Before there was Medicare, most older Americans did not have any or had insufficient health insurance coverage. The marketplace didn’t (and doesn’t) work when it comes to health insurance. This is especially true for older adults who, on average, have more medical bills than younger people. And because of that, they are unattractive to private insurance so free market price competition doesn’t work. What’s the incentive to compete for more costly consumers? In a free market where profit is king, older, sicker people face higher premiums, tighter restrictions on what’s covered, and even dropped coverage.
Paul Ryan’s plan would give older adults a voucher for a fixed amount that they would use to purchase coverage on the private marketplace. Where – guess what – they would encounter higher premiums, tighter restrictions on what’s covered, and dropped coverage (see previous paragraph). If the voucher doesn’t cover the cost of available plans, too bad, tough noogies, it’s sad to be you. And traditional Medicare would be left with the sicker, more expensive patients driving it toward a fiscal death that some claim is inevitable anyway. In fact, claims of Medicare’s imminent demise are an exaggeration that is repeated in increasingly loud voices the more the data make is clear it’s not true.
In short, once again, Ryan and those of his ilk want to screw over Americans who need help because they are unhealthy, or poor, or both and therefore, cost money, rather than generating profit.
Medicare is not perfect, but it’s fixable and it’s necessary. Others talk about the ins and outs of this better than I do (Robert Reich, for instance, is one of my favorites).
But here’s the thing that I keep coming back to. There are fundamental differences in beliefs underlying this and other challenges we are facing. So fundamental, that it’s hard to see how we can find any common ground to work from. In this case, it’s the belief of some that health care is a commodity just like my car, my house, the laptop I’m working on as I type this, or the shoes on my feet. Others believes that at least some basic level of health care should be guarantted and that insuring that level of care is not only the right thing to do, but is, in fact, good for the well being of everyone.
If I can’t afford a Tesla, I can make do with a used Pinto. If I can’t afford to go to my doctor for preventive care or fill my prescription for a chronic condition, something that was treatable may become life threatening, or at least more expensive in the long run. If my television dies and I don’t have the money to replace it I can do without my weekly dose of Z Nation (sad as that would be). If I have a stroke and can’t afford rehab, can I do without the ability to walk? The ability to talk? Pricing people out of the health insurance marketplace costs us all in the long run (and makes us mean people, too).
So here’s what you can do to save Medicare.
Privatizing Medicare will be on Ryan’s agenda sooner rather than later, but Democrats will fight it and there are Republicans who aren’t too thrilled about it either. Call your reps and let them hear your voice.
We can be loud and obnoxious, too.