Medicare and Guns of August

Guns of August

Title of 1962  book by Barbara Tuchman on the opening days of World War I

August 15, 2012 -  We are about to witness a political war over the future of Medicare.   Mitt Romney’s selection of Paul Ryan as his running mate assures us this war will occur.  The war opens with  three  major consequences related to the Ryan pick. .

One:  It dramatically shifts the terms of the  debate over  the future of Medicare, which now  consumes 40% of national spending, far more than the military (20%), and discretionary spending on all other items (15%), and may reach 100% of spending in 20 years if left unchecked.

Two:  It  may change the fundamental nature of the campaign, from “smoke and mirrors” – distractions, distortions, and dirty tricks – to “fire  and substance” -  to a clear choice of which idea works best in growing the U.S. economy – growing the government or growing the private sector.

Three:  It highlights and brings into focus the personalities and concepts  of young Republican leaders  - Paul Ryan, 42  (R-Wisconsin),  Eric Cantor, 49 (R.Virginia), and  Kevin McCarthy, 47 (R-California),  whose ideas are spelled out in Young Guns: A New Generation of Conservative Leaders ( Simon and Schuster,  2010).

On the Medicare front, 

·         Obama-Biden argue that cutting $716 billion (Congressional Business Office estimate)  out of Medicare is possible and desirable.  Government experts , they say, have the power to  “save” Medicare by making it more efficient and of better quality while expanding coverage to all Americans. In other words, big government knows best what is good for all Americans. Unfortunately for Democrats, 54% of Americans favor repeal of Obamacare, including 46% of seniors; and the CBO estimates Obamacare may cost $2.5 trillion rather than $954 billion.   Fortunately for Democrats,  their argument that the GOP will “end Medicare as we know it” has some traction.

·         Romney-Ryan and GOP young guns argue that the $716 billion price tag for Obamacare constitutes a “raid” on Medicare coffers, that historically so-called government “savings”  never eventuate, that a competitive market based system is the only path to lower costs and higher quality, and  that the GOP plan doesn’t effect current Medicare recipients and future recipients aged 55 or over.  Anyway, Medicare recipients in the future  can choose to stay on traditional  Medicare if they wish.  Why worry about something that doesn’t affect your personal choice? Unfortunately the GOP plan is untested and still evolving,   and fears of “privatization” of Medicare are pervasive  and persuasive even with facts to the contrary.

Both sides agree that Medicare as currently structured and implemented is unsustainable, and something must be done.   But what?   Let the voters decide.  The choice is now clear.

Tweet:  This year voters will have a choice: government-run Medicare or traditional Medicare or private options, which will include vouchers.