make gigantic tax cuts for rich people affordable.
To be fair, I think the primary impetus for delaying implementation for a decade was a slightly different political calculation: An assessment that taking away Medicare from seniors who have it now would, in fact, kill the plan politically. But Yglesias is right about the distributional effects of ending Medicare in the way that Republicans are likely to propose.
By the way, politics and motives aside, the Republican and Democratic approaches to reducing health care spending make for an interesting policy contrast. I'll talk about those in more detail soon.
Update: Philip Klein of the Washington Examiner offers a different, more sympathetic rationale for delaying implementation by a decade:
...it's also important to emphasize that the reason why many plans for reforming entitlements exempt those at or near retirement is that older Americans have built their lives around the existing system and don't have the opportunity to adjust to changes, whereas younger workers do. One of the things that Ryan has repeatedly argued is that the reason why we need to address these problems now is that the longer we wait, the harder it will become to protect current retirees from any changes.
8 comments
This is in line with the Republican mantra of "Social Security won't BE there when YOU retire, you new kids on the block, so help us destroy it!" That, and "privatizing" everything in sight, so their rich cronies can soak up the flood of dollars, THEN make the public pay through the nose for substandard care after that, assuming they can even afford THAT. If Bush-II had succeeded in privatizing Social Security before the 2008 Great Recession, there'd be a LOT more retirees struggling to make ends meet than there are now. A similar analysis applies to privatizing medicare.
- AllanL5
April 4, 2011 at 11:23am
I have as much confidence in Republican solutions for health care as I did in the South African Minister of health who advised the HIV infected to eat garlic and beetroot as a remedy.
- Nusholtz
April 4, 2011 at 12:00pm
Well, they get old WHITE people to vote for them. That's not irrelevant here.
- miceelf
April 4, 2011 at 1:04pm
Let's see. Older folks get to keep Medicare, but younger folks won't. Younger folks will be paying for older folks' Medicare even though they won't receive it themselves. And that bargain will last exactly how long before the younger folks pressure Congress to scrap Medicare. You have to think the way Ryan does in order to make sense of it.
- rayward
April 4, 2011 at 1:24pm
Ryan's plan seems to amount to "let us kick the can another 10 years down the road". The plan might work, most people I know don't even have 5 year plans for themselves, let alone 10 so I think they'll be predisposed to postponing the tough decision. Today's seniors will get to keep their generous benefits until they die, so they'll be happy with it. People close enough to retirement to actually care will still get their generous benefits and keep them until they die, so they'll be happy with it. And everyone else can be left to fend for themselves when the time comes.
- GSpinks
April 4, 2011 at 1:58pm
I don't think this will fly. It will probably alarm older people - don't assume that people over 55 are all white and Republican and also, selfish and right-wing. I'm none of the above. I see Ryan, et.al., as a real threat.
- Sophia
April 4, 2011 at 2:05pm
That wasn't my intention, Sophia. I was pointing out that the supposed republican electoral success with older people is primarily with older white people. I don't see much evidence that (say) elderly African Americans or Hispanics are backing republicans at all.
- miceelf
April 4, 2011 at 2:11pm
As a person not yet 40, I came to the conclusion 25 some years ago during the Reagan/Bush I years that I'd probably have a slim chance of having Medicare / Social Security. Not because I thought it would go broke but because I saw the inherent dishonesty of the Right in its decades long attempts at defunding, destroying and otherwise dismantling of any sort of social safety net under the guise of "reform" would probably result in the collapse of said safety net. I've resigned myself to the fact that I won't ever be able to retire and will die working. And I'm a professional not a coal miner. The economic stagnation and race to the bottom pressure across all spectrums of gainful employment put on by the kleptocrats has left me wondering what is the point of refuting these people? When you have a narcissistic, captive, conservative and under-informed voting block of aging white people that vote their social prejudices at the expense of a wider, more egalitarian and heterogenous population. As we continue to see the aging Boomer population put pressure on keeping the status quo for themselves while putting the screws to the future generations they pay lip-service to when talking about economic reform and taxes. About the only thing that keeps me going is a now deep-seeded anger at countering the irrationality of the GOP's marketing strategy to cut of the noses of our grand children to spite our children.
- singlspeed
April 4, 2011 at 4:39pm