Lamar W. Hankins : The Republicans and ‘Medicare As We Know It’

This past week, House budget kingpin Paul Ryan (R-Wis.) announced the Republican plan to privatize Medicare through a medical voucher system that, instead of paying for health care directly, would help elderly and disabled Americans purchase private insurance. Many people have said that the scheme will “end Medicare as we know it,” which is undoubtedly true. But it represents an interesting turn of events in our politics.

Ryan’s announced plan tacitly concedes that Medicare is needed by the overwhelming majority of seniors and the disabled and is an important part of the social/economic safety net. Although we agree about this issue, we have to consider how such care can be delivered in the best and most efficient way. Clearly, that will not be through a voucher system.

Almost 55% of medicare recipients are low-income or disabled. This means, generally, that their incomes are below $14,355, according to studies done by the independent Kaiser Family Foundation. The Congressional Budget Office (CBO) predicts that purchasing insurance comparable to the current Medicare benefit will cost more than $20,500 per year.

A large majority of seniors and the disabled will not be able to afford the privatization of Medicare, even with an $8,000 voucher as proposed by Ryan, and continue to feed, clothe, transport, and house themselves.

Another problem with Ryan’s plan is that the private sector has not proven able to provide Medicare services as cheaply and efficiently as has the traditional Medicare system. We know this because we have had a version of a voucher system for several years called Medicare Advantage. The only advantage seems to be that it enriches the insurance companies at the expense of seniors.

Medicare Advantage companies spend more than 13% on overhead costs as opposed to 1.7% overhead for traditional Medicare, according to Kaiser figures. That 11.3% difference is taken out of seniors’ health care services. In this case, less is certainly not more.

It seems reasonable to conclude that no politician who is a fiscal conservative would want to waste government money by enriching private corporations and shortchanging program recipients. Yet this is just what Ryan’s proposal on behalf of the Republican majority in the House would do.

Thirty-one years ago, my parents, after a cumulative work history of 75 years for the same company, retired on modest pensions supplemented by Social Security and Medicare. Without those two programs, paid for largely by payroll deductions, they would not have outlived their pensions.

And they were among the middle class. The situation among less well-off retirees is far worse. According to US News, about 44% of households over 65 have a yearly income below $25,000. Without a good health care insurance program (such as traditional Medicare), those families will not have much money left over for the other necessities of life.

Most Republican presidents in my lifetime have recognized these basic facts and believed that this country has an obligation to assure the welfare of all Americans, not just the 1.5% who make $250,000 or more per year. That’s right, 98.5% of American households have annual incomes below $250,000.

According to Newsweek, Richard Nixon indexed Social Security for inflation, helping ensure that the elderly and disabled at least stayed even financially as the cost of living rose. Nixon also introduced a comprehensive health insurance reform bill that would have created a government-run “public option,” something president Obama would not agree to in spite of his campaign promises to the contrary.

To assist with these proposals, Nixon raised taxes on the wealthiest Americans for the first three years he was in office.

President Ronald Reagan raised taxes on most Americans in 1982, 1983, 1984, and 1986. President George H. W. Bush’s final budget increased tax rates and phased out exemptions for high-income taxpayers. And even the least among recent Republican presidents, George W. Bush, got passed a drug benefit for Medicare recipients, while he succeeded in reducing taxes on the most wealthy 3% of all Americans, tax reductions which have been continued under President Obama, even when he had a majority of Democrats in control of both houses of Congress.

If tax rates now stood where they were during the Reagan years, we would not have a fiscal crisis and even Paul Ryan might not be trying to further impoverish millions of elderly and disabled American families by enacting an ineffective health care voucher system to replace traditional Medicare.

As most honest political observers admit, the Tea Party Republicans, which means basically most of the Republican Party, along with most Democrats, don’t believe that the government should be run for the benefit of all Americans. They do everything they can to make the government work for the corporations that largely fund their campaigns.

They don’t believe that those responsible for the economic meltdown of the last three years should be held accountable in either our civil or criminal justice systems. They are perfectly willing to continue to prosecute three wars that are not funded but are fought on borrowed money, destroying my granddaughter’s future if not the future of her parents.

They are perfectly happy to create loopholes that allow corporations to pay no — or almost no — taxes, including ExxonMobil, Bank of America, General Electric, Chevron, Boeing, Valero Energy, Goldman Sachs, Citigroup, ConocoPhillips, and Carnival Cruise Lines. And some of these companies made record profits while being bailed out of their poor and reckless business decisions by the taxpayers.

From mutilating Medicare, to giving tax breaks to millionaires and billionaires, to serving the interests of the corporations, most of our politicians do not serve the general welfare. The most optimistic among us believe that the only way to overcome these unAmerican, undemocratic, unjust, and unpatriotic forces is to work against them day by day, one small way after another, until the system is overwhelmed by the sheer weight of Americans who are fed up with politicians that sneer at true democracy in favor of oligarchy.

I don’t have that much optimism, but I am unwilling to quit fighting the corporatists and oligarchs until that day when the words of the Rev. Martin Luther King (quoting Amos) are fulfilled, and justice does indeed roll down like waters and righteousness like a mighty stream.

But I’m not holding my breath.

[Lamar W. Hankins, a former San Marcos, Texas, city attorney, is also a columnist for the San Marcos Mercury. This article © Freethought San Marcos, Lamar W. Hankins.]

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