Cong. Ryan takes one step toward Medicare cure

If we want America to survive, we have to fix Medicare (and a host of other entitlement programs).

Since Medicare’s launch in 1966, politicians have continuously tinkered with health care and methods to pay for it. Today, reasonable and honest politicians (no, that is not always an oxymoron) realize Medicare threatens our children’s financial future.

The simple fact is that each person younger than 30 years old already owes $289,000 to pay the unfunded cost of Medicare. There is no equivocation on this: Medicare is broken, and we cannot afford it as it is currently financed.

What solutions can we offer, other than government rationing of health care to Medicare enrollees? Cong. Paul Ryan got us off dead center this week by recommending what he euphemistically calls “premium support” payments for those individuals enrolling in Medicare starting in 2022.

(Premium support is another name for tax subsidies which is another name for welfare payments, if I might be so bold. Why do I say welfare? Because Medicare enrollees today and tomorrow will receive medical services valued far beyond the dollars they contributed to the program. You can call it Medicare benefits, but I call it welfare for old folks, like me, in 2012.)

Now don’t get me wrong. I commend Ryan for taking the first step. But we must do more.

The Democrats’ answer to Medicare and health care’s soaring cost is to tax us more, create new government bureaucracies to launder the money, and then expand the programs. Reid, Pelosi, and Obama decided to pay for this the backs of “high” income earners and every day citizens. For “high income” earners, the Democrats increased taxes on their incomes – more income taxes and fewer dollars to invest in new businesses and jobs.

Democrats also added tens of billions in user taxes to fund Obamacare. These are taxes on consumable medicines and durable medical products, plus a tax on health insurance. These types of taxes better fit the Founding Fathers’ concept of taxation – excise taxes, user taxes, consumption taxes – but they never favored income taxes.

Fixing Medicare, in my humble opinion requires the following (although I hold my nose with anything smacking of income tax manipulation):

1.      Means test Medicare by requiring those with greater incomes and assets to pay a larger share of their own cost. This is not necessarily good, but it is better than having everyone regardless of income and assets pay the same. Why should Billionaire Warren Buffet qualify for the same benefit at the same price as Warren Smith, whoever that is?

If the idea of requiring individuals to spend down their personal assets for their own health care is repugnant to you, if it makes more sense for children yet unborn to pay these costs, then I will change my position on the death tax: If you want to stash your mattress with cash and use my grandson’s piggy bank to pay for your health care, then let’s take 50% of your estate in taxes when you die.

2.      As Cong. Ryan’s bill would do, let Medicare pay a flat amount to the health plan of your choice for coverage. If you want a rich plan, go ahead, but use your own money to pay the difference. If you want a stripped down plan, by all means, do so. You choose, not the government. However, being able to afford the coverage you want might mean tapping your own funds and that is why I added the next step.

3.      Expand the use of Health Savings Accounts (HSAs). HSAs provide a safe haven for your hard earned income, and allow you to accumulate money in a non-taxable savings account. This money can be used to pay all manner of health care related expenses.

4.      Allow doctors to “balance bill” their patients. This means that doctors would be allowed to charge you a real price for medical services instead of the reduced price the government allows them under Medicare today. Balance billing is currently illegal, and partly explains why nearly 30 percent of doctors will no longer see Medicare patients.

5.      Here is the toughest change. Extend the age of qualification to enroll. Start it now. Perhaps 67 for my age group, and then move it to 71 over the next 10 years. Then index it in relationship to life expectancy.

Medicare has become a pox on us. Of course, I understand it has provided health care to tens of millions of people. I get it. But it also opened the door to endless meddling by politicians and as a result, when compounded by other Great Society programs, today our nation faces financial ruin.

Let’s find the courage as a people to face the fact: Medicare, Medicaid, federal government solutions, threaten our liberty. Let’s get on with this first step toward sanity.