Saturday, October 13, 2012

Why a Coward's Path to Medicare Reform Won't Work

I've made no secret of what I think of policy proposals that are not slated to take effect until after an election or, worse, after the next President is in office. Granted, sometimes the timing issues are a bit more complicated than they might appear at first blush. The "Bush tax cuts" were scheduled to expire after ten years not because Bush wouldn't have preferred to make them permanent, but because they were passed through reconciliation and thus had a ten year shelf life. Obamacare was implemented in phases not because there was concern about earlier implementation, at least on the part of the Democrats, but because of insistence that the bill be revenue neutral. The staged implementation allowed the financial projections to show revenue neutrality over a ten year period. Which is not to say that I don't think that the Obama Administration felt some relief when the least popular aspect of the plan was pushed to 2014, a happy side-effect of the bitter pill.

In stark contrast are policy proposals over issues that a President fears would be damaging. George W. Bush promised that his policies would lead to an independent Palestinian state during his second term because he didn't want to fall flat on his face trying to force a resolution before his reelection, taking advantage of any suckers who supported his reelection based upon his feigned interest in the issue then all-but-dropping it after his reelection.

The more difficult issues of our time, it seems, are placed on the coward's schedule. The ultimate cowards of our current election cycle are Mitt Romney and Paul Ryan, who are deliberately creating a conflict between generations in order to try to grease their way into the White House. They have made clear that they want to turn Medicare into a voucher program and would prefer to do so immediately, but they don't have the courage to stand behind those convictions.

Instead they claim that they will pass legislation that will take effect a decade from now, long after their assumed second term ends, that will leave untouched the Medicare benefits of anybody over the age of 55 but will give any younger person a voucher inadequate to pay for equivalent coverage - and with the voucher structured to lose value over time in relation to the projected future cost of health insurance. They pretend that they will make up some of the shortfall by reducing the value of the voucher for wealthier seniors, but know full well that the amount they could save through such a measure would be a relative pittance.

You know what else? Other than the fact that health insurance companies don't care to insure seniors, with their unpredictable and often high medical costs as well as end-of-life care, their present proposal sounds an awful lot like "Obamacare for seniors, with a public option." Funny how they're not worried about "individual mandates", public competition with private insurers, and the like when it's their proposal. That's not really a big surprise, though, given that Romney still supports Romneycare - his real objections to "Obamacare" are that (a) objecting could help him defeat a Democratic president and (b) it might work.

Back to the coward's time line. As anybody who knows anything about how our system of government works can tell you, Congress passes spending measures on a year-by-year basis. Congress meets and passes new legislation each year. If this year's Congress passes a law that attempts to bind future congresses, a future congress is free to change or repeal that law.

Why do Romney and Ryan quiver in their boots at suggesting to today's older voters, those age 55 and older, as well as current Medicare recipients that their benefits should be transformed to a voucher program? Simply put, those voters have more money and influence as compared to most other voter blocs, they like and want Medicare, and they vote. Romney and Ryan are happy to try to scare those voters with demagoguery about bureaucrats deciding what care they will get, or budget cuts that don't directly affect benefits and which they, themselves, have endorsed. But when it comes to telling that population, "Medicare costs the nation too much, you paid for it but not enough as compared to what you're getting, and it's only fair that you share the burden of our reform," nope, not happening. They propose continuing what they claim to be an undeserved windfall to today's seniors, while imposing what they claim to be an unreasonable burden on everybody else.

So let's move nine years into the future. Assuming Romney and Ryan win the election, they'll be out of office. And their Medicare reform? It won't yet be in effect. The voters they're presently terrified of confronting will be 65 and older. And an entirely new population of voters will be between the ages of 55 and 65, and the new generation of politician will be every bit as terrified of those voters as Ryan and Romney are right this very minute.

It appears to be the hope of Romney and Ryan that, when confronted with that anger, rather than repudiating the never-implemented Medicare reform, politicians a decade from now will look at the budget picture and say, "Let's just put this voucher thing into effect for everybody." More likely, they'll either say, "Let's put this off another ten years." Faced with enough voter anger, as the deadline becomes real and the weakness of the replacement benefit becomes obvious, they'll say "Oh well, I guess we won't be implementing that plan after all."

Either way, the most likely impact of the cowardly reform schedule is that rather than making tough choices, politicians of the next decade (for most of which Romney and Ryan hope to be leading the pack) will slough off the idea that they need to do any hard work to fix Medicare for the long term because, "Several years from now our reform will come into effect and the markets will magically fix all of this stuff." That is, Romney and Ryan are giving themselves an excuse to do nothing constructive and to show no leadership on the actual issues facing Medicare, knowing full well that their cowardice on the issue could create immense difficulty for the administrations that succeed them.

Perhaps they hope that their fiscal policies will leave the government in such bad shape that it cannot afford to perpetuate Medicare. But if that's the case, they should admit up front that they are offering a recipe to harm and weaken our nation, not one that will give it an strong economic footing. If, on the other hand, they believe their budget plans will improve the nation's finances, what are the odds that their successors are going to take the heat for decisions Romney and Ryan were too cowardly to implement when, just like Romney and Ryan, they can push the issue off onto a future administration.

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