They’re coming for your Medicare!

March, 2018

Complaining about the government is a long-time tradition in the United States. And a good one. Like all large organizations, government organizations are inherently unmanageable. They will inevitably become bloated and inefficient without the constant vigilance of the citizens they are supposed to serve.

But, for all its faults and inefficiencies, a complex modern society needs an active government. Unfortunately, there is a large minority of Americans who do not agree. As Ronald Reagan said “….government is not the solution to our problem; government is the problem.”

In 2001, Grover Norquist, head of Americans for Tax Reform, told the listeners of Natonal Public Radio that “I don’t want to abolish government. I simply want to reduce it to the size where I can drag it into the bathroom and drown it in the bathtub.”

Nobel-prize-winning economist, Paul Krugman, points out that: “For whatever reason, there’s a faction in our country that sees public action for the public good, no matter how justified, as part of a conspiracy to destroy our freedom.”

This anti-government movement has achieved some remarkable successes. They have passed multiple tax cuts, and have successfully restrained the “discretionary” part of the federal budget. As John Cogan of the conservative Hoover Institute at Stanford puts it:

“Surprising as it may seem, the share of GDP that is spent on national defense and nondefense discretionary programs combined is no higher today than it was seven decades ago” in fact “…all —yes, all— of the increase in federal spending relative to GDP over the past seven decades is attributable to entitlement spending. Since the late 1940s, entitlement claims on the nation’s output of goods and services have risen from less than 4% to 14%.”

Entitlements (including Social Security, Medicare, Medicaid, disability insurance, food stamps and several other welfare programs) are a serious burden on a country with an aging population, and they are now at the top of the anti-government army’s list. Unless they are slashed, they will continue to grow until most of the baby boomers have left the stage in 30 years.

The work has begun. The ink was hardly dry on the latest tax reduction bill when Speaker Paul Ryan announced that “entitlement reform” is next on his list. And arguments in favor of “reform” from conservative think tanks are now appearing on the op ed pages of the Wall Street Journal.

“Reform” is a good, positive word the Republicans use, but it’s not honest. Reform implies that you are going to find a more efficient way to accomplish the task, saving money without losing anything. That’s basically what they promised with the Affordable Care Act. And they claim to have been shocked when the only plans they could come up with (like high deductible plans) significantly reduced benefits.

The truth is that the choices are limited. You can cut the number of people covered, cut benefits, or raise money — either by borrowing it or raising taxes.

It looks like they’re going to run a similar scam with Medicare and Medicaid. They will claim that if we just “reform” Medicare Advantage, a partial privatization of Medicare, we can have better benefits for less money — but it’s not true. Medicare Advantage costs MORE than original Medicare. They are also talking about raising the minimum ages for both Social Security and Medicare, maybe to 75, and cutting payments to medical professionals on original Medicare.

I believe we should at least keep Medicare and Social Security as they are. I would like to extend Medicare (Medicare for ALL) and pay for both with a new tax on consumption, a modified form of sales tax used in Europe and Canada, a so-called Value Added Tax (VAT), combined with a small tax on financial transactions over $1,000.

We don’t need less health care, smaller pensions and less government; we need less debt and more efficient government.

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